Archive for Tuesday, January 17, 2006

Post-coma progress slow but steady

Woman awakened after 20 years in semi-unresponsive state

January 17, 2006

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— The question Sarah Scantlin asked her therapists came slowly and surely.

"What ... do ... you ... want ... me ... to ... do ... now?"

With her torso balanced between occupational therapist Kalwant Singh's arms and hands, and facing physical therapist Robin Kenyon, Scantlin had completed a set of 10 lower leg lifts, one leg at a time.

On request, she'd twisted her neck from side to side and pulled her torso up into a sitting position.

Thursday, Jan. 12, was "OK" day for Sarah.

It was exactly one year ago that she uttered an "OK, OK" in response to Golden Plains Health Care Center Activity Director Pat Rincon's question to another resident about whether that woman had understood what Rincon had instructed.

Sarah's OK was followed a few weeks later with a surprise telephone call to her parents, James and Betsy Scantlin of Cheney.

"Happy Valentine's Day," she said.

On Thursday, Sarah's Day, residents and staff, along with visitors, wore hearts bearing the letters "OK," with an X and O - kiss and hug marks - added for good measure.

Sarah's return to awareness after 20 years of remaining in a semi-unresponsive state was heralded by media around the world, and it signaled the beginning of therapy that has returned her to a much-changed life.

With intensive therapy and multiple surgeries, she has regained control of arms and legs that had moved only involuntarily. The unrestrained yowls she cried out in all those years have evolved into words and sentences that have expanded from one-word responses to questions she poses to others.

Miraculous progress

Jennifer Trammell, Golden Plains' director of special services, was on duty 20 years ago when Sarah was admitted as a bed patient after being struck by a drunk driver.

The accomplishments connected to Sarah's progress this year are truly a miracle, Trammell said. In recent months, Sarah's been able to take soft foods and semi-liquids by mouth. They expect that because she's gaining weight and retaining it, sometime in the future they'll be discussing the possibility of removing the feeding tube from her abdomen, Trammell said.

On Friday, Sarah was able to stand in front of her wheelchair between the two therapists without the standing frame harness that has lifted her upright for the past few months.

Singh and Kenyon called Trammell to witness that new first.

"I told Sarah, 'You never cease to amaze me with the willpower you have,"' Trammell responded.

On Sept. 21, 1984, Sarah, a Nickerson High grad that spring, was enrolled as a freshman at Hutchinson Community College. On a night out with her friends, she was struck by a drunk driver as she walked to her car after leaving a student hangout.

She suffered a massive head injury and her prognosis was grave. The Wichita neurosurgeon who operated and removed a fist-sized clot from her brain offered little hope that she would even live.

Since she awakened to the world around her, Sarah spent two months at the University of Kansas Medical Center in Kansas City for observation and intensive therapy, followed by a pre-Christmas trip to Wichita's Wesley Medical Center where a device was implanted that relaxes the spasticity of her muscles.

Therapy and goals

At Golden Plains, a typical weekday finds her in speech, occupational and physical therapy. On Thursday, as the routine continued, beads of perspiration formed on Sarah's forehead. Sometimes movements were accompanied by a protest of yowls, a signal that she wanted something to change.

"Are you too warm, Sarah?" came from Singh and was followed by opening a window and switching on a ceiling fan.

With a harness on her torso and her feet Velcro-strapped to a base, Sarah was cranked into a standing position and faced a worktable where she laboriously lifted and moved colored plastic cones. "Open your fingers, Sarah," Kenyon continued to encourage.

For the Scantlins, who've lived day-to-day with their daughter in an uncommunicative state, her return to the present world has changed their lives.

But Betsy Scantlin wanted to think about it before she answered how.

"It's a good question, but I don't know that I can answer it," she said. "It makes me happy that she can eat and express herself, make statements."

For 20 years they've guessed at what she wanted, an almost impossible task. Now that she's able to communicate, it's a comfort.

"During those times when she was silent and you left the room, you felt depressed," Scantlin said. "When she started yelling you wondered, 'What does she mean?' Now that she yells you know what it means - that she doesn't want you to leave."

While they were at Wesley Hospital before Christmas, Sarah told her mother that her arm hurt.

A closer observation showed a small cut between the thumb and finger.

"That's nice," Scantlin said. "'My hand,' she can say, and when we look at it there's something there."

"We're not putting any high hopes on anything," she said. "When Sarah does something like moving forward to lift eight colored cones on a tray, we're just as happy as if she were still lifting four."

But while they were at Wesley Hospital before Christmas, Betsy taught Sarah two Christmas carols, "Silent Night" and "Oh, Come all ye Faithful." Sarah sang them as solos at the center Christmas party.

For the therapists, this year's goal is for Sarah to be able to assist in feeding herself with the use of a harness that will help her hold a spoon and roll it toward her mouth.

The longest range goal will be an electric wheelchair that she could self-operate, Singh said.

And the next challenge for Sarah's emotions?

"We want to teach her to laugh and know what it means," Trammell said.

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