BreakneckBean: Part Two

Once I was surrounded by Trained Medical Experts, the situation escalated quickly - both in their response and my understanding of the severity of my predicament. Turns out Medical Experts take neck injuries VERY seriously (who would have guessed?) A hard neck brace secured, I was wheeled back to an ER table and descended upon by a small horde of medical professionals. I repeated the short version of my story to what seemed like a dozen different people, blood draws were taken, an IV was inserted, and before too long I was being wheeled back for a CT scan. There was a palpably equal sense of relief and astonishment from each doctor I spoke to - relief that in spite of a clearly serious neck injury I was experiencing no loss of motor control or sensation anywhere in my body - and astonishment that after suffering said neck injury I had proceeded to climb unassisted out of a ditch and then spend 3 or so hours meandering down to the hospital 50 miles away from where the accident had taken place.

What I quickly realized as nothing short of miraculous was that - other than the obvious pending neck diagnosis - I seemed to be in remarkably good shape. In terms of acute injuries, other than my neck, I had a decent sized cut on one knee, a small abrasion on my right shoulder, and a small spattering of other cuts and bruises. Every other major limb and part of my body seemed to have escaped unscathed. I can’t say for sure that I must have landed almost entirely on my head during whichever part of the plunge my body impacted the ground the most, but from the lack of other injuries, it sure seemed that way. Regardless, the doctors ordered immediate CT scans and x-rays of my entire body from the waist up just to ensure there were no other internal injuries.

One definite plus of this whole experience was a recalculation of my own personal pain thresholds. Y’know, the whole “on a scale of 1-10, where is your pain right now? It hadn’t been properly calibrated in a while and I was soon provided a great opportunity. As they tried to transfer me onto the table for the CT scan, it became apparent that after spending several hours in a seated or propped up position, everything in my neck and upper back had locked up to the point where getting me to a fully lying flat position felt almost impossible. While sitting or lying still I was more or less okay, but the instant I tried to move or tilt my upper body in any direction, pain radiated out from my neck like a series of cascading explosions. If a “10” on my Personal Pain Threshold is screaming at full volume, forcing my body to stretch out into a supine position took me to about a 9.6. Thankfully, doctors don’t seem to mind you screaming in their face as long as you apologize very sincerely once you can breathe again, so I don’t think there are any hard feelings on his part.

The CT scan showed fractures in the C1, C2, and C7 vertebrae of my neck. From my lying position I never did get to see the images (note to self - request those at next follow up visit to the doctor). The decision was quickly made to transfer me to the larger and better-equipped Greenville Memorial hospital downtown, so a nice dose of fentanyl later I finally checked off the bucket list item of getting to ride in an ambulance (no siren though, how sad). At Greenville we repeated much of the ER experience from Greer. I fully codified my story in repeating it to several doctors, basic neurological tests, more CT scans. A few hours passed here and finally I was moved to a regular room.

That evening I met Dr. Lynn, the neurosurgeon who would handle my case. We immediately got along well and he was able to make clear the situation and spell out the options. Your C1 and C2 vertebrae are at the top of the stack of the spinal column in your neck and function as the pivot joint that allows you to have side-to-side rotational movement of your head. Based on the level of fractures, we had two options. Option 1 was fusion surgery, where they would go in and fix all the broken parts of my neck with rods and screws - this would be, all things considered, a pretty standard procedure and would no doubt fix everything, with the unfortunate side effect of causing a 50% permanent loss of that rotational movement for the rest of my life. Option 2 was a Halo Brace, which by locking my head/neck/torso in place would cause the next 4-6 months of life to be very interestingly awkward - but, if all went well - would allow my neck bones to heal naturally, restoring full mobility and strength to the area just like any other broken bone in the body.

It was a pretty easy decision. Dr. Lynn said that were he in my shoes, based on lifestyle and age factors - he would opt for the Halo. The challenge of living with the difficulty of the brace for six months seemed to me to be a pretty solid trade off in order to be able to regain full use of my neck. And worse case scenario - if something with the Halo went wrong - we could always perform surgery at that point. Once you go the surgical route, there’s no undoing it though - so it seemed wise to keep that as a last resort. Late that night they took me for some MRIs, and the next morning we decided officially to opt for the Halo.

Hospitals are never the most entertaining places - and when you’re locked in place, on your back, in a neck brace, basically unable to move except for your arms - they get really boring, really fast. Time slowed to a crawl that first night - my pain wasn’t overwhelming, thanks to the regular doses of oxycontin they plied me with every four hours, but the discomfort was at a serious level. Sleep was fitful when I was able to doze off, and the twinges of pain, post-nasal-drip, and deep body fatigue that had finally set in kept me in a constant twilight of malaise. Thankfully, while she couldn’t spend the night due to Covid-related restrictions on visiting hours, Lindsay had managed to procure and send me up a phone charger cable so I had a lifeline to the outside world.

Tuesday was a long day of waiting and watching the hours tick by unendingly slowly. The Halo procedure was scheduled for Wednesday morning, so there was nothing to do Tuesday but lie and wait. I’ve never been very claustrophobic, but I soon discovered that being locked in place on your back in a neck brace can get real old, real fast. Time passed slowly, Lindsay was able to visit in the afternoon, the meds came on schedule, I sipped half an Ensure as the only food I could really get down, and soon night came again. A Harry Potter marathon on TV got me through the night, as I dozed on-again, off-again to the sounds of Order of the Phoenix and The Half Blood Prince.

Finally Wednesday dawned - Halo Day. At 9am I was wheeled down to pre-op, and by 10:30 they wheeled me back. The one other time of my life I had been put under anesthesia was for sinus surgery 15+ years ago, and let me tell you what, those professional anesthesiologists know what they are doing. Just like that procedure, I remember being wheeled into the operating room, being lifted onto the table, and then BOOM, out went the lights. In what felt like mere moments, the lights were back on and I was slowly swimming out of the post-op daze. By about 2pm I was taken to my new hospital room and the rest of the day passed in a daze of dozing and attempting to get used to this new sensation of being encased in this new contraption.

Easily one of the best things about being fitted with the Halo was that I was soon after allowed to have control of my own hospital bed - so I was able on Thursday to start adjusting my bed slightly up and down to give some variance of position. My pain and discomfort floated pretty regularly between a 3-7 on my 10 point scale depending on how far away I was from the next pain med allocation. I finally was able to get some food down - institutionalized eggs and grits never tasted so good as they did that Thursday morning. One side effect was an excess of jaw stiffness and tension, so eating was still pretty difficult - and I could still really only recline my hospital bed up so far - but it was progress in the right direction, and progress was what I was most eager for.

The timeframe for when I would get to go home was in flux and largely related to how soon I showed progress in getting up and moving around - the doctor wanted me mobile before he released me from the hospital. Thursday late in the morning the physical therapists came by for the first time. It occurred to me that I had not even done so much as sit up for 3+ days by this point, so I was more than a little anxious to see how much I could move. The short answer was - “not a lot”. Turns out that three days lying on your back, then adding a twelve pound weight to your upper body really messes with all levels of your equilibrium. We were able to get me to a sitting position (achieved in the Halo by rolling onto your side and then levering up into a sitting position, since the brace effectively removes your ability to twist, bend, or rotate your torso), which I found to be absolutely exhausting. We sat for a minute, then slowly got me up and into a standing position. Never in my life has standing up been so difficult and felt like such an achievement. The twelve pound Halo felt like a two hundred pound weight sitting on my head, and I was able to stand for roughly 60 seconds, sweat dripping down my face with the effort, until I started to feel lightheaded and my vision started to swim, at which point we eased me back down onto the bed and the therapists hailed a job well done for a first day. Personally I was more than a little disheartened - it felt pretty defeating to have to take such baby steps to build physical strength back - but I resolved to take it one day at a time and just look for incremental progress.

Also on Thursday my Orthotist, Todd - responsible for the Halo brace device itself - came by to tighten the screws. Yes, it was vital that the day after the brace was placed, he do a quick tightening of the screws bolted into my skull at four points to ensure they were maintaining the proper torque and tension. Honestly, it sounds a lot worse than it was. The screws didn’t so much hurt (there’s not really a lot of nerves there in the thin skin around your skull), as much as they just created the sensation of “tightness” around your head. More on that later. Todd prided himself on being so skilled with the torque wrench required to tighten the screws that he could adjust them to the proper 7-8 pounds of pressure purely on feel alone. I was impressed and trusted him completely (although really, what else are you going to do with the man screwing bolts into your skull?)

The rest of Thursday passed without much note. Hospital food tastes great when it’s all you have to eat, I watched Mission Impossible 3, and the NFL season kicked off that night and all these elements brought cheer into my life and kept my spirits up. On Friday I had 2 PT sessions and made terrific progress, being able to stand with more ease and even trudge slowly halfway down the hallway and back aided by a walker. The doctors said with this progress I’d be able to go home on the following day, and finally I had a clear path to getting out of the hospital and on to the next stages of recovery. That night I was able to find one of my favorite comedy films of all time, Tommy Boy, on TV to bolster my spirits, and even though it was a largely sleepless night due to general discomfort, Saturday soon dawned.

By 10:30am I was on my way - very, very slowly - out of the hospital. Easily the most difficult part was folding me into the car for the ride home - my mobility was still extremely limited at this point due to neck pain radiating out into my entire upper body, and the Halo brace poles extended up above my head on four points, so it required some pretty creative contorting to get me into the car. Once secured tho, we trundled on home and unpacked me the same way into the house.

It was good to be home. Getting out of the hospital and back into familiar territory provided a huge psychological boost back into the realm of “normalcy”, and while I knew recovery and finding the new “Halo Brace Normal” was going to be quite a journey - I was ready to take it, one step at a time.

Part Three - Adjusting to the Halo - The First Two Weeks