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Questions about Rehab

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    Questions about Rehab

    Hello all, My uncle was in a car accident just under four weeks ago in Maryland. He broke his c4 and c5 and is diagnosed as "complete". He is currently in the shock trauma unit at UMD in Baltimore. He lives in Alaska and was here visting friends and family in Virginia. My uncle Pat was in great shape prior to the accident and has no other injuries, his wife was also in the crash and thankfully just bruised.

    The first three weeks have been rough, as most of you know, however in the last week he has made great strides in improving. He his working hard to get off the vent and the Docs put in a speaking valve yesterday. He was able to speak for the first time and was suprisingly upbeat and seems ready to work hard to recover. He was also able to move both biceps during a visit with the OT and can feel some tingling in his fingers. Which I think is pretty suprising at this point?

    The hospital is pushing to discharge him soon to Kernan here in MD. It is my understanding this is a step down facility untill he can be transfered elsewhere? Pat and some family members are having a meeting with the doctors today to discuss his options. I have been searching this site for info on Kernan and have found both positive and negative info but all of it is from 2008 or later. Does anyone have any recent reports from this rehab center. Since some of his family is in Virginia how about MCV in Richmond? My Aunt wants to get him to the best facility possible regardless of location but would prefer close to Va or west coast since they live in Alaska.

    Any help would be greatly appreciated.

    Thank You, David.

    Hi David, You are doing the right thing to start looking for info. I'm sorry your family has had this terrible shock. It is great news he is able to speak with the valve.
    Having a good attitude is half the battle too.
    My husband was at Craig Hospital in CO for his rehab after his fall from tree in 2008. They were one of the few places that take vent patients for rehab. It wa shard to go so far from home for nearly 4 months, but was the best thing that happened.
    Best wishes to all of you.


      Linda is correct. She is a valued member here and is very knowledgable re higher injury care. Is you uncle a vet? If so there may be opprotunities there also.


        I am not familiar with the facility that you mention - but you may want to consider a few in the western part of the US to get them closer to Alaska.

        My husband was recently at Craig for a couple of weeks for surgery, he was injured in 1985 so did not need to be there for rehab. There were many vent dependent patients there. They also have apartments located on campus which are provided free of charge for the first month for family members to stay with patients who are newly injured, and after the first month, at a reasonable rate. They also have suites that they move patients to towards the end of their stay where family can also stay and learn to assist with care. Craig is located in Englewood, CO, just outside of Denver. I have worked in the rehabilitation field for over 25 years and was completely impressed with the facility. It is part of the Spinal Cord Injury Model Systems - definitely worth a look. Also one of the top rated in the country.

        I am also somewhat familiar with University of Washington Medical Center in Seattle - also a part of the Model Systems for SCI and know that they also accept vent patients there, but not sure of local accomodations - would get them closer to Alaska though and is a highly respected facility. Also one of the top rated SCI programs.

        Any chance that your uncle is a veteran? If so, he may also be able to receive his rehabilitation through one of the VA SCI centers even though his injury is not service connected- there is an excellent one in Seattle as well that serves the region including Alaska and is part of the model SCI system.

        I wish him the best in his recovery.


          Woodrow Wilson in Fishersville, Va is a good place to go.

          Edited: It looks like Virginia's model program has been moved from UVA to VCU/MCV. I apologize for the error in referring you to WWRC.
          Last edited by Patton57; 15 Mar 2011, 7:45 PM.


            I forgot to mention that they hope to have him off the vent soon, like a week. Should find out more info after todays meeting.

            No he is not a veteran.

            Thanks, for the help so far.


              Are they frequently turning him and watching his skin?
              Some of the people that came to rehab has skin issues that delayed their rehab.
              I often use the search feature on this site.
              Good to hear they expect him to get off of that vent.
              Breathing, eating and speaking are under appreciated.
              My husband is on the vent at night or if he needs a rest during the day.
              He has a weak shoulder shrug, but nothing below that. He broke C4,5 and 6 but had damage to the C3 area of the spinal cord.


                Ideally, it is best to select either a Model SCI System Center or at least a center that is accredited as a Spinal Cord System of Care by CARF. You can find a list of the Model SCI System Centers here, and CARF accredited facilities here. The University of Washington (Harborview) in Seattle is a Model SCI System center.

                In addition, I need to ask if your uncle is an honorably discharged US military veteran. If so, then getting him to a VA SCI Center would be the best. The one in Seattle is responsible for the state of Alaska and is a fine center.

                Ideally, he should select a center that will not only provide him with the best physical rehabilitation, counseling, and education about his condition and maintaining his health, but will also provide him with annual SCI check-ups for his lifetime. Things change, and getting these regular re-evaluations will go a long way to helping him maintain his health and functional abilities.

                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.


                  Thanks for all the help so far. First off he is not a veteran. Today he passed his barium test today so thankfully he can drink a little water. He is still doing better with his breathing and getting stronger everyday. My family and my uncle participated in a meeting with his doctors and others. They informed him of the cold hard facts of his injury and my mom says he took it well.
                  My Aunt will visit the Kernan rehab facility in Baltimore tomorrow and get a feel for the facility. They want to move him there as soon as he can breathe better on his own. My understanding is the stay at Kernan will be temporary. We definitley would like to get him to one of the model sytems for sci after that. My question is why the temporary move to Kernan? Why can't we move him straight to one of the Model sytems like the one in Washington state or VCU in richmond so he can be closer to family? The doctors are saying that if he went to Kernan which is close to the hospital if he has a setback he can go back. Is it just that it is too risky for him to travel at this point? The drive to Richmond is about two hours. Is it best to just transfer him the six miles to Kernan?

                  Thanks David



                    You can move directly to a model system from Shock Truama and should!

                    A move to Kernan will not likely be temporary it will be for his rehab stay, unless you request to leave. Kernan is a rehab facility and not a step down unit. Depending on your uncles insurance it may be more difficult to move him to a model system from there since they will consider that a lateral transfer and may not agree to several moves from one rehab to another. Furthermore, they will likely not cover the costs for transporation to another rehab once he is already in a rehab facility.

                    Since your uncle is still on a vent he may not qualify for some of the model system programs just yet. However, he will qualify for both the Shepherd Center in Atlanta and Craig Hospital in Denver both are excellent model system programs. Check out their websites and talk with staff there at Shock Trauma who might be knowledgeable of their program. You can request a referral be made to both of those facilities.
                    Best of luck to you!



                      I did my rehab at Shepherd, it is an amazing place. I have also heard the same about Craig.


                        As I understand it the reason my husband was able to go to Craig was because it was the closest (we live in MN) rehab hospital that would take a vent pateint for rehab.There was no place local that would/could accept him.
                        We went by air ambulance with 2 flight nurses. He was on the vent, may IV's, feeding tube etc. He was in pretty rough shape and at the time I was questioning why we had to go so far.
                        Since your uncle is expected to get off of the vent could be the reason they are looking at the closer places. Ask, ask and ask questions David.
                        Your aunt might be a bit shocked when she goes to see the places. I remember I was.
                        Her life will change in every way also.



                          I can tell you that Shepherd in Atlanta is well worth the trip from Virginia. I also know that hey take vent patients. My son did his rehab there in 2009 and the results were amazing. Granted Ryan is an incomplete injury but they will help your uncle not only wean off the vent but to maximize what he can do. In addition they train the family on how to care for their loved one and make sure you are ready when you go home.

                          Ryan wishes he had passes the barium test after only four weeks. He never did pass one but his speech pathologist at Shepherd took a chance on him since he was very good at protecting his airway and he went from level 1 on Monday to Jimmy John's on Friday. This was more than four months after his injury and this was torture for a 17 year old.--eak
                          Elizabeth A. Kephart, PHR
                          mom/caregiver to Ryan-age 21
                          Incomplete C-2 with TBI since 3/09


                            So it looks like my Uncle will be on a plane to Shepherd sometime this week. I hope we are making the right choice. I was really impressed with the Shepered rep that came and visited us in the hospital on Friday. She seemed really pasionate about helping my uncle. I am however a little concerned about some of the negative things I have read on this site concerning Shepered and high level complete patients like my uncle. I hope to report back in a few weeks nothing but praises. If we have to fight for agresive rehab than we will.

                            On another note my uncle was aff the vent the other day for 36 hours. He still is working with the hospital OT with his biceps. He is very motivated to work hard but is starting to realize and worry about his limitations.

                            Last edited by David F; 21 Mar 2011, 11:24 PM.


                              How are things going David?