Average stay 28 days
Going inside Gabrielle Giffords' new Houston home: The secrets of TIRR
A chalkboard at the cafeteria entrance inside The Institute for Rehabilitation and Research Memorial Hermann is emblazoned with a quote from basketball great Michael Jordan: "I can accept failure, but I can't accept not trying."
TIRR has provided care for many notables — most famously Buffalo Bills tight end Kevin Everett following a life-threatening spinal injury, Houston Astros slugger Jeff Bagwell following shoulder surgery and Houston oil tycoon Oscar Wyatt following a stroke. But now the renowned hospital is preparing for its most high-profile patient yet.
Rep. Gabrielle Giffords, is scheduled to be transferred to TIRR on Friday from Tucson's University Medical Center to begin rehabilitation work from the affects of a gunshot wound to the head.
Founded in 1959 by Dr. William Spencer, TIRR was originally intended to address the lack of clinical attention to the quality of life for patients with polio and cystic fibrosis. Through the years its specialties have changed and broadened with the time, and today approximately two-thirds of patients admitted are recovering from brain injuries including stroke, Parkinson's disease and traumatic brain injury, according to TIRR CEO Carl Josehart, with another 20 to 25 percent suffering from spinal cord injuries.
Giffords will first complete a brief stay at the Memorial Hermann Hospital's Level One Trauma Center, and upon transferring to TIRR will receive a comprehensive evaluation that can take up to 72 hours. The evaluation will set a detailed treatment plan and can include a rehabilitation assessment, a psycho-social assessment, a physical therapy assessment, speech therapy assessment, occupational therapy assessment and even a spiritual needs assessment.
TIRR is notable as one of 16 hospitals nationwide recognized as a Traumatic Brain Injury Model System and one of 13 named a National Spinal Cord Injury Model System by the National Institute on Disability and Rehabilitation Research. As such, it is a national center for data collection and sharing, conducting local multi-center research.
"From the standpoint of a patient, they can expect collaboration and the latest science informing clinical care," says Dr. Mark Sherer, the director of research and neuropsychology.
Though doctors declined to speculate on Giffords' potential diagnosis or time to be spent in the facility ("Patients with the same medical diagnosis can often present concerns that vary widely," says Josehart) the average in-patient stay at TIRR is 28 days, followed by a much lengthier out-patient program of physical therapy without the full-time medical supervision, either at TIRR or a facility closer to home.
"The circumstances around any injury are one factor in recovery, but a bigger factor is social and family support," says Sherer. Giffords' husband Mark Kelly is a NASA commander based in Houston and has stated the proximity to family and a support system was a factor in the selection of TIRR.
Peeking into one of the TIRR gym facilities (the center has five of different sizes and specialties, as well as a therapeutic pool), the space is busy with about two dozen patients of varying abilities working with physical therapists and occupational therapists.
There are body-weight-assisted treadmills for retraining patients to walk with a harness bearing some of their weight and preventing a fall or an injury; mats for stretching; a small staircase and ramp to practice climbing skills in a controlled environment; cardio machines to promote upper-body strength; and functional electrical stimulation cycles to reverse muscle atrophy, increase local circulation and improve range of motion.
Josehart describes TIRR's goals with any patient as achieving a "new normal."
"Not everyone gets to 100 percent recovery," says Josehart, but the hospital strives to reintegrate patients to "the parts that make life meaningful," including sports, school and work. TIRR has a wheelchair basketball team, a wheelchair hockey team and a gardening program, and offers vocational counseling and training in activities from getting in and out of a car to getting through security at the airport.
"What sets TIRR apart is having a medical system around us that includes Life Flight, trauma care, neurosurgery, recovery and home care," Josehart says. "Not every rehabilitation facility is furnished with a system that takes care of people from birth to geriatric care. It allows us to take patients with more complex injuries due to our relationships with medical school — UT and Baylor — and those with medical specialties."