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Sally: Physical Medicine and Rehabilitation

Sally, 55, has been engaged in a health battle for the past seven years, a battle that began when she was studying to be a nurse.

After feeling severely dizzy for two or three days, Sally, then 48, was told by her nursing instructor that she didn’t look well and she should go home and rest. She felt sick all night long and woke up to discover that her skin looked grey and unhealthy. Severely fatigued, she sat down on her couch but soon realized that she couldn’t use her legs and was unable to stand up. Sally thought maybe she’d contracted meningitis or the swine flu.

Alone at the time, Sally called the paramedics who took her to a nearby hospital where she developed locked-in syndrome, a condition in which the patient is aware of their surroundings but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except the eyes. A CAT scan revealed completely obstructed arteries. Her blood pressure was so low that she had no pulse and emergency personnel had to resuscitate her. Sally had to be life flighted to UPMC Presbyterian, where she was intubated while unconscious.

Sally was soon diagnosed with having suffered a stroke, even though she lived a healthy lifestyle and never smoked. During a month-long stay at UPMC Presbyterian, she had a second stroke. She also had more than ten stents placed in her vertebral, basilar, and PONS arteries, all of which supply blood to the brain. Upon recovery, Sally was transferred to the UPMC Rehabilitation Institute at UPMC Mercy where she stayed for nearly a month to regain her strength.

Three months after discharge, Sally had an appointment with Michael Munin, MD, a physical medicine and rehabilitation doctor who specializes in neurorehabilitation at UPMC. Due to spasticity in her entire right side, a condition in which certain muscles are continuously contracted, Sally had no functional use of her right hand, her fingers were always in a fist, her shoulder hung down, she wasn’t able to move her right arm, and she had difficulty learning how to walk again. Dr. Munin suggested Botulinum toxin (BOTOX®) injections to help relax her muscles and regain control of her hand, arm, and leg.

“Dr. Munin is just a wonderful man, period. He stops at nothing to help you,” says Sally. “He’s so caring and is a true patient advocate who listens to your needs and tries his best to please you.”

Sally is able to get the BOTOX® injections once every three and a half months, which means she’s gotten approximately 28 rounds of injections since her stroke nearly seven years ago. She is injected five to six times in her arm, calf, and side, respectively, but the amount of injections can differ depending on how she is doing.

For five and a half years after her stroke, she had to wear a leg brace in order to walk. Now she is brace-free due to the injections. After each round, Sally advises patients to stretch right away and get some exercise, to help move the fluid throughout the body.

“The BOTOX® has been great for my spasticity,” says Sally. “For the first few years, my progress was slow. Then all of a sudden, I saw a great improvement in my mobility and muscle usage. I want to remind others to be patient and stick with the treatment. It may take a while at first, but it works really well.”

Now that the injections have helped alleviate her spasticity, Sally has shifted her focus to animal rescue. The strokes left her unable to continue with nursing school, but she is now in the process of starting a dog rescue where she has already rescued 100 dogs. She also has nearly full use of her right arm and is able to complete tasks such as cooking, cleaning, and other hobbies.

“Dr. Munin helped me regain use of my right side so I can drive once again,” says Sally. “This is wonderful news for many reasons, but mainly because it allows me to get around so I can pair up more families with pets who are in need of a home.

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