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Thread: How much can doctors know after 20 days?

  1. #1

    How much can doctors know after 20 days?

    Hello all.

    Just under 3 weeks ago, my sister was shot in the neck, injuring the spinal cord at the C5/C6 level.

    Since then, the dotors haven't been able to give us a clear picture as to exactly what's going on with her body. I'll give a timeline as to what we know and the order in which we were told certian things.

    The first doctor (actually, think it was the surgeon) said that the bullet penetrated the spinal cord and there were bullet or bone fragments still in the cord. At this point, she's got a breathing tube down her throat, hopped up on pain medications and just pretty messed up in general. They say something about an entrance AND an exit wound.

    The next day, we were showed an X-ray of her neck from several angles. The left half of the spinal column was shattered, but the right side was fine. The bullet looks like it took out less than half of the spinal cord. The doctor says it's far too early to tell what she can or cannot get back, and the swelling needs to go down first. In the X-ray, there is a bullet-shaped object, that the doctor says is the bullet lodged in her neck. (The first doctor said there was an exit wound)

    About a week goes by, and she's getting the tube taken out of her throat, and a trach installed. My sister is starting to get a little feeling near her elbow at this point. A doctor comes up to my mother (who was having a bit of an emotional breakdown) and wants to go over some things about the x-ray upon further review. He says that from what he can tell in the x-ray, the bone deflected the bullet just enough so it didn't actually penetrate the cord. He says that it may have brushed against it, and probably burned it, but he said it looked like the whole cord is still intact. This leads my mother to believe it is likely an incomplete injury.

    A few days after the trach was installed, the doctors were doing some tests on her legs to see if she was regaining any feeling. They put a sheet up between her head and the doctor, and he proceeded to jab her with a toothpick. She correctly told him which leg he was jabbing each time he did jab her... but sometimes when he *didn't* jab her, she still said she felt something. So, they deemed that test "inconclusive." The next day, they did a different test... instead of a sharp jab, he grabbed a big chunk of one of her legs and pinched hard. She said she felt it, and correctly guessed which leg it was. However, the doctor said he can't be sure that her mind wasn't just playing tricks with her, so he isn't putting much faith in that test.

    A day later, they hooked up some electrodes to her, and no signals were getting through. The doctor said he didn't really expect them to this early, he was just hopeful

    At the two week mark, almost exactly, my sister said she is getting, as she put it, a "flickering sensation" thorughout her entire body. She described it to when you turn on a florescent lightblub, how it flickers a bit before coming on. A doctor asked her if she could describe it any other way, and she said "kinda like a tingling." She says it's a little bit like when a body part "falls asleep" with the pins and needles, but not quite. My sister is in good spirits at this point, and just can't wait to get into rehab. She's now breathing right over the ventilator.

    A few days ago, she was moved to Kernan rehab center here in Baltimore, which is supposed to be the best in the state. They've turned off the ventilator, but left the trach in just in case. Her legs have spasmed slightly, which my mother mistook as a good sign. She asked one of the doctors "so this is an incomplete injury, right?" And the doctor responded that the note from the doctors at Bayview is that it's a complete injury, but he hasn't personally evaluated it yet.

    This has my mother absolutely crushed. She was doing so well for a while, assuming my sister was going to be able to walk again after hard work and rehab, but those dreams for her have been shattered to pieces in an instant. I tried comforting her, saying that it's still too early for the doctors to know for sure.

    Thing is, I have no clue whether that's true or not. I've heard of cases where somebody was originally diagnosed as "complete," but ended up regaining much functionality below the injury. Is such a misdiagnoses a rare occurance? I mean, the doctors couldn't even agree whether the bullet penetrated the spinal cord... seems to me there's still too much swelling and such around the cord to determine if this is a complete or incomplete injury.

    Additionally, would she be feeling a tingling in her legs if it were a complete C5/C6 injury? Seems to me that would mean something is going through to the brain.

    Lastly, if the bullet hit less than half of her cord, and some studies show that only 10% needs to be intact for signals to get past, shouldn't that alone lead us to believe that it is an incomplete injury?

    Sorry for the long-winded post. Just have a ton of questions that the doctors don't seem to know the answer to, so I figured I'd talk to some people that have experienced these things firsthand.

  2. #2
    That she has some feeling is a very good sign.
    BTW, "complete" just means that there is no sensation at the anus, not that there's nothing functioning below the injury. So for example one might have absolutely no feeling or control in the legs or arms, but if one can feel a poke in the butt, they're incomplete. Or, on the other hand, one could have nearly perfect control&feeling in the legs, but if there's no sensation at the anus, it's a complete injury.
    People (e.g., my wife) often have feelings like tingling or pins&needles, or "asleep"; I don't know if they originate where they seem to be, or at or above the injury.
    As far as I know, the bottom line is you just have to wait & see, be happy for every sign of return, but try not to despair if it comes slowly (it never seems to be quick) or even not at all.
    I'm glad you found this site but sorry you needed to, it's the greatest. We will all be looking forward to hearing from your sister first-hand - the computer and the internet make an incredible difference to the SCI'd. And don't be afraid to ask any kind of question - anything goes. You'll learn a lot here.
    - Richard

  3. #3
    Senior Member
    Join Date
    Nov 2004
    Welcome, Jack.

    Don't waste your energy over complete or incomplete. It really does not mean much. Your sister has some feeling, and that is the good thing! She will experience much more recovery over the months to come. There is so much that will occur over the first year post injury. Stay stong. I wish all of you the best!

  4. #4

    I would print the article linked above and show it to your mom and sister. It was written for the situation you are in.

    Your mom will melt down, it's natural. What a horrible place for her to be in, she must be terrified. Please tell her that you are literally months, possibly as much as 2 years, from knowing how this will work out. After 20 days, the doctors don't know much and always give the worst-case scenario. I wouldn't listen to them too much about prognosis, they never told me nearly as much as the therapists and even nursing techs did. Usually damage from gunshots are particularly devastating to the spinal cord but I'm thinking she may have caught a break. Only time will tell.

    The sensations may be real, or not. I had sensations in my legs that they told me were imaginary, up until they saw me stand up in the swimming pool! I also had sensations of wire cables wrapped around my fingers that were obviously neurological. Your sister is so early in this game that she is larval. It takes an incredibly long time for the spinal cord to settle down.

    You are smart to have found us so soon. Please ask any questions you have. This is survivable, it's not easy but there is a life out there for her.

    PS-I'm not a medical pro obviously, just someone that's been there. Take my advice as only that. Please make sure your sister knows it is crucial she be turned in bed every 2 hours. Skin problems rear up that fast, and really set you back in rehab. She needs to be aware and not too trusting that other people know how important it is.

  5. #5
    We were so happy when Cisco started to spasm in his legs. I thought it was him recovering but at 2 months after injury he just started spasms. It had nothing to do with recovery and he still has them 7 years later. It doesn't mean that she won't recover though because 5 years after injury, Cisco is getting more movement. He can now use his abs and fingers and toes. Never give up and keep us posted on progress. MAKE SURE to roll side to side. DO NOT get a bedsore. When Cisco gets one, he's out for 2 months at least!

  6. #6

    Hey Jack

    I answered your PM. Use te direct number I gave you and give me a call tomorrow after 10 am. I will be happy to assist.
    Big question, does your sister have private insurance? Have you gone to Crime Victims assistance yet? We can go over all of this when we talk. If she has insurance she has more options than Kernan.
    Every day I wake up is a good one

  7. #7
    Jack, like everyone else has said, it's way to early to tell what return she will get back. I was 3 1/2 months before I moved my right leg. I am also a c5 c6. I also did my rehab at Kernan, they have an excellent SCI program there. I can't speak to highly of the nursing staff but when your in the gym, their the best. the best advice I can give you is to put your faith in Jesus Christ and "pray without ceasing". what is your sisters name? I will pray for her also. I will be at Kernan on 8/02 I will ask about her. you will meet "Jen"
    the rec therapist (if you haven't already), she is also here on the care cure site. Keep us all updated.

  8. #8
    Rod: My sister's name is Jessica. I'm not particularly religious, but the rest of my family (and Jessica) is, so they appreciate the prayers.

    I'm not there every day, so I haven't personally met Jen yet, but it's possible my family has. My mother is at her bedside from 8am to 9:30pm every day, so I'm sure most of the staff has met her by now. She had to quit both of her jobs to do it, but it makes Jessica feel more comfortable knowing her mother's right by her side. As far as the nursing staff goes, so far they've been nice. The man who was taking her blood for testing was a bit slow though... My sister had just finished her training to be a phlebotomist. She mouthed the words "he's slow!" to us when he was taking her blood.

    I appreciate the responses, all. I'll be giving you a call this morning, cheesecake. Since I'm pretty much the only one in the family who knows how to use a computer, I've been playing the part of "research guy," since so little information is coming from the doctors.

    I'll keep you guys updated, and you're sure to hear from me again if I have any more questions. Thanks again.
    Last edited by Jack21222; 07-23-2007 at 08:35 PM.

  9. #9
    Senior Member Robynbird569's Avatar
    Join Date
    Jan 2006
    Lake Isabella Mi
    Jack, my heart goes out to you, your family and your sister. My daughter was 3 when she had the same accident in the same area C5-C7. My advice dont go by what the dr.s tell you. They stick to much to what is written in a book and not what the patient is about. We went through some rough stuff with dr.s. Right now her body is going through shock and the swelling is to severe to determine anything. The swelling alone takes a long time to go down. I learned because of swelling an x-ray cant show anything (complete or incomplete). Right now focus on her getting her well and adjusted, the worse thing would be depression setting in.
    Boy you brought back alot of memories and my thoughts and prayers go out to you and yours.

    Stay safe my son. See you around thanksgiving!

  10. #10
    BE SURE your mom knows about turning her every 2 hours. Your sister is so fortunate to have such a supportive family!

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