In September of 2018, Michael was admitted to St. Michael’s Hospital (SMH) suffering from atrial fibrillation (irregular or abnormal heart rate). After an examination, the health care team at SMH also diagnosed Michael with cellulitis (serious bacterial skin infection) in the lower part of his right leg. This condition was complicated by septic shock. The treatment of all of these conditions necessitated a prolonged stay in the ICU for Michael.
“Every major organ,” says Michael, “was impacted by the infection — including my lungs.” To help Michael breathe, it was necessary for the health care team at SMH to insert a tracheostomy tube.
The health care team in the ICU stabilized Michael’s infection. Soon afterward, he began to receive limited physiotherapy (bed exercises) since at the time he had almost no ability to move his legs. He required the assistance of the nurses to help with his activities of daily living and the use of a lift to transfer to a wheelchair. The transfers were very painful because he had developed pressure injuries during his stay in the ICU unit at SMH.
Before he was admitted to SMH, Michael was obese, weighing approximately five hundred pounds. When discussing his rehabilitation options with SMH health care team, Michael made it clear that while he received rehabilitation to gain back his independence, he was also committed to losing weight. “I had started to eat right and exercise,” says Michael, “before I got this severe infection.”
The SMH health care team spoke with Michael about being transferred to The Salvation Army Toronto Grace Health Centre (TGHC) since its Complex Continuing Care (CCC) program had an excellent wound care program. They also informed him that the Grace’s Post Acute Care Rehabilitation (PACR) program had a bariatric program, designed to help obese patients lose weight.
Michael was admitted to the TGHC in May 2019. The interprofessional health care team determined that he had three pressure injuries: one, located at the sacrum (the base of the spine); another, located on his right hip; and the third, located on his right heel. Since a dietary management of obesity helps patients reduce weight and improves wound healing, Michael was put on a diet.
Michael started his rehabilitation. As a result of the collaborative efforts of the TGHC’s interprofessional health care team and Michael’s determination to attain his goals, he made excellent progress. After about a month of rehabilitation, he could transition with assistance from his bed to his wheelchair. By June 2019, he was able to move by himself to the rehabilitation gym.
Michael participated in a clinical trial at the TGHC to evaluate Curiato Inc.’s development of its smart surface monitoring platform technology — a mattress overlay, positioned under the bedsheet, that detects three major pressure injury risk factors in patients: mobility, temperature, and moisture. This technology, when fully developed, will allow nursing staff to monitor patients more efficiently, and so will help to prevent pressure injuries.
By early November 2019 Michael’s pressure injuries were completely healed. He regained most of his independence and was using a rollator walker to remain mobile. On occasion, he was able to go home for the weekend to spend time with his family, which helped Michael to slowly integrate him back to the community.
Michael was discharged on December 3, 2019, weighing 260 pounds.
Congratulations to Michael for remaining focused and attaining his goals!
By Gerry Condotta