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TMarie
08-20-2015, 12:52 AM
One of my secondary characters, a man in his early twenties, falls from a bluff about fifteen feet and lands on a rock slab. He's rescued and transported to the hospital within about two hours. Here is what I need for the plot, please let me know if this is feasible, and any details or changes that would make it more realistic:

He suffers a head wound, broken arm, cracked ribs, and a spinal injury. He is unconscious for over two days. He is bandaged and hooked up to IVs. Would he be on a ventilator? What might the doctor say about his injuries/prognosis? His family is told that if he wakes up, there's a chance he might never be able to walk again.

When he comes to, he can't feel his legs. He stays in the hospital for two or three weeks, then goes home in a wheelchair. Doctors give him a low chance of ever being able to walk again.

However, gradually, with therapy and time, about four months later he begins to recover his ability to walk, and about four months later he's walking normally.

Thanks for any and all input!

Pony.
08-20-2015, 01:56 AM
I've actually done this. I fell from a step ladder, not a bluff, and backwards over a knee wall. I herniated a disk at the lumbar thoracic junction and seriously couldn't walk. it took six months of physical therapy and a lot of steroids to get back on my own two feet but it is possible. I'm convinced learning to walk was easier the first time.

LJD
08-20-2015, 03:06 AM
I don't think this will give you all the details you need, but it's interesting you posted this today, after I read this article this morning: C.B.S. mother defies paralysis to walk with son on his wedding day (http://www.cbc.ca/news/canada/newfoundland-labrador/c-b-s-mother-defies-paralysis-to-walk-with-son-on-his-wedding-day-1.3194763)

MDSchafer
08-20-2015, 04:32 AM
He suffers a head wound, broken arm, cracked ribs, and a spinal injury. He is unconscious for over two days. He is bandaged and hooked up to IVs. Would he be on a ventilator?

It depends on the level of the injury. Typically most individuals with cervical injuries are trached and placed on a ventilator, but as a rule the lower the injury the less likely they'll be placed on an vent. Overall something like 60 percent of all SCI patients are placed on a ventilator, and typically the earlier the better.



What might the doctor say about his injuries/prognosis? His family is told that if he wakes up, there's a chance he might never be able to walk again.

It depends on the severity of the injury and where it's located. Spinal Cord Injuries are graded A to E, with A being complete loss of feeling and motor control after S4/S5 to E being no permanent damage. Typically we are very good at imaging injuries and after the swelling has gone down a doctor can have a realistic idea of the amount of mobility the patient have.


When he comes to, he can't feel his legs. He stays in the hospital for two or three weeks, then goes home in a wheelchair. Doctors give him a low chance of ever being able to walk again.

Please don't do this. I know a few newly injured patients are discharged from step down to home, but typically those are the exception to the rule. Most patients go to some sort of residential rehab when they have a SCI. Especially when the idea is that they will never walk again because they need to learn how to do everything safely. Rehab can be anything from a local nursing home to one of the world leaders like Craig in Denver, Rusk in NYC or Shepherd Center in Atlanta.


However, gradually, with therapy and time, about four months later he begins to recover his ability to walk, and about four months later he's walking normally.

I've read that something like 75 percent of patients who can feel full sensation in their feet eventually are able to walk. So it's not unrealistic.

My biggest advice to you is that this patient would typically go an intensive medical rehab facility like Rusk, Shepherd or Craig, if they had insurance or funding for it. The longer it takes muscle to come back the harder, and less likely it is to return. There's a lot of readable information about spinal injuries out there.

TMarie
08-20-2015, 08:28 PM
Thank you all for the great info! I really appreciate it!


It depends on the level of the injury. Typically most individuals with cervical injuries are trached and placed on a ventilator, but as a rule the lower the injury the less likely they'll be placed on an vent. Overall something like 60 percent of all SCI patients are placed on a ventilator, and typically the earlier the better.

So I think I will go without the ventilator, then, as his injury would probably be low. I only want his walking ability affected. I actually need him to know that he will still be able to function sexually, because his upcoming marriage would be affected otherwise.


My biggest advice to you is that this patient would typically go an intensive medical rehab facility...

Gosh, that makes a lot of sense, and I hadn't even thought of that. Thank you! If I have him go somewhere local, could I still have him come home to visit his family at home occasionally? (They also are willing to help care for him.) About how long might he live at the facility before coming home for good?

Thanks again!

greendragon
08-20-2015, 08:33 PM
My friend was in care after a stroke in January, and he just got home. He wasn't allowed to visit home, but they could visit him. The home had to be refitted to be safer and useful for him - bars in the bathroom, etc.

TMarie
08-21-2015, 09:15 PM
My friend was in care after a stroke in January, and he just got home. He wasn't allowed to visit home, but they could visit him. The home had to be refitted to be safer and useful for him - bars in the bathroom, etc.
Thanks for the reply. Wow, that was a long stay. Glad he's home now.

Good details about home being refitted. I'll be sure to mention that.