Twenty-four-year-old Kylee Mueller tried everything to relieve her migraines and bad neck pain. But after pain medication and muscle relaxers didn’t work, she sought relief at the chiropractor. She had no idea, however, that one adjustment would change everything.
“I had a stroke while being adjusted at the chiropractor,” Kylee said, using her eye-gaze technology device.
She was taken to Avera McKennan Hospital in Sioux Falls where doctors told her family to prepare for the worst.
“It was hard to hear, but they have us the worst scenario saying she could be paralyzed from the neck down,” Wendy Mueller, Kylee’s mom said. “The adjustment caused the dissected arteries which caused the stroke. But she’s a fighter. She’s not going to give up.”
Kylee came to Madonna Rehabilitation Hospitals requiring a ventilator and a tracheostomy tube to help her breathe. She also couldn’t speak, move or eat on her own.
After a month, Kylee was weaned off the breathing support and transitioned to Madonna’s Acute Rehabilitation Hospital and specialized stroke program, but she still needed assistance with everything else.
“She came down from our Specialty unit with challenges in swallow,” Natalia Nolting, MS CCC-SLP, speech-language pathologist, said. “She was NPO (nothing by mouth), receiving all medication and nutrition through a tube.”
To strengthen her swallowing and breathing, Nolting used the Iowa oral performance instrument to measure the strength of Kylee’s tongue and lips. They also used the threshold pep device to breathe in and out against resistance to work on the breath support for speech, but then also helping with her swallow.
Also unable to speak, Kylee worked with her care team to utilize augmentative and alternative communication devices to get her message across.
“She used eye gaze, and we worked together to pre-program those responses that she needed to quickly and efficiently communicate, whether that was positioning requests or what she wanted to trial during swallowing sessions,” Nolting said. “We also would play UNO and she quite quickly could call me a cheater if she wanted to. As she progressed in using the device and was not as fatigued with it, she was able to use the keyboard and communicate complex interactions as well.”
Also unable to speak, Kylee worked with her care team to utilize augmentative and alternative communication devices to get her message across.
“She used eye gaze, and we worked together to pre-program those responses that she needed to quickly and efficiently communicate, whether that was positioning requests or what she wanted to trial during swallowing sessions,” Nolting said. “We also would play UNO and she quite quickly could call me a cheater if she wanted to. As she progressed in using the device and was not as fatigued with it, she was able to use the keyboard and communicate complex interactions as well.”
Her hand gestures and facial expressions also became important as she developed relationships with her physician-led care team.
“When Kylee came from upstairs, she had limited movements in her arms and so she was communicating a lot through blinking,” Sarah Synek, OTD, OTR/L, a Madonna occupational therapist, said. “Then as she started to progress, she could communicate with nods and shake her head. We got to know Kylee well and could tell if something wasn’t quite where it should be, if something was going really well, and how we can enhance those things just from that nonverbal communication with her.”
Kylee’s occupational and physical therapist used specialized technology to capitalize on the movement she did have.
The functional electrical stimulation bike allowed the therapists to target specific muscle groups and start to strengthen both her arms and her legs. To improve her upper body coordination, Kylee then transitioned to the Armeo®Power, which uses a robotic arm to eliminate gravity or add some support.
To get Kylee up and moving, her care team first used the body-weight supported harness to have her focus on the walking motion while on a treadmill. She then progressed to using only a walker.
“When Kylee left us, she was able to do some overground walking, which was super, super exciting,” Sara Hohensee, PT, DPT, CBIS, a Madonna physical therapist said. “She was able to walk with a walker over 50 feet with really just one person assisting. She made such incredible progress.”
And Kylee agrees, recognizing that this intense recovery takes time.
“It’s been a slow process, but I am getting my muscle back,” Kylee said. “I can move my legs and hands. I can text again. I have had to relearn everything.”
Throughout the whole journey, one thing has remained steadfast, Kylee’s positive attitude and a laugh that could fill the whole hospital.
“She had the most spunk,” Hohensee said. “She was also joking around with us. She’s a bright light. We just love her.”