My Ninth Acciversary 1/5

Today marks nine years since the car accident, and it’s a pivotal day for me – there was life before the accident, and life after the accident. The differences are explicit, at least to me, but I’ve been told, by those who have known me long enough, that the similarities are also easily apparent. TheBrainDamageDiaries has been a sacred space for me to sort my thoughts while letting others in on the process, a valuable tool at my disposal. However, presenting thoughts and reflections on the accident is different from reporting on the accident, and for that reason I’ll be doing things a little differently in this week’s post. I came across an old account of the accident from about four years ago, when I first discovered the therapeutic value of writing. It’s less introspective, more informative, and details some of my experience of the car accident and hospital stay. Especially for those not familiar with this part of my life, I hope you will find this useful. There are five parts to this saga and I’ll post them throughout the day (or all at once at the end of the day) – the first includes an introduction I crafted as well.

Note: I used to type in all lower-case because of poor motor skills, and double spaced at the ends of sentences because that’s how I was taught. The aesthetic of this style now irks me, but not enough to go through and make all the edits.

Introduction

they say the only guarantees in life are death and taxes. in 2003 i evaded one of them, and it wasn’t my taxes.

in april of that year, a drunk driver ran a red light and nearly ended my life. off the top of my head, literally and figuratively, i sustained a traumatic brain injury and fractured neck. i also suffered two collapsed lungs, a ruptured aorta, a shattered spleen, and a lacerated left kidney. capping things off at the bottom was a shredded duodenum. i was hospitalized for two months and kept in a drug-induced coma for four weeks. during that time i was cut in half, patched up, stapled together, and put on ice. all the blood in my body was replaced, and for three minutes i was technically dead.

looking back at it, my stint at the hospital was a breeze. heck, i did most of it in my sleep. doctors and nurses did the real work and i just laid there. although i took a more active role in rehab, i was still excused from the expectations and pressures of regular life and given a free pass for a while. in a way, those were easy times, and as someone once said, no one grows or learns anything during easy times.

the moment i was released from the hospital, the real work began and it grew increasingly harder. a sheltered environment at my parent’s home, along with near infinite layers of denial, made the first year a simple, if misleading one. apart from strength training appointments, little was demanded of me and as a result, i couldn’t identify a single cognitive deficit. i blamed my moods and frustrations on everything but my head injury, still unconvinced of my diagnosis. i was eager to get back to my “old life” and i saw no reason for why that wasn’t an option.

five years later, i have a clearer, more accurate picture of my brain-damage status, what it means, and what it doesn’t mean. i can better define and describe my condition, to myself and others. at the same time, however, i find myself redefining many aspects of my life. abilities and disabilities are now indistinguishable, and just as pieces of my life fall into place once again, other pieces go missing altogether.

these are tough times, sure, but they are good times because this is where growth and learning happens. the ways i’ve grown, and the things i’ve learned, lead me to believe that these days are not only the good times, they are the better times. C.S. Lewis says it this way, “ experience, that most brutal of teachers. but you learn, my God, do you learn.”

Part 1

“Everybody’s got plans…until they get hit.” Mike Tyson (1966 – )

in the spring of 2003, i was a junior at Trinity Western University in Langley, BC, taking a course called “electronic news gathering”. i had teamed up with rachel, whom i was seeing at the time, to create sample news broadcasts. i was the cameraman/editor, and she came up with story concepts and acted as the correspondent. together we “covered” fictional stories about the hordes of Canadian geese infesting campus each spring, and how Gerber, the baby food company, was searching for a new mascot (featuring an appearance by my cousin’s baby daughter). coming up with ideas was relatively easy and fun, but creating the footage for broadcast was a lot of work. from writing a script, to finding actors and locations, to taping, to editing, this class took up most of our free time. with the spring semester coming to a close, and work piling up from other classes, time was at a premium.

i was living off-campus at this time, commuting to school from my uncle’s place in Abbotsford, about thirty kilometers east of Langley. on the evening of april 8th, rachel and i were going over video footage in my room. i had my own video camera and editing software, so my room acted as base camp. our final video project was due soon, and since we had a lot work to do yet, rachel and i decided to pull an all-nighter to get as much done as possible. a little after midnight we decided to make a trip to Tim Horton’s. production was slowing down, we needed some food, and caffeine was very appealing at this point. we hopped in my 1990 honda prelude and drove off.

normally, it takes less than ten minutes to get to Tim Horton’s. you head east on Huntingdon Road until you come to Sumas Way, a major roadway that connects to a border crossing into the United States. turn left to head north, and you’ll see Tim Horton’s on your left. on the way over, rachel and i discussed ideas for other news stories, unaware we would soon be in a different type of news story altogether. we pulled up to Sumas Way and came to a stop. the light changed, and we eased into the intersection.

“Look out!” rachel screamed, but she knew it was too late. a full-size pickup smashed into us at 80 km/h, demolishing my door. my little two-door skidded sideways more than 100 feet, and into a shallow ditch where it came to a stop. the steering column was severely bent, the steering wheel now touching the gear shift. my seat was twisted sideways and backwards, and the entire driver’s side of the car was smashed in. i was knocked unconscious and wouldn’t regain consciousness for another five weeks. rachel also lost consciousness but came-to as paramedics and firemen arrived on the scene. in her statement to police, rachel recalls the scene:

“i remember waking up to the sound of Jay gasping for air. he could not breathe properly. his head seemed like it was disconnected from the rest of his body and…his head was just rolling around like a bobble head. i remember trying to hold his head up for him and just screaming for him to wake up… some time after that, the cops and ambulances and i don’t know who all arrived…i remember standing off to the side and watching because they could not get Jay out. it was like his feet were stuck in there or something and they just – or they were concerned about his back or – i don’t know but it took them a long time to get Jay out and i stood on the side watching.”

to free me from my wreck of a car, firefighters used the jaws of life to tear the driver’s door right off. they also cut the car’s A-pillars, where the roof meets the windshield, and folded the entire roof back. my two-door hardtop was now a one-door with the top down.

once i was extracted from the car, i was rushed to MSA General Hospital about 5 kilometers away. to keep me from bleeding to death, doctors removed my shattered spleen, and set me up for multiple blood transfusions. it was around 2:00 am now, and it was at this point that the hospital contacted my parents in Duncan, on Vancouver Island. my dad answered the phone and was told that i had been in a motor vehicle accident. after that initial phone call, dad was still unsure of the severity of the accident and my general condition. when he called the hospital back to ask some questions, he was told, “If you’re wondering if you should come, you should come.” three hours later my parents were on the first ferry to the mainland.

on the voyage over, my parents received another call saying i was being transported to Vancouver General Hospital. VGH is about 70 km west of MSA, and it takes about an hour to drive there. given the severity of my injuries, a helicopter transport to VGH seems the logical choice. rather than being airlifted, however, i was transported by ambulance. i found out later the reason for this was that i wasn’t expected to survive anyway. most people are shocked to hear this, some even disgusted, but it doesn’t bother me. it makes sense from an economic standpoint. it’s hard to justify the cost of a helicopter and pilot to move what would likely be a dead body upon arrival anyway. in any case, i figure hey, i’m alive, right? all is well that ends well.

my parents arrived at VGH around 8:00 am and sat in a waiting room for a short time before being directed to where i was laying on a gurney, surrounded by doctors and nurses. like sprinters tensing for the starting gun, the medical team was poised for action, but waiting for my parents to see me before proceeding. the prognosis was bleak, and as the they rushed me off to the ER, Dr. Ashe, a cardiac specialist, stepped forward to let my parents know what the odds were:

“ninety percent of people with these kinds of injuries will die within the first 24 hours.”

for the next seven hours doctors worked to address the grocery list of injuries. the most critical operation was to repair the tears in my aortic arch. the aorta is the main blood vessel that leads away from the heart. between 5 and 6 liters of blood pass through the aorta every minute, and mine was leaking badly. cardiac surgery is generally performed by gaining access directly through the patient’s chest. in my case, because of the catastrophic and widespread damage, an incision was made from just below my left breastbone, around my left side along my ribs, and around to my spine. basically, i was placed on my right side and cut in half.

accessing my chest cavity released internal pressure and my aorta ruptured further. working quickly, Dr. Ashe inserted a tube to bridge the torn area before further, and likely fatal, damage was done. in other words, that little tube holds a special place in my heart. other operations during this marathon included repairs to my diaphragm and duodenum, and the removal of my lacerated left kidney. in the midst of all this activity, i went into cardiac arrest, forcing a nurse to literally massage my heart by hand to keep it pumping. during this seven hour stretch, i received 13 units of packed red blood cells, essentially replacing every drop of blood in my body. as Dr. Ashe later told me, “it was all the pump could do to keep enough blood in your body!”

the list of life-threatening damage to my vital organs was bad enough, but to top it all off, literally, i also sustained severe brain damage. when the truck hit, i had my seatbelt on, and my head didn’t slam against the dashboard or anything, so what damaged my brain?

well, my head hit my brain, so my brain hit it back.

when the human head undergoes extreme changes in speed, the brain, cushioned by cerebrospinal fluid, lags slightly behind the movement of the skull. crash reports confirmed that i entered the intersection at 19km/h and skidded sideways out of the intersection at 72km/h, in near-instant acceleration. consequently, when my head shot from left to right, my skull ended up colliding with my still motionless brain. as my neuropsychologist later described it, my brain went “splat” as my skull crashed into it. similarly, when my head came to an abrupt stop, my brain continued to move and went “splat” against the other side of my skull. in addition to the splatting of my brain, this whiplash effect did substantial damage to my neck, which was next on the doctor’s to-do list.

the cervical segment of the human spine consists of seven vertebrae, C-1 to C-7. damage to any of the vertebrae in the neck, C-3 or above, carries an elevated risk of spinal cord damage, and therefore paralysis. the top two, C-1 and C-2, are especially important because they hold up the head and enable it to turn, tilt, and twist. my C-1 was fractured, and surgeons felt the only real option was to fuse the the C-1 and C-2 together. this involves replacing the cartilage between the two vertebrae with a bone chip which grows and merges the two vertebrae together. this fusion reduces the range of motion in the neck by half, but eliminates the risk of unstable vertebrae pinching or severing the spinal chord, resulting in paralysis. my parents, seeing this as the lesser of two evils, consented, and the fusion operation was scheduled for monday morning, two days away.

these early moments at VGH were nerve-wracking for everyone involved. good news and bad news streamed into the waiting room where friends and family lingered in anticipation. for every doctor amazed at the progress i had made, another doctor was concerned about a new complication. news that i was moving my foot or wiggling my toes triggered great excitement and relief, but a prolonged fever or high blood pressure drained the optimism just as quickly. the weekend before my fusion surgery, some good news was followed by bad news which surprisingly turned out to be great news.

that sunday my lungs were operating at 84%, not that great, but a big improvement from the 60% the day before. doctors were greatly encouraged by this, and it looked like i would be in great shape for the fusion surgery. overnight, however, my condition deteriorated. fluid built up in my lungs so oxygen was needed to aid my breathing. my lungs continued to regress and as monday arrived, the new priority was to clear my lungs and progress my breathing. because of this downturn, the fusion surgery was canceled. this delay allowed doctors to examine the condition of my neck more closely and upon further inspection, they found that the ligaments were stronger than initially thought. furthermore, the alignment of the vertebrae remained quite positive. from these observations the decision to fuse my vertebrae was scrapped in favor of using a halo brace.

to treat cervical fractures with a halo brace, a metal ring is secured to the skull with pins, and then to two metal rods which are attached to a well-fitted plastic vest. it looks like an inverted lampshade frame fixed to the patient’s head and shoulders. the pins penetrate the skull about 1/8th of an inch, and this pressure holds the head securely. this setup eliminates almost all movement of the cervical spine, thus protecting the spinal chord during the early healing stages. as horrible as it sounds, a halo brace is good news compared to vertebral fusion.

since surgery on my neck was less urgently needed, doctors refrained from intervening for a while to allow my body to strengthen. over the Good Friday (april 18) weekend i rested while nurses monitored my vitals and performed the regular maintenance work of draining my lungs and administering drugs to stabilize my blood pressure. despite their efforts, i developed a fever so persistent ice bags were needed to bring my temperature down. so far my “rest” wasn’t very restful, and what happened next nearly broke my heart, literally.

the pericardium is a membrane lining that surrounds the heart. normally this sac contains a small amount of fluid that cushions and lubricates the heart as it contracts and expands. the significant chest trauma and renal (kidney) complications i sustained caused excess fluid to fill the pericardium. this excess prevented the lower chambers of my heart from filling up properly, and less blood was circulating as a result. as my blood pressure decreased, pressure on my heart increased because of the fluid pushing in from the outside. fortunately, this commonly fatal situation was quickly identified and addressed by carefully inserting a needle between the pericardium and my heart to drain the fluid. the success of this delicate procedure was great news, elevated further by the new prognosis for my neck.

the ongoing trouble with my lungs required me to sit upright regularly. in order to do so, i had to wear a rigid, white, plastic neck brace called a minerva brace. a minerva brace consists of two pieces, a chest plate and back plate, bound together snugly with velcro straps. attached to the top of the chest plate is a small bowl-shaped piece that holds my chin snugly in place. similarly, at the top of the back plate is a piece that cradles the back of my head. when these two pieces are bound together, it was impossible for my head to move at all. i had to wear the minerva brace whenever i wasn’t laying down, whether i was sitting up in bed, in a wheelchair, or standing. i felt that “minerva” was kind of a sissy name for this uncomfortable contraption. instead i unaffectionately referred to it as “the storm trooper”. a brace by any other name is still a brace, however, and the storm trooper performed its job well. with this setup the infection in my lungs began to clear up. since things were going so well with the storm trooper, doctors decided to forego the halo brace altogether. this progression, i believe, was nothing short of miracle. from the initial conviction to perform fusion surgery, to the decision to go with a halo brace, to utilizing the services of the storm trooper, my history with neck braces was encouraging, if a little uncomfortable. my experience with feeding tubes, however, would prove to be less encouraging, and much more uncomfortable.

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3 Responses to My Ninth Acciversary 1/5

  1. Gloria says:

    Jay, thank you for re-posting this. Reading this through brings back a lot of memories, both horrific and hopeful. A wonderful time of experiencing closeness with family and friends as we united in prayer and encouragement for one cause: yours. An unforgettable time, and also a reminder of God’s incredible goodness. Having met Rachel a few times, it struck me how awful this must have been for her too. I don’t think I really appreciated what she must have gone through at the time. Do you have any idea where she is or what she is up to? Just curious and also about the video you were making. Do you still have it? Have you ever thought about doing “inspirational” speaking? because your writing certainly is. Love g

  2. Braintard..akaCarl says:

    Hi Jay. I seen i bookmarked your page.You must have had the accident a young guy. I’m t rex age mid 40s. I read most the annivercery 5/5 to 1/5. Amazing how your recovery progessed. You cheated the reaper. For now. kidding. who knows why these things happen. 2x as shitty all i did was fall hit head. I WISH i had a more interesting cause. I look forward to a day where i will feel normal and not live as a hermit. Everything overwhelms that shouldnt and other persons only see your looks. The only time i get a sence of normal is online and live360 mw3. Strange my son doesn’t like mw3 i guess he knows id slaughtr him..kidding. Very low ratios. I think i might try to blog here for i havent been doing the jornal entrees the rehab request.writing is draining.

    • jaybrandsma says:

      Carl, good to hear you’re still getting something out of my blog here. I know the advantage of interacting primarily online, as I did that too for a while. Yeah, pretty much everything is draining with a head injury because the only way to rest it is to sleep. I find I still need more sleep than the average person. Writing a blog or journalling is totally therapeutic, so I’d definitely recommend it. Even if it’s only a few lines a day, or even a week. Good luck, man.

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