<!-- TODAY'S CONSUMER --> When Chris Reyes woke up in the hospital in January 2015, the prognosis looked grim. A bullet he had taken to the lower back during an attempted robbery in his hometown of East Chicago, Indiana, had left the then-22-year-old paralyzed from the waist down, and physicians weren't optimistic that he would walk again. Up until then, Reyes had held jobs that required him to be physical, including a stint as a forklift driver. He was also newly married at the time, with three children to keep up with-six-month-old daughter, Avaria; and sons, CJ, age three, and Terrell, age two. Overwhelmed by the challenges that would lie ahead, Reyes could have easily given up. Instead, he was determined to walk again, no matter what anyone told him. "When I woke up, I had no movement," says Reyes. "Being a strong-minded person, I just tried to clench my muscles and get my leg to move at all-and I had a little movement to where I could feel the muscle contracting in my right leg pretty much right away." Reyes continued to improve as he began therapy in late February 2015. "Once I started outpatient therapy, I really started getting some more movement in my legs, so I kept at it," he says. His therapy included electro-neuro stimulation to his legs to stimulate and move his muscles, as well as moving his legs from side to side. He also worked with a standing machine, which he would use to pull his weight up. It was at that point that Reyes' neurologist delivered positive news: He said there was a good chance Reyes would regain feeling in his legs. And he has. <div> [caption id="" align="alignnone" width="300"]<img src="https://opedge.com/Content/OldArticles/images/2016-03/2016-03_08-01.jpg" alt="Choudhary with Reyes" width="300" height="435" /> Choudhary shows Reyes how to shift his weight in the RGO. Photographs courtesy of Damian Rico, Northwest Indiana Times.[/caption] [caption id="" align="alignnone" width="300"]<img src="https://opedge.com/Content/OldArticles/images/2016-03/2016-03_08-02.jpg" alt="Reyes takes his first steps" width="300" height="368" /> Reyes takes his first steps since his injury.[/caption] </div> "I don't have touch sensation on my left leg yet, but I have pressure sensation on both legs, and touch sensation on my right," Reyes says. A major turning point came recently when, while showering, Reyes was able to feel the hot water on both of his feet for the first time since the injury. "I know [feeling] is coming back-and I can wiggle my toes a little bit." <h3>Game Changer</h3> Reyes says the care and encouragement he receives from his nurses and therapists, as well as the support of his wife, sister, brother, and mother, and the inspiration he gets from his children, have been key in his rehabilitation. Although he was already exceeding therapists' expectations, it was a phone call from Joy Corrales, PT, CKTP, Reyes' physical therapist at St. Catherine Hospital, East Chicago, to Vikram Choudhary, CP, BOCO, clinical director of Bionic Prosthetics and Orthotics Group, headquartered in Merrillville, Indiana, that most significantly impacted the course of his recovery. Choudhary remembers getting the call from Corrales. "She told me what they needed to accomplish [to get Chris up and moving] and she wanted me to see Chris," he says. Reyes was confined to a wheelchair when the two met, and Choudhary says he knew immediately that-with proper guidance-Reyes would be a good candidate for a reciprocating gait orthosis (RGO). Choudhary knew a conventional HKAFO would not have worked, he says, because of its static properties and the fact that Reyes would have had to use his hands to help support himself with traditional crutches at all times. Still, the RGO was an unconventional solution for Reyes, Choudhary says, based on the amount of time he had been in a wheelchair. Reyes had developed some flexor tightness, and RGOs are typically better suited to patients who begin orthotic intervention and rigorous rehabilitation right away. In Reyes' case, Choudhary showed him some stretching exercises for his hips, which Reyes strictly followed until Choudhary could get the RGO authorized and fabricated. For Reyes, who was motivated and compliant with instructions and therapy from Corrales and Choudhary, the device has been a game changer. "If you don't think outside of the box, then you can't offer the best possible solution," Choudhary says. "I thought the reciprocating gait orthosis was worth a try, and if his strength came back, then we could always dial it down." And come back it has. Reyes continues to outpace the expectations of his therapists and of Choudhary. On November 17, 2015, he took more steps using the RGO device than he had since his injury. "I was hoping [Chris] would just be able to stand, and then we pushed it right then, and he was able to take some steps," Choudhary says of that day. Reyes keeps improving, and that progress, coupled with a positive outlook, keeps Reyes moving forward. "I know I'm going to be walking in the matter of another year," he says. "My attitude is that by the end of this year I will be walking with my cane." Once Reyes gets strong enough to move his right knee, Choudhary will remove the locking mechanism on the RGO. Reyes believes reaching that goal is only a matter of gaining back more of the muscle mass he lost while he was in the hospital for three months. "I woke up and my legs were skinny," Reyes says. "I lost a kidney, my spleen, and had a pin put in my lower back." Since using the RGO, Choudhary has modified the device a couple times to compensate for Reyes regaining some weight and muscle mass, and to eliminate the RGO rubbing against his hip. "As I get bigger they'll have to open it up more," Reyes says. Making frequent changes to a device becomes an issue for patients when it comes to stipulations and limitations imposed on practitioners by insurance providers, Choudary says. That is the reason he and Sumesh Saxena, CP, BOCO, started their own practice in 2008. "Too often [in large companies] there is pressure from corporate about who is paying for what. And we want to help people-that's why we're in this profession-so we started Bionic," Choudhary says. "Even if we have to repeat something for years or months, we will do the right thing for the patient and it won't be questioned." The latest and greatest devices can overcomplicate things for patients, Choudhary says. "Patients should do their research, too, by being inquisitive and asking plenty of questions," he says. "We should not stick to just the expensive, newer devices available." He adds that O&P providers should consider more "basic" devices such as the RGO he used with Reyes, which does not have electronic components. Since Reyes' story made local news recently, Choudhary has seen six patients with gunshot wounds who he's been able to help with the use of RGOs. Like Reyes, Choudhary is an optimist, and he knows that a positive attitude makes a huge impact on a patient's outcome. "If someone has a positive attitude and high hopes, they tend to better fight their circumstances," he says. For Reyes' part, his positivity extends beyond his recovery. He admits he was in the wrong place with the wrong people when the shooting occurred, and he's since vowed to use the lessons from his own experience to benefit others. "God did this for a reason," he says. "My perspective and values weren't where they were supposed to be. It was a tragedy but it was an eye-opener as well." Reyes began offering support to others even while he was still in the hospital himself. He recalls meeting with a woman who had sustained a gunshot wound. "I understood what she was going through-that depression and feeling like life is over," he says. "I reminded her that her mind is the key and that nobody can tell her what her body is or isn't going to do. I think I inspired her and helped her see that [using] a wheelchair doesn't mean your life is over." Reyes says he wants to continue helping others and has recently enrolled in courses to become a counselor for drug addiction recovery and at-risk youth. "This has definitely changed my perspective and my values," he says. "I am still the same person, but I care about things I didn't care about before." <em>Tara McMeekin is a writer and editor based in Parker, Colorado.</em>
<!-- TODAY'S CONSUMER --> When Chris Reyes woke up in the hospital in January 2015, the prognosis looked grim. A bullet he had taken to the lower back during an attempted robbery in his hometown of East Chicago, Indiana, had left the then-22-year-old paralyzed from the waist down, and physicians weren't optimistic that he would walk again. Up until then, Reyes had held jobs that required him to be physical, including a stint as a forklift driver. He was also newly married at the time, with three children to keep up with-six-month-old daughter, Avaria; and sons, CJ, age three, and Terrell, age two. Overwhelmed by the challenges that would lie ahead, Reyes could have easily given up. Instead, he was determined to walk again, no matter what anyone told him. "When I woke up, I had no movement," says Reyes. "Being a strong-minded person, I just tried to clench my muscles and get my leg to move at all-and I had a little movement to where I could feel the muscle contracting in my right leg pretty much right away." Reyes continued to improve as he began therapy in late February 2015. "Once I started outpatient therapy, I really started getting some more movement in my legs, so I kept at it," he says. His therapy included electro-neuro stimulation to his legs to stimulate and move his muscles, as well as moving his legs from side to side. He also worked with a standing machine, which he would use to pull his weight up. It was at that point that Reyes' neurologist delivered positive news: He said there was a good chance Reyes would regain feeling in his legs. And he has. <div> [caption id="" align="alignnone" width="300"]<img src="https://opedge.com/Content/OldArticles/images/2016-03/2016-03_08-01.jpg" alt="Choudhary with Reyes" width="300" height="435" /> Choudhary shows Reyes how to shift his weight in the RGO. Photographs courtesy of Damian Rico, Northwest Indiana Times.[/caption] [caption id="" align="alignnone" width="300"]<img src="https://opedge.com/Content/OldArticles/images/2016-03/2016-03_08-02.jpg" alt="Reyes takes his first steps" width="300" height="368" /> Reyes takes his first steps since his injury.[/caption] </div> "I don't have touch sensation on my left leg yet, but I have pressure sensation on both legs, and touch sensation on my right," Reyes says. A major turning point came recently when, while showering, Reyes was able to feel the hot water on both of his feet for the first time since the injury. "I know [feeling] is coming back-and I can wiggle my toes a little bit." <h3>Game Changer</h3> Reyes says the care and encouragement he receives from his nurses and therapists, as well as the support of his wife, sister, brother, and mother, and the inspiration he gets from his children, have been key in his rehabilitation. Although he was already exceeding therapists' expectations, it was a phone call from Joy Corrales, PT, CKTP, Reyes' physical therapist at St. Catherine Hospital, East Chicago, to Vikram Choudhary, CP, BOCO, clinical director of Bionic Prosthetics and Orthotics Group, headquartered in Merrillville, Indiana, that most significantly impacted the course of his recovery. Choudhary remembers getting the call from Corrales. "She told me what they needed to accomplish [to get Chris up and moving] and she wanted me to see Chris," he says. Reyes was confined to a wheelchair when the two met, and Choudhary says he knew immediately that-with proper guidance-Reyes would be a good candidate for a reciprocating gait orthosis (RGO). Choudhary knew a conventional HKAFO would not have worked, he says, because of its static properties and the fact that Reyes would have had to use his hands to help support himself with traditional crutches at all times. Still, the RGO was an unconventional solution for Reyes, Choudhary says, based on the amount of time he had been in a wheelchair. Reyes had developed some flexor tightness, and RGOs are typically better suited to patients who begin orthotic intervention and rigorous rehabilitation right away. In Reyes' case, Choudhary showed him some stretching exercises for his hips, which Reyes strictly followed until Choudhary could get the RGO authorized and fabricated. For Reyes, who was motivated and compliant with instructions and therapy from Corrales and Choudhary, the device has been a game changer. "If you don't think outside of the box, then you can't offer the best possible solution," Choudhary says. "I thought the reciprocating gait orthosis was worth a try, and if his strength came back, then we could always dial it down." And come back it has. Reyes continues to outpace the expectations of his therapists and of Choudhary. On November 17, 2015, he took more steps using the RGO device than he had since his injury. "I was hoping [Chris] would just be able to stand, and then we pushed it right then, and he was able to take some steps," Choudhary says of that day. Reyes keeps improving, and that progress, coupled with a positive outlook, keeps Reyes moving forward. "I know I'm going to be walking in the matter of another year," he says. "My attitude is that by the end of this year I will be walking with my cane." Once Reyes gets strong enough to move his right knee, Choudhary will remove the locking mechanism on the RGO. Reyes believes reaching that goal is only a matter of gaining back more of the muscle mass he lost while he was in the hospital for three months. "I woke up and my legs were skinny," Reyes says. "I lost a kidney, my spleen, and had a pin put in my lower back." Since using the RGO, Choudhary has modified the device a couple times to compensate for Reyes regaining some weight and muscle mass, and to eliminate the RGO rubbing against his hip. "As I get bigger they'll have to open it up more," Reyes says. Making frequent changes to a device becomes an issue for patients when it comes to stipulations and limitations imposed on practitioners by insurance providers, Choudary says. That is the reason he and Sumesh Saxena, CP, BOCO, started their own practice in 2008. "Too often [in large companies] there is pressure from corporate about who is paying for what. And we want to help people-that's why we're in this profession-so we started Bionic," Choudhary says. "Even if we have to repeat something for years or months, we will do the right thing for the patient and it won't be questioned." The latest and greatest devices can overcomplicate things for patients, Choudhary says. "Patients should do their research, too, by being inquisitive and asking plenty of questions," he says. "We should not stick to just the expensive, newer devices available." He adds that O&P providers should consider more "basic" devices such as the RGO he used with Reyes, which does not have electronic components. Since Reyes' story made local news recently, Choudhary has seen six patients with gunshot wounds who he's been able to help with the use of RGOs. Like Reyes, Choudhary is an optimist, and he knows that a positive attitude makes a huge impact on a patient's outcome. "If someone has a positive attitude and high hopes, they tend to better fight their circumstances," he says. For Reyes' part, his positivity extends beyond his recovery. He admits he was in the wrong place with the wrong people when the shooting occurred, and he's since vowed to use the lessons from his own experience to benefit others. "God did this for a reason," he says. "My perspective and values weren't where they were supposed to be. It was a tragedy but it was an eye-opener as well." Reyes began offering support to others even while he was still in the hospital himself. He recalls meeting with a woman who had sustained a gunshot wound. "I understood what she was going through-that depression and feeling like life is over," he says. "I reminded her that her mind is the key and that nobody can tell her what her body is or isn't going to do. I think I inspired her and helped her see that [using] a wheelchair doesn't mean your life is over." Reyes says he wants to continue helping others and has recently enrolled in courses to become a counselor for drug addiction recovery and at-risk youth. "This has definitely changed my perspective and my values," he says. "I am still the same person, but I care about things I didn't care about before." <em>Tara McMeekin is a writer and editor based in Parker, Colorado.</em>