Day 17 - Finally! Some Information On Two Fronts

Here are a few slides from her CT scan on the day she was injured. These were taken at the Medical Center in Bowling Green. Pretty obvious to the untrained eye it is broken.

This image on the left is the top of her C2, viewed from above which displays the front where the C1 rests on top of the little point of bone that allows head movement. To the right is the visible crack as viewed from the side.


Next in the left image is the same bone farther down where the ring that surrounds the spinal cord is visible. The rear of the bone appears intact. The right image is of the same area a little more to the center of the spine.

The nurse practitioner finally called us back on Dec 29th while we were at the cardiologist's office. My wife had an episode of PSVT (paroxysmal supraventricular tachycardia) in early December. She had a heartbeat of 160 bps for more than an hour with a BP of over 200. She originally had that appointment for Dec 15th at noon. Unfortunately, we missed that one due to still being in the ER at Bilkmore with her new headgear.

So, the cardiologist says that three episodes in two and a half years is not significant enough to warrant going on a maintenance medication. That is encouraging. He says it isn't life-threatening and when the vest comes off he'll want her to get an echocardiogram, which is a technical way of saying heart ultrasound. We have that appointment for the first week of April. With any luck, she'll be out of the halo long before then.

Back to the NP of neurosurgery. She profusely apologized for the wrong and/or lack of information we received. She explained that she'd wear the halo for 12 weeks, regardless of what anyone else told her because they won't even look at healing until 12 weeks. The first visit is just to find out if she is still in alignment and to tighten the head bolts. She's not looking forward to that. The same thing will happen at eight weeks. Only at the 12-week visit will they actually do a CT scan to check for healing. If it is not sufficiently healed, they will determine if it is healing and will continue the halo for another month or she will be evaluated for surgery. I'm not really happy about her having to suffer for 3 months only to find out she would still have to have surgery anyway.

I'm still debating on whether to have my wife call the patient advocate over this whole affair. The ER nurses and the attending doctors were fine. They kept her comfortable and the pain manageable. However, the on-call neurosurgeon was another story. He seemed impaired as if sleep-deprived when he arrived at 2:30 AM to install the halo-vest. He kept referring to events that would take place in the future as tomorrow when he really meant in a few hours. I asked for clarification since I was definitely sleep-deprived and going on 20+ hours without sleep myself. This appeared to agitate him for some reason. Another sign of sleep deprivation and unprofessionalism.

Then as he was attempting to get the vest situated and he commented that it was crooked. Jan heard him say it, too! So, if the foundation is not correct, what does that do for the rest of the construction? Any contractor will tell you it won't work out well. So, now the bars are being installed by Dr. Crooked. After getting three bars installed, the fourth was at such an acute angle it wouldn't connect to the halo around her head. When I pointed out he could loosen another axis to get the additional working room, he said, "Who's the expert here?" Despite my usual smart-aleck self, I kept my mouth shut but certainly wanted to reply, "I don't know. Maybe we should page one!"

The points she should make to the patient advocate are as follows:

1) Her head is rotated 20-30 degrees clockwise from forward
2) They did not shave the posterior halo screw sites, difficult to clean
3) Gave us no guidance on pin care, didn't tell us to clean them or how
4) The vest was put on crooked and the doctor that did it acknowledged it
5) They have little or no concern for the person being traumatically put through this

I've always heard good things about Bilkmore but my faith is greatly shaken in the medical profession in general.

Day 14 - Two Weeks Later

First, this is a bit of a rant but I need to vent!

It is now two weeks later and the ordeal has stabilized. She will recover but I have major concerns for the way it will heal. Her head is rotated 20-30 degrees off of forward and her shoulder straps absolutely never touch her shoulders. She can't move her head so it can't be her fault.


When seen from the back, you can see how contorted the bars are. That is an indication of how far off the back is from the centerline of her spine.



On top of that, I've spent that last two weeks trying to get a local neurosurgeon, any neurosurgeon, to see her so we can avoid the tiring and jarring 65-mile drive to Nashville. She is a halo leper! Nobody will even look at her.

On top of that, her front pins appear to be migrating and weeping a pale yellowish fluid. There is bunched up the skin on top of the pin and it appears skin is pulled tight below the pins.

I'm becoming totally disgusted with the entire medical field. How sad is it when my insurance company has been the best people I've had to deal with?

Day 13 - How It All Happened

Dec 14, 2008, started like any other day. The usual Sunday routine of reading the paper and such. This particular Sunday we were going to my aunt's house for a pre-Christmas get-together. That went well and my wife and I were going to drop by my father's to see him as it is nearly on the way home.

Here's where it all went horribly wrong:

Google Map, Site "B" is approximate accident site

At about 4:00PM on that overcast Sunday, I was driving from Bee Springs, KY to Sunfish, KY on Hwy 238. I've driven this road many times on both 2 and 4 wheels without any problems. I came up this hill just before you head down to Bear Creek, coasting in 6th, which was bleeding speed when I crested the hill. The road drops down and makes a pretty hard right turn down to the creek. I think I tapped the brakes to bleed some more speed when the rear end oversteered, causing the front to point into the center of the turn instead of understeer out into a guard rail. My wife remembers me saying, "OH SHIT!" as the rear end drifted. She now recalls thinking it felt like we hit gravel. She said she wasn't afraid until I said that because she had the greatest faith in my ability to correct it. I only wish her faith had been enough.

We were sliding sideways in the inside shoulder and ditch area. As I looked helplessly out of the driver's door window, I could see the tile and driveway coming up fast on my side. I thought to myself, "This is going to hurt!" I fully expected to hit it pretty solid and come to a shrieking halt. Instead, we sort of skidded, straddle of the ditch and just caught a piece of the raised driveway. This immediately flipped the car and it continued to roll sideways.

It landed on the corner of the roof and passengers windshield pillar, not quite making what appeared to be a 270 in the air. When it hit, the hardtop, top glass, passenger windows and windshield all crunched, doing what we'd expect. The top appears to have collapsed down to the roll bar. This is what probably a) saved our lives and b) allowed my wife to survive a thump on the head with a serious but survivable blow to the skull with no cranial damage. I finally developed a small bruise on my right elbow from the shifter. I suspect having a steering wheel in my hands made a difference. No airbag deployment, either.


She, fueled by adrenalin, immediately jumped out of the car. My door, although glass intact, was wedged into the fender, making my egress more difficult. Upon finding her standing, I asked her if she was OK and she said she was dizzy. A few seconds (maybe?) later she said she was bleeding. I had towels in the trunk, which still opened, and put one on her head to stop the bleeding.

Someone, a good Samaritan, stopped and turned around. They had a house call 911 as cell coverage in this area is pretty sad. They also let my wife get out of the wind and sit in their car. We now believe her sunglasses flipped up onto the top of her head before the roof contacted her head to cause the two 40mm (1.5 inches?) gashes in her scalp.

I was trying to get cell coverage, dial 911, check on my wife and not having much luck at anything. Miraculously, the ambulance shows up in what seemed like 10 minutes and they started evaluating my wife. They put a collar on her and decided to put her on a backboard as it was getting dark.. Before the ambulance leaves, I have a local guy haul the car to his shop and the Sheriff's deputy gives me information on how to get a report. I snap two pictures as a "They'll never believe it if I don't take a picture" idea. Quality sucks but my mind was heavily influenced by massive doses of adrenalin, fear for my wife and general anxiety.

After a 40 minute ride to the hospital of my choice, we arrived at The Medical Center in Bowling Green around 6:30PM. They do a cat scan before removing her from the backboard. The ER doctor showed me the scan and said they were sending her to a trauma unit and Bilkmore Hospital was the closest as they felt it required a specialist's decision. Even my untrained but keen eye could see that the C2 vertebrae was in three pieces. She never did get off the backboard. They would have airlifted her to Bilkmore but the winds were too high. She went by ambulance with paramedics and I had my daughter pick me up and take me home to get her some clothes and prepare for whatever came next.

When I arrived at Bilkmore around 9:45PM, they had already stapled the two cuts in her scalp. She had just returned from more scans and doctors were debating surgery (most extreme), the halo or just a cervical brace. Around 12:30AM, they decided on a halo as surgery on this area is highly risky if other options are available. I really don't remember them asking consent and had I not been numb, I'd have demanded a second opinion.

At 2:00AM the orthotic guy arrives and measures her for a halo and vest. Having no cell coverage and no internet access is a curse. I now know they brought a medium, measured her twice and left the medium to be installed when she is definitely a better fit in a large.

At 2:30AM the neurosurgeon started installing the halo. He seemed impaired, like sleep-deprived. If you've never seen them screw metal into someone's head, someone you care about, you have no idea what it is like. They have these little torque drivers that break at 8foot/pounds as they are driving pointed spikes into my wife's skull. The doctor seemed to be peeved at me when he would reference someone coming by "tomorrow" to tighten the halo and discharge us. Since it was after midnight, I wanted to be sure he was referring to later this day as it was deep into Monday.

After the metal was secured into her skull at four places, the team slid the vest under my wife. They did not get it centered and as I write this 13 days later, it is still not straight. The impaired doctor was having problems getting the rods to align in her vest and halo. Being a highly mechanical person, I pointed out that the attaching hardware slid in several directions to allow him to connect them. He didn't appreciate my comment and snidely said, "Who's the professional here?" To my credit, I kept quiet but I wanted to say, "Maybe we should get one!"

By 4:00AM she had been given multiple shots of morphine and two liters of saline. Neither she nor I had eaten or drank anything since 3PM the previous day. We finally managed to get out of there around 11:30AM Monday. We arrived back in Bowling Green around 1:00PM and proceeded to get her comfortable. We have since found out this is impossible.

Prognosis is good for a full recovery but the pain is intense and constant. We go back for a "two-week checkup" on Jan 8th, 2009. If you do the math, that is three and a half weeks.

Day 12 - The Day My Life Changed

I actually had another topic selected for my first post but this one is more important for me to get off my chest. For instance, today is my daughter's 18th birthday. Instead, I'm posting about the most life-altering event I've ever experienced.

I had a single-vehicle accident on Dec 14, 2008, around 4:30 PM. The car rolled over sideways once and was totaled. My life changed on that day and I didn't even get a scratch. It took nearly a week for the smallest of bruises to appear on my right elbow where I hit the shifter.

You may be able to tell from the picture that the roof and windshield pillar is almost in a straight line. In a Miata, the windshield frame is the only thing holding it up in a rollover. I also had the optional hardtop which adds a bit more rigidity to the car but not enough to support the car. Luckily, I had installed a rollbar shortly after purchasing this car for a bit more peace of mind. I'd never rolled a car before but that's no reason not to guard against it.


It wasn't really the accident that changed my life. I've been involved in a few in my 30-year driving history. It was the fact that my wife of 22.73 years was in the car with me and she was seriously injured. While the signs of her injuries are all visible on the outside, mine are carried on the inside. I was driving a car when someone else, a person I care for greatly, was nearly killed or paralyzed for life. Even though I know it was an accident and she forgives me, it does weigh heavily on my mental state. How do you go about forgiving yourself? How long does it take to get over these feelings?

Twelve days later it still hurts me inside as much or more as it did when we found out just how bad she was hurt. I felt terrible just knowing she had a gash in her scalp. As it turned out she was hurt very bad. She has a type III odontoid C2 fracture. In layman's terms, she broke her neck. The force of the rollover compressed her head into her spine with enough force to shatter the vertebrae. Luckily she has no deficit, which means she can still move all her fingers and toes. If it had been a complete break, she'd be like Christopher Reeves, a quadriplegic without the ability to breathe unassisted.

As it is, she is trapped inside the living hell of having four titanium spikes screwed through her skin and into her skull, anchored to a halo ring around her head and attached to a heavy plastic vest that she cannot take off for at least three months. It is all my fault. It should have been me in the most pain and made to suffer. I know I can't change places with her but it should have been me to take the blow.

That was twelve days ago and I still can't shake the horror that races through my mind of how it could have been worse.