Sunday, September 29, 2013

Details of Injury and Abilities

We'll soon have something specific set up to communicate to those interested regarding Adam's condition, his progress, our needs as a family, etc. At this point, we've mostly updated through my and other friends and family member's status updates on Facebook. And they have usually been short little blurbs and maybe not understood completely. I just wanted to give a more in-depth glimpse at the injury and what Adam's capabilities are.

The injury: When Adam came down off his bike, his head hit the ground towards the front of his helmet and it hit in such a way that it hyperextended his neck backwards. It was explained by one surgeon as a "concussion" to his spinal cord. Initially, the CT Scan showed there were not fractures to the vertebrae. Later, they said that there were some small fractures to vertebraes C4 and C5 in his neck. The surgeon said he actually had some early signs of arthritis in his neck (because he's been a super-active guy) which may have caused the small fractures to occur. The MRI showed that the spinal cord was swollen, bruised, and had some bleeding on it. There were some small bone spurs that were putting pressure on the spinal cord in its swollen state also. We had options, it was explained as a "gray" area in which they weren't saying that it was absolutely mandatory that he have surgery. We could have waited it out to see if the swelling of the spinal cord went down and his neck was stable. Or we could have surgery in which a plate was put into stabilize the affected vertebrae and create spacers in between these vertebrae to alleviate some of the pressure of the spine and while in there they remove the bone spurs and clean up any areas that could cause some difficulties in healing. We had the surgery and the doctors did what they intended to do and were happy with it. Actual surgery time was only a little over 2 hours. Now, we probably need to go back to those middle school health lessons to remember what the spinal cord is. I did. The spinal cord is connected to the brain and consists of millions of nerve fibers which transmit electrical information to and from the limbs, trunk and organs of the body, back to and from the brain. [Disclaimer: I may not have gotten all of those technical medical info stuff right regarding his surgery and injury. This is the best that I came to understand it and explain it.]

So, how has this affected Adam's body? I'm going to be frank and honest and I hope it isn't discouraging to those supporting us, but it does need to be understood the seriousness of the injury. When Adam hit the ground, he stayed down. He could not move. He was not moved until paramedics arrived. He explained it to me that he felt like his body was floating and that only his head was on the ground. When he was being looked over and tested in trauma he could feel sensations everywhere. Tingling, numbness. He knew he was being touched and he could feel them doing things to different parts of his body. He could move his toes. He could move his arms. Throughout the last 4 days, he has participated in some physical therapy and his doctors have had him test out what he can do. He can move his arms in numerous directions at the shoulders and elbows. At the C4 and C5 area of the spine where he was affected, this is the area that affects his hands and wrists. He cannot move these at all. He can feel things and usually tell where he is being touched on his hands and he can identify hot and cold temperatures. His legs are clearly getting some signals. He can flex his thigh muscles. He can lift his knees up a little. He can pull back his toes. They have had him sit up on the edge of the bed. When I say that, don't misunderstand. 2-3 therapists are forcing and holding him in place in a sitting position on the edge of the bed and they are holding him there. He does not have the ability to do this on his own at this point. He's able to engage his shoulders and lean from side to side while he's being sat up. He has to concentrate a lot for these movements and they are minor sometimes and in need of support. When he is uncomfortable while lying in bed, he cannot simply shift to another position. He has to have medical staff come and move him. He spends the majority of his day lying in bed, except for an hour or so twice a day in which he sits in a special chair or if he has therapy. He does not have control of his bladder yet. At this point, he needs assistance and lots of it. He needs to be fed, teeth brushed, nose blown, etc. He still has a neck brace on to give his neck some stabilization. 

While all that may sound really bad and awful, all of this is actually really, really good for 4 days after a spinal cord injury. And its encouraging because it could be much worse. Many spinal cord injuries lose all abilities from the neck down or from the waist down. They have no feeling or ability to move. Adam has good signs that he may be able to recover a lot of his abilities. Every spinal cord injury is different and they all heal differently. It is a slow process though. His spinal cord needs to get the swelling down and then it will work to get some of those nerves connecting as they should again. When we share that his doctor is confident he will walk again.....that doesn't mean it will happen next week. The hope is that we can get him into an intense rehabilitation center as soon as possible. Adam is strong, he's determined, and his body is showing good signs that his limbs are still receiving messages from the brain and that those nerve connections can recover signals. We are hopeful and expectant of great things. This will be a long process though. 

He's on quite a bit of pain meds, blood thinners, steriods, muscle relaxers, etc. If you visit, you may catch him extremely loopy and unable to keep his eyes open due to some of the meds. You may also find him fully alert and able to participate in a really good conversation. Its hit-or-miss and we don't necessarily have it documented when those "good" times are and when he's sleepy. There's probably more of the latter still at this point. Today (Sunday) has been the first day that Adam has any sort of appetite. He didn't eat anything for the first two days. And then it was slow attempts at a liquid diet. He's not eating large amounts of food, but he's getting some good nutrition now which should put his energy levels up. 

The boys have not seen Adam yet. They know he had an accident on his mountain bike and that he is in the hospital. They know that I am spending most of my time with him. They've been praying for him to get better. Grandmas and Grandpas have been caring for them and giving them lots of attention, so this has been a bit of a "party" for them. 

Ok. I think that's enough information. But I feel like this paints a broader picture of what has happened to him and where he is at physically right now.