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Recent Spinal Cord injury from intoxication

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  • Recent Spinal Cord injury from intoxication

    My name is Jennifer and my dad has just sustained a spinal cord injury. At the time he had been on a two week drinking binge without food or water. He opened his front door and fell face first on concrete and chest first on steps. The impact broke his nose, four ribs, his neck, and he also suffered from a partial collapsed lung from the impact of the steps that broke his ribs.

    When he was rushed into the emergency room he was in complete Renal failure and was not breathing. He has been diagnosed with Central Cord Syndrome and I am not sure the exact medical term but it was in the C-3 region.

    He has been in the hospital now for a week as of today. They have reversed his Kidney failure, brought his Potassium levels and Sodium levels back up to where they should be and also balanced his electrolytes. His breathing is very "forced" so he has been on anywhere from 1-6 liters of Oxygen. Right now he is using 5 liters of Oxygen.

    He has VERY limited mobility in his arms and legs. The right arm can't be moved at all but he can squeeze his right hand. He can bring his left arm to his chin but can't move his hand at all. His left leg is very weak, and although his right leg is stronger, it is no where near 100%.

    My main concern right now is that he has been hallucinating off and on for the past three days. He things he is living in a "trailer park" that was formed in the middle of the hospital grounds. He also believes his bed is in a box and if we move it he will "fall 15 feet onto the ground". The doctors can't figure out what is causing his delusions. He has also shown signs of extreme paranoia to the point of an anxiety attack once a day. I am very fearful of the ongoing confusion and delirium. I am also concerned about his quality of life after sustaining these type of injuries. Oh...I forgot to mention he has been a two pack a day smoker for 30 years. And because of that he has a pocket of fluid in each lung. The Doctor has said that could turn into pneumonia. The fact that he can't walk means if he does get pneumonia, he is in trouble.

    I know the cause of his injuries are rare, but seeing my daddy in a hospital bed, speaking so weak and breathing weak, talking out of the top of his head and having me feed him is tearing me apart. He has always been my rock and voice of praise and encouragement.

    If anyone out there has had any similar injuries, please let me know how you and your family got through it. I am all he has and I feel alone through all of this.

    I know this was lengthy, so you can imagine how sick he is

  • #2

    I'm so sorry you have to go through this. Have you spoken to the doctors about his delirium? Perhaps he's suffering withdrawls from the alcohol and cigarettes and is also on some medication?

    I imagine not eating or drinking anything nutritious contributes as well.

    Take care of yourself first. You didn't do this to him.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12


    • #3
      Welcome to CareCure, though I'm very sorry about the circumstances that led you here.

      Is your dad on morphine? My husband (a T4 injury) was on morphine while in the ICU and he had some crazy dreams as a result.

      Lynnifer is absolutely right- you need to take care of yourself first. The first weeks are hard and you need to be sure you have the strength to get through them (meaning eat well-not hospital food- and get a decent amount of sleep).

      This is a great place to come with questions. Not sure I would have gotten through the last 11 months with my sanity in tact without CC.


      • #4
        I would first want to know what meds he is on as well. I hope they are not using Demerol for pain management, as it is notorious for causing delirium, esp. in older people (how old is your dad??). DTs should also be considered, which can occur even in binge drinkers when deprived of alcohol. There are other meds that can cause this too. Benedryl is also one that he should not be taking. Have his meds been reviewed by a good clinical pharmacist? Has he been evaluated by a psychiatrist as well?

        Where is your dad? Is he in a major trauma center or center that specializes in neurological problems? It is good he is not currently on a ventilator, but they need to know the proper ways to clear his lungs for someone with a SCI which may impair his coughing muscles. Using a Cough-Assist machine and/or a PneumoVest will be of great assistance in clearing his lungs, esp. with his long smoking history.

        Are they planning on moving him ASAP to a major SCI rehabilitation center? Does he have insurance? Is he by any chance a military veteran?

        Please come back and let us know what other questions or concerns you have. We can help.

        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.


        • #5
          I hope your Dad get's better or relief
          Take care of yourself as things like this are not easy on anyone especially immediate family

          KLD and Lynnifer are very informative

          Wishing you all the best
          Sincerely ;


          • #6
            They had me on fentanyl for the pain while I was in ICU, it works well on the pain but I had some seriously whacky hallucinations, some of which weren't too pleasant.

            Whats happened has happened, it's just a waiting game now, giving his body time to heal and recover. Make sure they are turning him regularly to avoid pressure sores, and keep your fingers crossed he doesn't get a chest infection. It's quite likely he'll regain some function, but it's impossible to say how much. Only time will tell.

            Look after yourself, and I wish you all the best in this difficult time
            T11 Asia A after near-fatal bike crash.. Just happy to still be here

            No, I didn't loose my mind... It got scared and ran away!!


            • #7
              Keep your spirits high in this difficult time. I agree with everyone else, make certain to rest and take care of yourself. As your father's body begins to recover from the trauma time will tell the outcome--take each day as it comes and be grateful. Other threads will mention this but, typically rule of thumb is return/improvement can happen as many as 24 months post injury. Some have reported improvements long after that.

              Take what KLD said to heart about the Cough-Assist machine. Gently, but forcefully take control of his care. Don't be afraid to ask the attending physician and nurses questions. Also, the internet is a wonderful tool-- but, take everything you read with a grain of salt and judge it open and honestly so there are no false expectations.
              Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.


              • #8
                Thanks Lynnifer for all of the kind words and encouragement. I did get some explanation about the delirium today. The doctor told me it was a combination of the withdrawal from alcohol, being in the same bed for over a week without mobility, the injury, and his poor health status. She also said that poor nutrition could play a huge role in it also. I know I didn't do this to him but I can tell how relieved he is when he sees my face so guilt does kick in when I am not there.


                • #9

                  My dad isn't on Morphine anymore. The side effects of decreased breathing or lung function was too risky for him. I am so very glad I found this forum because I would love to be able to stay on board with his recovery


                  • #10

                    Right now he is on a lot of medication. He is on 4 different types of meds for HTN and for his rapid heart rate (145 resting). He is also on Potassium and vitamins. He has taken Klonopin (SP) for the past 12 years 4 times a day to total 2 mg. They have been giving him a shot in his stomach to prevent blood clots. They are looking into Antidepressants because of obvious reasons. I am sure there is more I just can think of them. They gave him Oxycodone for 3 days which made him angry and very very paranoid so they discontinued that. In place of that he was given Adavan but only PRN and considering his mental status, he never asked for it so...He was also on a BiPap machine to help expand his lungs back to regular function but it caused so much anxiety it did more harm than good. I did find out to day his spinal cord injury was "incomplete" and I heard that was the best one to have (considering). Psych will be in to access his status as soon as they can get his other health conditions better. As far as a Clinical Pharmacist, I am not sure if his meds have been reviewed or not He is in a regular hospital called Wake Medical Center in Raleigh NC. He has been on the "Cardiac Wing" but was just transferred to "Neuro" and will undergo his neck surgery this Friday if he health improves. They will move him to a Skilled Nursing facility for rehab as soon as they can get him healthy but I think he will be in the same hospital for a while. He has no insurance currently but we are trying to work on Medicare and Medicaid. I know he is only 54 but there has to be something he can get considering his disability now. He is not a veteran either.


                    • #11
                      Thanks GL!!


                      • #12
                        Thanks SuprSi! I am glad everything worked out well and you have recovered


                        • #13
                          Thanks russianrob! I am trying to stay optimistic but I do realize he has a very long road ahead of him, and so do I. I am trying to learn as much as I can so I may be his rock and voice of encouragement and praise


                          • #14
                            No matter what, do NOT allow them to send him to a SNF for "rehab". A SNF is not equipped to provide quality intensive comprehensive interdisciplinary rehabilitation. He needs to go to a specialty SCI rehabilitation program, ideally one that is accredited as a SCSC (Spinal Cord System of Care) through CARF (the Commission for Accreditation of Rehabilitation Facilities). I happen to know that there is one associated with Wake Medical Center. This is where he should go. You may have a fight on your hands to get him there with no insurance though.

                            Depending on your state, he may be eligible for expedited approval of Medicaid due to his SCI. Unfortunately he is not eligible yet for Medicare unless he was previously designated as disabled and on SSDI for another disability. You must be on SSDI for 24 months to be eligible for Medicare, so that will only be an option for him down the road. I assume he was not working at all, so not eligible for state disability? Does he have 40 quarters of Social Security employment history? The social worker at the hospital should be helping you with these issues.

                            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.


                            • #15

                              You must carefully read the words posted by KLD above. They are critically important for your father.

                              Speak with the social worker immediately to find out the process of applying for Medicaid, and what other options your father has at this point and start applying. Ask every day how this is going, and what other state/disability funds might be available for your father. He must have this in place as soon as possible, or there will be difficulty getting to a rehab hospital.

                              He MUST NOT go to a subacute nursing facility (SNF). These are useless, and are not rehabilitation hospitals, and they will not have any expertise in spinal cord injury and the care is often poor. He MUST go to an acute rehabilitation facility, and the one KLD found appears to be associated with the hospital he is at (!) so INSIST that they send him there. We cannot emphasize enough how critical this is. Often the Case Manager is the person who arranges the rehab transfer, although sometimes the social worker helps.

                              Refuse to let them send him to a SNF. Just refuse. They can't force you to send him unless you let them. They may push you, threaten you but do not budge. Tell them you know that it is critical for his recovery that he go to acute rehab and try to get any ally you can on your side (eg. doctor, primary care doctor, physical therapist at the hospital etc...). The one limitation is that he must be awake enough to participate in at least 3 hours of therapy a day. He should be able to do this.

                              Good luck.
                              Last edited by hlh; 05-29-2012, 10:36 PM.