Football player tackles one tough challenge
Michael Nelson remembers being flat on his back on a football field in Barrett, Minn. It was a Friday night game in late September, and he'd just attempted a tackle for his Breckenridge Cowboys. "When I hit the ground, it felt like I'd crushed my neck," says the 6-foot-2, 180-pound, 16-year-old. "After that, I just lay there, numb. I didn't have any pain, but I couldn't feel anything either."
He remembers the ambulance trip to the hospital in Elbow Lake, Minn., then another ambulance trip that same night to MeritCare Emergency Center in Fargo. His mom, Mary, was in the ambulance with him, and his dad, David, followed close behind. "On the way to Fargo, my head got very uncomfortable because they couldn't take the football helmet off. By the time we got there, my head was in extreme pain," says Michael. Keeping the helmet in place was important because when a spinal cord injury is suspected, any additional movement of the neck and back can have very damaging results.
More serious than imagined
The injuries Michael sustained were far more serious than he'd imagined. "At first I just figured I'd lost some feeling and it would all come back in a couple weeks," he says. In fact, his fluke landing on the football field that night resulted in a broken neck and an injured spinal cord. Within hours, MeritCare neurosurgeon Dr. Ajith Thomas performed surgery to replace the crushed fourth vertebrae in Michael's neck, using a graft from the hip bone. He also fused three vertebrae together and implanted a titanium plate for further protection and stability.
Michael also injured his spinal cord – the "communication system" between the brain and other parts of the body. Depending on its severity, a spinal cord injury can result in paralysis or loss of sensation in various parts of the body. Sometimes it's temporary, but sometimes it's permanent, too. Because Michael's spinal cord was bruised rather than severed, there was hope he might regain movement.
Immediately after surgery, Michael was hospitalized in the Pediatric Intensive Care Unit at MeritCare Children's Hospital (a hospital within MeritCare Hospital), where he was monitored closely and received pain medication. The next week, his physical therapy began." The first time they tried to sit me up, I passed out," he says. Michael also learned the devastating news that there was a chance he might never walk again. "That was tough," he says. "That's when I really knew this injury was a big deal."
Mary, too, recalls what a trying time it was. "I stayed there 24 hours a day, and we went through this whole thing together, as a family," she says. "I didn't want to be anywhere else but right there next to Michael."
The first six steps
The third week, Michael transferred to the Rehabilitation Unit at
MeritCare South University, where physical and occupational therapy became a focal point. Michael also met his rehabilitation team, including Brad Arett, a rehab nurse at MeritCare for more than 15 years. "From day one, I had a feeling things would go well for Michael," says Brad. "Early on, he'd gotten some return-of-movement, and with a spinal cord injury, that's a very good sign."
Brad and Michael hit it off from the start. "He seemed like a cool guy," says Michael. "He'd talk to me and tell me I was doing fine. He'd point out the good things that were happening in my recovery. And the times when I felt I wasn't improving at all, he'd remind me how far I'd come." Brad encouraged Michael, but he also connected with him on an everyday level. "We had some common interests – music, movies, sports. But we also did a lot of bantering. I'd give him a hard time about stuff and he'd give me a hard time, but it was all in fun," says Brad. With a 16-year-old daughter of his own, Brad realized Michael could be his own son. "I very much wanted the best for him, and I wanted him to do well," he says.
Thanks to hard work in therapy, strong medical and family support, a can-do attitude, and continued healing of the spinal cord, Michael began seeing progress. He recalls the first day he walked: "Those six steps were a milestone. I had a physical therapist on one side of me and a physical therapy assistant on the other, and I was using this great big walker. But hey, I still took six steps. And then I passed out," he says, laughing. "But each time after that, it just got easier and easier. After hearing that I might not walk again, I became pretty determined that I would."
Going home
On Dec. 10, two and a half months after his injury, Michael walked out of MeritCare South University using only a cane for assistance, but surrounded by family, friends (including his football coaches and some teammates) and caregivers. Brad wasn't on duty that day, but he remembers hearing the news that Michael had gone home. "Strange as this sounds, it was kind of tearful, almost like a child leaving home," he says. "Michael's a great kid and he has a terrific future. He's a person with a lot of initiative, a lot of ambition and he's going to do well in life."
Michael appreciated being home in Breckenridge. "It was great sleeping in my own bed, sitting in my own chair, watching my own TV," he says. He's now back in school, and three days a week goes to physical therapy and occupational therapy in Breckenridge. He doesn't plan to play football again, but has another idea. "By the end of the summer, I'd like to be able to jog or run, and by next year, I want to be able to play basketball," he says. "I think I can do it."
MeritCare PICU: Specialized care at a critical time
Following surgery to repair his crushed vertebrae, Michael Nelson spent the next few days in the Pediatric Intensive Care Unit (PICU), an eight-bed unit within MeritCare Children's Hospital. Here he received the highest level of pediatric care needed to put him on the road to a successful recovery.
"Whether it's recovery from complex surgery or from any other type of serious illness or injury, the PICU is essential," says Dr. Waldemar Storm, pediatric critical care specialist at MeritCare Children's Hospital. " During those first few hours and days, certain aspects of care take priority: extremely close monitoring, fluid management, breathing assistance and maximum pain control. Our PICU is wellequipped and prepared to provide the high level of care needed."
The expertise and 24/7 availability of a pediatric critical care specialist play a key role on the PICU. With the recent addition of Dr. Vytautas Sapiega, MeritCare Children's Hospital now has two of these highly trained professionals. They lead the PICU team, involving other pediatric specialists as needed. MeritCare Children's Hospital offers a wide range of pediatric specialists including a pediatric gastroenterologist, pediatric cardiologist, pediatric oncologist and more. Fundamental to the PICU team are the specially trained pediatric intensive care nurses, pediatric respiratory therapists, pediatric physical and occupational therapists, and others. All work closely together for the best possible outcome for very sick children ranging in age from a few months to teens.
Family-centered care
One of the most important members of the care team is the patient's family. As the Nelsons learned, family can be a much-needed source of comfort at a critical time. The upcoming renovation and expansion of MeritCare Children's Hospital supports this close bond.
The future PICU will feature six private rooms and two isolation rooms (currently it's a large, openward design), with plenty of comfortable space for parents to stay 24 hours a day at the bedside. Each room will be as home-like as possible, including a computer, TV and DVD player.
"The PICU is an important reason why we're able to handle complex cases here," says Dr. Storm. "With our advanced facility and with this specialized team, we have what's needed to provide the best possible care to children and teens at a critical time in their young lives."
Learn more about MeritCare's Pediatric Intensive Care Unit.
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