Question
QUESTION: My step-son -in law was in a one car accident last Monday. He was not wearing his seat belt and was thrown through the back windshield of his truck. The vehicle  rolled over several times and once over  him , too.  Thank God the car behind him was an ER Dr. and he tended to Chris right away.  He has a bruised( compressed)  spinal cord , but not severed . He had surgery that afternoon at one of the best hospitals in the country for neurology. He currently has crushed C 4-5   and 6 ( which they wired  and completed a bone graft on Monday) and L5 . He has some ability to move his upper arms , but cannot grip  with his hands. He has had sensations in his shoulders and back  and can move them minimally( like they have been "asleep") . His digestive system appears intact and functional.He has been having physical therapy  to facilitate  and hopefully  regain the mobility  below  the injury site .We are hopeful that he will , with time regain his mobility. Prognosis? .. he has no insurance , as he just started a new job and his he has a side business building pools. I presume he will not return to this occupation . What percentage of people with this type of injury regain most of their abilities? He also has over 100 staples in his head , but seems to be functioning well , despite the trauma to his head , too. Just a side -bar , my own daughter was wearing a seat belt and had a very similar accident in June and walked away with a headache and a scratch on her thigh. Please , everyone , wear your seat belts !! Our family proves both sides!

ANSWER: Hi Janet-
I am sorry to hear about your step-son, but very glad that he had some good luck too (the ER doc, etc)

Chris has a similar injury and sugery as myself- they put steel bars from c3 to t1 I think, grafted with bone. My injury though was c7.  This would mean I'd have shoulders but not much use of my hands...yet somehow I have complete hand control.  
Anytime I have heard of someone with an actual spinal cord injury (not just bone injury)- if they have recovered any function it is generally like I just described: they function a vertebrae or 2 below their injury.  I have never heard of anyone walking again, regaining bowel or bladder control, etc etc

I am sorry to deliver that fairly bad news. you ask what percentage of people with SCI regain most of their abilities- I'll say 1 percent because there could be cases I don't know of.  My neurosurgeon, when i asked if I would ever walk again, said he'd never seen anyone with my injury walk.  The sort of injury doesn't matter to the spinal cord, it can be severed or just bruised and you get the same result...the good news is that he will live in a very different world if he can get his hands back.  It can make the difference between living independently and having to rely on someone else. This degree of recovery might be possible.

I had staples too- all up the center of my stomach and all down the back of my neck- looked like I could unzip my skin and jump right out...

As far as recovery, to summarize: his injuries are likely permanent.  I do not mean to not be hopeful, just suggesting to try to see the positive things in his current situation (he is alive, has his brain and wits about him, etc etc) rather than focus too much on recovering function. It is a terrible let-down to expect to get better then have it not happen, and if it DOES happen it will be just as wonderful. Does that make sense?

Please write back if you like, and again excuse my bluntness- I wish you all the best of luck-
leslie

---------- FOLLOW-UP ----------

QUESTION: Leslie
Thank you so much for your quick response . Since we  received your e-mail( my husband was kinda distraught by the harsh reality. He feels that if you tell someone they will never walk again , that they give up hope) I am more of a worst case scenario person...assume the worst and be surprised and inspired by the  improvements. We have learned that Chris is compete at C-5 .  ( My husband , I think s still in denial , hoping that when they do surgery on Monday that  he will get hand movement ). Am I right in assuming that it is like a train track and when C-5 is complete  even if they release the pressure on c-6 the end of the line is C-5?
Wow , this is a lot for this young family . He is ( was ) their sole source of income   and yesterday they came and told Kendra she will be his sole caregiver in  about 6-8 weeks and she will be taught all his care and therapy needs . How old were you when you injury occurred? Chris is 29 and very strong, although he had stated he would never want to live in a state such as he is in now. What resources are available for counseling , financial guidance , respite , etc that you can guide us to ? Any sound, practical  advice ?I am the practical one , my husband sometimes handles crises with "when in danger or in doubt , run in circles, scream and shout"!!!. Another irony , Chris had an appointment  to sign up for disability insurance last Thursday and the guy canceled and re-scheduled for this week. His accident occurred  on Monday.
Thanks , in advance for your wisdom
J

Answer
Hi Janet-
Yeah, I knew my first answer would be a bit harsh, but so often doctors hedge their bets and don't want to say things straight out- I try to balance this out a little, because false hopes are to me worse than dealing with the truth from the beginning.

You are right about the train track idea- say you injure the cord at c5, t4, and L1- it's really only that c5 that counts. At that level he may not have use of his hands, which is pretty rough. There are quads who can drive, have kids, do all the big things in life, but it takes effort for sure.

I was 21, turned 22 in the hospital. I'm now 33- it feels like a thousand yrs have gone by... It will be hard for Chris- he sounds like a very physically active, capable guy and the adjustment to limitations is really miserable.  The best advice I have for him and Kendra is to remember that how he is when they first go home will be the worst- from there on out he will learn more and more and the days will get easier.

I understand, I never wanted to live 'like this' either, tried to kill myself in the hospital (by holding my breath, a little ironic when attached to a ventilator- I was too full of morphine to get it). Then my boyfriend who was driving started doing heroin because he couldn't handle the guilt-- brought it to me in the hospital. Not caring if I lived or died, i thus began a 4 yr heroin addiction.

So, my point (illustrated well, I think) is that it is a mind-bending adjustment. But people are amazingly adaptable, especially when they have no choice.

Any other advice I'd give depends alot on what kind of person Chris (or Kendra, or your husband, etc) is. In rehab I was told I could learn to fly planes!!! This meant nothing to me, I just wanted to walk. I wanted someone who had been through it and would look me in the eye and say Yes, you're absolutely right, this is all really really bad. But it will get better if you can hang on for a little while. Having a rather dark sense of humor has also saved me on many occasions, as well as being by nature a stubborn (my dad would say 'mule-headed') person. I do everything but change light bulbs for myself- I do way more than my huz...

Your hospital should be able to hook you up with a financial counselor (there are also community and govt resources- check with Medicare/Medicaid for local help) and with psychiatric services as well. It'd be great for all of you to go, as this affects you all.

I'm getting long-winded, I'm afraid, so how about this: you're welcome to write me through this site again, or if any of you guys want to you can reach me at the email address below- feel free to use either, for real. I know all too well how this can screw people up and would welcome the chance to make it even a little easier on someone else. Sound ok to you?
[email protected]

good luck- hope his surgery is going well (it's today, yes?)
leslie