Rehabilitation After Immunotherapy Cancer Treatment: Ed's Journey from Not Walking to Rock Climbing

Ed Watkins received a life-changing medical diagnosis in May of 2022: stage IV bladder cancer.

“After going through the testing and diagnosis process, my prognosis was not good,” Ed said.

His oncologist recommended immunotherapy, a relatively new treatment option designed to stimulate the patient’s own immune system to fight cancer. While Ed responded well to the cancer treatments, some of the side effects he experienced were numbness, tingling, swelling and muscle weakness in the lower parts of his body.

“As the treatments went on, I lost strength in my legs,” said Ed. “I couldn’t walk or balance.”

In June 2023, Ed began having routine appointments at TIRR Memorial Hermann’s Outpatient Medical Clinic with Carolina Gutierrez, MD, associate professor at UTHealth Houston’s Department of Physical Medicine and Rehabilitation and affiliated physician with TIRR Memorial Hermann.

“When Ed came to us in the clinic, he could not walk,” said Dr. Gutierrez. “Unfortunately, he was experiencing a side effect from his cancer treatment. His weakness was secondary to Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIPD), a rare type of autoimmune disorder.”

With CIPD, the body attacks its own myelin sheaths, which are the fatty coverings on the fibers that insulate and protect the nerves. This was the case with Ed, and because of it he needed assistance with his daily activities such as showering, but he wanted to regain his independence.

In addition to his routine visits with her, Dr. Gutierrez recommended Ed begin working with physical therapy at TIRR Memorial Hermann Outpatient Rehabilitation – Kirby Glen Center twice weekly.

“At the time of his initial evaluation, Ed came to therapy in a wheelchair,” said his physical therapist, Margaret Wagner, PT, DPT. “He was unable to stand without at least one hand on a walker, and even with a hand on the walker, he was still limited in the amount of time he was able to stand.”

Despite his leg weakness and ongoing cancer treatments, Ed maintained his positive attitude. He continued doing activities he enjoyed, like attending concerts and Houston Astros games. “I would use a wheelchair and sit in accessible seating,” said Ed.

“Within the first month of participating in physical therapy regularly, Ed increased his distance in the walking tests, and he started standing for over two minutes without leaning on his walker,” said Margaret. “We got him custom orthotics for both feet and his gait continued to improve. He was discharged in October 2023 because he had met all his goals. He was still wearing the braces, but with them he was walking at a speed and distance that is within age and gender norms. His mobility was fantastic.”

At that point, Ed had regained enough motion in his legs to also begin driving again. He had his last cancer treatment in October 2023 and shortly after was in remission. “By February 2024 I was able to walk easily without the leg braces,” said Ed. “However, I had some swelling in my left leg due to lymphedema. So, I went to TIRR Memorial Hermann Outpatient Rehabilitation – West University for lymphedema treatment.”

“Ed went through several weeks of intensive lymphedema therapy consisting of manual lymph drainage and having his left leg wrapped in multiple layers of foam padding and compression bandages to help move the excess fluid out of the leg,” said his occupational therapist, Lisa McAllen, MOT, OTR, CLT-LANA. “The bandages were removed only to bathe. Even with the inconvenience of having his leg wrapped at all times, similar to a cast, Ed kept a smile and cheerful attitude. He was also prescribed a compression device to use daily for one hour on his leg to keep the lymphatic fluid from building up. Once the intensive phase of therapy was complete, Ed was fitted for a custom compression garment to be worn instead of the bandages, to maintain the progress made in therapy. Ed's success with this therapy was due to his dedication and commitment to his health and progress, and his positive outlook on all he has overcome. He is an inspiration!”

In October 2024, about a year after being discharged from physical therapy, Ed had the opportunity to visit with Margaret back at TIRR Memorial Hermann Outpatient Rehabilitation – Kirby Glen Center.

“He showed me photos of himself rock climbing,” said Margaret. “I'm not even a little surprised. He continued to challenge himself and work hard even after being discharged from physical therapy, and he just continued to make astronomical improvements. His dedication and motivation was the entire reason he returned to doing all sorts of incredible outdoor physical activities. We helped facilitate his improvement and guided him, but he is the reason he has accomplished so much.”

“This was a case of an entire multidisciplinary team coming together,” said Dr. Gutierrez. “He went from not walking at all, to hiking and rock climbing! Ed didn’t dwell on the side effects of his cancer treatment and had an excellent recovery.”

“TIRR Memorial Hermann is part of my family now, they got me back to the activities I love,” said Ed. “I had a huge support group of friends and family praying for me on and always had someone to drive or attend my chemo and TIRR Memorial Hermann appointments. As of late, I’ve been mountain biking again had a great ride this Summer 2025 in Aspen!”