New C-4 Compete (Brother)

[Captain Thad]

My brother had a recent tragedy that seems to be all too common as I try to find answers. I'm a captain of a vessel in the gulf of mexico. On the evening of the 4th of July, I had the worst wake-up call of my life. This is the article from that day.

"Man critically injured when he falls from tree
Saturday, July 05, 2008

Staff Report

A Mobile man was injured Friday when he fell more than 15 feet from a tree and landed head-first on the ground, authorities said.

Wade Findley, 32, was climbing a tree off Shipyard Road, intending to jump from its limbs into a body of water commonly known as Hippie Beach near the Cypress Shores community, when he slipped and fell to the ground Friday night, police spokesman Officer Eric Gallichant said.

Mobile Fire-Rescue Department spokesman Steve Huffman said emergency workers found Findley "about a quarter of a mile from the water in the woods. He was conscious and alert, but he wasn't able to breathe without help. He couldn't move his extremities."

Huffman said Findley's friends performed rescue breathing before help arrived.

Findley was taken by helicopter to the University of South Alabama Medical Center, where a nursing supervisor said he was in critical condition Friday night.

Gallichant said police have no reason to believe foul play was involved."


The surgeon said that my brother had a three column injury and they had to put some sort of plate in the front and rods and screws in the back. Fragments of bone had to be removed and replaced. His injury is classified as a C-4 Complete and he is on a ventilator. The doctors were concerned because of how quickly fluid was in the lung and outside of the lung with a week. A tube was put in his side to drain what they called plural infusion. I can't imagine this getting any worse. I just got back to work today because I have to, but my mother and sister moved to Atlanta because he was sent by air-ambulance to the "Shepherd Center". My mind is racing!!!

Today, My mother said they were trying to clear his lungs and he is coughing up a bunch of crap. They even ordered him a wheel chair so he can move around.

Here is some subsequent articles in the Mobile Press Register:

http://www.al.com/news/press-register/inde....xml&coll=3

http://www.al.com/news/mobileregister/inde....xml&coll=3

This is going to be hard for all of us. They said his cord was crushed. Is there any case studies that have a positive outcome with this type of injury?

[Lewis]

but my mother and sister moved to Atlanta because he was sent by air-ambulance to the "Shepherd Center". My mind is racing!!

In my personal opinion, as a Shepherd Center alumni 2002, he couldn't be at a better facility to cope with his injury, recover, and move forward. I call it "paradise" for the newly injured.

This is going to be hard for all of us. They said his cord was crushed. Is there any case studies that have a positive outcome with this type of injury?

Sailing into any storm requires you to batten down the hatches and prepare for the worst, but you always hope for the best.

Every spinal cord injury is different. It's like a fingerprint where no two C4 injuries are alike. I wouldn't concentrate on case studies because they can lead to false hope. Focus on your brother's progress and the triumphs he makes everyday. His progress will be the best indicator of what his recovery will be like. It's too difficult to say how much functional return, if any, he will get back.

Be his brother and challenge him.

[betheny]

He's in the right place, and that is a huge part of the battle. We can't offer you assurances that all will be well, that would be a disservice to him. You need to start preparing for a paralyzed brother. I've noticed with C4's, they tend to get off the vent eventually. Can't even guarantee you that, though. If he does, his life took a huge step in the direction of positive.

A good friend of mine has a C4 injury. She still works at her job, travels, is happily married and an effective mother. She's a powerhouse in the organization of Unite 2 Fight Paralysis. I can cite a bunch of folks like that. They adapt, they strive, they struggle, they achieve. Pls believe, his life isn't over.

Man, I'm sorry y'all are going through this. Prepare for the worst, hope for the best. Ask any questions you want, at any time. We're here.

Believe me, there is life after paralysis. We've all done it. It ain't easy, but it can be done.

[rfbdorf]

He's in good hands at Shepherd.
If he really is coughing, that's a good sign
- Richard

[Lewis]

Believe me, there is life after paralysis. We've all done it. It ain't easy, but it can be done.

And for many of us, it's still a damn good life.

If he has trouble coping with how his injury occurred, you should remind him that life can change in an instant and how it happened doesn't matter, it's what he does afterward that matters and defines how he and the rest of his life will be.

You said your captain of the boat so I imagine you must have some sailing experience.

I can't change the direction of the wind, but I can adjust my sails to always reach my destination.

The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.

[Chef]

I also have a C4 complete injury. Your brother will go through some difficult spots but make sure he has all the support of his family and friends behind him. Challenge him and push him to work hard in therapy. It has been nearly 4 years since my injury and as others have said, life does go on. If you feel like talking to someone or would like some questions answered, please PM me. Good luck to you all.

-- Colin

[Captain Thad]

Thanks for the responses

Thanks everybody. My brother has been in Shepherd for 2 weeks now and he is still on the vent, but at a rate of 4. They said he should get off the vent, but it will be more challenging than they thought. They did do a "pin prick" test when he arrived, but nothing. He hasn't even started rehab because of other heath issues.....fluid build-up in the lungs, and bowel. My brother will not eat at all, but he will drink smoothies.
It was kinda weird one day because they were giving him electrical stimulation to his bisep muscles...and nothing, but when we put a shaver in his hand and he had visual stimulation like he was moving the razor, his bisep would respond some.....but, just on the right side.
And my sister found a sore on his tail bone, but its almost healed. Shepherd sent in a whole skincare team.

edited to ask question:
There is a medical conference in the morning with my brother's care team and doctor. Is there any specific questions that the family should ask?

[Lewis]

There is a medical conference in the morning with my brother's care team and doctor. Is there any specific questions that the family should ask?

Shepard really knows what they're doing and it's in their best interest for your brother to get the most out of his recovery. I would just listen and follow through with the support that they ask of you and other family members.

I don't think there's anything you need to ask at this point. Ask questions that you have curiosities about? The biggest question phase will come when it's time for your brother to go home.

PS it's a good thing he's eating something. Everyone has their peculiarities after SCI. For some it's smoothies, and for others like myself, it was cold pineapple chunks

[betheny]

Ask them if they still label him complete, given that bicep twitch. Ask if they've tested his anal reflexes, the definitive test for "complete" and "incomplete". And ask if they think he is functioning at C4. (Again, it is still too soon to tell what he'll function at, no matter what they may tell you. They are pessimistic at this point, to shock the family into getting busy preparing instead of dreaming their guy will get up and walk away. I'm assuming you aren't doing that.)

I can't believe he got a sore at Shepherd. Good catch for your sis, there!

Ask if they can give him something to increase his appetite. My rehab roomie found salvation there in Paxil, of all things. Ask what else they can do to provide him nutrition. What do you mean, problems with his bowel? More than what we all have? No obstruction or anything, right?

And ask the plan for weaning him off the vent.

[2jazzyjeff]

I can't believe he got a sore at Shepherd.

It seems he was somewhere else for close to 2 weeks.. I'd bet they didn't turn him properly and this is where the sore originated.. When I was in rehab I met a few ppl. that went to trauma centers and never got proper turning and ended up having flap surgery.. these places should know better.

Capt, so sorry to hear of this hapening to your brother. It's great that you found us here so quickly. I too was 32 at the time of my injury. I graduated from Shepherd the 1st week of '03. He's in a great place with great ppl. Ask any question that comes to mind.

Are you currently at Shepherd or going soon?

[Captain Thad]

I think the sores (because there were two), was from him pooping his pants and not being cleaned soon enough. His bowel issues were from diarrhea, that they were attributing to a stomach virus. My brother didn't want to go into the gym because of embarrassment.
I will be flying to Atlanta to meet my brother next week. My sister actually changed her life around to be with my brother.
My mom got an apartment five minutes from Shepherd one week before his injury. Can you believe that??

Thank You everbody....and I will ask those questions betheny

[SCI-Nurse]

Ask them if they still label him complete, given that bicep twitch. Ask if they've tested his anal reflexes, the definitive test for "complete" and "incomplete".

Actually, Betheny, this is not correct. You can have an intact anal wink or bulbocavernosus (BC) reflex and be totally complete. It can also be seen in many people who are incomplete, and it will not show at all during spinal shock.

The test to determine if the injury is an ASIA B (incomplete) injury is if there is SENSATION (not reflexes or movement) at the anal sphincter. If he is still in spinal shock, this may not be detectable either.

Thad, ask the following questions at the conference:

• How long will he be able to stay at Shephard (per his insurance and the team's best guess)?
• Will he be able to stay in the Atlanta area and continue with an outpatient program?
• Do you think he will ultimately wean completely from the vent?
• Do we have problems we know about now regarding what his insurance will cover for equipment, home modifications, and attendant care? If so, what, and what other strategies do we have to get this set up?
• Does he have c. diff (causing the diarrhea)? If so, how is it being treated?
• How deep is the pressure ulcer (stage)? What is being done for treatment? Will this hold back his rehab?
• How much therapy is he getting now? Even without starting the formal rehab program, he should be getting daily PT and OT for range of motion and to work on any possible strengthening. He should also be working with rehab nurses, a rehab psychologist and social worker, and getting education about his injury and how to get and stay healthy.

Is the apt. your mother apt. wheelchair accessible? Could your brother live there initially when he gets out of rehab?

(KLD)

[Lewis]

He is fortunate to have family that care so much. As far as the bowels are concerned, the body can also still be in shock from the spinal cord injury and it takes time to readjust. Make him go to the gym! It's your duty as his brother

Bethany asked some good questions but don't hesitate to ask questions about her questions if you don't completely understand the terminology.

[Lewis]

Good one KLD, I often forget about insurance since it's not fun to deal with. Shepherd is pretty good about keeping their patients busy, at least they were when I was there. When he's allowed, make sure you schedule as many activities outside of the hospital as possible (i.e. going to the mall, going to the movies etc.).

[ginamarie]

Actually, Betheny, this is not correct. You can have an intact anal wink or bulbocavernosus (BC) reflex and be totally complete. It can also be seen in many people who are incomplete, and it will not show at all during spinal shock.

The test to determine if the injury is an ASIA B (incomplete) injury is if there is SENSATION (not reflexes or movement) at the anal sphincter. If he is still in spinal shock, this may not be detectable either.

Thad, ask the following questions at the conference:

• How long will he be able to stay at Shephard (per his insurance and the team's best guess)?
• Will he be able to stay in the Atlanta area and continue with an outpatient program?
• Do you think he will ultimately wean completely from the vent?
• Do we have problems we know about now regarding what his insurance will cover for equipment, home modifications, and attendant care? If so, what, and what other strategies do we have to get this set up?
• Does he have c. diff (causing the diarrhea)? If so, how is it being treated?
• How deep is the pressure ulcer (stage)? What is being done for treatment? Will this hold back his rehab?
• How much therapy is he getting now? Even without starting the formal rehab program, he should be getting daily PT and OT for range of motion and to work on any possible strengthening. He should also be working with rehab nurses, a rehab psychologist and social worker, and getting education about his injury and how to get and stay healthy.

Is the apt. your mother apt. wheelchair accessible? Could your brother live there initially when he gets out of rehab?

(KLD)

Just to clarify... According to Dr. Young, the definition of complete is sensation at the anal sphincter and/OR voluntary anal contraction (not reflex).