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  • c1 break c2 fracture

    One week ago my cousin was in a car accident. She broke in half the c1 and has a hairline fracture in the c2. She is alert and can answer questions by blinking her eyes and has, in the past 2 days, started to mouth words. She has been on a ventilator but a treach was put in yesterday and her breathing is 70% as of this morning. Several hours after the accident a nurse was trying to remove Emily's wedding ring and Emily, who was unconscious, was fighting the nurse and wouldn't let go. She has had no other hand movement since. She has been able to feel the doctors and nurses pinching her arms and legs. They will touch a part of her body and she can mouth exact locations where they are touching ie: right big toe, left pinky.

    We know there is a really long road ahead for Emily. These things give us hope. I can't find anything online that shows someone with this injury being able to feel touch like this. Is this normal? Is this a really good sign?

    The doctor said there is cord damage but I don't know how much. He also said that she streched the vertebrae down to the c7 and made a comment that this is a worse injury than Christopher Reeve. This confuses me as Emily is breathing so well and can feel touch.

    Any thoughts?

  • #2
    Hi Heather and welcome to CC. I'm very sorry to hear about your cousin. You are right about her having a long road ahead of her, but I would assume that her injury is incomplete based on what you said about her ability to feel touch. It's only been a week, so I would assume that there's still lots of swelling around her cord. I think it's safe to hope that once the swelling goes down, some of her function may return.

    Hopefully, one of the nurses will respond. The RN would be better able than I to advise you on what questions to ask the doctors to get a better idea of how complete the injury is and what her functional level might be.
    "The truth will set you free. But first, it will piss you off." -Gloria Steinem

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    • #3
      I forgot to mention that she broke 2 ribs and they punctured both lungs. They are healing well. We are just waiting until they are completely healed and hope she will breathe 100% on her own.


      She wasn't expected to live through that first night. She was not breathing at the scene and her pupils did not respond in the ER.

      She's a fighter!

      Comment


      • #4
        Can she move her hand or follow any commands at all with her hands or feet? Is she sedated? A complete injury would not leave any sensation intact, but withdrawal to pain is not the same as normal sensation. A C1-2 fracture with a complete SCI would result in the inability to breathe on her own at all.

        When you said she is breathing 70%, what do you mean?

        Not sure what you mean by "streched the vertebrae down to the c7". Does she have a fracture or dislocation there too? What is being done to stablize her cervical fractures?

        If she has a SCI, then ask the physician to tell you both the level of the cord damage and the ASIA type.

        Where is she? Is it a major trauma center? How old is she? How is her health otherwise?

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          She is in good health, 28 years old. She is at a hospital-not sure about trauma unit. She was to be taken from the scene by life flight-don't know if that makes it a trauma hospital but because of the ice on the road-the cause of the accident-they couldn't get to her and she was taken by ambulance. I believe they are going to move her to a hospital/rehab in Chicago that is supposed to be one of the best in the country for this injury. Don't have a lot of details about that. They have not done surgery but I have heard they plan to.

          She has not moved her hands or feet. I believe she is sedated but when they say her name she opens her eyes, can nod her head slightly to answer questions.

          I don't have the info on the exact severity of the injury. I just think it is strange that this doctor has said things were worse than they thought yet she can feel touch.

          As far as stretching down to the c7-that's all I know. I think he said something about space between each of the vertebrae-not positive. I am getting this info. second hand and the people talking to the doctors are just trying to make sense of it.

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          • #6
            What I mean by breathing 70% is that she is breathing on her own 70% and the machine is doing 30%. And they are weaning her from the machine.

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            • #7
              If they are talking about her going to the Rehab Institute of Chicago, that is an excellent place. It would be even better if they could move her NOW to the acute SCI ICU at Northwestern, which is associated with RIC. It would be the best place for her to get her acute care and continue to work on her ventilator weaning.

              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

              Comment


              • #8
                I agree with KLD. My family heard the Christopher Reeves comparison at the trauma center and I can walk. I would get her to Northwestern and Rehab Institute of Chicago ASAP! She will get get great sci care and information.
                2012 SCINetUSA Clinical Trial Support Squad Member
                Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

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                • #9
                  She will be going to the Rehab Institute of Chicago and I have told my Aunt to see if it is possible to have surgery at Northwestern instead of the hospital where she currently is. They are going to start breathing exercises soon and are weaning her off pain medication. They put her in a bed with an air mattress today.

                  A very good point my husband stated yesterday is that her injury may be worse than Christopher Reeve's but her outcome seems to be very different.

                  Comment


                  • #10
                    How long should Emily be in an inpatient rehab facility?

                    Comment


                    • #11
                      If she has a tetraplegic injury, it is rare that insurance with authorize more than 6 weeks of inpatient rehab now days, so it is critical to start working on discharge planning (home modification, caregiver issues, etc.) as soon as she arrives in rehab.

                      (KLD)
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                      Comment


                      • #12
                        Thank you. My Mom thought she heard the liason from the rehab say they would do everything possible for her in the six weeks they have her. I thought that she would be there for months but apparently not.

                        She has the halo on and hopefully they will move her this weekend. Still has feeling but no movement.

                        Comment


                        • #13
                          Hi Heather,

                          Has Emily been moved to RIC yet?

                          That would be an excellent Christmas gift.

                          I think the breathing and sensation are excellent signs. I was diagnosed as a C1-2 complete. My understanding is that spontaneous breathing (i.e. what is necessary to breathe without conscious effort / thought) requires "C3 ability" or better. C3 injuries typically have diaphragm access, which provides spontaneous breathing.

                          I remember the "no movement and mouthing words" stage all too well. Whether she is able to fully wean off the vent or not, she should (eventually) regain the ability to speak, and speak well. Regarding movement, I pray she gets a lot back (a full recovery would be fantastic) but even if her functional level remains C1-2, she should eventually be able to turn her head and have decent head/neck movement.

                          I figured that even as a C1-2 complete, I could still access my neck muscles, and I learned to breathe (not spontaneously) by using my neck muscles to simultaneously pull my chest up and chin down (like a mini-situp) to take in air. I learned to eat again by doing swallow therapy exercises. I also went back to school, and have had a busy & fulfilling life since my injury over 12 years ago.

                          Point being, life can still be good whether she regains significant function soon or not (if you visit the "cure" forum here, there are some doctors / researchers doing impressive things).

                          When I was injured (8-23-1997) there wasn't much info that I could find regarding life as a vent-dependent C1-2, so I started my personal website to share what I was learning and my experiences in hopes the info could help others. My personal website is below with my signature, if you're curious.

                          I also wrote and recently updated my "full story" which I thought might be helpful for newly injured people, and/or SCI support groups. Here's the direct link:

                          http://www.lookmomnohands.net/My_Ful...ort_Groups.htm

                          I hope / pray your cousin Emily makes miraculous strides in the coming months.

                          God bless!

                          Bill Miller :-)
                          C1-2 Quadriplegic with a 221 High Bowling Game
                          Co-founder of Manufacturing Genuine Thrills Inc. d/b/a MGT
                          My blog: http://powerwheelchairusers.blogspot.com
                          Business website: http://www.ikanbowler.com
                          Personal website: http://www.lookmomnohands.net
                          Wheelchair users -- even high-level quads... WANNA BOWL?

                          I'm a C1-2 with a legit 255 high bowling game.

                          Comment


                          • #14
                            Bill,

                            Thank you for the response and encouragement. Emily was moved yesterday to RIC. The move caused much anxiety for her and her fever spiked again. She was unable to sleep even with a sleeping pill so they have not yet begun the weaning yet. She has been having terrible anxiety attacks. I do keep hoping that things will work out for her. She is a wonderful person. I'll keep updating.

                            BTW I went bowling yesterday(I've only bowled twice in the past 15 years or so)and I bowled a 94 and a 67. Even the kids beat me! Your score is very impressive.

                            Comment


                            • #15
                              Thank you for the reply Heather.

                              I'm quite glad Emily is now at RIC -- getting there is progress.

                              Regarding her anxiety, when I was at Shepherd (a rehab facility comparable to RIC), I too had some fairly extreme anxiety, and wild fever spikes. My anxiety was primarily because I didn't trust the ventilator (how was I supposed to know it's amazingly reliable with well-designed alarms? Knock on wood and thank you God) and I didn't trust some of the staff working with me. I should clarify that and say that a couple of the nurses and respiratory therapists didn't project confidence and utmost competence, so I was uncertain that they could handle whatever happened, and at the time, I worried about what could happen.

                              But with Emily's ability to breathe some on her own already, and hopefully she'll quickly become comfortable with the nurses, etc working with her and that will help alleviate her anxiety.

                              Candidly, my worst anxiety was fear of coming home -- I had no idea who my nurses would be, and if I had a difficult time feeling comfortable with some Shepherd-trained nurses... I was quite scared to find out the care I would receive at home. I didn't want to leave the "safety blanket" that is a facility like Shepherd, where they are considered experts with SCI. But ultimately, coming home was a huge plus for me, however I'm getting ahead of where Emily is.

                              I trust she's on antidepressant medication?

                              Shepherd eventually had me on three concurrent antidepressants, plus Ativan (specifically for anxiety attacks) as needed! I eventually started to see how my life could still be livable, truly livable, and that's when I "turned the corner" and started weaning off the antidepressants. I still have one, a moderate dose of amitriptyline, which doubles as a sleep aid; I wanted to wean off them all, but my grandmother, who states that she "was an RN before penicillin!" she said that "exercise produces endorphins, and endorphins make us feel good, and Bill you cannot really exercise, so you should keep some pharmaceutical help."

                              Anyway, I hope this helps. I don't think I can provide much insight regarding her fevers, except to say my understanding is the wild spikes are common with newly injured people. The explanation I received was that, essentially, my body's "thermostat" was broken with the SCI, so I couldn't really regulate my temperature. But my fevers eventually mellowed and I don't recall the last time I had one (knock on wood and thank you God!).

                              God bless, and thank you for the bowling compliment! (Your scores might fare quite a bit better if you bowled regularly; it's hard to develop some rhythm and momentum bowling twice every 15 years!)

                              Please keep us updated on Emily's progress.

                              Bill Miller
                              Wheelchair users -- even high-level quads... WANNA BOWL?

                              I'm a C1-2 with a legit 255 high bowling game.

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