Alisha “Lish” Tomac, 34, is originally from Wheeling, West Virginia and worked part-time as an environmental air quality field supervisor. Married for 12 years to Robert, who goes by “Bear,” Lish loves playing with and training her six dogs, hunting, crafting, reading, traveling and spending time with friends and family.
Lish had been dealing with lower back pain for over three years, regularly experiencing spasms and blinding pain. “I couldn’t get anything to get the spasms to stop,” she said. “But then my feet went numb, and that’s when we knew something was really wrong.”
Lish sought care closer to home, but after being told there was a months-long wait, she and her mother headed to Cleveland Clinic’s main campus to meet with a neurologist. The physician ordered a battery of tests, including an MRI and lumbar puncture, also known as a spinal tap. When Lish’s test results came back, the news was something she never expected – a very rare tumor in the thoracic section of her spinal cord called an ependymoma. Lish proceeded to meet with a number of specialists who created a game plan for her treatment. “It was a big relief to finally know what was going on,” Lish said.
Lish underwent delicate spinal surgery to remove the tumor. When there were complications after the initial surgery, Lish had to go under the knife again. The procedures left her with incomplete paraplegia, meaning that, unlike complete paraplegia, Lish’s spinal cord was still able to convey some messages to and from the brain. Because of this, she was able to experience some sensation and movement below the level of injury. Lish knew she had a long road to recovery ahead of her and chose Cleveland Clinic Rehabilitation Hospital, Edwin Shaw because she felt the intensive therapy would help her reach her goal of regaining independence, walking and being able to hunt with her dogs again.
Upon arrival, Lish was unable to walk or complete any of her self-care tasks. “I felt so vulnerable because I couldn’t do anything and that’s not who I am – I’m a pretty independent person,” she stated. “I had to rely on other people in general for everything.” Lish had lost the strength and control of both of her legs, requiring her to complete most tasks from her wheelchair. Lish’s team of physicians, nurses, physical therapists and occupational therapists worked together to develop an individualized care plan to help her get back on her feet and regain her independence.
In occupational therapy, Lish’s therapists initially focused on strengthening her upper body so she could better manage her personal care. They taught her how to use several pieces of adaptive equipment to assist with dressing and self-care. Occupational therapists also worked to create the most suitable environment for her within her room to maximize her independence. By the end of her stay, Lish was able to complete stand pivot transfers to the shower, toilet, and bed with assistance or transfers with supervision/modified independence.
Toward the end of her stay, Lish began to direct some of her own care, coming up with treatment ideas and small goals that were important for her to achieve, all while maintaining a positive and determined attitude throughout each day.
Physical therapists worked with Lish to first stand, then walk. Initially, Lish required total assistance for all transfers, standing and walking. The moment Lish took her first steps in the parallel bars with support from her therapists became the highlight of her progress. “Even though it was a small moment, knowing that my legs would work eventually was a huge moment for me.” As Lish’s recovery continued to advance, her therapists introduced treadmill and stair training to help her improve her mobility. She also utilized the EksoNR exoskeleton, a wearable robotic device that provides power to the legs to help a patient relearn to walk. “I didn’t know those types of therapy existed,” Lish said of the exoskeleton. “You see it on YouTube used in severe cases, but I didn’t think anywhere really offered that type of therapy. It benefitted me tremendously.” By the time she was ready to go home, Lish had taken over 500 steps in the exoskeleton.
During Lish’s time at Cleveland Clinic Rehabilitation Hospital, nursing played a large role in her recovery. One day, when the nurse was tending to her, Lish was not feeling well and suddenly became short of breath. The nurse alerted Lish’s physicians that Lish’ oxygen levels were dropping and the decision was made to send her to the acute care hospital to be evaluated for a pulmonary embolism, a potentially life-threatening situation when a blood clot travels from the lower extremities and travels through the heart and into the lungs. The nurse’s instincts were correct – Lish ended up with bilateral pulmonary embolisms, or blood clots in both lungs.
After stabilizing, Lish returned to rehab even more determined than before. Lish began to participate in recreational therapy, which included visits from therapy dogs, painting, reading and doing crafts outdoors.
Over two months after she arrived at Cleveland Clinic Rehabilitation Hospital, Lish had made great progress. Her hard work paid off as Lish was able to walk 150 feet with a rolling walker and negotiate 12 stairs with assistance from a therapist as well as get in and out of a car with supervision. Lish could also complete transfers to the shower, toilet and bed with assistance.
Lish is grateful not only for her therapy team, but for the support of her family and friends. “They were a huge support group outside of the hospital,” she said. “There were low days that were really hard and sometimes I just needed that extra push or to cry and move on. I am super grateful for them.” Both Bear and her mother participated in family training to help learn how best to care for Lish as she returned home. She is most looking forward to seeing her dogs and sleeping in her own bed, and plans to continue her recovery with outpatient therapy.
Lish calls her experience in inpatient rehabilitation “fantastic,” adding, “It was hard, but if you put the effort in and you don’t give up, you’re going to reap the benefits.” She has the following advice to others who are facing a difficult recovery: “When you can’t control what’s happening, challenge yourself to control the way you respond to what’s happening. That’s where your power is.”