Growing up in the small town of Palmer, Iowa, 16-year-old Justin Metzger loves his life on the farm. He helps his dad tend to the crops and has since he was little. He also hopes to continue farming as a career.
“This is something I’ve wanted to do my whole life,” Justin said. “I just really enjoy farming.”
His desire to return to his rural life helped dictate his plan of care at Madonna Rehabilitation Hospitals’ specialized pediatric spinal cord injury program. His care team customized therapy sessions and meetings with peer volunteers to help him see everything that is possible for him after he sustained a spinal cord injury in May.
“I was in a dirt bike accident,” Justin said. “I had six compression fractures in my back. I partially severed my spinal cord at L1. I had a fracture in my C5. I punctured my left lung, a ton of broken bones, a broken nose, and a major concussion.”
Justin’s mom, Kelly, said she didn’t know what the future would look like for him, but she spent hours researching the next step in his recovery journey. She said Madonna became the obvious choice.
“I really wanted him to be with a population his age group, because even though he’s 16 and an adult-sized person, he’s still a teenager, and I felt like there could be different care for someone that age versus someone who is 18 or 20,” she said. “Also, I think the emotional part of it, being able to be around other kids and the fact that the equipment here was so extensive, new and updated.”
Lauren Cox, OTR/L, Justin’s occupational therapist, said she could tell from the beginning that Justin was determined to work hard in therapy and achieve every goal he had for himself. She was able to challenge him in therapies and he would push himself to succeed.
“When I first met Justin, he was super open about his injury and his accident, which I think played a huge part in his recovery and just his motivation and his willingness to try new things,” Cox said. “We knew no matter what we were going to give him, what we were going to throw at him, we were going to get him there.”
Justin and his care team looked beyond independence just in basic activities of daily living. He wanted to be able to be completely independent from a wheelchair level in every way.
“I don’t want my parents to have to help me for the rest of my life,” Justin said. “I want to be able to do what I want, when I want, on my own. I don’t want someone there at all times to help me. I think that was my most important goal.”
He set his sights on goals that also included returning to driving and learning ways to transfer himself into special farm equipment. Cox used Madonna’s driving simulator to help him get accustomed to steering with adaptive hand controls. Justin also worked with Sarah Hamilton, Madonna’s on-site driver re-education coordinator to get practice in a real car and pass his driving evaluation, just days after discharging from Madonna.
“All of the things that some people work on in outpatient, he was already starting on inpatient just because he excelled in everything that he did,” Cox said. “We knew that was going to be a big thing for him, getting him as independent as possible, even in all of the different environments he was in, his home environment, school environment and helping with farming.”
Cox collaborated with Jessie Franks, MA, ACSM-EP, CTRS, a recreation therapist, as well as AgrAbility, an organization that provides information and resources to farmers and ranchers living with injuries, illness or disabilities. Together, they showed Justin how farming might look with a spinal cord injury. Franks was able to introduce Justin to the Action TrackChair wheelchair designed to go off-road and help him start the process of purchasing one for himself through AgrAbility’s community resources.
“That was probably one of the coolest things I’ve ever actually driven,” Justin said. “Having a way to stand up was amazing. I loved that. I’m looking forward to getting one.”
Franks also invited several peer volunteers to meet with Justin, including Will Meyer, a spinal cord injury survivor who also recovered at Madonna and returned to farming. Franks said she saw Justin’s face light up when Will pulled up in his truck with a special lift that allows him to transfer to all of his farm equipment.
“Having them connect on that level is huge,” Franks said. “More than just showing Justin in a video and saying, ‘Oh, this is what Will does,’ and seeing Will’s footage on some of AgrAbility’s resource videos, Justin actually being able to see it in person and talking to him makes it feel real, makes it feel like, ‘Ok, I can do this. This is possible.’”
Madonna staff helped Justin identify what specific tools he might need and problem-solved ways for him to safely access farm equipment.
“We talked through different components of what his day-to-day looks like, whether he’s in a tractor, a combine, a skid loader, whether he’s loading and unloading things,” Cox said. “Madonna staff showed him different adaptations to vehicles and different lifts for him to get in and out of some of those bigger machinery items, which I think was a huge eye opener to him that he can still do this and he can still excel at the things that he loves. I think as a whole team, we did a great job of collaborating to figure out exactly what he needs.”
While at Madonna, Justin made it his mission to bring smiles to everyone in the pediatric unit. He bonded with other teenagers who were also learning to live with spinal cord injuries and always had jokes for the nurses. His mom says she’s proud of how much maturity he has shown as he navigated his new normal.
“There are so many days when I think, ‘I don’t think I could be as positive as Justin is,’” Kelly said. “He’s got such a good outlook on this. He’s always been a hard worker, and he’s always been determined.”
Kelly also credits his success to his care team, especially the nurses and therapists.
“I feel really strong compassion in this building,” Kelly said. “I feel like the nurses here are so wonderful. They’re so positive and happy and cheerful. I’m a nurse myself so I see a lot of facilities, and I see the total teamwork package here. The nurses, the nurse aides, the respiratory therapists, everyone has made our transition home smooth.”
Now back home, Justin is excited to adapt his farm equipment to fit his needs and help bring in the harvest. He’s also looking to share his story with other young people as a source of inspiration and hope.
“The best I can say is to work hard,” he said. “Know your life isn’t ending over this. It might look a little different, but there are plenty of things you can do. Just keep a positive outlook on everything.”