NEVIS CYCLE & TRIATHLON CLUB

He was riding with friends on the rail trail and didn't notice the guy in front of him slowing down.  When the guy yelled "Truck", David slammed on his brakes.  Roads cut across the rail trail, and roads have right of way.  The bike did a somersault.  David flew off the bike and also somersaulted, coming down on his face on the asphalt and then glancing off a metal piling thing.  He doesn't remember the piling thing, but he remembers the ground coming up to meet his face.  He cut and rashed up his face pretty well, and the guys spent some time cleaning him up.  He assured them that he could ride home, another 22 miles.  His neck was starting to hurt and he said he wanted to get home before it really stiffened up. He tried to call me at home, and when I didn't answer, he didn't think to try my cell.  He got home, washed his bloody clothes by hand, hung them in the basement, and was sitting down trying to read at the kitchen table with blood dripping off his chin when I walked in about 4.

I took one look and said we were going to the dr.  He looked very bad and couldn't turn his neck.  I called the dr. office and they said they didn't have any more appointments that day!  They said to go to Urgent Care.  We were there from 5-9:30. They cleaned his face and shoulder, etc.  In between they sent us to the hospital to get records and then waited for the radiologist's report.  He had X-rays on his shoulder too.  The shoulder one was fine.  The radiologist said the neck X-rays were indeterminate, that there was a lot of swelling and that there could be something lurking that he couldn't see, but to go home and go to the ER if any of several symptoms appeared. They thought it was probably a bad whiplash.

We stopped on the way home to pick up a prescribed neck collar.  When we got home after 10 pm, there was a message on the machine that we were to go back to the ER for a CT scan.  The dr. then called right away and said the radiologist just wasn't comfortable with the X-rays and really wanted to see more.  Thank god for the dr. who insisted on the X-rays and the radiologist who went the extra mile after he had already sent over the report.  Can you imagine if this had been Nevis?

We were in the ER from 10:30 until 3 am.  Again the docs had him turn and raise his neck, etc. and said he could walk to the bathroom, etc.   I imagine they are biting their nails over this now. Mostly they left us alone.  They did the CT scan around midnight or later.  About 45 minutes later, a nurse appeared with a rigid collar, put it on him, and told him he couldn't move.  The doctor walked in later and announced. "You broke your neck."  He said they were admitting him to the hospital and would do an MRI in the morning to see if he needed surgery.  He then took me down to some screens and showed me the CT scan.  He said it was crucial that David not move  - that he could be instantly paralyzed.  He said he couldn't believe that he could ride all the way home and then climb stairs, etc. and not suffer bad damage.  Every doctor we saw echoed how lucky he was.

The long and short of it is that he has a fractured odontoid process, Type III but first diagnosed as Type II, between C1 and C2.  This is the same place that Christopher Reeve had his fracture.  His fracture is classified as unstable, but it is not displaced.  It is the displacement that causes problems.  Just a little bit, and not only can you be quadriplegic, but your independent breathing is gone too.  Every function below the 2nd vertebra is affected.  The treatment is either a halo (a metal brace that screws into your head), surgery to fuse the 1st and 2nd vertebra, or a brace/collar thing.  The neurosurgeon doesn't much care for the halos because of possible complications, and needless to say, that wasn't David's first choice.  He didn't want to do surgery to fuse the 2 vertebrae if he didn't have to, because you permanently lose some mobility.  He and David were happiest with this collar thing.  They will take an X-ray every week.  If there is no movement of the fracture, they will go on to the next week.  If there is any movement, they will do surgery.  At the end of 8 weeks, he will have another CT scan, and if the fracture has fused, he might be done.  If fusion has not occurred, he will need surgery.

The biggest danger is falling.  And it's hard to see the floor in front of him because of the brace.  The next danger is a car accident.  The doc  doesn't want him in a car for 10 days, not because of the car ride, but because of the danger of an accident and being bumped.  If he falls or gets bumped hard, he is to go to the ER right away.  I have to change him into a different kind of brace before he takes a shower. This is a little scary, but a guy from an orthopedic company came to the hospital and taught me how to do it and let me practice a couple of times He can't lift more than a gallon of milk, but can sit, walk, and lie down as he pleases.  He knows it will be at least 8 weeks in this brace and then probably physical rehab to get his neck flexible again after being held rigid for so long.  He knows the danger if he does not follow medical instructions.  They don't beat around the bush with this.

We did have some bad things happen in the hospital - twice couriers came to take him for MRI, X-rays, etc. and asked him to walk from a bed to the cart and a bed to a wheelchair when he wasn't supposed to be up, and one day they mistakenly canceled the X-ray orders and never scheduled him when the dr. was waiting to see them so that possibly he could have come home. On the 4th morning I asked a nurse if they still gave sponge baths or something similar, as no one had asked if he wanted to be washed or cleaned up since he had been there.   There were other things too - things that make you very aware that you would never want to be in a hospital on your own without an advocate or overseer.  But I finally spoke to someone very calmly with list in hand, and did things change after that!  He got lots of personal attention, the doctor finally materialized after 2 days of never having met or spoken to him, and we were thanked and told that a number of changes would be made.  Overall, we were happy with the staff and the care and especially thankful for the initial Urgent Care dr. and first radiologist and grateful that he was assigned an excellent neurosurgeon.

David's brother from Wisconsin is arriving this afternoon for a day, and Courtney insisted on flying in next Saturday for a few days to help out, play games, and give each of us a break.  All the kids were ready to jump on a plane, but nothing was imminently dangerous after the first night, and there is not much they can do.  Everyone is already scheduled for summer visits at the cottage.

We were supposed to have moved last Thursday to the cottage.  We think we will get there later in June, but obviously it depends on how things go in the next week or 2.  David is going to get bored no matter where he is, and we have the same computer and DVD movie access there as we do here.  And here we don't have a bathtub or close-to-bedroom toilet because our bathroom is torn apart with nothing in it being remodeled at the moment.

As I said at the start, he is a lucky man.  Enjoy each moment - you don't know what life has in store.

Love, Les