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Author Topic: C4, 5 & 6 What are his chances  (Read 6878 times) Bookmark and Share
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jackie
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« on: June 11, 2007, 11:57:24 PM »

Hi

thought I would provide an update re my son, Craig's injury.

I have been told my son's injuries are C4,5 and 6.  He is having surgery on Wednesday to stregnthen his neck.  A plate will be inserted at the front. 

The surgeon has advised there is nerve damage but can't say at this point the level of the damage.  What are his chances of obtaining some movement?

He is becoming very frustrated as he is ventilated and can't talk due to the tubes.  He can breath on his on but the Dr has stated they will keep him ventilated until after the surgery.  He is trying to sit up and has asked to go home. 

Jackie

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« on: June 11, 2007, 11:57:24 PM »

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Jude
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« Reply #1 on: June 12, 2007, 12:12:13 AM »

Jackie,

I've been away for the weekend, at a Wedding, but the first thing I did, was to log on here to see how Craig was doing.....I'm sure I'm not the only one to do so.....We're all rooting for him.

I'm afraid I have absolutely no personal SCI experience....apart from a "cyber-link" with a rather cute T6!! Hence the learning!!

I DO know that Craigs Injuries are higher, but will leave the "nitty-gritty" to those in the "know". I think the key is whether he has a complete or incomplete injury, but the very fact, as a Layman, that he's trying to sit up, seems to augers well......?? SO hope this has a happy ending.

BIG HUGS,

Jude
xxx
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Gary Anderson
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« Reply #2 on: June 12, 2007, 08:20:19 AM »

HI Jackie

Good to hear about the surgery taking place.

Don't give up hope. At this moment they will not know the extent of the damage. That will only become clearer as time goes on.

It is good that he is breathing on his own - that will make a big difference.

As regards the trying to sit up. How succesful is he when he tries that? Perhaps that is an indication of how much improvement there will be as I would imagine he would not be able to do that if the injury was a complete one.

On here Andy used to have information leaflets that told you what to expect to a C4,5 and 6 patient.

It all depends on the incomplete or complete. If it is complete then I am afraid there is unlikely to be any movement. If it is incomplete then there is a chance that recovery of movement is possible.

I know a jockey who had an accident on a horse. He was taken to hospital and the docs told his parents there was no hope of any recovery. However, a year later he is up on crutches and getting around. The reason was the incompleteness of his injury and through therapy they were able to re-route messages from the brain.

If you can tell us whether Craig is complete or incomplete it will help as obviously there are two different outcomes. Andy, Gaz and I are "incomplete" but othes on here are "complete" who will be able to give you a different side.

Good luck with the surgery and keep us posted.

Perhaps Simon from Apparelyzed could come on here and tell you about C4-6. I am sure it is around about there that his injury is.

God bless.
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cauda equina lesion. Cord undamaged/intact (Accy. 1989) gammy arm & traumatic brain injuries (Accy. 2006)

ALWAYS REMEMBER - The darkest hour is only 60 minutes long and what won't kill you will make you stronger.
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« Reply #3 on: June 12, 2007, 08:31:04 AM »

Hi Jackie

Found what I was looking for - this indication may help you.

*** Note from Andy:- Gary's list below represents likely outcomes for 'complete' spinal cord injuries only.  A good percentage of all cervical spinal cord injuries will result in an incomplete permenant outcome.  To understand the differences between 'complete' and 'incomplete' spinal cord injuries please see this section of the site ***

http://www.spinal-injury.net/what-is-spinal-cord-injury.htm

C4Usually has head and neck control. Individuals at C4 level may shrug their shoulders.

Breathing: May initially require a ventilator for breathing, usually adjust to breathing full-time without ventilator assistance.

Communication: Normal, may have weaker voice projection

Daily tasks: With specialized equipment, some may have limited independence in feeding and independently operate an adjustable bed with an adapted controller.


C5Typically has head and neck control, can shrug shoulder and has shoulder control. Can bend his/her elbows and turn palms face up.

Daily tasks: Independence with eating, drinking, face washing, brushing of teeth, face shaving and hair care after assistance in setting up specialised equipment.

Health care: Can manage their own health care by doing self-assist coughs and pressure relief's by leaning forward or side -to-side.

Mobility: May have strength to push a manual wheelchair for short distances over smooth surfaces. A power wheelchair with hand controls is typically used for daily activities. Driving may be possible after being evaluated by a qualified professional to determine special equipment needs.


C6Has movement in head, neck, shoulders, arms and wrists. Can shrug shoulders, bend elbows, turn palms up and down and extend wrists.

Daily tasks: With help of some specialized equipment, can perform with greater ease and independence, daily tasks of feeding, bathing, grooming, personal hygiene and dressing. May independently perform light housekeeping duties.

Health care: Can independently do pressure relief's, skin checks and turn in bed.

Mobility: Some individuals can independently do transfers but often require a sliding board. Can use a manual wheelchair for daily activities but may use power wheelchair for greater ease of independence.

I would imagine that Craig will have a combination of these. However, as I say, the important thing now is to discover whether he is "complete" or "incomplete" and I expect that will not become clear until AFTER his surgery on Wednesday.

There is still hope for a positive outcome. You cannot rush these things. I was told the other day that 2 out of 100 spinal cord injury patients will walk out of hospital - fingers crossed that Craig is one of the 2.

My jockey friend said to me the other day, he was given a 5% chance of walking and he worked out his odds at 50-1. However, 50-1 in the racing world is classed an "outsider" but he said it is possible for an "outsider" to win. In his case, it worked. As he says, he may be walking on crutches and have weak hands but it is a better outcome than he was first given.

Keep your pecker up Jackie and let us know how Craig fares.
« Last Edit: June 12, 2007, 11:10:04 AM by Andy » Logged

cauda equina lesion. Cord undamaged/intact (Accy. 1989) gammy arm & traumatic brain injuries (Accy. 2006)

ALWAYS REMEMBER - The darkest hour is only 60 minutes long and what won't kill you will make you stronger.
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« Reply #4 on: June 12, 2007, 11:03:21 AM »

Hi again Jackie,

The most important thing at the moment is to know and understand spinal cord shock and the fact that every spinal cord injury is unique. the drs may have mentioned spinal shock to you?  In most cases the true extent of the permenant disability wont be known until this has taken place it can last some time up to 6 weeks post injury date.

Spinal Cord Shock
When a spinal cord injury is caused due to trauma, the body goes into a state known as spinal shock. While spinal shock begins within a few minutes of the injury, it make take several hours before the full effects occur. During spinal shock the nervous system is unable to transmit signals, some of which may return once spinal shock has subsided, the time spinal shock lasts for is approximately 4-6 weeks following the injury. In some rare cases spinal cord shock can last for several more months.  The loss of these signals will effect the persons movement, sensation and how well the body’s systems function. Often the persons loss of movement and sensation below the level of the spinal cord injury may appear complete soon after the injury. This may mask the real extent of the damage. Usually, over the first few weeks the some of body systems adjust to the effects of the injury and their function improves. Therefore, during this time and the early stage of ANY new injury it is unlikely that an accurate prediction of any recovery or permanent paralysis can be made.

Treatment begins with the emergency medical personnel who make an initial evaluation and immobilise the patient for transport. Immediate medical care within the first 8 hours following injury is critical to the patient's recovery. Nowadays there is much greater knowledge about the moving and handling of spinal injury patients.  Incorrect techniques used at this stage could worsen the injuries considerably.

When injury occurs and for a period of time thereafter, the spinal cord responds by swelling. Treatment starts with steroid drugs, these can be administered at the scene by an air ambulance Doctor or trained paramedic. These drugs reduce inflammation in the injured area and help to prevent further damage to cellular membranes that can cause nerve death. Sparing nerves from further damage and death is crucial.

Each patient's injury is unique. Some patients require surgery to stabilise the spine, correct a gross misalignment, or to remove tissue causing cord or nerve compression. Spinal stabilisation often helps to prevent further damage.  Some patients may be placed in traction and the spine allowed to heal naturally.  Every injury is unique as is the course of post injury treatment that follows.

see also:- http://www.spinal-injury.net/what-is-spinal-cord-injury.htm
 
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« Reply #4 on: June 12, 2007, 11:03:21 AM »

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Apparelyzed
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« Reply #5 on: June 13, 2007, 08:41:03 AM »

Hi,

Well, I'm a C5/6, so I can tell you what I'm capable of.

I can work this computer using a typing stick strapped to my hand, and instead of a mouse, I use a trackerball.

I can cook prepared food, use a kettle, and make cold drinks. I can also open cans of beer with my teeth.

I can push my wheelchair on level ground, and up moderate inclines.

I can transfer myself from my wheelchair to my bed and back again.

I can empty my own legbag, which is essential if you want to be on your own all day. My wife can leave me all day if she needs to, for example, she went to London the other week, she left the house at 8.00am,and got home at 11.00pm. I was fine.

What I can't do.

I need help in bowel and bladder management.

I need help with washing and showering, and getting dressed.

I need help with preparing food.

Help is needed  in getting into, and out of a car.

These are the general day to day activities that I come accross, but if you need to know anything specific, just ask.

As it's early days yet, and the full extent of your son's injury isn't known, it is difficult to say how many of the above activities he will be able to do. If he is a c5/6, then he should be able to do the same as me over time, but certain tasks can take years to learn. His functionality will also be affected by his strength and stamina, as well as bodyweight, so it's essential he goes to Physiotherapy and Occupational Therapy, and looks after his health in what he eats.

If you need to know more, just ask.

Regards

Simon.
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cate
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« Reply #6 on: June 16, 2007, 02:46:15 PM »

Hi Jacky
My daughter is c5 &6, she is one of the lucky ones in a way. She able to walk with a crutch and also work, but has a tilting stool to enable her to do this. also drives and lives on her own.  the problem was not discovered for some years, and once it was they operated immediately, and they hoped to  keep her out of the wheel chair, and so far very good. She has brown sequard syndrome.  which is the nerves effected badly. she has bad balance especialy in darkness. her spinal cord was completely squashed  and has not rejunivated because of the time lag, maybe your son will be more fortunate in that area, as I understand this the sooner this is found the better and more chance  the nerves may repair.   I hope this will help you to look forward with some hope. i have possible not explasined to well,  but may help a bit.
Sorry for the mistakes  my pc is broken and I am on my daughters,  which has a different keyboard to mine, I a struggling with it.  best wishes to you son and family, 
Cate
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Jude
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« Reply #7 on: June 17, 2007, 01:31:04 AM »

Jackie,

it must be day 3 post-op??...You must be SO scared, worried sick and exhausted.....We're all rooting for your boy, and I hope and pray that the op went well.....BIG hugs. xxx
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jackie
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« Reply #8 on: June 18, 2007, 03:29:21 AM »

HI Everyone

As you can see from the time of my email, I am having another restless night.  On Saturday morning the doctors were forced to remove Craig's ventilator tube as it was blocked.  He managed to breath on his on but was exhausted, never the less he held his own.  When we visited yesterday, he managed to chat with us and was asking me to massage his hands, he told me he could feel me doing this.  He was also shrugging his shoulders, so my husband and I were feeling reall positive for him.  We went to have a bite to eat and when we came back we were advised the doctors were "working on him".  2 hours passed and we were eventually told that they had to ventilate him again.  This was a big shock, as he was once again heavily sediated.  They advised they felt this was the best option as Craig was exhausted due to him having a chest infection.  He has MRSA in his chest and was struggling to get mucus from his chest, some had clogged in his lungs.  They told us the suction from the ventilation will clear this along with the antibiotics.  I feel really angry as it all happened so suddenly and he appeared to be doing so well.

I am really concerned re the level of sedation.  Craig is going to struggle big time when he comes around as the tube is back down his throat and he hates it, keeps bitting on it, so they sedate him to prevent this.  Surley they can't keep sedating him, it can't be good for him.  We have been told the reason he didn't manage to breath on his own for long (32 hours) was because he went from being heavily ventilated to none and his lungs did not get time to adjust.  Is this the case?  They advised they plan to wean him off the ventilator and hopefully have him breathing on his on asap. 

I really feel for him, as he was being so positive yesterday, telling us he was going to fight this all the way, that he would do what ever was asked of him ten times over.  I don't know how he will react when he comes round, he will struggle big time due to the tube being down his throat.


I phoned the unit at 3am they say he is settled and they have begun reducing the sedation. I want to be there with him, I can't stop crying as he must be so scared and alone.  Roll on 12pm so that I can get back up to the hospital.  Speak to you all soon and thanks again for all your feedback, it does keep me going.

Jackie
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Apparelyzed
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« Reply #9 on: June 18, 2007, 08:47:30 AM »

Quote
We have been told the reason he didn't manage to breath on his own for long (32 hours) was because he went from being heavily ventilated to none and his lungs did not get time to adjust.  Is this the case?

Yes, this is correct.

Before his accident, he would of been using other muscles in his chest called intercostal muscles to carry out the breathing function, in combination with his diaphram. Now he is paralysed, his intercostal muscles will no longer work, so all his breathing will be done by his diaphram.

The diaphram is also a muscle, and as such, will need to build up it's strength in order to compensate for the loss of the other muscles which prevously helped his breathing.

In some cases, high level quads can take quite a long time before they come off the ventelator, but if he is very determined, and his chest infection clears up, then he should be ok.

Regards

Simon.
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« Reply #9 on: June 18, 2007, 08:47:30 AM »

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gzarnke
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« Reply #10 on: June 18, 2007, 08:23:39 PM »

jackie  i am praying for you and your son. it is so very hard not to be with your son at all times i am sure that when he is more awake you will be able to be with him when ever you want.   

last summer when my son was in the hospital i got to stay in the room with him for 7 days. i had a cot to sleep on and everything it was good for me and my son so i could be there when he needed anything.

your son sounds very strong and is getting the best of care, you hang in there as you are doing the best you can for him right now.

gzarnke
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« Reply #11 on: June 19, 2007, 03:04:03 AM »

Hi Jackie,
Im glad he was able to chat to you a little bit and that he told you he was going to keep fighting. He will keep doing this even when he comes out of this current sedation and finds a tube down his throat. It wont keep him from being positive.

Its probably way harder for you having to watch him go through this than it is for him to go through it. He has had a major injury, he will have his ups and downs. It takes a long time to recover from something like this, as we all know.

Keep being positive for him Jackie... keep hoping and praying and doing whatever you can to help him recover. we are here for you when you need to dissolve ok...

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jackie
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« Reply #12 on: June 21, 2007, 12:46:54 AM »

Hi Everyone

Craig is still on the ventilator, but he is breathing on his own, the vent is there to help him if he gets tired.  He has gone 2 days without having to be put back on full vent.  His chest infection appears to have cleared, he is no longer sedated.  they have removed the vent from his mouth and put it down his nose, so he is coping better with this.  He was a little tearful today and didnt want his dad or I to leave his bedside.  We are telling him how well he is doing and trying to be positive.  He managed a few smiles today and when we left him tonight he appeared more settled.

We have been told if he keeps breathing the way he is he should be off the vent soon, so fingers crossed.  As I said  before he is a fighter and I pray he keeps up the fight.

Thanks again for all your kind words of support.

Jackie
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Jude
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« Reply #13 on: June 21, 2007, 05:08:22 PM »

Jackie,

I've got everything crossed for you, and hope that Craig will be off the ventilator soon....It's a step in the right direction, at least!! There's no doubt that it's going to be a long haul, and sometimes it'll seem as though you're taking a couple of small steps forward and a huge stride back, but stay strong and with your love and support, and Craig's own fighting spirit, you'll get there, I'm sure.

BIG Hugs!!  xx
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« Reply #14 on: June 22, 2007, 05:39:25 PM »

Jackie,

good to hear that Craig may be off the vent soon as Jude said that is a step in the right direction with a long way to go.  There will be more good days with bad days and the worst of days ahead but in time the good days will be more frequent, it will take time and a strong heart.

I think of you and your son often and i am here anytime you need to talk

gzarnke
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« Reply #15 on: June 24, 2007, 02:09:24 AM »

Jackie,

I want to start by telling you this is all to new for me. I have been reading many of these postings over the past month but have not posted until I read yours today. I have a Incomplete SCI Level C3/4 c4/5 and c5/6, I had surgery in Nov. Before the surgery I lost everything walking, writing, feeling, touching: it was a nightmare at the time, but what was important in those moments was my family, their support and their ability to knew when to push me and when to back off. They became my ears when I could no longer hear what the doctors were telling me, they became my eyes, when I could no longer look at myself, and most of all they just never let me forget who I was and still am. I think they knew I was more anger then scared in the begining, I don't know why scared came weeks later for me. I can only share with you a few months of my knowledge, you will find this site fill of information and support just by reading it.

I am still in rehab but I am at home and go as an outpatient.

Everyday is now A NEW BEGINING to me, I find big joys in the littlest of things, feeling is slowly returning, I'm relearning things like writing, typing and walking. Working through the walls of pain that you hit are the hardest but I do get over the wall by the fact I will not let this define who I am. I am allot older then your son, he has youth on his side which is what will make him excel.  I still have allot of healing to do, but this web site has let me know that I'm not alone, I read and I learn something new everyday. I have a 23 year old son who Told me this " How many people get a 2nd chances at life" I guess he is right, this is my second chance. Life will never be what it once was for me, but thats only NOW OKay with me, I'll adjust I know that now, and you and your son will get there too... but it will and must be on his terms, when he is ready. We all will take these lemons and make lemonade out of it.

Its taken me almost 2 hours to write this short note, but I did it! If you have questions please ask and I will try to answer them, remember there is still allot of unknowns for me and other might be able to give you more, but I will try. Keep the Faith, and please excuse the typing.

I will keep your son and your family in my prayers. I hope this helped.
God Bless
Anabel
 
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