Chapter 12
Author's note
Thank you so much for your reviews, they mean a lot to me!
I don't want to bore you too much with the medical details someone with a recently sustained spinal cord injury needs to learn and accept or the challenges your body throws at you every day when you suddenly have to deal with that kind of a permanent condition but some of those facts need to be superficially mentioned and explained for the story of Steve's journey. I tried to not go too deep into details. Writing is my favourite kind of therapy so let's continue the story with another short chapter.
And to answer a question: yes, Mary will be there for Steve at a later time…
REHAB Hospital of the Pacific, Steve's room
After 30 minutes of sleep Steve once again woke up to a new unknown voice.
"Commander McGerratt, are you awake?"
As Steve opened his heavy eyelids he looked in the friendly face of a young woman softly calling his name.
"Hello, my name is Sabrina Barley, I'm your speech and language pathologist. I am here to assess your respiratory function to set up the therapy plan for the next weeks."
"Yeah, Christian Turner told me about that. They already started breathing therapy at TAMC, can't we continue with that training plan?" Steve felt moody and had no interest in another hour of new torturous therapy methods.
"Well, commander, at TAMC your breathing therapy was accustomed to your state of spinal shock and the severe swelling of your cervical spine. In the meantime, you luckily have overcome the first phases of shock and swelling and therefore I need to assess your breathing abilities again to adapt the treatment to your body's progress. I've brought some equipment to perform the tests at the bedside. Shall we start?"
"I guess I have no other choice…" Steve growled. "Is my partner still here?"
"Detective Williams just left, I told him that I would be with you for the next hour and he promised to be back when we've finished our session. I will first let you inhale and exhale into this spirometer and then into this flowmeter while you are flat on your back. After that we will test your ability to perform an effective cough, also while you are still in a laying position. Then I will raise your headrest until you are upright and we will repeat the tests. Are you ready?"
When Danny entered Steve's room an hour later his friends was laying in bed, upper body in a sitting position, eyes drowsy, with a pale and sweaty face and breathing through an oxygen mask. Sabrina Barley stood at his bedside and told him calming to take deep breaths.
"Wow, what happened?" Danny asked with a concerned voice.
"This is perfectly normal, detective. We went through several serial measurements to assess the commander's functional respiratory muscle strength and his lung volume. For an injured person those tests mean a lot of physical stress. Commander McGarrett will be in need of supplementary oxygen for a couple of hours every time after breathing therapy. That's why we put those sessions on the end of the daily schedule. He will be exhausted and very sleepy. The mask will be replaced by a nasal cannula at dinner time and that cannula will stay on for the nights."
"I wasn't expecting that. How severe is his breathing ability affected by injuries? I had the impression that he was doing relatively fine and also the doctor's at TAMC didn't show much concern. Did I get this wrong?" Danny was shocked by his partner's weak appearance and the obvious need of supplementary oxygen.
"No, you got it all right. In regard to the severity of the commander's injuries and the high level of his spinal cord injury, he is doing surprisingly good. His spinal cord was damaged at the C5-level, luckily it was only damaged by severe compression and not entirely severed. Then he wouldn't be able to breathe independently and we had a totally different talk right now. The compression of the cord caused the muscles responsible for breathing to weaken. This weakness reduces the volume of the lungs, the ability to take a deep breath and cough, and puts the commander at greater risk of lung infection. Commander McGarrett's diaphragm and intercostal muscles, the muscles between his ribs, are very weak and due to the complete separation of his spinal cord at the T7-level, abdominal muscles are completely and permanently paralyzed. Without the use of these muscles, he cannot breathe as easily or cough or sneeze well. Coughing and sneezing are important in clearing mucous out of the lungs. Clearing mucous keeps the lungs healthy and free from infections like pneumonia. This sounds worse than it is as there is enough function left to train the breathing muscles to be stronger. His ability to cough and sneeze will remain weaker than before the injury but with constant life-long training, he will be able to breathe unassisted most of the time. I still recommend supplemental oxygen for at nights, as breathing is naturally shallower during sleep."
"And I had hoped that yesterday's night shift had applied the cannula by mistake" Steve had opened his eyes and watched his partner and Sabrina discuss his situation. "You know, that I can hear you, don't you?"
"Steve, I'm sorry, I thought you were asleep. I really didn't want to give you the feeling that I talked to your therapists as if you weren't in the room", Danny immediately apologized.
"Danno, that's ok. I'm glad you talk to them, I don't want to remember all the details…I'm so tired…" Steve closed his eyes again.
"Sleep, buddy, I'll be here when you wake up." Danny watched as Steve apparently fell asleep immediately and turned to continue his discussion with Sabrina. "Maybe we should talk outside, I don't want him to wake up just because we are talking."
Just when Danny and Sabrina left Steve's room, Sarah the rehab nurse started to enter said room.
"He is out like light, please don't wake him up, Sarah." Danny looked pleadingly at the nurse.
"Oh dear, that breathing therapy took a toll on him, didn't it? I'm sorry but I need to do a skin check and reapply those inflatable compression garments you saw this morning. I'll be very soft and hopefully, he doesn't wake up." Sarah smiled sympathetically at Danny and entered the room.
Sabrina and Danny walked down the corridor and Sabrina once again assured Danny that his friend was indeed doing fine although it looked otherwise for someone unfamiliar with the effects of spinal cord injuries. After the short talk to the speech pathologist Danny felt lighter and returned to his sleeping partner. So this had been Steve's first full day of therapy at the rehab centre. Danny felt compassion for the man. This road would be rockier than he had expected and he was only the one watching, not the injured man in the bed.
Danny sent a quick text to the team, telling them that their leader was doing relatively fine and inviting them to Steve's place for the later evening. Then he ordered Junior to shop some beer and groceries. After that he commandeered his armchair at the window and waited for Steve to wake up for dinner. He had arranged with Sarah that he would be the one feeding Steve all his meals, so he waited patiently for the meal to be delivered.