11 months post accident I was finally discharged from hospital on the 24th of November and I moved into a continuing care home called the Haydon Hill Leonard Cheshire home in Milford, Surrey. Although desperate to leave hospital I have to admit I was a little apprehensive about moving into a care home with more elderly residents, fearing that I could be jumping from the frying pan into the fire. However, after one week here I have been impressed by the attentive and personal approach from the staff and the homely ambience which is in stark contrast to sterile and stressful environment of the NHS whose staff are overstretched often beyond their limits. I've been particularly impressed with the physio here, a Zimbabwean man who goes by the name of Mr. Never Mind (no joke), which is his tribal name translated into English and in some way quite apt for his line of work. In the little time I've been here I can already feel a rapport developing between us, he understands my rehabilitation priorities and seems committed to do his utmost to maximize my potential. I have to say that it has given me a fresh impetus and a more positive outlook on my possibilities which is just what I needed. The recent freeze and heavy snow which accompanied it has made it very difficult and at times impossible to have visits or to even leave the building (snow and wheelchairs don't work well together) which was particularly frustrating and led to the feeling of being incarcerated. However things have improved and I look forward to more visits next week and going out more often in order to get a much needed change of scenery.
Reflecting on my time in hospital since my accident, the first 2 and 1/2 days spent in the clinic in Leticia were undoubtedly the darkest, most hellish days of my life. Realizing that I was in such desperate need of help and so impotent to help myself was a situation that I would never wish to repeat. Since then arriving in the clínica Del country hospital in Bogotá after coming so close to death and then waking up to be surrounded by so many beautiful and affectionate Colombian nurses was probably just what I needed to make me realise that life really is worth living. Their expertise and professionalism undoubtedly kept me alive and enabled me to fight off pneumonia and a whole host of respiratory infections and made me well enough to fly home at the end of February. Upon arrival at Stoke Mandeville I learnt of the severity of my pressure sores which I picked up while lying flat on my back without moving for just three days after the accident. The consultant later informed me that within a question of weeks I could have died from septicaemia had I not received adequate treatment. Thanks largely to their specialist knowledge and state of the art equipment like the oasis bed and a vacuum pump and then a masterful skin graft operation (thank you Dr. Gauche) I was able to overcome the horrendous pressure sore on my lower back (pre and post op. photos are available on request for those interested). Arriving already infected with MRSA was a bit of a double edged sword. On the one hand it gave me the privilege of having my own room for the entire duration instead of sharing a six bed ward. In terms of privacy with guests and being able to speak to friends in Latin America on skype late at night this was an undoubted bonus. On the other hand it restricted my time in the gym to just one hour a day during the MRSA session. This became a source of great frustration for me and my family to be in an institution with undoubtedly outstanding facilities and such exceptional staff but having such a limited access to them. Despite this I left stoke Mandeville feeling well prepared and knowledgeable about facing life with a spinal cord injury and I am eternally grateful to all the staff there who gave me another chance at life. Of course some staff stand out particularly in mind due to their genuine compassion and care and while it would be undiplomatic to name them some individuals deserve a special mention. Firstly Terry Holloway who after hearing of my plight in the press made sure that I got a place at stoke Mandeville just in the nick of time. Were it not for her intervention I may not be here to tell the tale. Also to Alfonso and Jesus for giving me the opportunity to practice my Spanish and Manuel and Anna for being my Portuguese teachers and for keeping some Latin flavour in my life.
Throughout my entire time in hospital I have been truly blessed able to count on the support of relatives and great friends who have kept me going through the most difficult times both in England and Columbia during my first two months post accident. There are so many of you that have shown great kindness and generosity towards me, including those people I have met as a result of and since my accident that have gone on to become friends. A few people deserve special mention simply because without them I wouldn't be here today. Firstly Kevin and Terence, my great friends and travel companions who were with me when I had my accident. They stayed by my bedside the entire time when I was in the clinic in Leticia, and fought earnestly on my behalf to get me out of the jungle in air ambulance while my Insurance Company looked for every which way not to help me. By the way guys, sorry to ruin your holiday, if we ever travel together again I promise to have an accident on the last day rather than the first day of the trip. In addition Olga, the academic director from Bennett College who made the arrangements for the air ambulance from the jungle to the hospital in Bogotá. My great and loyal friend Aline, who was there to meet me when I arrived in Bogotá and visited me nearly every day for the entire two months whilst I was in hospital there. And of course my mum and sister who flew out to Bogota to be with me by my bedside when I was in such a critical condition and who stayed with me until I improved. In the meantime my dad and stepdad worked diligently behind the scenes to organize an air ambulance and my smooth transition into stoke Mandeville Hospital whilst Fred and Poonam from Casa Alianza and Diana Clift, inspired by an idea from her grandson Kyle launched a Facebook campaign and justgiving page to raise funds to get me home. Lastly and most definitely not least I have to mention my dear friend Paola who made repeated visits from Cali to Bogotá to be with me and then made the trip from Colombia to England to spend a month with me while I was on bed rest in stoke Mandeville. One of my most valued and trustworthy companions on this journey has been meditation, I was fortunate enough to do a couple of Buddhist, spiritual retreats in my early twenties where I learnt a technique called Vipassana or insight meditation. I think if there's anything that kept me sane whilst I was on bed rest for six months waiting for my pressure sore to heal been turned from side to side every 5 hours that was it.
Reviewing my progress I would say there have been some significant and major improvements in functional motor ability in my left arm. For some time now I have seen the biceps in both arms develop from small twitches to strong muscle contractions, especially in my left arm. My right arm although considerably weaker than the left has started to show more strength in upwards and downwards movements from the shoulder and also definite muscle twitches on both the bicep and the tricep. With regards to sensation, there has been a slight increase in sensation in my chest region, especially on the outer pectoralis region near the armpits, accompanied by muscle twitches which has enabled inward arm movement most notably on the left side. I believe that the hydrapool sessions have been hugely beneficial, both in terms of muscle stretching and increasing muscle strength and range in the arms. Of all the physio I have had at stoke Mandeville I would consider the hydrapool exercises to be the ones which possibly hold the most potential and in which I would like to invest most time and energy in the future. Unfortunately due to time restraints and the sheer quantity of patients I was restricted to just half an hour week in stoke Mandeville, which is not enough in order to maximize full rehab potential.
Before I first arrived at Stoke Mandeville some people told me that once the spinal swelling had gone down all sensation and movement that was going to return would return within the first three months post injury. When I arrived I was told me that it could be up to six months and then by others up to two years. Since then I have heard stories of people who have had movement in their hands return five years after their injury. In my case no new sensations or movement came back until at least five months after my injury and since then I have progressed from a chin operated chair to a chair which I can now operate from a joystick with my left hand, and my arms continue to get stronger. What is clear to me is that there are no hard and fast rules and that every case is different, however I feel that even with the most intensive physiotherapy and state of the art rehabilitation there comes a point when progress will most likely plateau. Beyond that continued progress would depend on non conventional therapies and approaches, be them spiritual/holistic or a surgical intervention further down the line. I have been encouraged by recent investigations into spinal cord injury using stem cells where rats and dogs who were paralysed from the hind legs down later recovered over 90 per cent of full movement after specialized stem cells were injected at the site of injury. In June 2010 the first ever operation was conducted on a spinal cord injury patient using embryonic stem cells by a California based company called Geron, the full results of which are yet to be known. In any case such developments are extremely encouraging and considering the exponential rate at which science and technology progresses there is every reason to believe that within the next few years there will be some kind of surgical procedure which would enable patients with SCI to regain a greater degree of sensation and/or movement. If and when such an intervention becomes available I would like to be in the best possible condition to take advantage of such an operation. As such my rehabilitation goals over the coming months and years will be twofold. Firstly, to build as much strength and movement in my limbs and major muscle groups as possible using conventional and state of the art physiotherapy such as weights, hydrapool and functional electrical stimulation (FES). And secondly to utilise holistic healing techniques and such as, acupuncture, reflexology and including meditation and creative visualisations.
The day before I left stoke Mandeville on the 23rd of November I decided to have a meeting with my consultant to talk through my injury and see my MRI scans which were taken when I arrived in February. I had deliberately delayed asking about my prognosis since, already realizing that I had a severe lesion I felt there was no need to have that confirmed, such gloomy news may have impeded my ability to remain positive. Looking at the scan I could see the damage to my spinal cord between the C4, C5, and C6 is quite extensive, covering an area of about three centimetres. However clearly some nerve fibers remain intact passing through the areas of scar tissue in the a zigzag type of pattern. It still amazes me how such a shallow dive could have caused so much damage, but there is no point revisiting the issue and certainly no value in regret. What's done is done! On a positive note the consultant told me that it is vital to keep myself in the best shape possible through continued exercise and physiotherapy, utilising such techniques as functional electrical stimulation in order to keep the muscles toned and to prevent atrophy. He informed me that although current studies on stem cells with the spinal cord injury patients were inconclusive he felt that stem cell therapy was the way forward and that within a few years some kind of effective treatment could become available.
Clearly suffering a spinal cord injury now it is not the same as it was five or even two years ago and there is every reason to remain optimistic!
