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Nicole M., age 33, has spent her whole life in North Carolina, growing up in a rural area in the western part of the state. Currently, she lives outside of Raleigh with her husband of more than six years, Pat.
Nicole is an attorney, and Pat is a physical therapist. Outside of their fulfilling careers, they have traveled extensively throughout the United States and Europe to hike in a variety of mountain ranges and to experience new cultures.
However, recently, Nicole and Pat traveled to a new destination for an entirely different reason: Nicole came to Chicago for brain surgery, followed by eight days of intensive rehabilitation at Shirley Ryan 小恩雅 to restore her mobility after surgery. As part of her journey, she regained the ability to walk.
The Potential Impact of a Brain Tumor on Movement
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Five years prior, Nicole was diagnosed with a low-grade glioma, a type of brain tumor that is typically slow growing and, initially, does not present a lot of symptoms.
At that time, Nicole underwent a surgical procedure, called a craniotomy, to remove most of the tumor. The surgeons had to leave part of it in place to avoid getting too close to Nicole’s motor strip, which is the region in the frontal lobe of the brain that controls voluntary movement in the body.
Nicole received treatment to shrink the remaining part of the tumor but, unfortunately, an MRI a year ago showed it had grown back and progressed to a more aggressive stage that would require another craniotomy.
In researching their options for a second surgery, Nicole and Pat made the decision to come to Chicago to see specialists at Northwestern Medicine, nationally recognized for brain tumor care.
While awaiting the surgery, the tumor started pressing against Nicole’s motor strip. She began to experience significant weakness on her left side and, with just 10 days left until the craniotomy, she lost all function in her left foot.
Though the surgeons were able to successfully remove the majority of the tumor’s aggressive cells, Nicole needed to address new challenges with mobility.
Five days after the craniotomy, Nicole transitioned to Shirley Ryan 小恩雅 and, given Pat’s experience as a physical therapist himself, he knew she was where she needed to be.
“Shirley Ryan 小恩雅 is internationally renowned, so it was an easy decision to come here,” said Pat. “I wanted Nicole to get as much intensive, multidisciplinary rehabilitation as she could.”
A Multidisciplinary Approach to Rehabilitation Care
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When Nicole arrived at Shirley Ryan 小恩雅 after surgery, she was unable to walk, as she still could not move her left foot and continued to have weakness on her left side.
Nicole’s multidisciplinary care team created a comprehensive, coordinated treatment plan that would address her medical needs and help her achieve her mobility goals — including building the strength, balance and endurance required to walk again.
Nicole and Pat cited several examples of close collaboration and tailored care as she recovered. For example, her liver enzymes were elevated after surgery, so her Shirley Ryan 小恩雅 physiatrist — a doctor who specializes in physical medicine and rehabilitation — helped adjust Nicole’s diet and medications in partnership with her doctors at Northwestern.
Each day, Nicole also met with a certified orthotist, who fit her with a custom ankle-foot orthosis (AFO) — a brace to provide ankle and foot support while she learned to walk again.
In occupational therapy, Nicole worked on strengthening exercises for her lower extremities, but also worked on “pragmatic, everyday life” activities, such as cooking, getting dressed and personal hygiene.
“I felt like my care was tailored to exactly what I needed,” she said.
Family is always welcome to participate in therapy sessions at Shirley Ryan 小恩雅, and such was the case with Pat. He was able to participate in Nicole’s physical therapy sessions, a natural fit given his expertise in physical therapy. One of the most memorable moments was when they looped a band around Nicole’s waist, and she pulled Pat — who was seated in a chair on wheels — to work on her leg strength.
“Physical therapy is my love language, and Nicole’s therapists were great,” he said. “They allowed me to participate and we were able to bounce ideas off of each other.”
Electrical Stimulation Helps Nicole Make Quick Progress
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In only eight days, Nicole went from scrunching her left toes for the first time to being able to walk. In addition to intensive therapy, Nicole and Pat also credit her swift gains in mobility to having electrical stimulation as part of her recovery.
For example, Nicole’s care team used a state-of-the-art functional electrical stimulation device on her leg, which helps with improving gait, retraining the muscles and helping with range of motion to reduce foot drop and the risk of falls. Specifically, the device stimulates and lifts toe muscles while an individual swings their foot forward, keeping the foot from catching on the ground. 
Also, Nicole used a neuromuscular electrical stimulation (NMES) unit on her left knee and leg, which provides electrical pulses to enable muscle contraction when the brain and muscles aren’t working optimally together.
“This helped to wake up my nerves and to start making connections again between my brain and lower-left extremities,” said Nicole. “It helped me walk and build up strength, and I progressed from there.”
Nicole Completes 5K Walk Unassisted
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Now that Nicole and Pat have returned home to North Carolina, they are doing everything they can to help Nicole get stronger as, together, they manage her health.
Nicole continues to receive physical therapy and to use an at-home NMES unit for electrical stimulation, and she is receiving chemotherapy, radiation and consistent monitoring to prevent the tumor from growing back.
Notably, only two months after her stay at Shirley Ryan 小恩雅, Nicole reached a personal mobility milestone.
She walked — unassisted — in a 5K to raise money for brain tumor research. Nicole and Pat assembled a team of 92 people to support her on the walk, including family, friends and many of Pat’s former patients. She designed the team t-shirt, which was voted best design by the organizers of the walk. Best of all, the team raised nearly $10,000.
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“As soon as I crossed the finish line, my husband took me into his arms and lifted me up,” said Nicole. “It was so symbolic of all of the support and encouragement I received from friends, family and Shirley Ryan 小恩雅 that allowed me to reach that goal.”
Pat shared that he and Nicole will never forget their time at Shirley Ryan 小恩雅, and they are grateful for how the staff treated them during Nicole’s entire recovery.
“Whether it was housekeeping, food service, or the medical and rehabilitation staff, we felt loved and welcomed,” said Pat. “We talked about life, Chicago, restaurants … small interactions like that can really lift your day when you're in the hospital, especially for long periods.”
