Returning to Work after Spinal Cord Injury
Megan Helsel had a passion for the outdoors and dreamt of working with wildlife. After earning an associate’s degree in natural sciences from Bergen Community College in 2010, she completed a bachelor’s degree in biology from Montclair State University. Megan excelled during her undergraduate studies, winning a competitive scholarship from the New Jersey Chapter of the Society of Women Environmental Professionals. With a love for ornithology (the study of birds), she volunteered with the New Jersey Meadowlands Commission and Bergen County Audubon Society. There, Megan participated in educational programs, led nature walks, and participated in conservation campaigns.
In 2015, Megan began working for a federal wildlife management agency as a seasonal technician in both New Jersey and New York. In this role, her responsibilities included wildlife damage management, which required many hours of labor-intensive work outdoors. “The job was very physically demanding, but I loved it,” said Megan. “It involved walking, hiking, and kayaking throughout various parts of New Jersey.”
Megan’s on-the-go lifestyle came to a halt in October 2016. She began to experience back pain and over the next week, gradually lost the ability to move both legs. Unable to stand or walk, Megan was rushed to a local emergency room where an MRI showed that a tumor had ruptured in her spinal cord. She was admitted to the hospital and two days later, after showing no improvement, was told that she would need emergency spinal cord surgery.
“My first question was, ‘When will I be able to kayak again?” Megan recalled, “But, reality quickly set in when I was told that a good outcome would be maintaining the limited amount of function that I had when I arrived to the emergency room.” She questioned whether she would ever be able to return to her physically demanding position.
After surgery, Megan continued her recovery at Kessler Institute for Rehabilitation in West Orange, NJ. With support from her employer, she enrolled in a leave donation program and received nearly eight months of donated leave time. This gave her enough paid leave to complete her intensive inpatient and outpatient rehabilitation.
Fortunately, Megan was eligible for Kessler’s Resource Facilitation Program,* a service for inpatients with SCI. Based on early intervention, the program’s goal is to help people return to work by connecting them with vocational services during their hospitalization. In late October 2016, Megan met with Kessler’s interdisciplinary rehabilitation team to discuss her goals after discharge, and identify needs for additional training and/or accommodations. Megan’s interdisciplinary team included physical therapists, a counselor from the New Jersey Division of Vocational Rehabilitation Services (DVRS), and a vocational resource facilitator, who offered job coaching and follow-up support services as needed.
On Megan’s 11th day in physical therapy, she took her first steps; she was then fitted with an assistive brace called a KAFO (knee-ankle-foot orthosis) to help her walk more efficiently and safely. Through determination and persistence, Megan demonstrated substantial improvements within a few weeks, and was discharged in November 2016.
To ensure successful reintegration into employment, Megan’s team of outpatient physical therapists worked with her to simulate scenarios she commonly encountered while working in the field. “The team was extremely resourceful in creating life-like situations, often taking me outside for our sessions to work on improving my balance on uneven terrain,” explained Megan.
After several months of outpatient therapy, Megan began to gradually transition back to work. Her supervisor worked with her so that she was able to return slowly and build up her stamina. Each week, she increased her work hours and assignments, and in August 2017, she resumed her position full-time.
Megan successfully managed her work responsibilities until the cold weather began to set in. The AFO (ankle-foot orthosis) assistive brace that she was now using was unable to fit in winter boots, making it difficult to work outdoors in the cold. With the help from her outpatient therapist, Karyn Baig, Megan was introduced to a flexible device that was compatible with her boots and would allow her to perform her job despite wintry conditions.
However, the device—Bioness L300® Foot Drop System that works by functional electrical stimulation—cost nearly $9,000 and was not covered by New Jersey DVRS.
Because Megan had enrolled in the Resource Facilitation Program during her inpatient stay, she was eligible for follow-up vocational services. Mary Lea West, then the program’s vocational resource facilitator, worked as a liaison between Megan and DVRS to help secure funding for the Bioness device. Although the funding was denied, Megan was assertive. She contacted DVRS and Bioness Inc. to inquire the reason for rejection. After nearly six months of advocacy by both Megan and Mary Lea, New Jersey’s DVRS approved Bioness as a vendor and funded all but $500 of the cost of the device. The remaining amount was waived by Bioness once they learned of Megan’s story.
“Having the right type of assistive device has enabled me to keep the job I love,” Megan reported. Using the Bioness has given her more freedom and allowed her the ability to use the footwear she needs to complete her work.
Podcast featuring Megan Helsel:
*The Kessler Vocational Resource Facilitation Program was a pilot study funded by a Craig H. Neilsen Foundation grant, and includes the participation of the New Jersey Division of Vocational Rehabilitation Services (DVRS), United Spinal Association, Kessler Institute for Rehabilitation and Kessler Foundation.