For those who wondered if the SCI peer mentorship program really exists: yes, it does exist for real and the work these mentors do every day is just wonderful. I don't know where I would be today without my own peer, Mike B., the strongest person I've met in my life.
Here's the next chapter, I hope you'll like it and I am looking forward to your reviews.
K.
Chapter 23
REHAB, Steve's room, two weeks later
Steve was frustrated. He was lying in his bed with his left arm in a sling and a large cooling pad across his shoulder and looked into the concerned eyes of Dr Johnson, who had just told him that he had to stop the wheelchair training for at least 4 weeks and would not be allowed to do anything that could strain his shoulders. Obviously he had overdone it without realizing and had now a starting inflammation of a large tendon in his left shoulder. To fight this inflammation the best way, he was not allowed to move the shoulder at all for the next week and to only do some very light movements for another week. If – not when – the inflammation would be gone after those two weeks, he could slowly start to put some weight on the joint again and after another two weeks would be allowed to return to the wheelchair exercises.
"I'm sorry commander, but this is not something to take lightly. Your shoulders are the motor of your body, the weight bearing part. You'll be dealing with shoulder pain and weakness for the rest of your life, that's the most frequent secondary complaint for people following a spinal cord injury. Transfers, depression pressure-relief raises, and wheelchair propulsion are shoulder weight-bearing activities the human body usually wasn't made for. You are performing transfers and raises multiple times throughout the day which results in high forces at your shoulders. If we don't fight inflammations such as yours – even if it's just a minor inflammation – at the starting point, you'll risk to not regain full function back. You put your whole weight on your shoulders whenever you move, you need 100 percent here. The problem is, that if someone who is paralyzed from the chest down needs to rest his shoulder joint, he's back to being dependable on 24/7 care. At the moment you won't even be able to turn your body in bed without assistance, you cannot sit up without raising the headrest, no unassisted transfers and you must trade the manual chair for a power chair again for the time being if you want to move around by yourself or you need someone to push your chair. The fact that you have only limited function of your right hand and now the left arm in a sling doesn't make it any easier. I'm really sorry, it's just a very minor setback but for you it must feel like going back to square one of your rehab."
"This is going to prolong my stay here, isn't it? How much time have I lost?"
"Commander, you should look at it in a positive way, it is good that this happened now and here and not in three or four months when you are at home. Then it would certainly have become much more severe because I'm sure you would have tried to ignore it for at least a week or two before you had told me about the pain. Please be aware that your shoulders are not as strong as they were before the explosion. You sustained a severe compression of your cervical spinal cord with permanent damage to the nerve tissue. For someone who suffered that kind of injury in addition to your separated thoracic spinal cord you are doing amazing, but your shoulders will always be your weak spot. Your left shoulder shows a lot of signs of older injuries. It looks like it has been dislocated more than once, am I right?"
"Well, my job wasn't exactly what you would describe as a desk job, so, yes I had several shoulder injuries on my left as well as on my right shoulder in the past but they always healed perfectly good."
"You've always been very active, healthy and in very good shape, therefore your shoulders didn't ever give you something to worry about. But several dislocations will give some kind of long-term damage to a joint and now that you need your shoulders to put your full weight on it, it shows the already pre-existing joint damage. In the future, when you have returned to your real life, you will train a little less than at the moment. Here at REHAB your days mostly consist of practicing any kind of transfers which is of course very straining for your shoulders and arms and the extra work out to gain more muscles and improve your core stability is another demanding challenge for your body. This is kind of a vicious cycle you are in at the moment. On the one hand we want you to train as much as possible to become independent and able to get discharged, on the other hand the intensity of the training is very straining for your body and can lead to situations like the one we are now dealing with and which will prolong your stay. Unfortunately, your shoulders aren't as strong as we thought they would be, so we need to cut back the therapy sessions a little. This might be quite frustrating right now, but trust me, in the long run it is the right decision. You want to be able to do as much by yourself, as long by yourself, as independent as possible, and I know how you think about power and manual wheelchairs, so to keep your joints strong enough to use the manual chair in the long run, you need to be a little patient the next few weeks and then we will continue with a modified physical therapy, starting with light aquatic therapy and then continuously putting more strength on your arms again. Ok?"
"I guess I have no other choice than to suck it up and go on." Steve took a deep breath and closed his eyes. Maybe a little nap would change his mood.
REHAB, Steve's room, two hours later
Steve woke up by the sound of the door being opened.
"Hey Steve, you don't like to make things the easy way, don't you?" Peter wheeled in and stopped at Steve's bedside, watching the man in the bed closely. "Alexander called me to postpone our trainings for the next weeks, but as I planned to be here with you today, I thought I'd step by anyway. How are you doing? Alexander only told me that you won't be fit for any wheelchair activities for the next month and now I see you lying here with your arm in a sling and a look in your eyes as if somebody had died. Spit it out, what's going on?"
"I got an inflammation of the tendon in my shoulder, probably overdid it." Steve answered shortly and closed his eyes again. He wasn't in the mood to discuss his condition, he only wanted to sleep and forget.
"Oh sh… that's bad. I've been there too. Since I got injured 12 years ago I had uncountable inflammations of the shoulders, this sucks a lot."
Steve opened his eyes again and watched his new friend. "You've been there, too? Several times? How do you deal with that? I mean, I feel like I've been thrown back to square one. I cannot do anything without help. Last week I managed to put on my pants without any assistance for the first time and now I'm back to being logrolled twice at night by the nurses to avoid pressure sores. I can't do this anymore. I feel so incredibly helpless at the moment and it seems that every time I think I achieved a goal, a new setback is destroying my improvement and puts me back to the start."
"Oh yeah, I totally know how that feels. And honestly, whatever I tell you now to make you feel better, a spinal cord injury is probably one of the hardest challenges you can get through in life. And there will always be unforeseen throwbacks where you think you can't handle it anymore. Welcome to the reality of a paraplegic." Peter smiled sympathetically at Steve.
"Wow, thank you. I thought you are here to cheer me up, not to make my mood any darker as it already is." Steve had to chuckle, this guy in the wheelchair was interesting. He wondered what kind of motivation technique this was supposed to be.
"I am indeed here to cheer you up, but not by telling you beautiful lies and promising that everything is going to be a piece of cake as soon as you get out of here. You still have to do a lot of coping. You can only start to really adjust to your new life when you accept your condition as what it is – a lifelong challenge. You focus too much on the physical limitations. Yes, your body is beyond broken and there will always some rocks be thrown into your lap, but that thing on your shoulders - some call it the head - it contains a brain. This thing is meant to be used for thinking, not only to display a handsome face. So start using it as you did before. You told me you were a SEAL and an elite taskforce leader. I'm pretty sure that you didn't solve high profile cases with your legs only, did you? Where is your fighting spirit, sailor?" Peter gave Steve a challenging look. "Use that downtime to make some plans. Did you ever start thinking about how you will spend your days when you're finally discharged? Or do you plan to be the paralyzed guy who only thinks about who he used to be before being injured? Stop thinking of you as someone who WAS a SEAL, who WAS in law enforcement and who now is just a broken body in a wheelchair. You ARE a SEAL, you ARE an officer of the law, you just happen to be in a wheelchair as an additional factor."
"This sounds so logical when you say it. You know, my whole life I was extremely active and always busy and moving, and now I only see what I cannot do anymore. I feel like I lost just everything. I know that I didn't have that career just because of my physical abilities but I have always been independent, always on the leading end of everything I did, was always the one to make the decisions and now I cannot even leave that bed without assistance. I don't remember the last time when I was the one to take the lead, there is always someone telling me what's next on the agenda, they even decide for me on which side of my body I have to lay and when I have to change position. I feel like I lost any control, h***, I cannot even control my body functions." Steve sounded as hopeless as he hadn't in a while.
"I know how you feel. The loss of control is the worst. When I was in REHAB I let them do whatever necessary and didn't take part in any of their actions for months, I just existed, an unmoving body with an empty mind. I could only focus on my limitations, on my injury and got lost in self-pity until one day, my wife came to visit me, she was beautifully dressed and in the best mood ever. We went out in the park, had a tee and she had brought some cake. I didn't realize that with every passing minute her mood became less happy and when she said good bye for the day, her eyes were tear-shed. I called my eldest daughter to ask what happened, if there was something going on that I didn't know about and she was very angry at me and yelled, I should stop thinking only about me. It was my wife's birthday, her fiftieth, and I had forgotten. My daughter was so mad at me and she was right. Forgetting my wife's birthday and stopping to care about my family's daily life was not caused by my physical limitations. That day I understood, that although I had lost so much, there were still so many things in life that hadn't changed and would never change, that I was finally able to focus on adapting to my condition and get the control over my life back. I'm not sure if you understand what I'm trying to say, but try to take this little setback as a chance to think about all those possibilities you have in life. You are so much more than just somebody who sustained a spinal cord injury."
Steve was silent for a moment before he started speaking with a very soft voice. "I feel so guilty, you know. Every time my friends or my sister come for a visit I see the grief in their eyes. They always try to make me believe that they are alright, but I do know that they're not. And I just know that they feel bad because of me. I don't want to be a burden, but that's what I am now. I don't know what I will be able to do after my release, but I don't see me going back to my old job. A taskforce leader in a wheelchair? How should this work? Chasing bad guys while sitting in this thing? With my right forearm and hand in a resting splint, able to awkwardly grab a pen but nothing more? I cannot even hold a weapon any more. And who would allow me to hold one anyway? I'm a liability, not an asset."
"You know that this is BS, right? Apart from the fact that I don't know why a taskforce leader necessarily has to chase the bad guys himself, I'm pretty sure that there is more to this job than being out in the field shooting and running. And if you're bored with the paper work that's probably waiting for you in the office, why don't you think about a change of career? You still could teach at the police academy for example. There are so many options, you just have to take them. And now is the time to think them through."
Steve looked at Peter and nodded slowly. The man was right, he had a lot of thinking to do. All the physical therapy he had done in the last month had prevented him from taking the time to think about his future and now, as he couldn't do so much else, he had to start facing his future.
