Mark was riding his motorcycle home from a job in northern Wisconsin, on Hwy 70 coming out of Spooner, headed towards Hwy 53 to go home, when he went into the ditch and flipped, around 6:30 p.m.
The car behind him saw a water bottle on the road. Mark later said he did have a water bottle "tucked in behind him." He has no recollection of what happened, and has hypothesized that maybe he fell asleep. He was taken by ambulance to the Spooner hospital. They did a chest xray that showed broken ribs and potentially a severed spine. They airlifted him to Regions hospital in St. Paul, arriving around 8:30 p.m.
They did x-rays and CT scans and confirmed that Mark's spinal cord was severed at the nipple level. The neurologist said this is as bad as it can get, and he will never have any feeling or function below that point again. He also has a broken neck in which the spinal cord is not severed, but it needs to be operated on as soon as possible. He will likely need multiple surgeries, depending on how stable and strong his body is. His blood pressure was incredibly low upon arrival, so they gave him medicine to boost that and pump blood to the spinal cord. He was only given very small doses of fentanyl for pain until his blood pressure could stabilize. He was very cold and his body is having a hard time regulating it's own temperature because it was in shock, and normal functions are not operating properly.
He will be getting an MRI in the middle of the night (as soon as possible) to get more detailed pictures of the neck injury. The heart rythm and breathing can be erratic with a spinal cord injury, so the stability of this is key before doing the MRI and then surgery. They did originally want to operate tonight, but then changed their mind. It would be surprising if he doesn't have surgery before Friday, but he needs to be stable enough to be flipped onto his stomach for the operations.
The neck injury is causing weakness and numbness in his arms, but the hope is with surgery, this will improve and come back. It is still significant damage and there are several broken bones. He will need surgery to place screws, rods, maybe plates in order to allow him to sit upright in a wheel chair. The MRI will clarify what the surgery plan will be.
He has many contusions on his lungs, as well as bruises and broken ribs. Mark also has a broken shoulder blade. As far as the doctors can tell, it doesn't appear that he has any other internal injuries.
The doctor estimates that Mark will be in the hospital for weeks, and then he will get moved to an appropriate rehab facility. The rehab facility needs to be what is best focused for him, and also as close to home as possible. Primary concern - appropriate rehab needs based on his injury will be met. Secondary concern - location.
Mark was still asking each of his visitors how they are doing and what's new and joking a little bit about how he would indeed be making people's jobs difficult around the hospital. He's bummed that he "missed" the helicopter ride (because he has no recollection of it).
There is not any sort of in-room guest sleeping, so Michelle slept on a recliner in a family waiting room outside of the Surgical ICU (where the lights don't all turn off).
Thursday, September 13, 2018
Mark had an MRI this morning that confirmed the type of damage suspected in his spine and allowed the neuro team to come up with a plan for surgery. We learned that, along with his spinal injuries, broken ribs and scapula, he also has a broken clavical. The contusions on his lungs are bleeding and he had some fluid on his lungs. They decided it would be beneficial to put in a chest tube to drain his lungs.
He had a number of procedures done at the same time today, around noon. First the chest tube, then a feeding tube. Mark has use of his mouth to eat, but has to remain laying flat, which would make it difficult to get enough nutrition to give his healing body what it needs to actually heal. He is currently laying at about a 10 degree angle. Lastly, they put a new central (pic) line in on the left side of his upper chest. It was previously in the groin, but the upper chest is a more sterile and accessible area. The procedures took about an hour and a half. The feeding tube went in much easier than expected. He then went to x-ray to verify the placement of the chest tube and pic line - which looked good. He was given Versed prior to the procedures so he would remain comfortable and have no recollection of it.
When he came around after the Versed wore off, he was annoyed with the "thing in his nose," but seemed to be demonstrating some improved short term memory. Nicole told him that Rachelle was driving from Colorado and was bringing Penny (her puppy), which he later repeated to his sister Karen, admitting that he kind of likes Penny. At this time, he was still asking if he's going to walk and did not remember that he would be in a wheelchair.
The head of neurology stopped by to make sure his team was communicating and that we had the information we needed (which they have been). He confirmed and again explained the plan for surgery which will be first thing tomorrow morning at 7:30 a.m. Mark could go into pre-op as early as 5 a.m., as he needs to be intubated to support his lungs during surgery. He will remain intubated after surgery until he can be weened off (likely within a couple of days).
The surgery is estimated to last about 5 hours (give or take an hour) and they are trying to do it in one surgery. His vitals are holding strong now, and the doctors are "optimizing" his body for surgery (keeping his vitals strong and medications balanced for his vitals to remain as they are). He does have a slight temperature around 100 degrees but this doesn't seem to be of major concern. During surgery, he will be on his stomach and they will be focused on the broken bones and stability. They will place a number of screws from the backside, going into each segment of the spine from C4 to T7. The screws have a holder for a rod to sit in. There will be "hardware" in the neck area and down through the chest level break, which will all be connected. He will be stiffer for the benefit to support him, but he will still have the ability to turn his head (losing less than half of what mobility he had). They are also going to do a laminectomy (unroofing the spinal cord) from C5 to T1 to give it space to swell and heal. The surgeon is Dr. Jonathan Choi, who studied at Duke. General risks include need for blood transfusion, further nerve damage, and potential for infection.
Mark will stay in surgical ICU for about 5 days to a week after surgery. He will likely move to the trauma floor next (short term) after his blood pressure goals are met, and will have rehab there as well, but then will move to in-patient rehab for a minimum of about a month. He will have a social worker assigned, who will help Mark and Michelle determine the best place (hopefully closer to home!) for Mark to continue his rehab. Mark GLADLY signed his surgical authorization papers on his own.
The head of rehab came in this afternoon as well. They intend to start rehab as soon as the surgery is complete and they have the go ahead from the surgeons to move his body. They will start with range of motion exercises, even on the lower extremities, sitting up in bed, and sitting on the edge of the bed pretty quickly after surgery, likely even by tomorrow afternoon.
Mark has a very long road to recovery, with months and months of rehab ahead of him. He will need to relearn how to do every day tasks that we take for granted, such as dressing himself. There are many costs associated with this, not only with the actual hospital and rehab care, but also back and forth for Michelle from Chippewa Falls to St. Paul, hotel stays, equipping a new vehicle to accommodate a wheel chair, adjustments made to their home, lifestyle, and work. Mark and Michelle's lives have changed in the blink of an eye and any support you can lend is so much appreciated.
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