The first thing you notice about Carolyn Cesar is her 200-watt smile.
But don’t let that friendly façade fool you—there’s a fighter behind those pearly whites.
She recently rejoined the workforce at Spectrum Health United Hospital and Spectrum Health Kelsey Hospital as a respiratory therapist after two long years of rehabilitation following an automobile crash.
Cesar believes the green light to return to work this spring was divine timing.
“It felt like God had a plan for me,” she said. “His plan was to get me better in time for COVID-19.”
She injured her right arm and hand in a crash on Feb. 16, 2018. The car she was in slammed into the rear of a vehicle that had stopped to turn into a driveway.
Cesar glanced up just before impact.
“My first thought was, ‘I need to go to work tomorrow, this can’t be happening right now,’” she said.
From caregiver to patient
An ambulance took her to an Ionia hospital emergency department, where doctors treated a hairline fracture in her arm.
But her injuries ended up being much more complex, testing her resolve, patience and faith to continue in the job she loves.
She suffered swelling in her right hand, likely injured when the vehicle’s airbag deployed.
Weeks passed and Cesar’s hand still wouldn’t improve.
Dr. Thiel ordered more X-rays, which showed no other breaks in the hand.
He then diagnosed reflex sympathetic dystrophy. He scheduled occupational therapy to help desensitize Cesar’s hand to stimuli.
A common symptom of reflex sympathetic dystrophy is increased sensitivity to touch. Cesar would start to have tremors if anyone or anything came close to her hand.
“If the wind blew on my skin I would tremor,” she said.
Doctors referred her to Spectrum Health neurologist R. Ross Coleman, MD, who diagnosed her with a functional movement disorder.
With a functional movement disorder, brain cells miscommunicate with each other, which causes abnormal movements.
It is often associated with an emotional, traumatic event.
“For Carolyn, we identified her automobile accident as an emotional traumatic event that might have an association with her symptoms,” Dr. Coleman said.
Functional movement disorder, which includes functional tremors, is often misunderstood by the medical community and general public, he said.
“People experience a functional tremor as involuntary and disabling just like a patient with Parkinson’s disease does, but the cause and the treatment differ,” Dr. Coleman said.
Fight mixed with faith
Still unable to return to work, Cesar began to feel discouraged.
“I was under a lot of stress,” she said. “I wasn’t able to go to work and that meant a lot to me.”
She pushed on, challenging herself, working around the house on everyday tasks like dishes and mowing the lawn.
“I knew the hand was going to swell, but it was something I had to push through,” she said. “Because I had to challenge myself.”
Cesar kept the faith.
She felt buoyed by positive support from her medical providers, family and colleagues.
“I have faith in God and I couldn’t imagine he would put me on that cliff and push me over,” she said.
Suspecting Cesar could be dealing with post-traumatic stress from the crash, doctors suggested she try eye movement desensitization and reprocessing, a psychotherapy treatment.
She began weekly sessions where she would follow a light bar with her eyes and try to recall being at the accident—without the memories evoking a physical response.
But the tremors persisted.
In January 2019, she failed a functional capacity test. She couldn’t perform certain body movements without tremors.
Dr. Coleman asked Cesar if she would be willing to visit Lansing for a week to enroll in an intense, week-long program to address functional movement disorder.
The program: The Recovery Project.
Cesar would try anything. She wanted her life back.
The new program combined physical therapy, occupational therapy and meditation.
She learned to perform exercises that retrained her muscles while visualizing the activity without experiencing tremors.
“Treatment involves cognitive behavioral therapy focused on their history of emotional traumatic life events and/or physical and occupational therapy,” Dr. Coleman explained. “The good news is that functional movement disorders are treatable.”
It became the breakthrough Cesar had been hoping for.
“There was quite a bit of improvement by Wednesday, of having fewer tremors, and certainly by Friday,” she said. “I still had them, but they were significantly improved.”
She got home with directions to continue the new movements and exercises.
She would move a weighted ball around her body, walk, stretch and strain muscles by pulling heavy bands, continually increasing the threshold of activity before a tremor would occur.
“It really worked,” she said. “It gave me hope. It was like ‘OK God, I see the rainbow.'”
She resolved to keep fighting.
To push her body and mind.
To reclaim her health.
She became driven to care for patients again. She would see former patients around her hometown in Lakeview. That made her fight even harder.
“That gave me the courage and fight I needed to push through to get back to what I do, to what is my passion and what I believe God put me here to do,” she said through tears. “It’s a job and you’re saving lives, but I like being able to connect with people.”
She never gave up hope.
“I live by faith and not by fear, but it was very hard to do sometimes,” she said.
Called to care
Cesar missed working with patients and making a difference in their lives.
“It hit me really hard psychologically, because respiratory therapy and taking care of people is my passion—it’s like oxygen almost,” she said. “I didn’t want to lose the ability to help others.”
Her dream of returning to the job she loves came true in February, about two years from the date of the crash.
She practically skipped into work.
“I was so excited,” Cesar beamed. “It’s actually kind of overwhelming at times, my very happy emotions.”
When she returned to work, the 48-year-old Battle Creek native had to go through orientation again.
Her colleagues had fun calling her rookie, even though she’s a 10-year veteran.
Six months after re-entering the work force, she said the accident and her fight to come back has made her a better respiratory therapist.
“I’ve always been compassionate, but it’s a whole different level of compassion now,” she said.
She still exercises daily.
She hopes by sharing her story, she may inspire others with a similar diagnosis to keep fighting.
“If I can help someone, if can give them hope, that’s important,” she said.
“It took me two years, but it can happen.”