“Every day we have the opportunity to get patients back to a better quality of life,” says Jeff Cleveland, president of Clear Choice Health Care in Melbourne FL. “It’s our pleasure to share the efforts made by the patient and staff to our community,” says Cleveland.

Local resident, Mark Crockett was expecting the normal sequence after a quadruple bypass open heart surgery. A couple of days in the ICU, a week of hospital stay, and then he’d be able to return to golf.
Instead, his round trip from hospital to home had a few bumps in the road. He spent 45 days in the intensive care unit, 35 of them on a ventilator pumping extra oxygen to help him breathe.
First, he had to endure four intubations that invaded his throat, injured his windpipe, inflamed his voice box, and left him with one paralyzed vocal fold.

“It was like taking one step forward and two steps back,” says Mark’s spouse of 41 years, Sandi Crockett. She says he would come off intubation in the ICU but didn’t have the ability to stabilize respiration and blood pressure. He even needed an implant to temporarily help pump blood into his aorta.

Eventually, doctors determined why he couldn’t stabilize. Weeks into his ICU bout, they diagnosed Crockett with heparin-induced thrombocytopenia and thrombosis (HITT), which is an allergic reaction to Heparin, a drug that prevents formation of blood clots. It is an immune-mediated drug reaction found in about five percent of patients with ironic results of abnormal formation of blood clots.
Sandi Crockett was relieved to find the culprit of Mark’s inability to stabilize and thought they were in the clear. Turns out, they weren’t. “We didn’t know the repercussions of all the intubations,” she says.
“It’s a well-known fact among my profession that the more intubations one has, the more complications you will have,” says Stacey Lang, Crockett’s daughter and a speech language pathologist working for Melbourne Terrace Rehabilitation Center.

Having more than one intubation is rare, and the procedure comes with risks. For adult patients 50 plus, the overall mortality is 37 percent for one intubation, with a median survival time of 11 days.
Crockett overcame the percentages, but he was robbed of his ability to speak, eat and drink resulting in a weight drop to 136 pounds. One vocal fold was paralyzed and his epiglottis, a small, movable “lid” just above the voice box that prevents food and drink from entering the windpipe, wasn’t properly closing.

Crockett was then at high risk for airway obstruction and aspiration pneumonia, which occurs when food, saliva, and liquids, is breathed into the lungs, instead of being swallowed down the throat and into the stomach.
His journey from the hospital to a three-week stint in an acute rehab center finally lead him home where had several weeks of home-health therapy.
Still, he was not able to speak or eat and he was nowhere near the progress he imagined. What’s more, his physician (ear, nose, throat specialist) said that he might have to have surgery on his vocal fold to safely enjoy food and beverages.
He might have gone down surgery row had it not been for Lang. She was well versed in his diagnoses, but his condition was chronic and severe. Knowing the latest speech rehab equipment and technology, she believed treatment could provide best outcomes. So, he was admitted to Melbourne Terrace Rehab Center for more intensive speech and physical therapy.

“I knew the team there wouldn’t give up on him,” says Lang.

“I was cautious to provide a prognosis,” says primary treating speech language pathologist, Shalana Hawley – M.S.Ed. CCC-SLP, for Melbourne Terrace Rehabilitation Center. Hawley, a 23-year veteran therapist reports that Crockett’s recent hospitalization, the four intubations, his medical history and his current lack of, safely eating or drinking, swallowing and voicing kept her in reserve.
“But the team loves a challenge,” says Hawley. So, Crockett’s therapy began with strengthening exercises to promote swallow function; lingual(tongue) function, laryngeal (voicebox) elevation, and airway protection in preparation for an assessment with FEES to determine the safety of his swallow.
With FEES (flexible endoscopic evaluation of swallowing), they can visualize and assess the patient’s muscle activity while swallowing liquid and then use that data to guide a therapeutic program to strengthen and improve a patient’s swallowing ability.

To help strengthen his swallowing ability, electrical stimulation was used. Electrodes were placed on both sides of Crockett’s face and on his throat near the vocal cords. While the muscles are stimulated, cues are given for timing and strength. Crockett slowly started food trials with different consistency like ice chips, apple sauce – and as he progressed, he was given higher food consistencies.
“She explained how we were trying to get my paralyzed vocal cord to move and protect my airway,” says Crockett. He says he was given a series of exercises that were reviewed almost every session.
For tongue exercises, “We would over emphasize words with hard consonants like ‘kick’ and ‘cake,’ and sing upscale for pitch and strength with ‘EE’ and ‘AH,” says Crockett.
In short time, he had the team singing his praises. “Because of the strength of our team, we had mind-blowing results with Crockett in such a short time,” says Hawley. “One of the reasons why our patients have best outcomes… each clinician brings in a new angle.”

“We are so proud of how we achieve best outcomes,” says Cleveland.

After 19 weeks and four days of a whirlwind medical experience, Crockett is now home.
Instead of communicating by pad and pen and getting his nutrition through a tube, Crockett is now thriving, conversing with family over his choice of dinner and drinks, and he’s smiling at surviving it all. His current thoughts are on the greens, golf keeps calling him to get that elusive hole-in-one.
For more information on Speech Therapy, call Melbourne Terrace Rehabilitation Center at 321-725-3990. They offer comprehensive rehabilitative outpatient and inpatient services for short or long term care located at 251 East Florida Ave., Melbourne, FL 32901