desperate for advice

[Charlotte]

My Fiance was in a car crash on the 24th October 2007.

He was in ICU for 7 days in Birmingham City Hospital.

He was told he had swelling/bruising on the spinal cord and needed to be air lifted to a specialist unit... The Robert Jones & Agnes Hunt Orthopaedic Hospital in Oswestry.

On arrival he was given tests and scans which showed he had NOT Cut his spinal cord but had broken his C4/C5 bones, the bone was pressing on the spinal cord causing the bruising and swelling.

At first he could not feel from his chest to his feet.

After a few weeks he became aware when and where he was being touched, but only if it were on his arms and chest.

He was put on bed rest for 2 and a half months, with a neck collar to prevent him from causing more damage to the broken bone in his neck.

This caused all his muscles to become stiff.

He has been in hospital for over 5 months, he can now feel his whole body, and can move his arms.

He still wears his neck collar but doctors say that his bone has healed and moved off his spinal cord.

A few weeks ago, he began to move his legs.. but only slightly.

This movement has now got stronger and he can now slowly bring his leg up, swirl it around, and with effort he can bring it back down to the ground, but, the major problem is stiffness and spasm.

Sometimes when he lifts his legs up, he cannot get them down again.

When this happens, I try to bend his leg and with all my strength, i cannot do it.

If he leaves it and lets it relax, eventually it will slowly start to go back down on its own.

Another problem is sometimes when he is practising lifting his leg, he has a spasm run through his body and his legs will shake uncontrollably, again he finds it extremely hard to bring his leg back down and control it.

The spasms have gradually decreased with time, they still occur often, but not as bad now as when he was first admitted.

I would like to know what and why these spasms happen, is there any way to stop them? or decrease them? or a technique to overcome them whilst he is moving.

Another thing i think is holding him back from being able to get back on his feet and walk is this stiffness.

I'm not sure if this is something to do with the injury to the spine, or from being on bed rest for so long and being unable to move for so long.

He attends physiotherapy for 40 minutes from monday -friday where he stretches, and stands up still against a support block 3 times a week.

This does his muscles to relax, but during the day they become stiff.

His hands are also a problem, he still cannot move his fingers, and his wrists are very stiff.

He's been given tablets to help with the stiffness and spasm but they do not seem to be very effective.

What are the odds of him being able to walk again? how can he get rid of the stiffness and spasms?
what can he do to to achieve the best results?

the way i see it is if he can move, even its slight.. its still movement, this must mean something
please tell me what you think

[Apparelyzed]

Hi,

Muscle spasms are caused by stimulation of sensory neurons sending messages in a feedback loop (reflex action) back to the muscles, where there is no longer an inhibitory signal being recieved from the brain.

Before the accident, his brain would of sent a signal to stop his leg jumping whenever it was touched, as the brain would determine if the item touching his leg was dangerous or not.

Since the brain can no longer send an inhibitory signal, the reflex works on the assumption that everything touching his leg is dangerous, an causes an exagerated reflex called a spasm, or hyperreflexia.

If he is getting movement back, he really needs to work hard on his physiotherapy, as there is a good chance he will regain even more movement with hard work. It is still early days, and return of function can still occur upto 3 years after the initial injury, but the most progress is made in the first 18 months after the injury.

Although the muscle spasms are a pain, they will keep his muscles toned and help prevent atrophy, or muscle wastage. Taking drugs such as baclofen to reduce muscle spasms will also partially block signals passing through the spinal cord, so may reduce the effectiveness of physiotherapy.

It's quite a fine line, put up with the spasms, knowing the maximum signals are getting through, or reduce the spasms with drugs, and reduce slightly the signals getting through to the muscles.

Muscle spasms in themselves also reduce the effectiveness of physiotherapy, as they give a constant resistance to the function of muscles.

It's a case of trying out the drugs and seeing which is best really.

Hope that helps.

Simon

[Charlotte]

Wow
Thank you so much
You've been such a help, im ever so grateful.
Ive understood so much more, Ive learnt more from your reply than i have over the 5 months of him being in hospital and asking questions!

He has been taking baclofen for a month or so, it doesnt seem to benefit his as well as everyone initially thought so his dosage has been increased, if no change, it will reviewed to possibly try other drugs.

Do you think 40 minutes of physio a day, 5 days a week is good enough? there are some problems with staff so time is limited but is there anything he could do after physio, whilst he is just siting in the chair?

The loss of movement in his fingers worries me also. Is it a common thing to regain movement in arms but not hands and fingers? His hands are also mishaped, they seem to curl round.
Ive mentioned holding a pen and trying to write or having a sponge ball in his hands to get used to holding objects and then trying his hardest to maybe grip them with his fingers.
Is this a good way of training himslef or is there something better he could be doing?

At the moment, all advice given to encourage movement is noted and put into motion straight away.
whether its to do with excersise, massage, prescribed drugs, herbal treatments, spiritual blessings or whatever it may be..
im all ears and open to anything that could help him!
Thank you so much again.
I cant say how grateful i am, so much more at ease.. and much more Hopeful

 

1 thing i havent mentioned is diazepam, which has been given to him.
Do you know much about this drug?
Ive spoken to my brother who has mentioned a few things, such as diazepam is a drug used for anxiety related disorders and its highly addictive
He also mentioned a hebal tea called Valerium (not sure of the spelling) which has a similar affect, like a relaxer??
any ideas?

[Apparelyzed]

Hi,

From your description, it sounds as though his injury is an incomplete injury known as central cord syndrome. This is when the lower half of the body's functions are partially preserved, but the upper portion, ie, the arms and hands, are affected more.

Andy, the forum Admin has this I think, so he may be able to expand on it further.

As for the spasms, stretching exercises are essential immediatly prior to any physiotherapy, as the stretching will reduce the spasms, allowing him to initiate more function in the muscle groups he is working on. Swimming is an excellent way to reduce spasticity, but the practicalities every morning may not be possible due to staffing issues.

The other option is to look for outside help and physiotherapy, but you will have to pay for this yourself. If he sueing for compensation, get him to talk to his solicitor to arrange an interim payment, as this should be covered in his compo deal. If you need a solicitor, there is a list on the Spinal Injuries Association website at: http://www.spinal.co.uk/b-08.aspx

Regarding his fingers, he should still keep doing physio on them. The degree to which they are paralysed will depend on his level of injury. If he has no finger function, he sounds like he is a C5/6 cervical (neck) injury. His doctors can tell him this. As he is an incomplete injury, only hard work and time will tell if he regains any function in his fingers.

Anything which involves picking up objects is good physio for fingers, in hospital, I was the king of connect four! Sorting coins is good as well.

Regards

Simon

[Gary Anderson]

Diazepam is another name for Valium and is highly addictive. I would avoid this at all costs. Unless you are being closely monitored by a doctor.

Valerian Tea or some of the other calming herbal teas are very good - I am a lover of them myself.

Like Simon says, the only way around this is by hard work. I was in a similar position to your boyfriend - I hit an all time low at the time of my accident and it was only the nagging of my Mum and the sheer hard work of myself that got me on the road to recovery. Mind you, my own injury was a lower back one.

As Simon once told me if you dont use it you will lose it. Muscles waste over time and so you have got to keep as fit as you can. I know a chap with an injury like your boyfriends and he works out every day in a multi gym. The result is he has better control over his body and the muscles are not weakening.

Hope this helps.

[Apparelyzed]

Hi,

I forgot to add, that Diazepam is also given as a muscle relaxer, so it's probably being given in combination with baclofen for his spasms.

When I was in hospital, I was on the top levels of oral baclofen, diazepam and dantrium for my spasms, but all they did was turn me into a zombie, and made me sleep all day!

I ended up getting a baclofen pump in the end, and am no longer on any oral medication. A pump at this early stage would not in my opinion be the best course of action in your boyfriend's case though, as it could interfer with his recovery.

Regards

Simon

[Lieveling]

Hi Vectra,

I was in a similar situation to your's last May after my partner's car accident. He is currently C6(incomplete)/C7(complete).

I have found over the course of the last 11 months that medication is pushed a lot and that you really need to question how necessary it all is and if so question the dosage. As Simon said earlier, some dosages can leave you wiped out. And of course not everything about spasms is bad news.
A recommendation I can give you is that even though my partner was not familiar with reflexology before his accident, since starting it after his accident (once he was out of ICU and into rehabilitation) he finds it beneficial now. This is of course complementary to medicine, it's not a replacement. But he feels his body better and has a more general healthy feeling as a result of his sessions.

I would also advise, if you can afford it of course, to get some extra physiotherapy into his routine if possible. As Gary said, it really is hard work, every day, all day, it's full time rehab ! However, it really does yield results. It is so very important to maintain the range of motion and muscles. My partner has the attitude of viewing everything as an exercise. It's also important for example to balance out left and right hand, sometimes it's the weaker hand that is "neglected".
Simon, I think my partner would give you a good game of Connect 4 too !!! He regularly plays it. He also plays ping pong, as he can't hold the bat he has it taped to his wrist and this helps with balance and muscle tone in arms.
In any case, sport is highly beneficial, both mentally and physically.

Don't forget yourself in all of this. Whilst his rehabilitation is the priority and it is and will remain so for the next few years, you must also ensure that you can do sport and balance your life out socially, professionally and emotionally. By ensuring this, you ensure that you are the best help possible to him.
Finally I can only say that you've come to the right place, these people are truly brilliant with their sharing and caring experiences, words of wisdom and insight and support. It's a great place here and I have found it invaluable in the past months.
Take care !

[Apparelyzed]

He also plays ping pong, as he can't hold the bat he has it taped to his wrist and this helps with balance and muscle tone in arms.

Last time I tried that, I nearly took my head off!

Swinging the bat's no problem, but without tricepts, stopping it is another story, it just keeps going until it hits something!

Simon

[Charlotte]

wow wow wow
ur blowing my head off now!
cant say how much i appreciate everything you have all said,
Not only do I feel a lot better.. but i have read everything to Shy.. (my fiance), and its really given him a boost, he has been low for a few weeks.
As u know too well this type of injury is so hard to come to terms with, not just physicaly but mentally also.
Still, i have hope and faithe that he can battle through it and with time and Hard work, get back up.
Connect four?... hes become quite a master himself !
Thanks again for all your advice and kind words