Paralympian's recovery: Legs regained, dreams lost

By RAF CASERT

Associated Press

AMSTELVEEN, Netherlands - Monique van der Vorst's competitive spirit thrived even after she lost the use of her legs as a teenager. She won two silver medals at the Beijing Paralympics and hoped to win gold in London in 2012.

Those dreams are gone now, because another was fulfilled: She began regaining feeling in her legs over the summer, and now she can walk again.

Van der Vorst savors every step through the snow. Every climb up the stairs. The ability to look somebody in the eye standing up.

The Dutch 26-year-old says she doesn't need Christmas this year: "Every day was special."

But her gift also means that more than a decade after reinventing her life, she has to reinvent it again. At the London Paralympic Games, she had hoped to win gold in both handcycling and wheelchair racing. Now that she can walk, she's ineligible.

Competing "was such a passion," she told The Associated Press from her apartment, filled with Paralympic medals and mementos, weight machines and her idle handbike and wheelchair. "It's difficult because I need to find a new purpose in life."

Those who knew her as a competitor understand her mixed feelings.

"It is not easy for her because she must say farewell to the Paralympics," said Andre Cats, head of the Dutch Paralympic Mission. "But in this we support her so she can make the transition."

Van der Vorst was a 13-year-old field hockey standout but kept on twisting her ankle. She says an operation to correct the problem went wrong and afterward, "my leg swelled up, went purple and cold, filled with liquid that stayed there." She said she couldn't move her leg, even after the liquid subsided.

She said doctors still aren't fully sure what caused the leg to go limp. The following year, she lost most movement in her right leg, too.

"It affected my muscles and nerves and everything in the leg. When I got it, people didn't really understand it."

"With my family we tried everything possible, but my leg was paralyzed. So at one point, there is no longer any use" to look for medical explanations. So she never got the exact medical details. She declined the AP's request to talk to her doctors from the late 1990s, citing privacy concerns.

The handcycle, a three-wheeler powered by the arms, helped her rediscover the joy of competition. Van der Vorst competed in her first handcycle race in 2000, at age 15.

"It gave me self-esteem. I learned how to think in possibilities, not limitations," she said.

She turned out to be so good, there almost were no limits. "I really missed running, but there were so many things that made up for that. I was independent. I could drive, I could fly. I had a good life," she said.

Paralympic and international sporting federations certified her paralysis and allowed her to compete in the HC C class for athletes with complete or partial lower limb function loss.

Boards of two or three people, including at least one person with a medical background, conduct such certifications, and athletes may be examined several times in the course of their careers, said Robert Balk, head of the Athletes' Council for the Paralympic Movement.

Van der Vorst can still feel the thrill of the 2008 Paralympic Games, when she missed gold in the 40-kilometer handcycling road race by just 0.13 seconds and won a second silver in the time trial.

She medaled in a neck brace. Months earlier while training on her handcycle in Florida, she was hit by a car and suffered spinal cord damage.

"I don't know how I did it, but I had focus and a goal," she said. "Willpower did it."

Van der Vorst thinks another accident in March played a role in her recovery.

On the Spanish resort island of Mallorca, a cyclist rammed into her from behind as she raced down a road on her handcycle. The impact sent her crashing to the ground. Her legs seized up with spasms.

Her first thought was about how the injury would affect her competition schedule. She resumed training but soon back pains were making her workouts agonizing. She was hospitalized, then went into a long rehab.

In June, she says, she started to feel a tingling sensation in her left foot. Her legs were still thin from years of inaction, but before long she could feel them both. At first she told only her doctor, not even her parents.

"There is no way you can realize this. To feel something in your legs, where you felt nothing before," she said.

Standing up was the next step. She used her powerful arms to hoist herself between tables and dangled her feet to the ground, gradually increasing the pressure, forcing herself to build strength and balance.

"Every time, I crashed to the ground and fortunately, I didn't feel any pain yet. I tried it hundreds of times," she said.

She progressed to walking, she says, a few steps at a time.

"Mentally, Monique went very deep," her rehabilitation coach Dr. Christof Smit told Dutch TV. He declined to be interviewed for this article.

The crash, he said, "apparently lifted this blockage and recovery started. I find it medically difficult to explain."

None of several specialists contacted by The Associated Press could comment on whether a trauma like the one Van der Vorst experienced could play a role in reversing paralysis. They said it's extremely rare, but not unheard of, for paralysis victims to regain use of their legs under any circumstances.

"About half of all people with spinal cord injuries have varying amounts of sensation after a period, but it is unusual to be able to walk again," Dr. John Ridwell, who specializes in spinal cord injuries at the University of Glasgow but has not treated Van der Vorst.

He said an athlete like Van Der Vorst would have a better chance at recovery.

"With a strong cardiovascular system and minimal muscle wasting, a determined, strong person could use whatever remains to strengthen their nervous system and possibly become functional again," he said.

Van der Vorst does her rehab at Amsterdam's Olympic Stadium, but she misses the intensity and camaraderie of competition.

In her apartment, she proudly points to pictures of the 2009 Ironman triathlon in Hawaii, where she was the top handcycle athlete.

There is no running for her yet, but already her mind is racing forward.

"It would be a dream of me to do the Ironman as an abled athlete," she said.

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Associated Press Medical Writer Maria Cheng contributed to this report.

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