Touching Lives - September 2004
Spinal injury: road to recovery
Paralysed from the waist down in a motorcycle accident just before Christmas 2003, Martin will never walk again, though with the help of the staff at the National Spinal Injuries Centre at Stoke Mandeville Hospital, he’s determined to regain as much independence as possible.
At the time of his accident, Martin was working as an engineer in an aircraft factory and had lived for eight years with his girlfriend, Jo, in a country cottage in a village near Leighton Buzzard.
“My would-be parents-in-law had bought us an ornamental Christmas tree, but one of the bulbs had gone. I decided that I’d go into Luton to buy a replacement. Basically I’d use any excuse to go out on my motorbike — it was my passion.”
It was a damp Sunday afternoon, but quite good weather for the time of year, when Martin set off. He was travelling at about 50 miles per hour on a twisty B-road, when suddenly his rear wheel slid out from under him, flicking him up into the air and into a hedge. His bike had skidded on an oil spill on the road that he hadn’t spotted.
“When I was flung into the hedge, I hit a tree, so ^I was in a bad way. At first I was conscious, but I couldn’t see anything, and I couldn’t breathe.^ I remember someone saying ‘it’s all right, we’ve called an ambulance’ — and then I blacked out.”
Martin was rushed to the nearest accident and emergency unit, at Luton, and was unconscious for three days. He had a punctured lung, eight broken ribs, a broken shoulder, his aorta was ripped open — and his spine was broken. The medical staff thought he would probably bleed to death, and told his girlfriend to go in and say her last words to him.
“Apparently I was conscious, and talking — saying ‘make sure you get the bike out’! But they rang round the hospitals to find somewhere that would take me for the operation on my aorta, and I ended up at St Barts in London.
“At first, my back wasn’t the main issue, it was getting my heart working, and getting me so that I could breathe on my own. Then, after they’d patched up my heart, I went to the Royal London where they plated my back” [by screwing in a metal plate to hold the break together and give some strength to the spine — Ed.].
Martin was in London for about two months, and it was while he was there that he contracted the ‘superbug’ infection MRSA.
“The MRSA itself wasn’t a problem, but they are really careful about infection, so when I moved to Stoke Mandeville for rehabilitation in February, I was put into isolation. That was awful — worse than being in prison. I was in bed behind a closed door for three months and it really put a hole in my rehab process.”
But as soon as he was out of bed, Martin got to work on the remarkable Stoke Mandeville rehabilitation programme, which is carefully tailored to meet the needs of each patient.
“The day starts at 5am with bowel management,” explains Martin. “Because of where my injury is, I can’t feel my lower half so I can’t consciously control any of the goings-on down there. But I’ve still got quite a lot of nerves that work, which means that if you set it off, it will do the job itself — so I’ve been taught techniques for doing that. It takes about an hour to work. You’re basically sitting on the toilet all that time, waiting for something to happen!
“Then I have a shower and get dressed. ^I’ve been trained how to dress myself, though I haven’t got the hang of doing it in a chair yet^, so I have to go back to bed. That takes about half an hour. After breakfast, the day really gets going.”
There are two main sorts of physiotherapy which make up the bulk of Martin’s day at Stoke Mandeville. One focuses on day-to-day living skills, mainly practising ‘transfers’, which means getting in and out of your chair and on and off surfaces of different heights.
Martin’s now at the stage where he can get on to the floor and back into his chair again — really important if he has a fall when he’s on his own. The other sort of physiotherapy is in the sports gym, and is geared to building up muscle strength. Weights machines, table tennis, and archery all feature in the programme.
Martin explains why these activities are so ideally suited for rehabilitation of spinal injury patients:
“I’m a T10/T9. The ‘T’ bit stands for the thoracic part of your back. What it means is that my spine is totally broken around where the ribs are attached. With spinal injury, you can’t feel anything from the break down. Nothing below my belly button has any strength or support in it at all. So for me, it feels like the top half of my body is sitting on a bag of jelly, or a half blown up ball — it’s really wobbly.
“That’s why it’s important to practise balance and building your upper body strength. Table tennis is good because it makes you stretch beyond what you might think your limits are if you were doing it consciously — you just try to get the ball and that’s it!
“We have dinner around 5pm, and I’m usually in bed by eight. By then my back’s starting to hurt. I’d rather go to bed then than use painkillers — I don’t want to take any more drugs than I have to. Plus they can make you constipated, which messes up your bowel management routine.”
Being able to have control over simple things like when you go to the toilet will be crucial in enabling Martin to live as full a life as possible when he leaves — hopefully by the end of September 2004. There are lots of challenges, as well as things to look forward to.
“The first thing to do in preparation for leaving the unit was to find a house. We’ve had to sell our cottage — we couldn’t have even got the wheelchair in through the front door. So now we’re waiting to exchange contracts on a new house — it’s a bungalow, which is obviously ideal for me. But we will have to make some adaptations — we’ll put in a ramp for the front door, for example. The main thing is the bathroom, which will have to be converted into a wet room.”
Then there’s the kitchen. Martin used to do most of the cooking before his accident, but most kitchens have cupboards all the way round at floor level, which means that when you’re in a wheelchair you can only reach the surface at arms length. So it might be necessary to take some cupboards out.
“We’ll live there for a couple of months and see how it goes, and then the occupational therapist will come in and suggest any changes.
Back to work
“I’m hoping to go back to work in October, part-time at first. I’m really lucky because my boss is keeping my job open for me. Soon it will be back to the normal grindstone — that’s good in a way, ^I don’t want any special treatment. If I find it too much, I’ll have to say no, I can’t do it, maybe find another job^. I’ll just have to adapt.
“Not being mobile is definitely one of the things you miss. If you think about it, what you first want when you’re a teenager is a driving licence, to get your freedom. I’ll have to work my way back to that — I’m hoping to have an adapted vehicle eventually. But just getting in and out of a car takes ten minutes. When you get into this condition, everything takes an enormous amount of time — that’s the biggest factor.”
Stage by stage, Martin will do all it takes to get back to living a life as independent and active as it was before the accident.
“Obviously I won’t be able to do everything I used to — like, karate, for example, which was my second big interest. I got my black belt ten years ago. I could probably go back to karate to some degree — I could do judging or grading. I think my instructor’s got something planned!
“I do have a licence to say I can use an adapted motorcycle. But I don’t really think it would be fair on my relatives — they’ve been through enough without me getting back on a bike. At the moment, it’s not a priority.”
Martin’s extraordinarily positive outlook drives his determination to be independent again.
“I’ve got nothing to moan about. There’s always someone worse off than you — I could have got brain damage, for example. This is my second chance at life, that’s how I look at it. I’ve got to 40, and now I’ll be spending the second half of my life with wheels instead of legs. It’s a new challenge. It won’t be easy, but I’ll keep trying.”
Action Medical Research has funded four grants in the last five years investigating the repair of the spinal cord and better care for patients with spinal injury. An Action Medical Research project, completed in 2002, identified ways of promoting spinal nerve repair — bringing us closer to an effective treatment for people with spinal cord injuries.