Cost of rehab puts limits on patients

Published: January 22, 2007  |  Source: freep.com
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01222007CORTNEY HOFFMAN’S CHALLENGE: She pushes for independence

Whether she’s tired or not, Cortney Hoffman wakes up before dawn, three days a week, to make the one-hour trip to the Rehabilitation Institute of Michigan in Detroit for therapy meant to coax her damaged body to move.

Hoffman, paralyzed from her shoulders down in an auto accident in 2002, still does not walk unassisted, but she is stronger and has made gains that make her healthier and more independent.

Two years ago this month, Hoffman, 20, of Riga underwent experimental stem-cell surgery in Portugal in an attempt to regain mobility. The surgery, not approved in the United States, involved using her own stem cells from nasal tissue.

In therapy, Hoffman can walk 134 feet around a track with leg braces and an upright walker, with help from her athletic trainer, Kerrie Walker. Hoffman can do 100 push-ups, kneeling forward on an exercise ball, and pedal for a half-hour or more on an upright bicycle-like device, once she is strapped to it.

At home, she can get in and out of bed on her own, using a wooden slant board. She can take off her pants in 2 minutes, not the 15 it took a year ago. Last year, she got her driver’s license.

Last week, she began attending classes at Monroe Community College.

“Everything’s easier,” she said.

While Hoffman has been undergoing therapy, the Rehabilitation Institute has become a leading center in aggressive rehabilitation after a spinal cord injury, attracting patients come from all over the world.

“More than 160 spinal cord patients have enrolled in the Detroit program in the last two years,” said Paula Denison, administrative director for specialty services at the institute, which has added an aggressive-rehabilitation program in Grand Rapids.

With a formal collaboration with the team from Lisbon, Portugal, the institute hopes to become the first U.S. site of the stem-cell procedure for spinal cord injury. But first, it must analyze outcomes of patients having the surgery abroad, to convince the federal Food and Drug Administration that the surgery is safe and effective.

The Lisbon team has performed the operation on more than 60 patients. A report on the first seven of those patients, published last year in the Journal of Spinal Cord Medicine, said all have had “a modest amount of improvement in function.”

Many are taking a wait-and-see approach to the surgery.

Hoffman’s newest challenge is more typical of those her age: She will test herself to see how she adapts to a college Environment where buildings aren’t as wheelchair accessible. She has other worries, too, including making friends.

“I don’t want everyone to stare at me and wonder, ‘What happened to that girl?’ ” she said.

She wants to be a speech therapist.

And she still wants to walk someday at her own wedding.

Copyright © 2006 Detroit Free Press Inc.