Select Specialty Hospital staff are used to receiving neurological trauma patients from a wide spectrum of sources—motor vehicle accidents, falls from ladders or horses, people surviving severe assaults, pedestrians hit by cars and even the farmer stampeded by his own cows. Then there was Vester Wroten, who fell from the sky.

An amateur pilot for over 40 years, the 87-year-old Wroten was flying a small plane on June 7, 2008, when the crash occurred. He had an odontoid fracture in the vertebrae of his neck, a finger tendon laceration, multiple areas of bruising and respiratory failure requiring ventilator support. He had contracted pneumonia as a complication of his respiratory state and inhibited mobility. Wroten’s past medical history has included hypothyroidism (low thyroid output), hypertension (high blood pressure), atrial fibrillation (severe heart arrhythmia), hyperlipidemia (elevated fats in the bloodstream) and congestive heart failure. His mental state had deteriorated due to encephalopathy, or swelling on the brain. He had been in the Regional Medical Center at Memphis’ trauma intensive care unit for 10 days, and they had found that his carotid artery in his neck was 90 percent blocked. When he was admitted to Select on the evening of June 19th his confusion and agitation were causing him to try to get out of bed and pull out his IVs.

“I was worried about Dad hurting himself. I told the charge nurse Dad would need someone to sit with him 24 hours a day. They found someone that night to come and sit with him. I was impressed with that,” said Kelley Wroten, Vester’s son.

Select provides a nurse-to-patient-ratio driven by the patient’s condition. Not only high-tech, but high-touch, the hospital customizes patient care plans through interdisciplinary conferences, making sure the entire spectrum of the patient’s needs are handled.

“Even when brain injury patients are comatose, we provide a stimulation program, or sensory diet, for them,” said Jun Labilles, P.T. “Therapists will provide different textures and rub them on the skin, rough and smooth, or provide different scents, different noises or vibrations—all to stimulate the senses of the patient.”

The therapy disciplines work together to plan out a stimulation program, said Labilles. A speech therapist concentrates on speech and swallowing, occupational therapy focuses on the upper extremities and the activities of everyday living and physical therapy works with the lower extremities and mobility. All plans are tailored for each patient’s needs.

In physical therapy, the goal at Select is to get the patient sitting upright as soon as possible. This helps them orient to their environment and gets their lungs and heart working, said Labilles.

“Working up from semi-sitting to a 90-degree sitting angle can improve trunk and head muscle tone, which was important for Mr. Wroten because of his neck injury,” he said.

Then as the neuro-trauma patient weans more and more from the ventilator, they are able to work on sitting to standing and make transfers from the bed to a chair, walking with parallel bars and walking with a walker, as was the case with Mr. Wroten, he explained. Occupational therapists also worked with his left hand where his tendon had been repaired.

Meanwhile, respiratory therapy evaluated Wroten to work on ventilator weaning and check for complications.

“Usually, when you have a neuro problem, it affects your breathing rate. And if the patient is with you a while and really out of it, they can get pneumonia or get in respiratory distress,” said Lorie Dennis, R.R.T., Pulmonary Program Manager. “Mr. Wroten came to us with pneumonia and was in a neck brace. The Med had already put in a tracheostomy because he needed an airway.”

Neck injury patients require a tracheostomy, because in the event of a medical emergency, the patient’s head cannot be bent back to insert an endotracheal tube. By the time Wroten left Select, he had weaned off the ventilator and was requiring only oxygen using a bi-nasal cannula.

The tracheostomy tube was capped, as he was not using it to breathe, but he had to keep it available as a precaution, Dennis said.

Wroten’s son was impressed with Dennis’ attention to detail in her care of his father.

“Lorie was a real savior. She went way above and beyond her responsibilities in taking care of him. She just took a personal interest,” he said.

Wroten was discharged from Select one month after arriving there. This, in itself, was remarkable.

“Most fractures heal in six to eight weeks in an 18-year-old. Here he is nearly 90. In four weeks, we accomplished a lot,” said Labilles.

He had progressed from being on a ventilator to breathing on his own, from bedridden to walking with a walker and ready for inpatient rehabilitation, which he completed at St. Francis Hospital. From there, Wroten went to a nursing home in West Memphis, Ark. for a couple of months to fine tune his rehab and functioning, and on to assisted living. His body was strong enough to withstand surgery on his carotid artery in November 2008. He is now going out to eat, going to casinos and living with a friend.

“Select dealt with some pretty intense stuff. There were a lot of complications, and I have to hand it to them, they did a good job there,” said Kelley Wroten. “I’ll say that as far as attention and caring for the patient—they were better than anywhere else we’ve been through all of this.”

Select Specialty Hospitals are part of a national network of specialized acute care hospitals within Select Medical Corporation.  All Select Specialty Hospitals are JCAHO accredited, Medicare certified and licensed by the state in which they are located.  They are also participating providers with a wide variety of HMOs, PPOs and Managed Care plans.