A Long Journey Back to Work: Keith’s Success Story

By, Allison R. Weder

Keith Swaltek’s journey back to a pain-free life began several months before his first appointment at Phoenix PT-Richland Township. We begin his story with the incident that nearly changed his life forever.

“I was in the bay washing my ambulance. And while washing it, I was pulling the hose backwards because it started to get kinked up. I was trying to pull it backwards and I tripped on some boxes that were on the ground. I hit my head on a trailer and lacerated my scalp. It hurt.” That moment was the beginning of a traumatic, painful time in Keith’s life. Keith is an Emergency Medical Technician. It is a job he puts his heart and soul into every day. “I lost my dad when I was 14 years old. He was 51 and had a massive heart attack. I made it my dream back then, if I could help one family by saving a loved one, giving them a little bit more time, I would be happy.” Unfortunately, that day in the bay, nearly put an end to his dream.

Keith’s head was stitched up at the hospital. He left with instructions to see his primary care physician if there were any other issues. Keith describes what happened when he woke up the next day. “I went to get out of bed, and not only did I have serious pain in my head, but I also had serious pain all through my lower back and hip area. I tried to nurse myself through the weekend using heat, and I attempted to return to work.” Keith knew something was not right. He spoke with his boss who agreed he needed to be seen by his employer’s workers’ compensation doctors.

Keith met with Stephanie Kamzik, from the Corporate Care office. He explained what happened and described his pain. “She sent me for an X-ray of my hips to make sure they weren’t fractured. And then she said she was going to get me scheduled to get into the concussion clinic. I was able to get in that week and they tried to do a baseline concussion study. I became very nauseated and couldn’t see straight. My back was still hurting.” The concussion team stopped the tests. Keith was prescribed a steroid to help with his back pain. He recalls the next steps. “(The steroid) did ease the pain, but I could still feel it. I was able to go back and get the concussion testing done. The tests showed I had suffered a severe concussion.” Keith was sent to physical therapy for the concussion, but he knew his back and hip pain needed to be addressed. He requested a separate prescription for that as well.

Keith was sent to a physical therapist recommended by Corporate Care. He spent about six weeks there, working to recover from his concussion and hip pain. “I was finally cleared with the concussion, but I still could barely walk. I could not get up steps and knew there was something serious going on within my hip.” Keith endured tests and therapy for the next several months, but the doctors and therapists could not find the cause of his pain or resolve it. Keith met again with Stephanie desperately searching for help. The pain was devastating. “The only thing that I could think was I’ve been working in the EMS field since I was 12 years old. I started off as an explorer for a local ambulance service and through the years I was a volunteer fireman and I spent 23 years in law enforcement. I just thought that my time doing what I love, saving people, was going to come to an end.” Keith felt comforted by Stephanie, who never stopped trying to help. “She never gave up on me. She said, ‘Listen, I know you’re telling the truth, and I’m trying to find the answer.”

Stephanie found Keith a sports medicine doctor. That doctor did a few manual tests and looked at his MRI. Keith recalls when the doctor finally gave him an answer. “He said I tore the labrum in my hip. He said he could clearly see it on the MRI.” Relieved after hearing an actual diagnosis, Keith was eager to learn about a treatment. He was given two options: surgery or a steroid injection. Keith decided to try the injection, which would take effect in about two weeks. “He was absolutely a savior. I went to meet with him after those two weeks and I walked into his office. I had no pain in my hip whatsoever. It was a great feeling.”

Keith was still going to physical therapy for his hip during that time, but the orders from his doctor were extremely specific for a work hardening program. Keith recognized the therapy sessions he was completing did not match his goals. He went back to Stephanie and explained why he did not want to continue therapy at the clinic he had been going to. Stephanie agreed. Keith explains how she found his new Physical Therapist. “It was just mere coincidence. Anthony Damiano, PT, DPT, CSCS, (from Phoenix Physical Therapy – Richland Township), happened to be there that day talking to Stephanie about his clinic’s Work Hardening Program.” Stephanie felt confident Anthony would be able to help Keith, and she set up an evaluation at the clinic in Johnstown, Pennsylvania.

The following week, Keith entered the Phoenix clinic for the first time. “Anthony, came over. He introduced himself and said, ‘we’re not going to do anything other than see where your baseline is and what you are able to do.’ And for the next hour and a half, he and I sat in a room while I lifted different amounts of weight, tried to walk with weights, and rotated my legs back and forth. I had more weakness in my hip than anything, and my leg was so shaky. I explained it was like my left buttocks had a stroke. I could not feel any muscle left in that area.” After Anthony knew what Keith could do, he shifted gears to his goals, the most important of them, getting back to work. Anthony then created an individualized recovery plan, based on his work skills and what he needed to do each workday. Then, the challenging work started.

The sessions started slowly, with Keith pedaling an exercise bike and walking up and down stairs. Keith immediately felt like he was in the right place. “Shannon, Missy, Tina, and Anthony: that is one awesome team.” Shannon is Shannon May, PTA, Missy is Melissa Ribblett, PT, and Tina is Tina Homyak, Patient Care Coordinator. Keith remembers what made him feel comfortable at Phoenix. “When I got to physical therapy at Phoenix, it was a totally different experience. Every patient in there had a will to not only recover from what they went through, but to recover and be better than what they were prior to their injury. It was awesome. Everybody talks about their stories, but everybody works hard, and everybody encourages each other.”

Keith was completing therapy sessions three times a week. But slowly, his strength increased, and he was able to go four and then five times a week. “It was a workout. It was physically straining by the time I was done working out. I really couldn’t do anything the rest of the day. But Anthony, the entire time, just kept motivating more and more.” Keith’s job requires him to lift and carry people up and down steps. Anthony started him with exercises to work toward being able to do that again. “We started working with adding weight to a box that I carried up and down a set of steps. The first time I tried it, we used a box that weighs 12 pounds with two 10-pound weights in it. So, I have a total of 32 pounds, and I could barely lift that up the steps. It was hard, especially when I started getting into 50, 60 pounds. It was very hard to get my legs to move right because the box was there.” As Keith progressed, he and Anthony knew they would need to adjust their exercises to simulate the lifting and carrying action more appropriately. “I was able to bring in a stretcher from work. I showed it to Anthony and explained to him how it works and everything. And from that point on we began using the stretcher as my tool at physical therapy.”

Keith and Anthony also used other tools to help with Keith’s recovery. “They not only wanted my hip to get stronger, but they also wanted my entire body to get stronger. It wasn’t just about working my left leg. It was working both legs. It was working my arms. It was pushing and pulling. We used a sled. I called it the dreaded sled because it was so hard to do. I think the sled weighs 75 pounds, so with 20 pounds of weights on it, I was pushing and pulling 95 pounds.” Keith completed everything he was asked to do. He knew the exercises were making him stronger. “When I say it was a total body workout it was not only physically my body, but my mind. The positive information (Anthony) gave me, the knowledge to help in my own recovery, was just amazing.”

Anthony’s positivity came into play when Keith had a tough day, or was in pain from the day before. “We called them modified days. I physically could not lift weight because I gave everything my body physically had the day before. (Anthony) understood.” Anthony treated the muscle pain with myofascial decompression or cup therapy. He used massage and deep heat to help resolve the acute pain. “He was doing these things for me, explaining to me why it’s important, and how I could make myself better at home. The following day when I came in there, we were right back to working hard and I felt great.”

It came time for Keith to decide what he needed to be able to do to get back to work. “I explained to Anthony, it’s kind of hard to say how much weight we have to lift. But I said if you think the average. person is about 200 pounds, I have to be able to lift a minimum 200 pounds and go up and down steps, forward and backward.”

After several more weeks of demanding work, Keith’s 200-pound testing day arrived. “I will tell you this. I was scared. I was very nervous, and I did not want to let Anthony down and I did not want to let my friends down. Everybody there stopped what they were doing to come watch. My wife was there with me. Psychologically and emotionally, it was one of the hardest things that I was going to subject myself to in a long time.” Keith’s therapy team loaded the stretcher. Keith grabbed one side and Shannon grabbed the other. “When I went to put my left foot, which was my injured leg, up on a step and push up, I used so much strength in pulling backwards that I just kind of sat down. At that point, all I could hear were gasps in the room and I thought, I can’t. It’s just way too heavy. As I sat there looking at Anthony, and looking around the room, and seeing everybody starting to tear up, I stood up. I don’t know where the power came from, but I got up and did it. It was wonderful.”

Keith will remember that day forever. It was the day he knew he could return to the job he loves. “As I stood there that day, the cheers finally erupted. Everybody there came over and gave me a hug, and congratulated me. I then asked Anthony, ‘Did I pass, and can I return to work?’ Anthony looked at me and said, ‘let me ask you a question. Are you able to go back to work and do your job and do it better than you did before?’ And I said, ‘absolutely!’ He said, ‘Well, there you go!’”  Keith reflects on Anthony’s response. “When I finally thought about what he had just said, and I never did this during this long journey, but the answer was never within Stephanie at Corporate Care, the answer was never within my doctor, the answer was never within Anthony, whether I was going to get back to work. The answer was always in myself.” Anthony always knew Keith would reach his goal. “When Keith started his work hardening program at Phoenix, you could tell he was determined to get back to work and would do whatever it took to get there. Each week he would work harder and harder with greater intensity and motivation as he saw the gains in his strength and ability. Even when he had setbacks, Keith was an inspiration to everyone in the clinic. His attitude was contagious to us all.”

Keith is grateful Stephanie found the Phoenix PT – Richland Township team. He knows his recovery would have been vastly different without them. “(They) were like a family. It was a family atmosphere there. It was not only about completing therapy and getting back to work, but it was so nice to walk into that place every day and for three hours knowing that I was going to be near people that cared about me. And I cared about them.”

Keith is back to doing the things he needs to do and loves to do. “I love to ride bikes in the summertime. We are a big biking family. And I could finally return to being normal again, where I’m getting up at six o’clock every morning to read the newspaper online and drink a tea and, just get ready to start my workday. The normal routine that had disappeared for seven months is back. I can’t thank Anthony, Shannon, Missy, and Tina enough for their professionalism. I give them all the kudos in the world because I don’t know of anywhere around here that can offer a true Work Hardening Program like they do.”