Chris' Story*
For 54 days, U.S. Navy service member Christopher Mann battled a machine.
The machine was actually on his side. It was an exoskeleton, a device that looks like a backpack with metal robot legs. As part of the arsenal of equipment at Dignity Health Rehabilitation Hospital in Las Vegas, the exoskeleton was designed to help patients like Chris, who was recovering from a freak spinal cord illness that left him paralyzed, learn to walk again.
As an inpatient and with the help of therapists, Chris could slip into the exoskeleton and walk. The mechanical legs compensated for the strength that was missing in his own legs. As he walked, the device would record a percentage. What portion of the movement was caused by Chris using his own muscle, and what percentage was the machine handling the work of walking for him?
During his stay, Chris strained and sweated to move those percentage points in what was ultimately a war of attrition with himself. The prize was his former life.
At first, it was no contest. The exoskeleton handled 80% of the walking.
For months, Chris felt like his control over his own life was facing the same long odds.
His girlfriend had rushed him to the Walter Reed National Military Medical Center Naval Hospital near his home in Pensacola, Fla., one day with a 103-degree fever and a slowly growing numbness that had usurped his ability to move his legs. When his family arrived from his hometown of Las Vegas, they found Chris unable to sit up in his hospital bed and struggling to breathe.
After CT scans, MRIs and a spinal tap, Chris’s doctor found an answer: transverse myelitis, an inflammation of the spinal cord so rare it affects only eight people for every 100,000. The hospital started Chris on plasmaphereses ― a procedure that removes a patient’s blood plasma and replaces it with special fluids geared to stop the inflammatory reaction caused by the illness. He began to regain some of the feeling he’d lost from his chest down, but the good news came with its own set of tortures – the retuning sensations veered between chills to burning pins and needles.
For Chris, the illness was a brick wall at the end of a charmed run. He’d grown up riding a skateboard, dirt bikes and eventually hurtled Harley-Davidson motorcycles through the expansive Nevada deserts. Now, he’d moved from Las Vegas to Pensacola for a job as an air traffic controller in the U.S. Navy. Professionally, he was climbing – Chris had just taken his test for a promotion to E5, or petty officer second class. During his time off he tinkered with cars, shot pool and played darts, but now the sands on which he recreated were beach, not barren. He’d taken up skim boarding, a variety of surfing that uses a smaller board.
After a month at Walter Reed, Chris was flown to Dignity Health Rehabilitation Hospital in Las Vegas so he could be nearer his family. He was still paralyzed, but his goal was to walk out of the hospital where he hoped the physician-led team of physical and occupational therapists might turn his luck around.
Chris had his work cut out for him. In addition to not being able to move his legs, his arms had become considerably weaker, so he wasn’t able to shift from his bed to his wheelchair without a transfer board – a surface that could hold his weight while he scooted across it to whatever destination he desired. For practically every daily routine, from getting dressed to using the toilet, therapists assessed that Chris needed 75% to 100% assistance. He was also continuing to use a catheter to drain his bladder.
Understandably, he felt out of place. At 21, he was the youngest patient in residence at the time. But he also he felt motivated. “I was eager,” he said. “Let’s do this today.”
His physical therapist started him on exercises to help build his core. The therapist also used an electronic stimulation machine that employ electrodes to strengthen muscles with electric pulses. While electrodes taped to his arms and legs delivered charges, Chris performed physical therapy exercises, such as practicing getting in and out of his chair and strength training. As his ability to move increased, he notched his first big win: Within a week, he’d become strong enough to ditch the transfer board.
Then he met his competition. The exoskeleton. Machine vs. Mann, bout No. 1: 80% to 20%. Advantage: machine.
Chris’s family, who’d been by his side throughout his rehabilitation, had been preparing for his return home. They studied what kind of medical equipment they’d need to take care of him - if using his legs wasn’t an option anymore.
But Chris was insistent. He’d recover, he said. He’d learn how to use the toilet on his own, he promised. He’d get up and walk from his bed on the third floor of the hospital and take an elevator down to the exit, he vowed.
“I wanted to walk out of here,” he said.
So, physical and occupational therapists worked on getting Chris up and walking. The first few sessions were discouraging, but soon he was vertical again, holding himself up on parallel bars, and lowering his body onto his weakened legs. Chris’s first time standing was one of his biggest accomplishments. For a long time, he’d been viewing the world from waist height.
“It made me feel normal,” he said.
Chris started leaning on a walker and shuffling forward painstakingly, increasing his distance every day.
He also kept up his daily competition with the exoskeleton. One day, the numbers had fallen to Mann 75%, machine 25%.
Advantage: Mann.
Each drop in the amount of assistance he needed from the exoskeleton added fuel to Chris’s fire. His work on the walker became easier. Before long, he’d increased from only a few feet to more than 100. Chris was resolute.
In another major return to normalcy, doctors removed his catheter. To his great relief, Chris began toileting on his own and also added showering and getting dressed back to his list of activities performed independently. He’d learned strategies from the expert, personally tailored advice provided by his occupational therapists coupled with regimens of exercise designed to help him build the muscle he needed.
His confidence grew on the parallel bars. From his first tentative steps clinging to them, with therapists and other staff members helping to support his weight, he could push forward for 4 or 5 feet. Over the weeks, the number of steps increased.
Then, one day as his discharge date drew near, the register on the exoskeleton flashed the number he’d been waiting for.
Mann, 100%. Machine, 0%. He’d conquered it.
When he left the hospital after 54 days, Chris walked out on his own, as promised, with only a walker to help. By then he could do 300 feet without assistance.
After his discharge, Chris continued to receive help from home recovery care. The milestones keep coming. His walking has become less labored. “I’m not bouncing and limping, and I am blending in with the crowd,” he said.
He’s getting back into some of the games he used to love. He recently went bowling for the first time since his illness.
Chris isn’t 100%, yet, but the 300 feet he could walk has lengthened into several miles. And counting.
“I am still moving forward until the day I don’t,” he said. “I am still walking as far as I can.”
Victory: Mann.