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From struggle to celebration: Beacon helps a mother triumph over spasticity to dance at son’s wedding

Jill Kovatch

Just about any mother would dream of dancing with her son on his wedding day. But for years, Jill Kovatch had difficulty with her balance and energy while walking, let alone dancing.

So while she was incredibly excited about her eldest son’s upcoming wedding, she expected that her health issues would mean carefully choosing how to participate in his big day.

Truth be told, Jill has been through a lot. Thirteen years ago, a scan taken to determine whether she had suffered a stroke revealed a benign (non-cancerous) brain tumor. Her neurosurgeon kept an eye on it for several years. But when the tumor began to grow and bleed, surgery was necessary.

The surgery was successful, but it resulted in two other health conditions that would significantly affect Jill’s life: spasticity and, to a lesser degree, epilepsy. With spasticity, certain muscles all contract at the same time, affecting a person’s strength, balance and ability to move smoothly. Spasticity can also cause pain and disrupt sleep.

For Jill, spasticity meant having to walk with a brace. She often used a cane as well, especially for longer distances. Pushing too hard meant more pain and an increased risk of epileptic seizures. This had become her “new normal.”

Dr. Christopher Ketcham

Looking for answers

“I lived with this for years, until about a year ago,” Jill said. “Finally, I thought, ‘There’s got to be something that can be done.’” And she found options—but given her other medical conditions, they would have meant trading one problem for another.

Jill kept looking for answers.

“I wanted to feel better. I wanted to get some relief from the challenges of walking, the pain, the tightness in my leg muscles,” she said.

She learned that for some people, Botox shots could relieve tension from spasticity. “I didn’t know if it was even an option for me. So, I did some research to find the best physiatrist in the area, and Dr. Ketcham’s name came up.”

Jill had her first appointment with Dr. Christopher Ketcham, physiatrist and medical director of Inpatient Rehabilitation, Beacon Bone and Joint Specialists, within just a couple weeks of calling his office.

While there are a handful of treatment options for the management of spasticity, Neurotoxin injections — including Botox — have become the standard of care regarding the treatment of focal spasticity, Dr. Ketcham said.

“In Jill’s case, I am able to put the medication exactly in the muscle that is causing the issues with Jill’s inability to walk and dance freely, as opposed to other treatment options that require a pill to be taken multiple times per day that ultimately has effects on the entire body and mind,” he said.

At the University of Notre Dame Basilica.

Signs of promise

At her first appointment, Dr. Ketcham told Jill she would be a good candidate for a medication that worked similarly to Botox. So at her next visit, Jill received two injections. These first two would help Dr. Ketcham determine the best injection sites for her first full set of three shots.

But even the initial two injections had a promising effect. For the first time in years, Jill felt relief from her discomfort and experienced a new sense of possibility. She told the doctor that her son Evan would be getting married on Sept. 9 so they could plan ahead for it. This treatment could make a really big difference in her ability to fully enjoy the festivities.

“I was worried about being able to get through that day. It was a big wedding with different events over the course of five days. I wanted to focus on the rehearsal dinner and the wedding itself,” Jill said.

The ceremony would take place at the University of Notre Dame’s Basilica, which is known for having a very long aisle. She didn’t want to have to use her cane to walk through the Basilica on her son’s wedding day. And she wanted to enjoy that special mother-son dance at the reception.

With that in mind, “We wanted to time my shots so the effectiveness would peak as close to Sept. 9 as possible,” she said. The injections take about six weeks to reach peak effectiveness. But Jill didn’t have to wait that long to see results.

“Within two minutes, I could feel the difference. As soon as I stood up, I could suddenly feel the entire bottom of my foot,” she said.

Spasticity had been causing her to put her weight on one side of her foot. This was the first time in nine long years that she had felt all of her foot pressing on the floor.

“Many times we need to tailor the dose over a few rounds of injections in order to find the best response, but Jill turned out to have a great response with the initial injection,” Dr. Ketcham said. “I have found it to be very much an art with regard to treating the appropriate muscles to best obtain the patient’s desired functional outcomes and finding the appropriate dose to ensure the patient doesn’t experience ill effect.”

Jill’s sleep improved, which also helped her epilepsy. She began to use her cane less as she felt more stable when walking. She felt less pain.

“As the weeks continued, I realized it was getting better and better,” she said.

Jill Kovatch dances with her son, Evan, at his wedding.

The wedding day

When her son’s big day arrived, Jill was ready. “I was able to walk down that massively long aisle without the use of my cane, as comfortable as possible as a person with spasticity,” she said.

Not only that, she was able to dance with her son. The mother-son dance song they chose was “Bridge Over Troubled Water,” which now holds new meaning for her. “I will never forget dancing to that song with Evan. The fact that I was able to dance with him made me feel as though I could actually be that bridge he may need in the future. Because of my spasticity, there have been times when I’ve not been so sure,” she said.

“I was dancing the entire time, from the moment of my first dance with my son until they played the last song,” Jill recalled fondly. In fact, she spent the entire evening cutting the rug with her husband, children and friends.

“I had been praying about being able to do that,” she said. “It was unreal. I only sat down a couple of times to grab a drink of water, and then I was right back up dancing.”

“When I walked down the aisle, I was too nervous to focus on the fact that I could walk down the aisle. It was when my son and I were dancing together that I realized that my life had changed.”

The night was emotional – not only for Jill, but also for her loved ones. Her friends and family know her story and the struggles she has had with walking. “Not only was I crying, everybody that was there was crying,” she said. “People were as shocked as I was that I was able to stay out and dance as long as I was.”

“My first thought was ‘Thank you, Lord, for prayers answered.’ And thank you, Dr. Ketcham, for giving me these shots and timing it so well,” she said. “He did everything within his power to make that night as special as possible. He’s an amazing doctor. He looks you in the eye, he really listens. He makes you feel like you’re the most important patient he has.”

And that’s because every patient is, in fact, the most important patient to Dr. Ketcham.

“It is patients just like Jill who bring me to work every day,” he said. “It is a great pleasure to be able to assist patients in obtaining their very best functional outcomes while working through any significant functional disabilities.”

Finding strength

Looking back, Jill contemplates the fact that it took nine years and her son’s wedding to finally spur her to seek help.

It took something as momentous as a wedding to push past the potential disappointment of a failed treatment and try again to find relief.

“You get to the point where you feel like maybe this is what God wants for me,” Jill said. But God works through doctors, he works through other people. He works through beautiful ways to help us with our suffering. I’m just so thankful that He inspired me to give it another try and find Dr. Ketcham.”

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