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Therapy horse provides comfort to Mary Bridge patient with rare disorder

Carmel rides a horse as a form of occupational therapy.

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By McKenna Hoecherl

Compassion always leads to miracles — that’s Sophie Hartman’s outlook on life.

In 2008, Hartman traveled from her hometown of Kalamazoo, Michigan, to visit the South African country of Zambia for the first time. She went back in 2009 for an extended internship and decided to move there indefinitely to make Zambia her new home.

Hartman spent the next five years working in crisis intervention and social work, most often with orphans and other vulnerable children. It was during that time that she made the decision to adopt her first daughter, Miah, and a few years later, Miah’s sister Carmel.

Hartman gained custody of Carmel when she was just 3 weeks old. At 4 months, she started to notice that Carmel wasn’t hitting the same milestones as other kids.

As time went on, the delays became more evident: she wasn’t cooing or crawling, she had abnormal muscle tone and she always had her fists closed. Hartman thought her daughter might be suffering from cerebral palsy (CP) or something else like it. She knew she would have to move her family back to the United States to get Carmel the level of care she needed.

Mary Bridge provides missing answers

After moving to Washington state in 2015, Hartman took Carmel to a hospital where she was initially diagnosed with epilepsy and CP. Her parental instincts told her that although those were accurate diagnoses, there was still something more severe going on. But doctors wouldn’t run additional tests without seeing the symptoms she was describing.

Carmel was having episodes that left her unable to move at all.

“It was frustrating more than anything for me because we’d go into the doctor’s office and she would seem okay, despite her obvious motor delays that were explained by CP,” Hartman explains. “And I’d say, ‘No, really, she was paralyzed this morning.’”

An especially severe episode required Carmel to be hospitalized when she was just 2 years old, which urged Hartman to seek a second opinion. That’s what led her to Mary Bridge Children’s Hospital.

“Immediately from the moment we got there, we got connected with a list of all the best doctors,” Hartman says.

Carmel saw Amy Yuen, MD, a genomics physician; Majeed Al-Mateen, MD, a pediatric neurology physician; and Michael Pickens, DO, a pediatric gastroenterology physician.

“They cared about her and they knew I wasn't just a parent exaggerating,” Hartman says. “They knew she was an anomaly — that there was something else going on and they valued figuring out what was actually happening.”

Just days after her third birthday, Carmel was officially diagnosed with alternating hemiplegia of childhood (AHC), a severe, life-threatening and progressive neurological disorder that causes episodes of paralysis. The attacks cause her to experience anything from mild weakness to complete paralysis on one or both sides of her body — sometimes just for a few minutes, and sometimes for hours or even days.

Carmel and Gigi: The perfect fit

There’s no known cure or treatment currently available for AHC, but one of the best ways to prevent an attack from happening is to keep Carmel’s stress levels low. Giving her things to look forward to and activities that build her self-confidence are key to her emotional well-being.

Carmel loves to be outside and loves animals, so Hartman researched different types of therapy for children that involved both.

That’s when she found Little Bit Therapeutic Riding Center in Redmond, which offers therapeutic horseback riding and occupational, physical and speech therapy services incorporating equine movement (also known as hippotherapy). It was a two-hour drive from their home in Lynden, but Hartman was willing to try it out if it meant giving Carmel something she could grow to love.

Carmel riding Gigi

The hippotherapy wasn’t covered by insurance, and paying out of pocket wasn’t an option. So Hartman turned to Carmel’s social worker at Mary Bridge, Valaree Schelhammer, for help.

Schelhammer contacted the Mary Bridge Children’s Foundation. Thanks to generous donor contributions, all 12 of Carmel’s initial hippotherapy sessions were covered from a special fund that pays for comfort therapy for Mary Bridge patients.

Today, Carmel visits Little Bit once a week for sessions with her therapy horse, Gigi. It’s an activity that helps fuel her confidence, while simultaneously providing an additional source of occupational therapy. She gets to ride Gigi around the ranch with her Little Bit helpers, learn how to brush her and give her treats (her favorite part).

“Carmel is the most Carmel when she’s on a horse,” Hartman likes to tell family and friends. “Gigi loves to be brushed, and Carmel is so engaged with the brushing part of it, which is all occupational therapy because she’s using her hands.”

Between sessions, Carmel counts down the days to her next visit with Gigi.

Carmel and Gigi

Carmel’s future

In March, Hartman will take Carmel to a dedicated AHC clinic that’s part of Duke University Hospital in North Carolina. She says the Mary Bridge team has been instrumental in helping her get the appropriate paperwork and forms needed to request insurance approval for the trip.

Before their trip across the country, though, Hartman and her girls are anxiously awaiting the exciting arrival of a new family member: Leya was recently adopted from Ghana and will be another big sister to Carmel.

Hartman’s dream is that one day, their growing family can live somewhere out on a farm so Carmel can have a few horses of her own to take care of.


“Carmel is the most Carmel when she’s on a horse.” — Sophie Hartman 


Although she doesn’t know what lies ahead for Carmel’s battle with AHC, her hope is that Carmel always knows she’s so much more than what she can and can’t do — that though her body and mind may be bound to illness, “her spirit can always soar.”

Learn more and support comfort therapies

You can support comfort therapies and care for kids like Carmel by making a contribution to Where the Need Is Greatest.

You can read more about Hartman's experience in Zambia and her journey to adopting Miah and Carmel in her book, “Crowns of Beauty: A Story of Brokenness, Courage and Beauty Rising from Ashes.”

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