There’s not much that college students want to deal with less than final exams.

Acute Transverse Myelitis that paralyzes from chest down would qualify.

In April 2022, just before her five final exams, Nicole Briar, a 20-year-old University of Colorado Boulder sophomore, caught a cold that put her under the weather on a Friday and at Boulder Community Hospital by the following Tuesday. Her Delta Gamma sorority sisters had been keeping an eye on her. As she became immobile and incoherent, they called 911.

Good that they did, because Briar’s condition was life threatening. The virus that had caused the cold had gotten into her spinal cord and inflamed the insulating myelin sheath, causing paralysis and numbness below the chest. Her arms functioned, but only just.

She spent five days in the intensive care unit and another two weeks in the hospital. Plasma exchange therapy, intravenous antivirals, and other meds pulled her back from the brink and restored feeling and afforded some movement to her legs. But upon discharge, she rolled out of the hospital in a wheelchair, unable to walk and her prognosis murky. Many with transverse myelitis recover fully, thought that can take months. Others have permanent disability.

Acute Transverse Myelitis forced her to relearn how to walk, one step at a time

Her next stop was UCHealth Broomfield Hospital a few miles down U.S. 36. That’s where Boulder Community Health and UCHealth are partners in an 18-bed rehabilitation unit for patients recovering from such conditions as stroke, neurological disorders, and brain and spinal cord injuries.

There Briar would focus on learning to walk again. Marisa Leykam, the UCHealth Broomfield Hospital senior physical therapist who would work with Briar most closely, had seen transverse myelitis cases before, but none so young. During 90-minute sessions five days a week, Leykam and physical-therapist colleagues focused on building Briar’s strength and improving her balance. This was a continual process of evaluating Briar’s movements, focusing on exercises to challenge deficiencies, and repeating as she gained strength and function.

The work included mat work; walking with the walker and, later, trekking poles; stair climbing; balance training on different surfaces and dynamic balance training involving throwing and kicking a ball; and much more. A planned summer trip to England and Ireland – one that would involve a lot of time on her feet – served as additional motivation. By the end of her first week, Briar managed to walk the 0.3 miles uphill to the nearest Starbucks with help from a walker. Leykam paced her from behind while pushing a wheelchair that stayed empty. The Starbucks was closer than the Delta Gamma house is to the Norlin Library on the CU Campus, but it felt like a whole lot farther. Starbucks then served as a venue for some impromptu occupational therapy, Leykam says.

“Once you’re at a Starbucks, not only do you get a treat, but it’s practice in opening doors, standing at a counter, and carrying a drink,” Leykam said.

More work to do

Meanwhile, UCHealth occupational therapist Sarah Bury and colleagues worked with Briar on practicing life skills from dressing, eating, bathing, and, in Briar’s case, baking brownies and cooking up quesadillas.

Two weeks after she rolled into UCHealth Broomfield Hospital, she walked out with aid from a walker. She had, in therapy, graduated to trekking poles, and was able to walk unaided with Leykam spotting her. She flew home to parents Beverly and Keith’s home in Alamo, California, where she did another month of twice-a-week outpatient rehabilitation. She continued to improve and did make it to England and Ireland. A three-mile walk along Ireland’s Moher Cliffs was a turning point.

“I didn’t know how long it was when we started it. But at the end of it, I checked my Apple Watch,” Briar said. “After that, I was like, ‘OK, I think I’m strong enough to do almost anything now.’”

But a full recovery would indeed take months. The last holdout was her bladder. It wouldn’t completely cooperate until she was back at CU Boulder the following fall semester, at which point she could ditch the catheter. She took two of the final exams she missed that fall, too. (She had been doing well enough in her other three classes that her professors excused her from the tests.)

Two years hence, Briar was preparing for her last round of finals before graduating. The psychology major with minors in business and sociology will walk across the stage at the CU Events Center during the Psychology & Neuroscience ceremony on May 10. She’ll soon leave Boulder behind as she seeks a job in medical or pharmaceutical sales in California’s Bay Area. She hasn’t forgotten the health care providers who helped her get back on her feet.

“At Boulder Community Hospital, they were awesome,” she said. “At UCHealth, they were amazing. I mean, I felt like I was friends with everyone, which was super fun.”