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Thread: C5 injury, 3 weeks out

  1. #11
    I am not sure as to whether they have called this injury complete or incomplete; he does have some feeling in his legs now so maybe that means incomplete? This is all so new to us that we don't know all the terms yet. He has been able to lift his hands to his nose, but couldn't bring them back down a couple of weeks ago. He says he keeps feeling like he's falling off the bed. The doctor said that could be a side effect of the morphine, so they are going to stop that because there is not much pain now. If my daughter touches his feet, he has started to jerk them away. i am not sure if that is just a reflex action or something else. He also said that he felt pressure on his lower back like something was behind it, but nothing was. Could that be some kind of sensation trying to return? I appreciate everybodys input. We are just so confused right now.

  2. #12
    Quote Originally Posted by CASPER
    I am not sure as to whether they have called this injury complete or incomplete; he does have some feeling in his legs now so maybe that means incomplete? This is all so new to us that we don't know all the terms yet. He has been able to lift his hands to his nose, but couldn't bring them back down a couple of weeks ago. He says he keeps feeling like he's falling off the bed. The doctor said that could be a side effect of the morphine, so they are going to stop that because there is not much pain now. If my daughter touches his feet, he has started to jerk them away. i am not sure if that is just a reflex action or something else. He also said that he felt pressure on his lower back like something was behind it, but nothing was. Could that be some kind of sensation trying to return? I appreciate everybodys input. We are just so confused right now.
    CASPER,

    From your description, it sounds as if he has a C5 or C6 neurological level. The deltoids (that lift the arm from the shoulder) is C4. The biceps (that flex the elbow) is C5. The wrist extensors (that allow the wrist to be held straight) is C6. The triceps (that straighten the elbow) is C7. The neurological level is the lowest intact level. So, depending on whether he can extend his wrist, it sounds as if he has a C5 or C6. The fact that he can bring his hands up to his nose indicates that his biceps are working. If he can hold his hand straight to touch his nose, he may have some C6. However, the fact that the cannot move his arm back down means that he has very weak triceps.

    Regarding "complete" injury, it is defined by the absence of voluntary movement and conscious perception of sensations below any level of the spinal cord. Please note that his spinal reflexes below the injury site are still active, explaining why his leg pulled away from his daughter touches his leg. He, however, should not be able to feel it. Since the lowest part of his spinal cord innervates the anal region, the absence of sensation and voluntary contraction of the anus is generally the criterion used by doctors to indicate whether he has some level below which he has loss of all sensation and voluntary movement.

    During the early phase after injury, the presence of sensation below the injury site may or may not be predictive of recovery. However, a majority of people will recover 1-2 segments below the original injury site. So, he should be working on trying to get his wrist extensors and triceps back. These two muscles will make a big difference for his independence. Having the wrist extensors will allow him to operate a computer keyboard. Having triceps will allow him to lock his arm and transfer to and from the wheelchair. Having hand function will allow him to catheterize himself. In general, the segments close to the injury site are the most likely to recover.

    Finally, I dislike the term "complete" and "incomplete" because many and doctors misinterpret these statements to mean that there is no connection across in the injury site in "complete" injuries. This is not true. Even in people with "complete" injuries, they may have some connections still crossing the injury site... it is just not enough. Of course, being "incomplete" is a good sign and a majority (>90%) of people who are incomplete during the first 48 hours after injury can eventually recover walking.

    I hope that this is helpful. Please do ask more questions if you don't understand.

    Wise.

  3. #13
    Quote Originally Posted by Wise Young
    CASPER,

    From your description, it sounds as if he has a C5 or C6 neurological level. The deltoids (that lift the arm from the shoulder) is C4. The biceps (that flex the elbow) is C5. The wrist extensors (that allow the wrist to be held straight) is C6. The triceps (that straighten the elbow) is C7. The neurological level is the lowest intact level. So, depending on whether he can extend his wrist, it sounds as if he has a C5 or C6. The fact that he can bring his hands up to his nose indicates that his biceps are working. If he can hold his hand straight to touch his nose, he may have some C6. However, the fact that the cannot move his arm back down means that he has very weak triceps.
    Thank you so much for that explanation. It never made sense to me that my fiance's injury was at C6, but they called it C8 tetraplegia. Now it makes sense.

  4. #14
    Okay, we really don't know what is going on now. Yesterday, he started having some uncontrolled trembling; doctor is going to run a brain scan today to check this out. His fever still is ongoing. Is fever a common side effect of this kind of injury, or can they just not find the answer and won't admit it. He cannot be moved to rehab until these issues are resolved, but he will never get any better until we can get him into therapy. Our frustration level is through the roof, as well as being scared of these other things that are starting to occur. They did put him into a deeply sedated state yesterday to do a deep lung suction; could the trembling afterwards be a side effect of coming out from under the sedation? We just don't know and need answers.

  5. #15
    Quote Originally Posted by CASPER
    Okay, we really don't know what is going on now. Yesterday, he started having some uncontrolled trembling; doctor is going to run a brain scan today to check this out. His fever still is ongoing. Is fever a common side effect of this kind of injury, or can they just not find the answer and won't admit it. He cannot be moved to rehab until these issues are resolved, but he will never get any better until we can get him into therapy. Our frustration level is through the roof, as well as being scared of these other things that are starting to occur. They did put him into a deeply sedated state yesterday to do a deep lung suction; could the trembling afterwards be a side effect of coming out from under the sedation? We just don't know and need answers.
    Casper- I had a temperature of 101 for over a month after my c4/5 injury. trembling, shivering, shaking could be from many different things. I'm pretty sure those symptoms can be result of a fever.

    Once he can get his lungs stronger, he will have a better chance of bringing the fever down. His situation parallels my past experience -- I'm sorry. From what I remember the most important thing my family and friends did was to continuing to show support and love. It's unfortunate for so many things to be out of control. Being here, asking questions, and being there for him is incredibly important.

    Stay strong.

  6. #16
    Okay, now just told pneumonia has set up. What next? SO FRUSTRATING

  7. #17
    most get it. it's from laying on your back all the time , weak lungs and not being able to cough hard. i had it after 4 weeks or so.
    oh well

  8. #18
    The fever was from the pneumonia developing. This is nearly universally a problems for anyone with a new cervical cord injury.

    Treatment for pneumonia includes lots of "pulmonary toilet" which include chest physical therapy with a "thumper" or the VEST, which does this all the time, plus often IPPB, and vigorous and frequent assisted cough with the Cough-Assist or manual quad coughing, along with rest, oxygen, and antibiotics (assuming this is a bacterial pneumonia which is most common). There should be frequently assessments of the lungs by the nurses and doctors listening to the lungs, chest Xrays, and blood oxygen measurement (usually non-invasive oxymetery). Sometimes a vent is needed until the acute phase is over.

    You can also ask about his WBC (white blood count) to guage how well the infection is being controlled. Sepsis is the major risk and I am sure that at Shephard they are very experienced in managing this. Ask them LOTS of questions. It is their job to answer questions from the family and patient.

    (KLD)

  9. #19
    i can tell you this i had average temp of 104/5 for near 2-3 months its was horrible they couldnt get read of my pnuemonia and he could be having spasms now if he has uncontrollable tremors but i thought that came after a couple months

  10. #20

    what ever you do

    stay away from fraiser , i was there for 5 wks and it was a nightmare , go to shepards

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