Collaborative
TEARS OF STRENGTH
Ryan Clark & Allison Perry, CHS Contributors
CHS volunteer learning to walk again with professor’s help, exoskeleton therapy.
“Deep breaths, April. Deep breaths.”
April Ballentine nods, steeling herself. As she sits inside the lab of the University of Kentucky’s Sports Medicine Research Institute (SMRI), her anticipation stirs up an incredible amount of pure nervousness.
This is one of the most important days, a day the Lexington native has been waiting for, working for — for weeks, months, even years.
A crowd has gathered to witness this moment, including April’s friends and family, UK faculty, and physical therapy students from the UK College of Health Sciences.
With great trepidation, she shifts her body into position, channeling her mindfulness to conquer this new task. Then, she is asked the million-dollar question.
“You ready?”
April looks up at the physical therapist in front of her, unflinching. “Yes.”
Today, the 51-year-old will stand and walk for the first time in more than eight years.
‘I’ve got to get up’
In August 2013, April was out with friends at a happy hour when an ex-boyfriend showed up, gun in hand. As he raised it toward her face, she blocked his first shot. But in the chaos, she blacked out and fell to the ground. He then unloaded the chamber on her in front of more than 50 witnesses.
At some point, April woke up, covered in a white sheet. Her ears were ringing, and all she could utter was one phrase, over and over. “I’ve got to get up.”
She then heard a voice gently reply, telling her to lie still, followed by sirens. She couldn’t breathe. Then, everything went black again.
When April woke up for the second time, she was at the University of Kentucky Albert B. Chandler Hospital.
She had survived five gunshots at close range. A trauma team, led by Trauma Medical Director Andrew Bernard, M.D., had stopped the bleeding — ultimately saving her life.
Because she was hooked up to a respirator, April’s medical team gave her a dry erase board to communicate.
“I wrote my daughter’s name with a question mark, and they said she was fine,” April said. “Then they asked me if there was anything they could get for me. And I said I was hungry as hell.”
That fighting spirit kept April going during her stint in the ICU — a time she calls “one of the greatest challenges I’ve had to go through in my life.” After several weeks of intensive care, she was discharged to Cardinal Hill Rehabilitation Hospital.
“That’s when I learned I was paralyzed,” April said. “I had never heard that word before — or if I did, it just never registered because I was so highly medicated.”
April spent 90 days at the facility. She’d heard of companies that made robotic exoskeletons, which allowed users to stand up and walk again with bracing and support from the upper body. Occasionally during her therapy, April would try to stand, holding herself with her arms.
It was far harder than she had expected.
“It was so difficult,” she said. “I recall trying to push myself up, and it almost seemed impossible. That dream was shot really easily.”
Standing Tall
April’s arm muscles bulged and strained.
Her teeth clenched. And, with the help of the exoskeleton, she struggled to stand on shaky, unfeeling legs. Slowly, and with a seemingly superhuman effort, she pulled and pushed and willed herself out of her sitting position.
The crowd that had gathered around her exploded into cheers. They clapped their hands, and some wiped away tears. Few were prepared as to how emotional the presentation would be.
“I’m standing today,” she declared. And before the day was through, April Ballentine would do a lot more than that.
‘Live in the moment’
More than 50 family, friends and students gathered at UK’s Sports Medicine Research Institute last spring to encourage April as she used a special rehabilitation exoskeleton to help her stand and walk.
Dozens of other students, faculty and staff watched as the courageous effort was shared via a livestream.
It wasn’t the first time April had presented to a crowd.
In October 2015, she was speaking about her experience at a church to raise awareness for Domestic Violence Awareness Month. Fayette County Sheriff Kathy Witt heard her story and approached April with a proposition.
“She said, ‘I want you on my team,’” April said. “She’s been a great advocate for domestic violence awareness for a very long time.”
April began working with the Sheriff’s office, first as a volunteer, then as an employee. She now serves as a victim advocate intake specialist in Amanda’s Center, a 24-hour point of contact for victims of domestic violence located in the Fayette County District Courthouse. In this role, she helps ensure victims have access to the resources and help they need.
April describes her current work as “a calling” that has helped her heal, process and understand her own trauma.
“I understand what it’s like to be a victim, and I understand what it’s like to be afraid and to not be afraid,” she said. “And I believe that I’m a good resource to help someone escape, or to help them understand the extreme behavioral issues they’re experiencing.”
April also began volunteering at Cardinal Hill, playing a mock “patient” for physical therapy students to learn how to work with people who have spinal cord injuries.
Denise O’Dell, PT, DSCPT, associate professor in Physical Therapy, met April when she was volunteering for the students.
“It's very challenging to role-play and teach the students how to help someone who had a spinal cord injury or a brain injury,” O’Dell said. “April has volunteered a large number of years for my colleague, coming into the lab and the students perform a Physical Therapy evaluation.”
“And I make it fun, too,” April said. “So, I think the personality fits because I break the ice, and make them laugh, and say the unexpected. But that's basically how it started. And I’ll continue to do so as long as she has me.”
April and O’Dell, who was just hired in 2021, have only worked together with the students one time. But O’Dell was impressed. She saw a spark in the survivor.
“What do you want to do?” she asked April. “Have you had goals?”
“I have a goal to walk,” she replied. “I’ve been in talks with ReWalk, but no one here in the community does it.”
O’Dell could see how important standing and walking was for her — even though it would be different than before.
“I’ve taught for, or I’ve assisted as a faculty member, for almost 20 years in different part-time and full-time roles,” O’Dell said. “I have had a lot of these opportunities with community patient volunteers and that one was different. Her drive and success to date is what made me share my contact information with her. Which is not, again, what usually happens.”
‘That spark’
So, O’Dell got involved. And together, they brought ReWalk — a company that produces wearable, robotic exoskeletons to enable individuals with spinal cord injuries to stand upright and walk again — to the University of Kentucky.
“I could see the drive that she has to, one, give back to society, to better herself, to stay engaged,” O’Dell said. “So, we talked about how great it would be if we could partner together more in certain situations. And she was telling me, ‘I’ve worked out. I go three times a week. I work with the trainer. I moved on to be able to live by myself, which I hadn't been able to do.’
“So, she had taken all of these steps, and all of this work,” O’Dell continued. “And so, I just saw that spark in her that, ‘I still want more.’”
But you also have to keep perspective, April said.
“As a paraplegic, you want to walk,” she said. “That's your goal. And so, every day that was what I was pushing for, but I had to learn that I had to live for today and not tomorrow. Because if I lived for walking, then I couldn’t live in the moment.”
‘So much positive energy’
So, on the day that so many people watched her in SMRI, April used the time to not only stand upright — she used the exoskeleton to walk two laps around the perimeter of the room.
Her daughter was there, along with her mother. Her trauma surgeon. Her trainer. All cheered her on, amazed at what they saw.
And then there were the students. O’Dell hoped her students would relish the opportunity to see something so special.
“I hope, one, that they always ask, ‘Why not?’” she said. “Even in today’s health care environment that’s really challenging and demanding, and has a lot of burnout, that there are these one-off cases, or these opportunities that they can do more. They get an opportunity just see what’s out there, and how much it can help our patients.
“A lot of times, early in their career, it’s like, ‘We want this person to get everything back they had.’ In neurologic rehab, that’s not always the case. But there are a lot of ways to get that quality of life that are different than the everyday classroom experience.”
Hannah Young, a Physical Therapist student in the Class of 2024, said the experience reaffirmed why she chose the major.
“This truly will be an unforgettable moment, and I did get teary-eyed seeing the reactions of her support system — especially when her daughter hugged her while she was standing. That was something I'm guessing they never thought would happen again, but it did,” Hannah said.
The student said she now wants to explore the neuro specialty of physical therapy.
“I was impressed by this experience, and I can confidently tell you that I saw what is possible — and it makes me fall in love with physical therapy even more,” she said.
O’Dell said that after watching April, the entire trial day went beyond her expectations.
“There was so much positive energy for April to succeed,” she said. “By having such a team approach and inviting varied groups of people to the experience in person and virtually, so many more people have an awareness of the power of access to upright mobility options for individuals following spinal cord injury. I’m hopeful this leads to more opportunities in Kentucky.”
‘Prove you wrong’
For patients with a spinal cord injury, a ReWalk exoskeleton isn’t just about the chance to walk again. The mobility it offers comes with a number of health benefits that can improve the patient’s overall quality of life — better circulation, muscle spasticity, bowel and bladder function, and even nerve pain.
“The opportunity to stand and walk is multifaceted,” O’Dell said. “Physiologically, being upright, your gastrointestinal system works better. Your heart, your lungs work better. An individual such as April will rate their quality of life higher from a participation and health standpoint.”
But April still has more work ahead of her.
Although insurance will cover the cost of training with the device, it does not cover the cost of the device itself for non-veterans. ReWalk continues to pursue insurance coverage opportunities, but for now, April will need to cover the cost of her own exoskeleton.
To help fundraise for the device, April is working through a nonprofit organization called Help Hope Live, which set up a donation page for her (https://helphopelive.org/campaign/20338/). Once she has her down payment, she can begin working with ReWalk-trained physical therapists to become proficient with the exoskeleton, a process that usually takes 20-30 sessions.
She isn’t deterred by the cost. Where there’s a will, there’s a way, and April Ballentine always finds a way.
“Throughout the last nine years, there have been people saying, ‘You can’t do this, you can’t do that’ – whatever,” April said. “I’m going to prove you wrong every time.”
‘Tears of strength’
At the end of the grueling two-hour workout in front of family, friends, ReWalk representatives and students, she took drinks of water and tried to stop her hands and arms from shaking.
With effort, she used a finger to wipe away a tear.
“These are tears of pain,” she said, taking a deep breath. “But these are also tears of strength and tears of joy.
“It was all of that together.”
And it led to another goal. In November, April’s daughter was to be married. April said she wanted to be there — and she wanted to stand up at the wedding.
As always, April found a way.
‘An amazing event’
After raising enough money to put a down payment on her own exoskeleton, and after practicing for months and months, November 12 — the day of her daughter’s wedding — arrived.
April was wracked with nerves.
Could she do it? Would she fall?
On top of that, her normal trainer could not be with her that day.
Enter, once again, Denise O’Dell, who stood in to help on that important day.
“I was nervous for her,” O’Dell said. “I just wanted to make sure I could be there for her for everything she needed.”
Both arrived at the venue in their formal gowns, which only increased the nervousness.
“We’d started therapy back in August and I believe we got up to maybe 22 sessions before the goal date,” April said. “I will tell you, maybe a month or so before the actual date — I never told Denise this — but it was so hard, I was rethinking what I was doing. And I almost told myself, ‘I don’t know if I can do this.’ It is very challenging. It’s the hardest thing I’ve ever had to do. This challenge was harder than being shot.”
But she finds a way — and once again, she rose to the occasion. They practiced in the Marriott hotel, and the day of the event, she looked O’Dell in the eye.
“I got this,” she said.
And she did. When it came time for her to stand, she stood in front of the crowd of 150 people. Witnesses say it was difficult to find a dry eye in the house.
“There’s just this drive when you’re working with April and you know it will happen,” O’Dell said. “It was an amazing event.”
“You have to block them out and stay focused,” April said. “I had to not allow myself to be emotional at my daughter’s wedding. It was a lot — there was so much excitement around, but it was different. It was more personal, because of the people there. I didn’t have my own space and it was just — I think about it now and it takes my breath away.”
Then again, no one should bet against her.
“I don’t really think about it, I just do it,” April said. “So, when I reflect back on what has occurred, I — I realize what I’ve truly done.”
Even now, she’s not finished. She says that in 2023, she will continue her volunteer work, as well as her job advocating for domestic violence awareness. She wants to write a book and continue to improve with the exoskeleton.
But she also needs to keep fundraising, to share her story and to help others.
“It increased everybody’s faith and everybody’s belief,” she said. “It motivated so many people, no matter what their challenges are. If you fall, you get back up and you keep going. That’s the message.
“You just keep going.”
LINKS
To learn more about April Ballentine’s story, visit her Facebook (https://www.facebook.com/april.ballentine.75) and Instagram (https://www.instagram.com/ayb724/).
To learn more about Amanda’s Center, visit: https://www.fayettesheriff.com/?page_id=12
