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    CPMC Helps a Dancer Learn to Walk Again

    Jean Bruschera is an artist. In addition to painting, sewing, designing woodwork, and teaching dance at San Francisco Recreation and Parks, the 83-year-old San Franciscan choreographs for the Grant Avenue Follies, a troupe of senior Asian-American dancers who do outreach performances throughout Northern California and who have become an integral part of San Francisco Chinatown’s colorful cultural life.

    For seven years Jean created the troupe’s vibrant tap combinations until a sudden illness literally stopped her in her tracks. One morning last July she was rushed to Sutter Health CPMC after she woke up to excruciating pain all over her body and could barely move.

    Specialized Continuity of Care

    Jean's perplexing case was brought to Mark Saleh, M.D., who directs CPMC's Neurology Consultation Service. The service is dedicated to treating inpatients who have non-stroke neurological conditions, like seizures, meningitis, Parkinson’s disease, and multiple sclerosis. While other hospitals often rely on office-based neurologists, at CPMC an in-house physician manages patient treatment from admission to discharge, even if the patient transfers from one hospital unit to another. This provides continuity of care, and also faster patient evaluation since physicians across various neuroscience specialties can easily communicate.

    In Jean’s case, Dr. Saleh turned to the neuromuscular department to help pinpoint a diagnosis. Together, doctors determined that Jean had Guillain-Barre syndrome (GBS), a rare autoimmune disorder that affects the peripheral nerves in one to two out of every 100,000 people a year. Most patients experience weakness or pain, often after a gastrointestinal or upper respiratory infection.

    “It was awful,” Jean remembers. “Nothing could relieve my pain.” Doctors tried to minimize Jean’s suffering with pain medication, and then when she was stabilized, she moved to the skilled nursing facility (SNF) at CPMC’s California campus, where a multidisciplinary team started her rehabilitation.

    Even in her new location, Dr. Saleh remained Jean’s neurologist. “CPMC is unique in that we have multiple campuses, but the same doctors continue to manage each patient no matter where they are,” Dr. Saleh explains. “It’s great for patients because they see a familiar face who has known them throughout their hospital course.” “Dr. Saleh is wonderful,” Jean emphasizes. “He’s attentive and genuinely concerned. He would sit down with me, and if I wanted to talk longer, he didn’t have a problem with it.”

    Back on Her Feet

    Unable to walk, button her clothing, or fully use her hands, Jean faced an uncertain future. Although most GBS patients eventually recover, it can take weeks, months or years for symptoms to subside. Still, both physical and occupational therapists at the SNF worked with Jean every day. “When we work with patients, we look at them as a whole person,” says Bobbie Becker, an R.N. caseworker at CPMC. “Jean is an unbelievable artist, so we brought in art and dance therapy to help her rehab physically and emotionally.” “The staff got me paper, pencils and chalk so that I could sketch,” Jean recalls. “They went out of their way to take care of me.”

    Given her uncertain prognosis, the staff couldn’t predict how Jean’s recovery would go. “She’d make progress and then have a setback, and we kept plugging along,” says Bobbie. “But she was extremely motivated and worked hard. We were excited whenever she made a big step.” Eventually Jean could stand, and the staff cheered the first time they saw her walking in the hall with a walker.

    Shall We Dance?

    After two long months in the hospital, Jean could finally return home, but her care didn’t stop there. Bobbie arranged for in-home care with physical therapist Jeff Mauk. “I was crazy about him,” says Jean. “He pushed me to do things that I didn’t think I could. He insisted, Now I want you to hold onto the kitchen counter and tap dance. It was awkward, but I did it!”

    After her in-home care was complete, Jean finished her physical therapy at CPMC’s Outpatient Rehabilitation Program. Physical therapist Anne Castellano was impressed with Jean’s dance background. “Jean could do things most people her age couldn’t do,” marvels Anne. “She was nimble and flexible, and the fact that she was still able to dance was fun for me - we could make rehab more creative.”

    Through the following months, Jean improved her strength and endurance. “Then this spring, Jeff called and asked me if I had returned to teaching and choreographing,” says Jean. “When I told him no, he said that I should go back. So now I’m hanging onto my walker when I’m dancing, but I’m doing it!”

    It’s been a year since Jean was diagnosed with GBS. Although she still feels pain and uses her walker when she’s out, she now walks around her home unassisted and has returned to the dance studio choreographing for the Grant Avenue Follies.

    She attributes all her progress to the staff at CPMC. “I was treated so well by everyone there,” says Jean with a smile. “I’m amazed every time I think about it. I don’t believe you could find better care anywhere else. They saved my life.”

    CPMC’s Rehabilitation Services

    CPMC offers a wide variety of physical, speech, and occupational therapy to patients hospitalized and needing rehabilitation services at its Skilled Nursing Facilities and the Regional Rehabilitation Center.

    Additionally, CPMC offers care at the Outpatient Rehabilitation Program, which includes a neurological services. There, a dedicated team of neurologic-rehabilitation therapists provides individualized care to patients who have experienced neurological deficits resulting from stroke, traumatic brain injury, spinal cord injuries, multiple sclerosis, and Guillain-Barre syndrome.

    For more information, please contact Outpatient Rehabilitation at 415-600-5393. If you have a referral for therapy, you can contact the department for an appointment at 415-600-2700. Visit us at cpmc.org/rehab.