Question
A child in my extended family was in a car accident 3 weeks ago.  His mom was killed and he suffered 2 broken femurs, broken neck with "severe bruising" at C6/C7.  He has had surgery to put a plate in his neck, pins in his legs and his most recent surgery on Monday was to put a trach in .  When they have tried to wean him off the ventilator, he gasps for air, but nowhere near enough.  Recently, when they tried to restart an IV, he jerked his hand that they were sticking.  He wakes up and smiles, cries, etc.  Its just devastating.  Anyway, all my info comes from his grandma who is staying with him.  She said they said "he wont breathe on his own b/c his injury is too high."  Is this true?  I thought with an injury at C6/C7, he should be able to breathe.  Can he get better?  I thought since it was "bruised," there could be hope for some recovery.  I know enough to know that there is no set timeline, but I'de appreciate any information about this.

Answer
Hi Paula-
I'm very sorry to hear your story- a long journey has just started out for the poor kid, and the rest of you as well.

Basics of SCI: it doesn't matter if the cord is severed or "just bruised"...the resulting injury can be exactly the same, can result in the same paralysis. It's just how our nervous system works (in the brain and spine, anyway- peripheral nervous system can heal itself). At a c6-7 level he should ultimately be able to breathe without a ventilator, yes (this is very good- so many problems related to being on a constant vent). It's not unusual to get a trach- especially if his lungs were damaged in the wreck. For example, my seatbelt broke my ribs which in turn punctured my lungs. They tried to take me off of the vent (tubes down the throat) but I couldn't breathe and my lungs would collapse. They eventually did the trach and used chest tubes to keep my lungs clear until they could heal. I feel fairly certain that his situation could be very similar. If you want to know for sure, ask about additional trauma to his lungs...

Other than aspects like this one, he will most likely not get better (by which I mean he will probably remain paralyzed below the armpits, where c6-7 connects). Any improvement that could come generally occurs in the first 6 months as swelling in the cord decreases- but it is most often a matter of gaining functionality a couple of vertebrae lower than the original level. I am sorry to have to say all this- it is a hard time ahead of him.

The good news is that he should have use of his hands- this makes living independently very possible, makes a world of difference! Adaptive equipment is getting better all the time and if he's half as stubborn as I turned out to be, he will adapt and have alot of the normal joys and experiences one expects in life. It is a hard start though- my heart goes out to him.

I wish you all good luck-
leslie