William's Story

A native of Indiana, William “Bill” Behrman and his wife, Cheryl, moved to Gainesville four years ago to be near his two adult children and five grandchildren. The 69-year-old former college president and consultant was in good health and wanted to stay actively involved with his family.
But Bill’s life changed quickly in January when he developed flu-like symptoms, including a cough and fever. When he began to struggle to breathe, Bill went to the hospital. There, he was diagnosed with pneumonia and respiratory syncytial virus (RSV), a virus that infects the lungs and breathing passages. The two conditions left Bill with acute respiratory distress syndrome (ARDS), a serious lung condition that causes low blood oxygen.
When his condition further declined, Bill was moved to the ICU and underwent a series of procedures. Bill was placed on a ventilator and surgeons performed a tracheostomy to further support his breathing and inserted a feeding tube into his stomach. When his breathing did not improve, Bill was placed on an extracorporeal membrane oxygenation (ECMO) machine. The device took over the job of Bill’s lungs moving blood and blood gasses through his body, which allowed his organs to rest. Moving to ECMO resulted in another condition – an acute kidney injury (AKI) which meant his kidneys couldn’t filter waste from his blood. To treat the condition, Bill was placed on continuous renal replacement therapy – 24-hour dialysis.
“I don’t remember the entire month of January because I was so sick,” Bill said. “They told my family to say goodbye to me three different times.” Miraculously, Bill pulled through, but his prolonged hospitalization left him incredibly weak. He was still unable to eat and requiring total assistance for every task, from moving to bathing and dressing. Bill’s physicians recommended inpatient rehabilitation as the next step in his journey. For that, he chose UF Health Rehabilitation Hospital.
Upon arrival, Bill was suffering from critical illness myopathy, meaning his muscles had severely atrophied after almost three months in the hospital. His physician-led team of physical, occupational, speech and respiratory therapists worked with Bill and his wife to devise a treatment plan that focused on rebuilding strength and endurance.
Bill’s physical therapy sessions initially focused on helping him with bed mobility, including sitting up and getting in and out of both bed, and later, a wheelchair. Once he was ready, Bill’s therapist utilized a body weight-supported harness to lift him from a seated to standing position. This allowed him to be upright for increasingly longer amounts of time which helping build strength and improving stability while also preventing falls. As he progressed to walking, Bill continued to use the harness to support his weight while taking his first steps.
Occupational therapy worked to help Bill regain independence with his personal care, given his weakened state. They taught him techniques to conserve energy while safely using the bathroom, showering and dressing on his own. They also focused on guiding Bill in using a walker to help with transfers as well as strategies for using adaptive equipment such as a reacher and sock aide.
Because Bill’s main goal was to be able to eat and swallow, the care team devoted a lot of attention to speech therapy. They concentrated on improving his swallowing which gradually allowed the removal of his feeding tube. To accomplish this, therapists guided Bill in the use of a Respiratory Muscle Strength Trainer (RMST) device and Expiratory Muscle Strength Trainer (EMST). The RMST and EMST devices gradually improved Bill’s lung strength and capacity by boosting the oxygen flow to his vital organs. The device also helped retrain Bill’s inspiratory (breathing in) and expiratory (breathing out) muscles. Over time, these devices helped increased Bill’s speech and swallowing abilities. Concurrently, therapists worked with Bill on isometric chin tucks against resistance, a technique used to improve swallowing by strengthening the muscles used in for that function. During the exercise, the patient pulls their chin toward their upper chest and squeezes a rubber ball or similar object that is placed between their chin and chest while sitting.
Throughout his inpatient rehabilitation experience, Bill’s family members participated in his therapy sessions, learning how to help him when he returned home. “My family has meant everything to me,” Bill said. “My wife, my son, my daughter, my son-in-law, my daughter-in-law…they’ve constantly been beside me. When I couldn’t speak, they would read my lips and interpret for me.”
Three-and-a-half weeks after arriving at UF Health Rehabilitation Hospital, Bill was ready for discharge. He was able to walk over 180 feet and go up and down 12 steps with a rolling walker. He could also handle his own personal care needs bathing, dressing himself and using the bathroom, all while using a walker for support. “When I first got here, I could not move my arms or legs. I couldn’t even roll my wheelchair. Now I can lift my arms up, sit up and get up to my chair,” Bill said.
Bill is excited to return home where he will continue his recovery with home health nursing and physical, occupational and speech therapy. While he hadn’t regained his ability to eat at discharge, Bill’s hard work paid off. Within three months of leaving UF Health Rehabilitation Hospital, Bill regained the ability to eat a normal diet and progressed to walking with only the assistance of a cane.
In reflecting on his illness and recovery, Bill said he’s learned many lessons. “The biggest thing that I’ve learned is to not take life for granted. You never know from one day to the next when it would be all over. Appreciate each day as it comes. Be happy and not critical of others.” He continued, “I really want to encourage others who need rehab to battle through the challenges. You have to fight through the depression and force yourself to improve.”