Saturday, November 21

I wish I had some better news, but the last day has been pretty awful.  First of all- he is still alive.  His doctor sat down with us yesterday to go over the extent of his injuries.  The MRI indicated that things were not as great as I've been allowing myself to hope.  I don't remember all of the details and I will probably bungle this description, so please bear with me.

The MRI showed that the damage to his spinal cord was more extensive than the CT scan indicated.  This is just the nature of these types of tests.  His spinal cord is damaged, crushed at cervical vertebra 5.  This means that he will be a quadriplegic.  The doctor told us that the best case scenario is that he has some movement in his arm (probably never in his hand) but the ability to move his arm means that he could operate a motorized wheelchair.  If that's not the case then there are voice-controlled wheel chairs or other technology.  However, this is not anything to really think about right now. 

The MRI showed that there is bruising in his forebrain (which controls, among other things, personality, decision-making, compulsions).  This may or may not be permaently affected.  This is the least of the doctor's concerns right now and I am choosing not to dwell on it.

The MRI also showed that there was damage to the spinal cord all the way up to cervical vertebra 2 (C2).  The higher the damage, the worse the prognosis.  C1 is right below your skull, C2 is the next one down, etc.  People with injuries at C3 or higher are ventilator-dependent for life.  Until the swelling in his spine subsides, we won't know the extent of the long-term damage.  The MRI also showed that there was bruising in his midbrain (the part of the brain that controls among other things heart rate and breathing).  Between the damage and swelling in his spinal cord and the midbrain bruising, he's having a really tough time maintaining reasonable heart rate, blood pressure, and breathing.  So, he's on a ventilator for now and until the swelling subsides (that won't be for another week or so) we won't know whether or not he will need to be on a ventilator for the rest of his life.  He's still in critical condition and he's having a lot of trouble breathing despite the ventilator.  Some of this can be explained by midbrain and spinal cord injuries, but some of it is still a mystery.  There is some slim chance that he won't pull through this part of it.

Everything above we found out last night.  We are all in shock and this is still slowly sinking in.  He had a test last night where they slipped a small camera down his windpipe to look at his lungs from the inside.  There was no sign of injury or damage (that's good)  but he did have some mucus in the bottom of his lungs.  They removed that and he went on to have an uneventful night (which is practically a good night considering) and they are spending today tweaking back the ventilator settings.  He got a couple of blood transfusions and I thought he looked much better today.  His breathing is not nearly as labored as it was last night and when I spoke to his doctor this morning she was encouraged by these small steps.  In the meantime, he has developed a dent on his left lung and today had a chest tube inserted on that side.  That surgery went fine and was also "uneventful".  From what we hear, tall, skinny guys are susceptible to developing blebs (small air blisters on the top of the lungs) and given everything else going on these blebs may rupture and cause a pneumothorax (which is the fancy way of saying collapsed lung which is what I'm calling dented lung because it sounds better).  So- this is not a surprise to anyone here and is remedied with the chest tube and is controllable.  It's just one more thing.

The staff here is amazing and I had a long talk with a nurse last night who held my hand and called me sweetie.  She did not give me any false hopes, but she did tell me that there is always hope, and I desperately needed to hear that.  He's young, strong, and healthy and people like that are able to recover better.  If this had happened to someone twice his age then we could be more sure of the prognosis.  There's no way to know how his recovery may go and where he will be in a week, a month, or a year.  Right now he needs rest and we have to wait for the swelling in his spine to subside.  I thank you all for your thoughts, encouragement, and prayers.  Mike (my husband) came out this week and has been an enormous help.  We are all eating, getting outside for walks, and doing our best to stay healthy and cope with this.