A specialized approach provides intensive physical and occupational therapy after chemotherapy, right in a patient’s hospital room. Here's how the program gave one man hope.
The odds were stacked against Michael Champion.
The 65-year-old was diagnosed with acute lymphocytic leukemia, a disease that requires aggressive chemotherapy designed with much younger patients in mind.
Thanks to a new cancer rehabilitation program at the University of Michigan Rogel Cancer Center, Champion was able to recover from the debilitating effects of treatment and gain enough strength to resume life at home with his family.
The Mobile Comprehensive Oncology Rehabilitation Evaluation program, or MCORE, was created by Michigan Medicine's Department of Physical Medicine and Rehabilitation to provide a more aggressive physical rehabilitation for cancer patients.
The goal: to decrease the length of a patient's stay in the hospital.
MCORE has been vital for Champion, whose aggressive chemotherapy sapped his energy, strength and mobility.
"It was a blessing in a sense that he was healthy, so they said we can really slam this, but then as you get more and more chemo, we were not prepared," says Champion's wife, Pat.
It's a common sentiment that inspired Sean Smith, M.D., Champion's rehabilitation medicine physician, to launch the program.
"People going through chemo or just having finished a cycle are some of the most fatigued people we get up here," Smith says.
The path that led Champion from working out at his local gym in Kalamazoo, Michigan, and staying active with his family to celebrating the small victories of sitting upright and walking on his own began in December 2017.
The retiree noticed a drop in energy levels and blood blisters inside his mouth.
His doctors referred him to the Rogel Cancer Center, where a diagnosis was made. Champion began chemotherapy treatments at a hospital near home as well as at Rogel.
But his health began to decline from side effects. By June 2018, he was so weak his family knew additional help was needed.
"We could see the cumulative effect of all of this," Pat Champion says. "I kept saying he shouldn't be at home. It's not safe."
Soon after, Michael Champion was moved to the inpatient rehabilitation unit at the end of the month to begin his journey back to full strength.
Two weeks into his hospital stay, Champion was in a better position to start regaining his strength.
Champion says he was foggy for most of these discussions but remembers Michigan Medicine physical therapist Sara Houlihan talking about a new program that might be a good fit. The program was MCORE.
"They said it's a three-hour daily commitment," Champion says. "And going from here to a chair was a commitment to me, so it was foreign to me but finally it worked out."
MCORE therapists devote more time to patients and create individualized plans to help with the intensity of the program, Houlihan says. And they can hold sessions in a patient's hospital room if recipients are too weak to travel to the rehab area.
In addition to more intense and individualized therapy, another benefit to patients in the MCORE program is being included in MCORE rounds.
A recipient's entire health-care team — including a rehabilitation medicine physician (or physiatrist) who specializes in cancer rehabilitation — evaluates patient progress and adjusts the plan to maintain the required intensity without going beyond what a patient can tolerate.
Houlihan says programs like MCORE are common at premier medical facilities in stroke, concussion and burn programs but are still rare in cancer programs.
"People have this misconception that cancer patients can't get better, that they can't tolerate this," she says, "but cancer is an area that works really well for this."
As Champion's discharge was drawing near, his family resisted the notion of moving him to a subacute rehabilitation facility where he likely wouldn't get the same intensity and individualized level of care.
Because of the progress he had done with MCORE, Smith was able to recommend that he transition into Michigan Medicine's Inpatient Rehabilitation Unit to continue progressing towards his goals.
After a two-week stay on the rehab unit, Champion was able to be discharged home.
Though it's unclear if and when his cancer journey will be behind him, Champion is staying positive.
"I wish it was five years down the road," he says, "but in the back of your head, you know nothing's 100 percent."
Pat Champion has been taking photos of her husband since his first admission to the hospital and sending them to Houlihan to chronicle their journey. The photos show the progression of a man weakened and gaunt from chemotherapy and pneumonia to a man with robust expressions and even facial hair.
In one photo, Champion sits in a wheelchair at the end of a pier looking out at Lake Michigan. Another image shows Champion walking on his own.
Champion and his family praise the value of MCORE and the results it produced. They want to be sure other patients know about it.
"The goal is on the front end to have people participate and receive physical therapy before discharge," Champion says. "In the long run, it'll save money and certainly help people."
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