Before my Injury
minute I was enjoying a summer's afternoon cycling across a local park.
The next thing I recall is lying on my side on the grass next to my mountain
bike. I could see my arms and legs but couldn't feel or move anywhere
below my neck. I had great trouble breathing. It felt like I was
trapped under a collapsed rugby scrum or something similar. Surprisingly I
felt very little pain but I knew straight away that I had injured myself very
I remember a number of people talking to me but I couldn't answer them as my breathing was extremely difficult. I was totally helpless, fighting desperately to remain conscious.
I was physically very fit but now my life
depended totally on help from other people at the scene of my accident. I
recall 2 or 3 young boys telling me an ambulance had been called. I saw a
woman walking towards me with a few pillows in her hands. I knew from my
first aid training in my own job that it was essential that I wasn't
moved. She wanted to make me more comfortable, I tried to say 'don't
move me' but my breathing made it impossible. Before she could move me one
of the young lads told her not to and to wait for the ambulance. I will be
eternally grateful for his intervention. Any movement of my head at that
stage would have had very serious consequences, making my injury a lot worse and
maybe even killing me.
I heard sirens in the distance and soon 2 paramedics were looking after me. I could tell by their faces and their conversation that my injuries were extremely serious. They told me that they were going to see if the 'Air Ambulance' was available to get me quickly to hospital. Fortunately for me it was flying that day and was landing alongside me about half an hour later.
I was soon being treated by an extremely competent Doctor. He injected steroids straight into my neck, to help reduce the swelling. He told me that he thought my neck was broken. With the assistance of the two paramedics he stabilised my neck in a collar. I was then very carefully lifted onto the helicopter's stretcher. In a few minutes we were airborne heading for the Royal London Hospital in Whitechapel, London. The helicopter was met on the roof of the hospital by an emergency trauma team. Soon I was in the highly sophisticated emergency trauma unit. I remember lots of people talking to me but soon afterwards the numerous drugs I had been given had kicked in making me very sleepy. After a lot of x-rays and scans I was taken to a high dependency unit.
The scans and x-rays revealed that I had badly broken 3 bones in my neck. Their medical name is C2 C3 and C4. It wasn't known at this stage how bad the damage was to my spinal cord. I would be facing one of the most severe physical disabilities were it severed completely.
My neck was stabilised using halo traction, this involved drilling 4 titanium screws through my skin and into my skull. Then about 8 Kilos of weight were hung by a series of pulleys off the head end of my bed. This was to stretch my neck and allow the broken bones room to start healing. I recall seeing family and friends but was drifting in and out of sedation all of the time. After a week at this hospital, it was decided that the best place to treat me would be a specialist spinal injuries unit. The Royal National Orthopeadic Hospital, in Stanmore, Middlesex was chosen. This necessitated the removal of my halo traction and another helicopter transfer
|Click here to see a detailed diagram showing 'Halo Traction'|
this time the Doctor's had decided on my treatment. They ruled out
repairing my broken neck bones with metal plates. Mainly due to the complexity
of the breaks themselves and the very real risk of making my spinal cord damage
worse. They would also have had to use the base of my skull bone as a
securing point for the metal work, which effectively would rule out me ever
being able to look left or right again without moving my whole body. I was
also told that the extent of my spinal cord damage wouldn't be known for at
least 4-6 weeks after my injury, because of the swelling and the fact that
the 'cord' goes into 'spinal shock' I was told it was unlikely that I
would walk again and I would probably remain paralysed from the neck down.
Then I was told that I would have to spend the next 6-8 weeks in bed, motionless
to allow my neck to heal. The thought of that was horrendous.
Once in my wheelchair for the first time I was given a tour of the spinal unit by one of the nurses. I was amazed at just how different the unit actually was now I was upright again. It looked totally different than I imagined it when I was lying in my hospital bed. I was now able to see other patients faces properly for the first time. I then realised just how much for granted we all take our surroundings. This was the first time I was able to look out of a window in nearly two months. The colours of the sky and the trees were somehow more vibrant than I remember them. I sat there for several minutes just taking it all in again.
A good friend of mine called Deane, had a horrific motorcycle accident in
1991. He broke his back in several places, and spent a year in hospital and on various spinal
units, eventually ending up for several months at Stoke
Mandeville. After a lot of hard work and recuperation he managed to leave the unit walking on sticks as an incomplete paraplegic. We were
always good friends at work and I used to visit Deane on a regular basis during
his recovery. I remember seeing newly injured tetraplegics in the spinal unit he
was was on. I remember thinking I couldn't possibly live like that, little did I
know I would find myself in that same position just three years later. Deane
became a tremendous source of encouragement and motivation to me. He
helped me through some really difficult times and when, at times, I was prepared
to give up he was the one who made me carry on. He understood more than anyone
what I was going through and I will always be grateful for his dedication.
Gradually the time I was able to spend in the wheelchair increased until I was able to stay up in the chair the two to three hours at a time. You may wonder why I couldn't spend any longer than that the wheelchair? There are many reasons, perhaps the most important one is that, with any spinal cord injury your feeling and skin sensation will be affected.
Some will feel nothing at all or may have very limited perception of touch or pain. This can lead to the skin becoming damaged, and if left untreated to the further complication of skin pressure sores. These can be life-threatening if they get too bad. That's why every tetraplegic or paraplegic will have to keep a very watchful eye on their pressure points and their skin and do what is called pressure relief every half-hour or so. This is to prevent the skin cells breaking down and dying.
I was soon attending the spinal unit gymnasium once or twice a day. Here the
physiotherapists went through various exercises to strengthen my legs abdomen
and arms. A lot of these exercises were passive, as I didn't have the movement
to do them myself. It felt to me, that my arms were very weak and a lot weaker
than my legs. I asked many nurses, physiotherapists and occupational therapists
if it was possible for someone to recover enough movement to walk, yet still not
be able to use their arms. They all said yes it was, this didn't seem possible
I still had to be pushed from the spinal unit to gymnasium and therapy areas by a member of hospital staff. I found this very frustrating as a lot of the well recovered paraplegics used to fly past me in their wheelchairs. I often wished I had broken my back and not my neck so I had the full use of my upper body. At least then I'll still be held to take part in sport and become entirely independent. Nowadays with the recovery I've had, I've come to terms with being a tetraplegic. Whilst I won't be able to take part in sports that I used to love, there are many things I can do independently or with a little intervention from other people.
At mealtimes I was still being fed by a nurse. Personal hygiene and eating are something else that we all take the granted. All your dignity goes out of the window when someone else has to do those tasks for you. It's frustrating, and somehow you never get the job done the way you would have done it in the past. There was nothing worse than watching your dinner go cold while the nurse who was meant to be feeding you is discussing the latest happenings in 'Neighbours' with her colleague.
As time went on my legs became stronger. One day in the gymnasium my physiotherapist, Sharon decided it was time to see if I could take my weight on my feet. Five or six therapists came over to assist. With their help supporting my weight I was lifted into a standing position. Although my balance was precarious, I was actually standing for a few seconds. Even though I was still supported by six people, it was an absolutely momentous occasion. Friends and family who were there looked smaller than they used to. This was because of the traction applied to my neck through the halo attachment and body brace had made me over an inch taller than I used to be. I was now standing at six feet five inches!
On a spinal unit, every time a patient manages to stand or walk the first time word soon gets around. When I was pushed back to the unit in my wheelchair just about everyone already knew I had stood up. They all offered congratulations, staff and patients alike. This was very humbling because many of the patient's new already they would never walk again, as their injuries were diagnosed as complete.
My arms were still very weak and would be a long-time before I recovered any
useful function in either of them. As time went by my leg strength still
continued to improve. The time I was able to stand up gradually increased
On all spinal units and rehabilitation centres preparing patients for a new
life in the home environment is very important. At the spinal unit I was on as
soon as the nursing staff thought you were fit enough to journey home they would
arrange a home visit. For me this came some four months after my injury. I was
only used to the confines of the spinal unit and the safety that that had
afforded me. My journey home would be in an adapted minibus. I was in my
wheelchair which was in turn bolted to the floor of the van. I knew the journey
would take about 2 hours. Whilst it was nice to be seeing the outside world
again this was proved to be one of the most upsetting experiences
since my injury.
My therapy continued over the next few months and the next major milestone was when I was able to use a walking frame for the first time. This frame had wheels on the front of it. My arms had to be strapped onto the handles so I could move the frame forwards. I wanted to stay upright with this frame for longer than the therapists would allow me to. As the weeks went by I progressed to using the frame for short distances. It took me ages to walk a few steps but ultimately the sense of achievement was more than worth it. My arm function was still very much behind the recovery shown in my legs. My left arm had virtually no function in it. My right arm was showing slight sign of recovery. I still had no hand function to talk of. The occupational therapy team were very dedicated bunch of people. They persisted with lots of exercises and routines to improve my hand and arm function. By the time I was to leave hospital I was able to hold an adapted pen with my right hand and move my right arm through about 30 percent of its normal function. This still wasn't enough for much practical use, but this continued to improve after I left the hospital.
Patient education, is another priority which is high on the agenda of most
spinal unit's. It is essential that everyone with a spinal injury or a person
who is going to care for someone with a spinal injury fully understands the
nature of the injury and the complications that can go with it. These
complications are touched on throughout my story, they are numerous and vary
greatly depending on the nature of the actual injury.
Because the autonomic nervous system is affected by spinal cord injury patients above the level of T 7 , they can also be affected by a condition called autonomic dysreflexia. This in very basic terms is when the bodies autonomic nervous system reacts to outside stimulation that it can no longer control effectively i.e. an overfull bladder/bowel or injury/pain etc. If left untreated it can result in very high rise in blood pressure and ultimately a stroke and death. I remember being very scared, in fact petrified of this condition when I was educated about it by a nurse.
The doctors treating me and the nursing team regularly met with me and my family to discuss progress, treatment and a possible release date from hospital. At the spinal unit I was on on average a paraplegic would leave hospital after three to six months. A tetraplegic would usually require a longer stay, normally in the region of ten to eighteen months.
My stay turned out to be just short of one-year. Towards the end of my stay in hospital I was coming home at weekends to visit my family and friends. This was an excellent experience to prepare me for my full return home. I left hospital able to walk a few steps on my own using two elbow crutches. As my arms and hands were still very weak most of my personal needs were still taken care of by family, community nurses and care workers.
The months following my release from hospital were very hard indeed. The amount of physiotherapy that is available in the community varies a great deal. I managed to get three one-hour appointments each week at the local hospital. The hospital staff said financial and employment constraints meant that was the absolute maximum that anyone would ever get. At this point only one-year post injury, they were still plenty of time for me to gain further recovery. It was a real shock going from at least five to six hours of therapy every day on the spinal unit to only three hours a week. I had an Exercise routine to do at home but looking back I'm sure I would have made much better progress with more input from the local hospital.
I missed the other people on the spinal unit and motivation and encouragement
they offered. In short, I tried to make the best of a bad situation but I found
everything very frustrating. As time went by, I realised that was only me that
was going to make a difference to my overall recovery. After ten months or so at
home, with the help of my doctor, I managed to get a further six-week stay in a
neurological rehabilitation unit. This was going to mean a further six weeks
away from home. The conditions of this hospital unit were pretty dire, but I was
back receiving daily physiotherapy and occupational therapy input. The staff
were well motivated and I feel I made excellent further improvement.
These scans detected that my right kidney was unusually large. The urinary
and renal specialist from the spinal unit told me that this was because the
kidney contained a very large cancerous tumour! Apparently renal tumours are very rare in anyone of my age.
Obviously, this set my overall recovery and progress back a long way. The incision required to remove the tumour goes from the front of my stomach round to the small of my back on the right side. This is major surgery for anyone to undergo and as a tetraplegic my recovery was going to be a lot longer and a lot harder.
It took a further six months to fully recover from the effects of this surgery. I lost a lot of the movement and function I had already regained and once again I was an emotional low. I managed to get a further admission to an excellent rehabilitation centre which is owned and funded by my former employer. With further hard work and persistence I regained the mobility and function to the level that it was before the surgery.
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