On April 30, 2017, Carlos Chavez, a 73-year-old patient, arrived at Life Care Center of Escondido, California, for skilled nursing and rehabilitation needs after undergoing a left below-the-knee amputation due to foot gangrene.
Chavez came to the facility with a methicillin-resistant staphylococcus aureus (better known as MRSA) infection and was on dialysis three times a week. Prior to his amputation, he lived independently with his family in a single-story house with three steps to enter. He used his front-wheel walker as his primary mode of walking and was independent in his activities of daily living, such as grooming, dressing and bathing.
When Chavez arrived at the facility, he required two associates to help him with bed mobility, transfers and standing activities. He also had a wound VAC on his amputation and was using a knee immobilizer to keep the knee straight. He experienced severe pain on the amputated leg, which was gradually controlled by medication and therapeutic intervention.
“I was very depressed when I got here,” said Chavez. “I was dependent on the staff to take care of my personal needs.”
With great motivation from his family and Life Care Center of Escondido’s associates, coupled with his strong perseverance to get better, Chavez attended therapy conscientiously. He initially started with the parallel bars, practicing standing with two therapists by his side. He slowly began to take small steps and progressed to walking with the use of his walker and new prosthesis on even and uneven surfaces. Improving balance and strengthening his muscles was the initial focus of intervention in order to prepare him for safe stair training and outdoor walking with his new prosthetic leg.
Chavez eventually learned to independently don and doff his prosthesis, with pain in the amputated leg decreasing with the help of exercise and desensitization massage. As his strength and endurance got better, he began to regain his independence and improve his self-confidence.
After three months of intensive therapy, hard work and strong determination, he has shown an excellent improvement in function. He is now independent with all aspects of bed mobility, transfers and walking using his front-wheel walker on different indoor and outdoor surfaces, pain free.
Chavez has also returned to being independent with all self-care tasks, including dressing and bathing. He is able to safely go up and down stairs and get in and out of the car safely and independently.
“Carlos’s success is a reflection of his dedication toward his rehabilitation with his ultimate goal of walking out of Life Care Center of Escondido using a walker,” said Florante Noble, director of rehabilitation. “He was able to go home with his family to spend quality time with his 14 children and 42 grandchildren happily and successfully.”