Caleb's Story
Brain injury and multiple trauma
Caleb Utley’s life transformed in an instant. One moment he was driving on US 75, the next, he was trapped underneath a large truck with his car engine on his lap.The accident left the 34-year-old restaurant server with multiple serious injuries—fractured legs, damaged internal organs and a traumatic brain injury. If it hadn’t been for a quick acting police officer who wrapped Caleb’s left arm in a tourniquet, it would have been lost.
Emergency responders rushed Caleb to Medical City McKinney, where doctors stabilized him and took care of his additional issues: a punctured and collapsed lung, internal bleeding, fluid on the brain and damage to his small intestines, kidneys and liver. Caleb required four surgeries to repair his bones and wounds and an added procedure to relieve pressure on his brain. He needed a ventilator to breathe and a feeding tube for nutrition.
After 17 days in intensive care, doctors recommended Caleb transition to a critical illness recovery hospital for further medical monitoring and healing. His family chose Select Specialty Hospital - Dallas Plano. Upon arrival at Select, Caleb couldn’t breathe, eat, talk or walk. He arrived with a tracheostomy, a slit in his windpipe with a tube that connected to his ventilator.
Over the next 25 days, a physician-led, multidisciplinary team coordinated Caleb’s care, which included respiratory, speech, physical and occupational therapies.
Caleb participated in breathing trials that involved lowering his ventilator settings or removing him from the machine for increasing amounts of time so that his lungs had to do more of the work. During the trials, Caleb’s speech therapist connected a Passy Muir valve to his tracheostomy that moved air through his vocal cords, allowing him to speak while also exercising his throat muscles.
Simultaneously, Caleb’s care team helped him sit upright at the edge of the bed to rebuild core strength and balance. Each day, Caleb increased the amount of time he held himself in place. He moved his arms, hands and fingers although his body movement was still limited from his injuries.
Caleb progressed quickly. Within a week, the ventilator was gone and two days later, so was his tracheostomy. Caleb passed a test demonstrating that he could swallow without aspirating and he was cleared to begin eating again, starting with thickened liquids and pureed food and progressing to a regular diet.
By discharge—16 days after admission—Caleb was breathing, eating, talking and able to hold himself upright for 20 minutes, even reaching while he did so. Caleb was ready for the next level of care to continue working toward independence.
Research led his family to Baylor Scott & White Institute for Rehabilitation (BSWIR) - Frisco.
Caleb arrived unsure about inpatient rehabilitation.
“I honestly didn’t want to be here,” he said. “But I knew it was needed.” That said, he had one key goal, to walk again. To get there, Caleb had to work through challenges. He couldn’t stand or put weight on either of his legs and needed two people to help him move from bed to wheelchair. Constant pain and sensitivity in his legs hindered him. In addition, he no longer sounded like himself—the brain injury impaired his voice and speech—which frustrated Caleb.
Caleb’s physician-led rehabilitation team developed a comprehensive therapy plan, including physical, occupational, speech and recreational therapies. Physical therapy started him with small movements. A tilt table helped Caleb begin bearing weight on his right leg while protecting the left one, which was still healing. Therapists pushed Caleb, which initially bothered him, but he soon realized they knew he could do more, and their encouragement helped him get there.
Throughout his stay at BSWIR, Caleb learned to operate a wheelchair independently, which he used for mobility while he regained his strength to stand and walk. He did seated activities, like boxing, to work on sitting tolerance and core and upper body strength. As he got stronger, Caleb stood and took his first steps with an assistive device and gradually moved to a walker, followed by a four-point cane and later, a single-point cane. As he progressed, his team helped him improve his posture, balance and endurance. It was tough, but within six weeks, Caleb was able to walk for short distances without a device.
Occupational therapy focused on rebuilding his daily skills and coordination. A disc golf enthusiast, therapists worked the sport into Caleb’s treatment sessions and later had him toss a Frisbee while seated, then standing which allowed him to continue to regulate his balance and build strength.
Meantime, Caleb also worked to improve his ability to independently shower, dress and perform other daily living activities. During these sessions, Caleb frequently got an added lift. His fiancé Blake, family and friends were often on-hand to observe and learn how to best help Caleb when he returned home.
Speech therapy played a key role in helping Caleb regain his voice. “I wanted to work on my speech and return to how I sounded before the accident,” he said. Therapists taught him breathing techniques to improve his voice, and he recited lines from his favorite movies—a natural prompt to add expression to his voice.
“Repetition is key to aiding in brain injury recovery,” said Caleb. Whether he was gait training or practicing his enunciation, he repeated activities to retrain his brain and rewire damaged connections, according to his occupational therapist.
Recreational therapy brought an unexpected source of comfort. To help reinforce skills and restore his spirit, Caleb was introduced to Darren, the BSWIR - Frisco facility dog. During one particularly tough session, Caleb was in pain, frustrated and struggling to stay engaged. But when Darren approached, his mood shifted. “As soon as the dog came over, my whole demeanor changed,” Caleb recalled. “A smile came across my face, and I immediately started talking to him.”
By the end of his stay, Caleb could walk short distances with almost no help, climb eight steps with someone nearby for support, get in and out of a car on his own and communicate more confidently. “There was one day when I had 20 friends show up to come eat a meal with me,” said Caleb—a nice surprise and a really good way to practice communication skills.
One of the most emotional moments came when his physical and occupational therapists took him home for a visit before discharge. This visit would prove to Caleb that he could do all the skills he learned at rehab in his home. There was, after all, a time when coming home to Blake and the dogs seemed unlikely.
“Walking into my house for the first time in months was surreal,” Caleb said. “It made me realize that going home was possible.”
Caleb said his experience at BSWIR - Frisco was life-changing. “I learned that my body can be broken and put back together,” he said. “[It was] amazing—over-the-top amazing.”
Recovery from a brain injury is a long process, and Caleb is continuing therapy at home. His mobility and speech continue to improve and he is able to manage household chores. He enjoys being back at home and expresses a lot of gratitute to Blake and his family for helping him in his recovery.