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PARK CITY - Belly down on her parents' living room floor, Dena Brehm Gennerman cries as she props herself up on her elbows.

The 39-year-old, who suffered a traumatic brain injury two years ago, could be in pain, though it's hard for parents Bob and Eva Brehm to say. Except for a couple of simple hand signs - fist up or down for "yes" or "no" - what Dena thinks or feels is largely a mystery to her family.

Pained by his daughter's sobs as she endures her morning physical therapy with certified nursing assistant Chris Mrdutt, Bob Brehm sometimes has to leave the room.

While it is difficult for the Brehms to watch Dena struggle with even the simplest of tasks, they believe they are seeing tiny improvements since her recent visit to Shenyang, China, and the 463rd Hospital of the Chinese People's Liberation Army.

There, doctors placed six injections of adult stem cells - gathered from umbilical cords - into the spine of the former pilot.

Adult stem cells - which can be gleaned from bone marrow, umbilical cord blood, aborted fetuses and tissues throughout the body - have some ability to transform, possibly replacing damaged cells, studies suggest. Some researchers believe the cells also play a support role, excreting chemicals near injuries and assisting in repair.

Except for bone marrow transplants, the federal Food and Drug Administration has not approved them for widespread therapeutic use.

But, Bob Brehm said, "we're open to trying just about anything that will benefit her."

Prepare for the worst:

Dena was a passenger on an Egyptian bus traveling back from Mount Sinai in 2005 when the bus rolled and her head was slammed against a rock.

After an operation, Dena, comatose and on ventilators, was airlifted from Egypt to University Hospital in Salt Lake City. Her prognosis was bleak.

"She'll never be the same," doctors said, according to Bob Brehm. "Prepare yourself for the worst."

Once a United Express pilot based out of Washington, D.C., Dena spends the bulk of her days stretched out on a reclining chair or outside in her wheelchair soaking up the sun.

Paralyzed on her right side, Dena needs help bathing, dressing, eating and walking.

Dena's husband and 3-year-old son - who was just 8 months old when the accident occurred - visit several times a week.

It wasn't the retirement the Brehms' had planned. But they couldn't fathom putting their beloved daughter, an avid hiker, biker and skier, in a nursing home. They began looking for a treatment that might help restore at least some of Dena's motor and thinking skills.

A conversation with a Salt Lake City doctor who treats brain injury patients with hyperbaric oxygen therapy further fueled the Brehms' interest in stem cell therapy.

Bob Brehm called Tim Schmanski in Orem, whose 16-year-old daughter, Tori, received adult stem cells at a clinic in Hangzhou earlier this year. Like Dena, Tori suffered a traumatic brain injury in a car accident that left her unable to walk or talk.

Tori's last injection was Feb. 12. While her family believes it will take up to eight months for the therapy to work, they say her swallowing, eating and chewing already have improved.

Taking a chance:

The Brehms, who were already leaning toward taking Dena to China, decided to give the experimental therapy a try. Dena's U.S. doctors had mixed reactions; one expressed concern about the cleanliness of the clinic and the purity of the stem cells.

But "for the most part, they were encouraging," Bob Brehm said. One neurosurgeon said "we definitely need people like you to try these things," Eva Brehm added. "It's the future."

The Brehms traveled to Shenyang in May and stayed for nearly two months, while Dena received a bone marrow transplant and daily sessions of acupuncture and physical therapy along with the injections of stem cells.

Provided by Beike, a Chinese biotechnology company formed in 2005, the stem cells came in batches of 10 million, packaged in tiny plastic vials, Bob Brehm said. Dena received the injections in her spinal cord in a living room-like setting.

"That was kind of scary," Eva Brehm said.

Each therapy lasted about 20 minutes and required that Dena lie still for hours afterwards to avoid getting a headache, a common side effect reported by patients, her parents said. Following the injections, Dena was given growth hormones to stimulate the cells.

The Brehms said what they saw at the hospital was encouraging. One woman arrived a quadriplegic. After several months of stem cell therapy, she left a paraplegic.

While the Brehms were told it typically takes four to six months to see any results, they've already noticed some improvements, albeit small ones.

At times, Dena is more mentally alert and able to follow movements with her eyes. She can draw lines and circles and is better able to tolerate the time she spends in her stander.

"Some days she's right there with you," Mrdutt said.

Though the stem cell treatments and bone marrow transplant cost about $28,000 - paid for with money raised for the family - Bob Brehm said it's likely he and his wife will take Dena back for additional therapy.

"I think she'll show enough improvements that we'll be encouraged to do it," he said. "I think this is the future for any kind of improvement she's going to be able to have."