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Louis Meno:
Recovering Independence After a Spinal Cord Injury

Louis Meno, a graduate of Purdue University, had earned his degree in mechanical engineering and was working at a nationwide company in the field of heating, ventilation, and air conditioning. He enjoyed his job designing projects involving boilers and hydronics. On Memorial Day weekend in 2013, Louis and a few friends headed to the Indy 500 race for a long holiday weekend. While at the race, in an impulsive moment, Louis fell and broke his neck.

Louis was rushed to the nearest hospital and immediately taken into surgery. When he awoke, he was told that he had fractured the C5 and C6 vertebrae, injuring his spinal cord, which resulted in quadriplegia. He was paralyzed from the chest down and the injury affected every aspect of his body.

His physicians recommended intensive inpatient rehabilitation; Louis and his family chose Marianjoy. After eight days in the acute care hospital in Indiana, Louis made the long ride via ambulance to Marianjoy.

“I didn’t know what to expect, and I was scared,” Louis says. “Though my doctors told me I was paralyzed, I couldn’t really process what that meant. When they put me in the ambulance and we headed toward Marianjoy, I began realizing that my situation was permanent. I didn’t know what was ahead for me. I just kept praying to God that somehow, some way, I would get all of my movement and sensation back.”

Louis’s intensive rehabilitation program included both physical and occupational therapy. With limited strength in both arms and the inability to grip with his hands, he required assistance with dressing, bathing, and transferring in and out of his wheelchair.

“Everyone was very nice, and they helped me to settle into a routine,” he notes. “Monica and Sarah, my occupational therapists, immediately started working with me on learning how to feed myself with the limited use of my hands. They used a variety of tools, like specially designed silverware, to help me eat independently. As soon as I mastered that, we began working on transfers from my wheelchair to the bed or therapy mat and back again. I was so weak and needed so much assistance, but they kept pushing me.”

Monica Blaauw, Marianjoy occupational therapist, explains: “One of the first things Louis told us he wanted to be able to do was to use his cell phone, computer, and the TV remote. We worked together and adapted these items to help him be independent in using them. We also taught him a technique called tenodesis, which means that he would flex and extend his wrist in order to facilitate passive finger movements to help with gripping and handling objects. Another goal was Louis’s desire to return to work, so we spent time helping him improve his ability to type and use a computer again.”

Physical therapy was also an integral part of Louis’s rehabilitation program. “My physical therapists, Julie, Tracy, and Alan explained to me how important it was for my muscles to stay flexible,” he says. “Since I couldn’t move my legs at all, the muscles were already beginning to deteriorate.  We worked on stretching and keeping my muscles loose, which I learned was very important.”

Louis’s care team, which included his therapists, physician, nurses, dietitians, and others met weekly to discuss his progress, re-evaluate his goals, and determine the day he was looking forward to: the day he would be discharged home.

“Dr. Stambolis, my Marianjoy physician, was really great and very involved in my care,” notes Louis. “He would check in with me, make sure the medications he prescribed were working for me, and confer with the therapists on my progress. Several times during my stay, my discharge date was pushed further out because the team felt there was still more that I could accomplish. Since I was going to live with my parents, they wanted us to be prepared and feel comfortable with every aspect of my care. I was really grateful for that.”

After almost eight weeks in inpatient rehabilitation, Louis was discharged home, and a week later, he began outpatient therapy at Marianjoy.

“I came three times a week for both physical and occupational therapy,” Louis says. “I wanted to get better at transfers and at being independent. When you’re an inpatient, it’s all overwhelming. You’re just getting used to your situation and how to handle it. The therapists focus on the basic things you’ll need to learn, like feeding yourself, getting yourself dressed, and being able to transfer. When you get to outpatient, the therapists work on honing those skills, and they focus on the things you’ll want to be able to do in the future.”

After seven months in outpatient therapy, Louis was discharged, but he continues to work on improving the skills he’s learned. He is back to work, putting in 30 hours a week from home. His goal is to get back to the office as soon as he can.

Throughout most of his rehabilitation, Louis used a power wheelchair, but he has just received his new manual wheelchair, which features power-assist wheels.

“Some of our spinal cord injured patients start out using a power chair because they don’t have adequate arm strength to push a manual chair at a functional pace or distance. A power chair also helps the patient to avoid overuse of their limited shoulder movement, which can lead to additional pain and injury,” explains Sandy DuPree, a physical therapist who works in Marianjoy’s Wheelchair and Positioning Center, specializing in custom-fitted seating. "Before Louis was discharged from inpatient, he tried out a manual wheelchair and was able to propel it. So we ordered him a customized manual wheelchair with power-assist wheels to reduce the strain on his arms and allow him to propel longer distances in the community, as well as to help him navigate carpeting and inclines independently without excessive fatigue.“

With a touch of a button, Louis’s chair can be converted from a manual-push wheelchair to a power-assist wheelchair, which has the potential of reaching a speed of as much as 5 miles per hour.  For every manual thrust of the wheels, the motor can double or even triple the rotation, propelling him ahead further while conserving his physical energy. In addition, the power-assist wheels have a quick release so the chair can be easily converted to a conventional manual wheelchair, making transportation of it in a vehicle easier and avoiding the need for ramps or power-operated lifts.

His next goal is to enroll in Marianjoy’s Driver Rehabilitation program, enabling him to learn how to drive with specific hand controls and equipment so he can return to work and be independent.

“The hardest part of therapy was not immediately seeing the results I wanted to see,” he explains. “The therapists do a great job of putting your situation into perspective for you and showing you how much you’re changing. You don’t realize it though until you step back and see where you started from.

“Towards the end of my time in outpatient, I was able to get around the hospital myself, basically being independent. I didn’t think I would ever be able to transfer or take care of myself, but here I am, doing it. My outpatient therapists, Jaclyn and Kelly, stuck with me through the whole process. I can cook, I’m back to work on a part-time basis, and I am able to use a phone and computer. I’m getting there.”

In speaking with Louis, you can tell he has a fondness for the Marianjoy staff that he spent so much time with over the last year. “The therapy staff made it enjoyable, though it’s hard to think that intensive therapy could be described like that. They are good at what they do. Having therapists with experience in treating patients with my particular injury made a difference. The therapists help each other by giving feedback and ideas to each other for the sake of the patient. And the inpatient nursing staff was incredible. They get you so comfortable, you don’t want to leave.”

When asked what advice Louis would give to other individuals who might find themselves in the same situation, his advice is straightforward. “The first step is accepting it. You get sad and angry about it, but the longer you dwell on what could have been, the longer it’ll take to accept what you now have. You need to get to a point mentally where you take responsibility for your recovery, including asking for help from your therapists and allowing them to help you.

“I’m striving to do whatever I can so I won’t be dependent on someone for the rest of my life. Therapists, friends, and family will tell you that you can do anything, but you need to figure out what you want and a new way to live your life. My therapists helped me to get there. I just needed to ask for their help.”