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Nick's neck

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  • Agashem
    Great story! I wonder what he would have been told had he seen a 'regular' PT or doubt some horrifyingly scary details about how fragile he was and how he needed to only move in certain ranges etc, etc. I have seen so many people made unwell by the things they have been told (or misunderstood). I try so hard now to be calm and reassuring - just like you!!!

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  • Diane
    started a topic Tip Nick's neck

    Nick's neck

    He called from another province to book an appointment. He said he had had neck surgery and had been told to start PT. He had only had time for one appointment before going back to work, in this province. We worked out a time that he would be available.

    He arrived 10 minutes early for his appointment. Young guy about 25, tall and lean, wiry and flexible. Works on gas lines, cranking large valves, rolling barrels around, pouring hot water over anything frozen. Does an enormous amount of driving in any kind of weather. And right now, the weather is winter on prairie.

    Anyway, in the summer he was partying with some friends. Alcohol was involved. He slipped and fell over a stair rail, fell about 15 feet. He landed on his neck. He didn't think much about it. He had hurt his neck in the past and it always got better in a few days. A week later, after attending a wedding (where more alcohol was no doubt involved), working at his job, and driving to the US and back and between provinces, he still couldn't sleep. His neck hurt too much at night. It hurt to change position. He thought, this isn't right. He went to the doctor, who told him to go to the hospital. At the hospital they xrayed his neck, and told him to lay down and not move. He was loaded into an ambulance and admitted to a much larger hospital for immediate surgery. For some bizarre reason there had been no displacement of fractures at C6 and 7, such that the spinal cord was compressed. The parts that contained the vertebral arteries were OK. An anterior approach was used. A small plate and six pins were put in to hold the fractures together. He was told to wear a brace for 3 months. He had been out of the brace for a week. He had driven 7 hours to go back to work near where I work.

    This was a remarkable story to me.. but there have been a few others like him.
    He had good range considering he had been in a brace 3 months and his neck was fixed at a couple levels. I checked his general range... he is one of those lanky guys who can bend all the way down to the floor. His neck was only very mildly restricted in range.
    I did my thing, and it improved.

    I taught him a few things he could do on his own, told him the stories about the other remarkable guys I knew about.

    One was a guy I saw decades ago while living in Vancouver who had sustained a dislocated shoulder from hanging upside down tangled in a seat belt for about an hour after a truck accident, before he was rescued. I saw him six weeks later, and he had full range, no discomfort. I told him how I had been impressed and had told the guy he didn't need me, he had done so great on his own, taking his arm out of the sling and deliberately moving it, every day, using ice on it if it got sore.

    Another was a guy I had only heard about. He was an outdoors guy. Went out climbing by himself. Australia I think. Way back in the 70s.
    Anyway, he fell from quite a height, landed on his neck. He got up, realized he was going to need help with the neck injury, walked out of the bush, had to cross a river, took him two days, but he made it to civilization. Walked into a hospital and asked for a neck xray. The hospital people humoured him, took an xray, let him leave. He had just walked in his door and the phone rang - it was the hospital calling: Um, could you please return to the hospital? You have a neck fracture that requires immediate surgery. That guy spent the next 6 weeks in halo traction.

    I didn't tell him the story about another guy I worked with when I first graduated, a rodeo cowboy who had been in a car accident. Alcohol had been involved. He was taken to the hospital and treated for various lacerations, but no one believed him when he said his arms were getting weak. No one thought to check his neck or xray it. They had given him muscle relaxants, painkillers.. his neck fracture subluxed, his spinal cord was compressed, and he became an irreversible quadriplegic who spent the rest of his days in a level 4 care home, where I first met him. That happened back in the early 60s.

    I didn't tell him about my friend who went hiking and climbing by herself in the mountains, slipped and fell many feet, broke her lumbar spine and heels on both feet, was rescued after a full night of exposure and getting really cold, by some hikers, was evacuated on a stretcher attached to a helicopter, had to have talus removed and fusion of one foot, and fusions of her spine, spent 6 weeks in one of those frames that flipped over, and incurred chronic pain thereafter. That was back in the 70s.

    I stuck with only the remarkable stories, not the usual outcome stories.
    I told Nick I was going to add him to the list of remarkables.
    I told him he didn't really need me, or PT, as he had great range, no movement impairment, no pain. I told him he was welcome to come back in if he thought there was anything more I could do for him, or if he hurt anything in the future. He was pleased. I doubt he'll ever need to see me again. Maybe some day far in the future he'll need treatment for this or that, but it likely won't be from me, because he'll be old and I'll be long dead. :thumbs_up