New SCI from Hong Kong

[Cancankwok]

Hi Dr. Wise,

I am very pleased to be able to seek information from this channel at this helpless moment. My 29-year-old sister got a car accident while travelling Scotland on March 24th. She was severe injured and was just out of ICU few days ago. Doctor says that she gets spinal cord fracture in C4-C5 and broken spinal cord from C6-C7. She has undergone several operations for internal bleeding, broken leg, chest ribs and neck since then. And she will has another one for her front neck so as to allow herself to sit up as soon as possible. However, doctor here says given today's medical resouces / technologies now, my sister will not be able to walk again. My parents, sisters and my sister's friends who have flown to Scotland from Hong Kong after the accident, were shattered apart after hearing the bad news.
Dr. Wise, could you please advise how we can do next? Is my sister really hopeless even in the future according to what doctor said? We understand that my sister can't leave Scotland until she has no problem breathing her own. And our plan is seeking doctors in China and Hong Kong, actually wherever are possible for treatment. Is there any doctor who has started stem cell transplant in Asia?
Thanks for your taking time for us.

Candy Kwok

[Wise Young]

Dear Candy,

I am so sorry to hear about your sister. Several things you should expect are:

1. Recovery is the rule rather than the exception. If your sister has some preserved sensation below the injury site, especially in her anal region, the chances of substantial recovery is high (on the order of 50-90%). Even if not, there will be some recovery. While there is no guarantee of recovery, hope is warranted.
2. Recovery takes a long time. While 60-80% of recovery occur during the first 12 months, recovery typically takes 2 or more years. Therefore, patience is required and both your sister and family need to settle in for a long haul. Rapid recoveries are rare.
3. Motor recovery requires work. The more severe the injury, the more work it will take. That is because the brain and spinal cord has to relearn how to do things using what remains and regrows. Repetitive exercise, standing, and walking is essential for recovery of locomotion.

Take one step at a time. At the present, the most important objective is make sure that she is stabilized from her multiple injuries and that her spinal cord is decompressed. It sounds like they are doing that. The next step is to get her to the best rehabilitation center that you can. Hong Kong University has an excellent rehabilitation center. Finally, please know that we are doing everything that we can to get therapies into clinical trial to help people like your sister. The clinical trials will be available in Hong Kong.

Wise.

Originally Posted by Cancankwok

Hi Dr. Wise,

I am very pleased to be able to seek information from this channel at this helpless moment. My 29-year-old sister got a car accident while travelling Scotland on March 24th. She was severe injured and was just out of ICU few days ago. Doctor says that she gets spinal cord fracture in C4-C5 and broken spinal cord from C6-C7. She has undergone several operations for internal bleeding, broken leg, chest ribs and neck since then. And she will has another one for her front neck so as to allow herself to sit up as soon as possible. However, doctor here says given today's medical resouces / technologies now, my sister will not be able to walk again. My parents, sisters and my sister's friends who have flown to Scotland from Hong Kong after the accident, were shattered apart after hearing the bad news.
Dr. Wise, could you please advise how we can do next? Is my sister really hopeless even in the future according to what doctor said? We understand that my sister can't leave Scotland until she has no problem breathing her own. And our plan is seeking doctors in China and Hong Kong, actually wherever are possible for treatment. Is there any doctor who has started stem cell transplant in Asia?
Thanks for your taking time for us.

Candy Kwok

[adi chicago]

[*] Motor recovery requires work. The more severe the injury, the more work it will take. That is because the brain and spinal cord has to relearn how to do things using what remains and regrows. Repetitive exercise, standing, and walking is essential for recovery of locomotion. [/list]


Wise.[/QUOTE]
sir i have a question please ....have you ever meet[know] a complete quad[asia a] who regain his locomotory functions after intensive rehab ?
i asked this question because you said that the brain and spinal cord has to relearn how to do things using what remain and REGROWS ....can dead neurons regrows by intensive rehab [exercise ]only?
thank you.

[Wise Young]

Yes, although only recently so. Wise.

sir i have a question please ....have you ever meet[know] a complete quad[asia a] who regain his locomotory functions after intensive rehab ?
i asked this question because you said that the brain and spinal cord has to relearn how to do things using what remain and REGROWS ....can dead neurons regrows by intensive rehab [exercise ]only?
thank you.

[adi chicago]

thank you sir ...in other words the brain and intensive rehab can help the neurons to regrow.i am sad because since my injury i did not worked [exercised]hard to be ab again.shame on me.if i can make again the connection between my brain and my damaged spinal cord i will be the most happy human on earth.

[skippy13]

So, at what point (if ever) is it too late to start exercise and intensive rehab to see some improvement? Even a little bit of improvement is better than nothing, is it not?

[cementhead]

I worked out and excercised every day for 2 years post injury with no return whatsoever.I went to Turkey and tried cells 4 health treatment with my bone marrow and spent thousands and thousands on therapy with no results.Still to this day I use my worthless hands with no finger movement to (type,brush teeth,dial phone,operate tv remote,pick my nose open doors)still no voluntary movement in my hands almost 4 years post.So,I don't believe that my nerves will reconnect on their own with physical therapy.
Tom

Can Can sorry for your sister

[Cancankwok]

Hi Dr. Wise,

Thanks for your advise and encouragement. I am not sure if she has perserved sensation below her injury site esp on her anal region. But she told us twice that she felt full bladder, and was it a good sign though or it's just a false feeling of her at this stage? Besides, is the clinical trial also considering those who got complete broken C6-C7 spinal cord as my sister's case?
Regarding the rehab center in HKU, since we are clueless on how to get in touch with them, your advise will be highly appreciated.
Thanks for your kind attention.

Candy Kwok

[SCI-Nurse]

It is also critical at this time that everything be done to prevent the development of pressure ulcers which could hold back her rehabilitation for months. Talk to her nurses about what they are doing to prevent these, andd someone from the family should learn how to thoroughly inspect her skin daily for the early signs and bring them to the attention of the nurses.

Contractures of her shoulders must also be prevented by daily range of motion exercises and proper bed positioning. A condition called adhesive capsulitus is common and largely preventable. It can also hold back her rehab, and may not be correctable if it is allowed to occur. A good PT or OT can do this. Be sure she is getting this.

Most people at her level of injury can be weaned off the ventilator. You may want to download the clinical practice guidelines on respiratory care in SCI and get them to the family members who are going to Scotland. You can find them from a link at the top of the Care forum here.

I suspect that this is the rehabilitation facility in Hong Kong that Dr. Young was referring to: http://www.ha.org.hk/visitor/ha_visi...tent_ID=100138

Depending on your family's resources and insurance, there are also many excellent rehab facilities in the USA that you may want to explore. Picking the right program is critical.

(KLD)

[Cancankwok]

Thanks and I will check with my sister's doctor. But one thing is, what is the early sign like on her skin if it really happens?

Besides, is the clinical trial also considering those who got complete broken C6-C7 spinal cord as my sister's case?

Thanks!

Candy