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ColumnistsRelated Stories |
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EMS: Courage and Compassion in ActionBy Shawn Godfrey - July 09, 2007
 | | Shawn Godfrey is a certified paramedic and the operations manager for the Village Ambulance Service Inc., Williamstown. |
The Spirit: The True Backbone of Us All
In 1995, actor Christopher Reeve fell from a horse and severely damaged his spinal cord, leaving him paralyzed from the neck down. From then until his death in 2004, our beloved Superman became the most recognizable face of spinal cord injury.
But he was not alone. Every year, about 12,000 Americans experience trauma-induced spinal cord injuries that permanently change their everyday activities, their jobs, their relationships, their dreams, their long-term happiness and their lives.
Paramedics and emergency workers are trained to treat people who have sustained traumatic head or neck injuries as if they already have a spinal cord injury or an unstable spinal column, until a thorough neurological screening and diagnosis can be completed. In fact, pre-hospital spinal immobilization is arguably the most emphasized treatment modality found in any emergency medical technician (EMT) text book or training syllabi.
One key step in the initial treatment of a traumatic head or neck injury is immobilizing the spine. Immobilizing the spine can prevent injury to the spine or forestall exacerbation of an injury that is already present. For this reason, emergency personnel receive training in handling such an injury, so as not to further manipulate the person’s neck and back. EMTs carefully apply rigid collars around the injured person's neck and methodically employ techniques to place the injured person on a rigid board, until a complete evaluation can take place.
In the emergency room, a physician may be able to rule out spinal cord injury by carefully inspecting an injured person, testing for sensory function and movement and asking some questions about the accident or mechanism of the injury. But if the injured person complains of neck pain, isn't fully awake or has obvious signs of weakness or neurological injury, further emergency diagnostic tests may be needed.
Significant injury to the spinal cord usually leads to permanent disability or loss of movement (paralysis) and sensation below the site of the injury. Paralysis can involve all four extremities, a condition called quadriplegia, or only the lower body, a condition called paraplegia.
An accident that results in permanent paralysis can be a life-changing event, whether you've lost movement in your legs and lower body or all four limbs. Recovery from such an event takes time, but many people who are paralyzed move on to lead productive and fulfilling lives. The will to live in all of us is amazingly strong and the adaptability used by many affected people to lead their lives is extraordinary.
Many scientists are optimistic that important advances will enable some motor and sensory function in people with spinal cord injuries within the next 10 to 25 years. In the meantime, medications, rehabilitation and counseling allow many people with spinal cord injuries to lead happy, active and independent lives. And make no mistake about it, those living with para/quadraplegia don’t expect or, quite frankly, want sympathy because of their condition. They simply ask we recognize that they are no different from the rest of us.
Jesse’s story is a reminder that the spirit is the backbone of us all.
Jesse’s Story
(Edited for Content)
When I was 18 years old, I was hired for summer work by the local highway department. Among an array of duties, one of the job responsibilities consisted of operating a street sweeper. While driving the sweeper, I had to cross a set of infrequently traveled railroad tracks to dump the contents at a nearby waste station.
After dumping the contents, I needed to cross back over the tracks to continue my route. Unfortunately, due to an abundance of drooping overgrown tree boughs, I could not clearly see to my left. As I inched forward to see beyond the encumbering tree line, a train engine was quickly backing down the tracks.
I remember the engine speedily emerging from the trees and violently crashing into my vehicle. I was ejected from the cab then violently landed on the corner of an old railroad tie lying in a nearby conduit. The impact permanently damaged most of my C-5 (numbered top-to-bottom from C1-C7, atlas [C1] and axis [C2)], are the vertebrae that allow the neck and head so much movement) vertebra.
After summoned by another motorist, the paramedics, realizing the seriousness of the injury, immediately injected a steroid that helped contain the swelling in the spinal area. From the scene, I was airlifted to a nearby trauma hospital and immediately operated on by a team of neurosurgeons and other specialists.
The only injury I sustained was the broken C-5 vertebra. The surgeon had to extract most of the bone and reconnect the remaining segment by fusing bone from my hip and securing it with a plate that attaches to the C-4 to C-6 portion of the spinal column. He explained to me that my spine was “bruised” and that none of the nerves were severed.
Following surgical stabilization, I was eventually sent to a rehabilitation hospital to start my “new” life. While there, I started to regain sensation, albeit limited, in both arms and wrists.
I am now classified as a C-5/C-6 quad. I have the ability to strongly raise both my wrists, palms down, but cannot raise either, palms up. I also regained a small amount of triceps (upper arm muscle) use and can flex the muscle slightly, but it is too limited for effective utilization.
Aside from the ability to feel above the nipple line, I do feel pressure throughout my entire body. I also feel indescribable discomfort in my back, buttocks, and feet. Although difficult to explain, I can also sense when I am touched on these areas.
My feet are especially sensitive to touch, with a “pins and needle” sensation, and I have the ability to feel when both buttocks are getting sore from sitting in one position too long. Fortunately, this reminds me to reposition myself in order to prevent painful pressure sores.
The present condition of my hands is interesting, too. I can feel what could be classified as a “normal” sensation in my thumbs and index fingers, but only a pressure-like sensation in the remaining digits. I also feel pain in my upper arms, shoulders, upper chest and head.
I suffer from periodic spasms in the paralyzed muscles, but it is usually controlled with 50mg of Baclofen (medication used for the treatment of spastic movement, especially in instances of spinal cord injury) a day.
All things considered, I am relatively healthy. My doctor often tells me I am the poster child of what life as a quadraplegic can be, and thanks to the excellent care I receive and the effort and enthusiasm put forth in my rehabilitation, things will only become easier.
Truthfully, I am not looking to walk again, but I wouldn’t mind doing so. Mostly, I would like to have full use of my arms and hands. This would allow me the ability to care for myself and not constantly rely on the help of others on a daily basis.
Just the ability able to transfer myself from the wheelchair to and from the bed; dress; cook; bathe, or throw a baseball again would be wonderful!
One Step at a Time
Today, there's still no way to reverse damage to the spinal cord, but advances in recent years have improved the recovery of patients with spinal cord injuries, cutting in half the amount of time survivors must spend in the hospital. Researchers are working on new treatments, including innovative therapies, prostheses, and medications that may promote nerve cell regeneration or improve the function of the nerves that remain after a spinal cord injury. |
| This a story is a great reminder. Sometimes We wonder why we board everyone that has had a fall or car crash. Then we have a pt. that has a cervical fracture that would be parylized if they weren't placed in a crevical collar and on that backboard. | | from: JLQ | on: 07-13-2007 |
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| Good Story, we sometimes forget that once we drop them off at the hospital our journey usaully ends with them, but their journey will last the rest of their life. | | from: Midnight Medicine | on: 07-13-2007 |
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| Sean -- Excellent article, I really enjoy reading your column on Iberkshires and find them very informative. Keep up the great work. | | from: Steve | on: 07-10-2007 |
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| great article. not something we think about on a day to day basis until it happens to us or someone we love. | | from: veronica | on: 07-10-2007 |
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| Yes, people with permanent paralysis are handed a mobility disadvantage, but for those I have met, they remain socially active and instrumental in delivering positive contributions to everyone around them. | | from: Colleen | on: 07-09-2007 |
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| Hey Shawn!! Interesting column. Can someone suffer an injury that paralyzes the arms but not the lower extremities? just wondering. ;) | | from: wag | on: 07-09-2007 |
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| Loved the column! I can't imagine the work that is need to recover from such a devistating injury. | | from: Jorge | on: 07-09-2007 |
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