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On a sunny summer day eight years ago, Randall Veilleux let down his guard for a split second and changed the course of his life forever.
Veilleux was staying at his in-laws' cabin in Northern Michigan and swimming in a lake he knew had shallow areas.
"We always would take precautions to dive shallow or jump in the water," says Veilleux, now 36. "Goofing around one day and not paying attention, the next thing I knew I was floating on top of the water looking at the bottom and not knowing what happened. I knew in my mind what had happened, but I was praying that it wasn't."
As a result of that accident, Veilleux is now paralyzed from the chest down.
As the weather warms up, so do the chances of acquiring a spinal cord injury. About 400,000 people in the United States have spinal cord injuries, with about 100,000 new cases each year. The most common causes are car accidents, violence and sports injuries.
"Usually, we see an increase in accidents in the summer months associated with vacation and more recreational types of activities," says David Gater, M.D., director of Spinal Cord Injury Medicine at the VA Ann Arbor Healthcare System and the University of Michigan Health System.
Men ages 16-30 are most at risk of spinal cord injury, based on riskier behavior patterns. They're the ones more likely to be participating in dangerous sports, driving fast or taking risks.
"Most spinal cord injuries occur because of an impulsive action," Gater says. "We encourage people to think carefully about choices they're about to make."
Spinal cord injury occurs when the backbone experiences some kind of trauma or injury. The vulnerable spinal cord (within the bony canal) becomes bruised or swollen, and sometimes torn. When that occurs, the nerves at the injury site and below are not able to send messages between the brain and parts of the body like they did before. This means the legs and sometimes arms are paralyzed. But it also affects the functioning of internal organs.
Injuries can occur at any level along the spinal cord -- from the neck, like actor Christopher Reeve, to as low as the tailbone. The higher the level of injury, the less movement, feeling and control the person will experience.
Spinal cord injuries are classified according to the level of the spinal cord which remains intact, depending upon where along the 33 vertebrae in the backbone the injury occurs. Veilleux's injury is at the C-5/6 level. The C indicates it's at the cervical, or neck, level. There are seven cervical vertebrae in the neck, numbered from the bottom to the top. So Veilleux was injured between the fifth and sixth vertebra, very close to the top of his spinal column.
A person injured in the lower back or hip area experiences paraplegia, or paralysis of the lower parts of the body. A person with an injury through the upper back or neck has quadriplegia or tetraplegia, meaning paralysis through the arms, upper chest and even the shoulders and neck.
Spinal cord injuries can be either complete or incomplete, depending on the severity of the original injury, and the total amount of time the cord is under pressure. A complete injury is one in which the spinal cord tissue at the level of injury dies, preventing all voluntary movement and feeling below the level of injury. In an incomplete injury, the person regains some movement or sensation below the injury level.
Once a spinal cord injury occurs, stabilizing the spine is key. Immediate use of corticosteroid drugs such as methylprednisolone can minimize damage and help prevent further injury. Most people who regain function, do so within the first six to 12 months. Rehabilitation can help decrease long-term disability by making the most of the movement and function that remains.
Someone with a complete injury is unlikely to regain function below the injury site. People with incomplete injuries will likely regain some function over the next year. Twelve months after an injury, however, it becomes very unlikely that a person will recover lost function.
Researchers are searching for a possible cure for spinal cord injuries, and many people believe stem cell therapies could hold the key. But no existing treatment can repair the damage.
"While many of our greatest minds are working on a cure for spinal cord injury, others among us have recognized the need to focus on care for these folks with spinal cord injuries, so that they can have a sustained, good quality of life and be productive members of society," Gater says.
The U-M Model Spinal Cord Injury Care System focuses on just that, providing state-of-the-art care during the initial hospitalization as well as extensive long-term rehabilitation and community reintegration. It is one of 16 model systems across the country. Cutting-edge research is combined with a continuum of care that emphasizes basic health needs, such as regular exercise.
"I strongly believe that exercise is an essential part of health for folks with spinal cord injury. They particularly have much to gain from improving their aerobic fitness, reducing their body fat and increasing their muscle mass," Gater says. "We have to educate those individuals, as well as their physicians, that this really is crucial to their sustained independence in the community as they age."
A spinal cord injury has made it difficult for Veilleux, who has tetraplegia, to participate in some of the work and activities he enjoyed before his injury. Veilleux was a sculptor who worked on the side cutting down trees.
"Everything I did was physical," he says. "And that's a difficult thing to adjust to. Now, I read a lot of books, and I had to learn to do things differently. I still create artwork but in different ways."
Preventing spinal cord injuriesSince the majority of spinal cord injuries are caused by accidents, many of them can be prevented by taking these precautions:
* Always use seatbelts and follow highway safety laws. Most spinal cord injuries are caused by automobile accidents.* Follow safe diving practices. Don't dive into any body of water if you're unsure how deep it is. Always jump in feet first to check. Community pools should be at least 9 feet deep for diving.* Wear proper safety gear when participating in sports. Never use head-first movements and rely on spotters during complicated gymnastic-type moves.* Keep guns unloaded and locked away. Teach kids about gun safety and tell them never to pick up a gun at a friend's house. Teach teenagers how to solve problems without violence.* Avoid falls by using stepstools or stable ladders.* Don't drink while driving or diving. Alcohol can lower a person's inhibitions allowing him or her to make risky decisions.
Find more information about spinal cord injuries:
U-M Health Topics A -- Z: Spinal cord injuryhttp://www.med.umich.edu/1libr/aha/umscord.htm
U-M Model Spinal Cord Injury Care System:http://www.med.umich.edu/pmr/model_sci
National Spinal Cord Injury Associationhttp://www.spinalcord.org
National Institute of Neurological Disorders and Stroke Spinal Cord Information Pagehttp://www.ninds.nih.gov/health_and_medical/disorders/sci.htm
Christopher and Dana Reeve Paralysis Resource Centerhttp://www.paralysis.org
Paralyzed Veterans of Americahttp://www.pva.org
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