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> CASE 5 Spinal Cord Injury

Bobby was a fearless child; his mother told stories of him riding his big wheel down the stairs outside his Colorado home. He preferred individual sports, so he took up racket ball and swimming when his family later moved to California. In high school he became a triathlete, joining a group of dedicated older athletes who met regularly to swim, ride, and run. Sunday mornings they swam 3 miles in the ocean, and after a rest finished the day with a 13-mile run. Cycling through 56 miles of Southern California mountains and canyons completed the weekly training. It was a disciplined, active life he shared with his best friend.

Everything changed on a beautiful March day when he was 17. It was too pretty to be inside at the gym, so he decided to go for an easy ride, from his parents’ house, past the high school and back a few laps. A car darted toward him from the side, and as he swerved to avoid that collision, he ran into the back of a bus that was illegally parked in front of a fire hydrant. The accident fractured his spine, permanently damaging his spinal cord at the fifth cervical level.

In the hospital, reality came slowly as he gradually became aware of his new limitations. He was placed in traction initially while they ran tests to determine the severity of the injury. He heard words like quadriplegic, and struggled to move his arms as he lay in bed. Once, he was able to wiggle his shoulders and flex his arm in front of his body, only to have it get stuck against his face, unable to extend his elbow due to paralyzed triceps brachii. A few days after the accident, he lay there while a physician told him he would never walk again, news he did not fully accept at that point. Far more immediate was the plan to place him in a halo for the next few months. A halo-stabilizing device immobilizes the cervical spine with a metal band encircling the skull, fixed by four screws. Long metal rods extend downward from the halo and attach to a vest worn around the torso. Bobby's father had worn a halo a few years before due to a cervical fracture, and he remembered his father's pain and discomfort very well, fearing the next few months living in the halo more than anyone on the rehabilitation team imagined.

Once he was transferred to the rehabilitation unit, Bobby found comfort and familiarity in the routine. He focused on learning new skills in occupational and physical therapy, and mentally planned to complete a race in a few months, once he recovered. The positive, focused nature of the rehab team made each day easier, along with a tremendous support network of family and friends, who filled the hallways each day until the staff had to ...

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