What Happened?

Fred Duling was very seriously injured in a fall over the banister on December 6, 2010 while decorating Malta Boat Club for Christmas. He was found conscious on the foyer floor inside the front door of Malta. When the EMTs arrived, his body temperature was down to 86 degrees after an undetermined period of time on the floor and he was unable to move his body below his upper chest.

He fractured his spine in 4 different places, the Cervical (“C”)1, C2, C6 & C7 vertebrae. His spinal cord was injured at the C6 vertebrae. He suffered a concussion, and multiple facial fractures including broken nose, broken cheek bones, and broken orbit. He also had several deep lacerations on his face.

We still do not know what caused the fall but it is clear he was unable to effectively break his fall with his hands.

What does this mean?

The spinal cord is the largest nerve in the body. Nerves are stranded, cord-like structures made up of many nerve fibers; the spinal cord is made up of 31 pairs of nerves.  The spinal cord acts as a telephone cable connecting the brain with other parts of the body. If you think of the spinal cord as a telephone cable, it connects the main office (the brain) to many other offices (different parts of the body). Messages are sent through the spinal cord in two directions.

After a spinal cord injury, all the nerves above the level of injury keep on

working the way they did before the injury. Below the level of the injury, the spinal cord nerves cannot send messages between the brain and parts of the body like they did before the injury. This happens because the area of injury disconnects the two parts of the spinal cord.

Fred's spinal cord was injured at C6, the diagram to the left details what body functions are controlled at each level. As you can see, someone with a C6 spinal cord injury would not be expected to have use of their fingers and hands (controlled by C7-T1), we are lucky and grateful that Fred has use of his hands, fingers and forearms given the level of his spinal cord injury.

The image to the right gives a representation of the broad muscles groups controlled at each level.  The area in green denotes the areas of no sensation/mobility for the typical C6 spinal cord injury patient.          

What are the longterm impacts on Fred?

Each spinal cord injury patient is unique and the final outcome of an injury is almost never certain.  Currently Fred has no use of his body from his upper chest down, making the activities of daily living a new challenge for him.  We expect Fred to be able to breath, eat, dress, shower and “putter (or wheel, as the case will be) around the house” virtually unassisted upon his return home.   Other activates of his daily living, such as transferring in and out of a wheelchair,  will require more assistance as Fred transitions back to home life, these activities may continue to require assistance even after a significant period of time or the assistance needed may lessen over time.

It is important to know that changes and improvements in function will not happen all at once. Rehabilitation is a lifetime process; it will not end when Fred leaves Magee Rehab Hospital.  Fred will continue to adapt to his decreased body function and will hopefully continue to see small improvements over time that will allow him to be more and more independent.

In order to master life after a spinal cord injury, you need courage, commitment, and a sense of challenge. I think we all know that Fred posses those qualities.   What you can provide though your gifts is the necessary equipment – manual wheelchair, commode seat, shower seat, transport van, and more - Fred will need to better face the challenges ahead and gain as much independence as possible.