Today is bittersweet; it’s been one month since the accident, and today is Jesse’s birthday and also the day of Corey’s memorial service. All of this is so far from how we ever would have hoped or expected to spend this day, but we’re doing our best to wrap our minds around the intense combination of grief, loss, hope, and appreciation.
Jesse’s rehab has been going well; we are SO fortunate to be here at Craig and continue to be amazed by the care, compassion, knowledge, and professionalism of the staff here, including everyone from the cleaning and kitchen staff to the nurses and techs to the therapists and doctors.
Jesse’s team includes his rehab doctor and resident, physical therapist, occupational therapist, clinical case manager, psychologist, recreational therapist, and a whole crew of amazing nurses and techs. He sees his doctor daily and has an hour of PT and OT each day, with additional classes and therapies through the week. Beyond that, Craig offers a huge range of services and classes, from an adaptive gym staffed daily by PTs, to community reintegration specialists, to wheelchair class and adaptive driving instruction. Jesse also has access to massage and acupuncture through the Chanda Center for Health (link), an amazing organization that provides integrative and complimentary therapies for people with injuries and disabilities and has successfully advocated for integrative healing to be covered by Medicaid. The massage therapist Joby and acupuncturists Yvonne and Lisa have been so wonderful and accommodating, and they are really excited to work with him since his injury is so recent relative to many of their patients.
Earlier this week, we had a conference with Jesse’s whole medical team and got to see some of his x-rays and MRI images from before and after his spinal fusion and decompression… pretty crazy stuff. He suffered a burst fracture of his T12 vertebra, which is exactly what it sounds like; the vertebra essentially exploded, pushing into his spinal cord and causing his paraplegia. He also sustained a transection of his aorta very near the site of the spinal injury, which was repaired with a graft inserted through the artery in his leg. Although his injuries are very serious, the good news is that his spinal cord wasn’t severed, and from what his doctors here can see, the surgeons did an excellent job of repairing the aorta, relieving the pressure on his spinal cord, and fusing the vertebrae two levels above and below T12 to stabilize his back.
Doctors classify spinal cord injuries based on the ISNCSCI (International Standards for Neurological Classification of Spinal Cord Injury) score, which measures muscle strength and movement, sensation (light touch and pinprick), and impairment grade (incomplete or complete loss of sensation and function below the S4-S5 vertebrae, which are at the very bottom of the spinal cord) using the American Spinal Injury Association (ASIA) score in each category. Jesse is diagnosed as having a complete injury at T10, meaning he is paralyzed below the waist, with complete loss of function and sensation below S4-S5. This classification isn’t fixed and could change as swelling goes down (this can take up to three months!) and his injuries heal.
So… what does this mean? Right now, it means learning new ways to approach every part of living without the use of his legs. Even more difficult is the fact that spinal cord injuries above S4-S5 affect bladder, bowel, and sexual function. Needing assistance with getting in and out of bed, getting dressed, showering, and going to the bathroom would be challenging for anyone and is especially humbling for someone as fiercely independent as we all know Jesse is. With time and practice, he will be able to manage all of these things on his own, but in the meantime, he’s had to allow himself to be vulnerable and accept help from his nurses, techs, and me to accomplish the tasks that we all take for granted every day. We’ve had some hard days with tears, frustration, and anger, and it’s still hard to accept that this is the current reality. But, we also know that things WILL get better and easier, and we’re finding reasons to smile and laugh each day.
As far as the long-term prognosis, several practitioners here have told us that when you’ve seen one spinal cord injury, you’ve seen ONE spinal cord injury. Every injury and patient is different, and it can be hard to predict long-term outcomes with any certainty. While doctors expect some improvement, they can’t make any guarantees. Jesse is determined to approach recovery from every possible angle, from physical therapy to meditation and visualization. He is strong and determined, and we know he can overcome this.