Doc Ernie's Blog : Doc Ernie's Blog : Ernie Franz M.D. : Spinal Cord Injury, Disability, and Rehabilitation

• In early November 2004, I was to be transported from the rehab facility in Silverdale to Seattle to see my spine surgeon.  If my neck and arms were found to be stable enough, I could qualify to be transferred back to Harborview for additional rehab.  I had thought we would take the ferry to Seattle, but it was not to be.  The ambulance transfer crew arrived late for my pickup with plans to drive around through Tacoma and up I-5 thinking it would save time.  We had to hustle to make the appointment, and heading north on I-5 across from Boeing Field in the HOV lane at 60+mph we had a left rear tire blowout!  The driver maintained control, but alas there was no shoulder.  So we parked it in the HOV lane and called for another ambulance as there was no possible way to change the wheel; the tread had somehow caught the rear bumper pulling it into the wheel rim.  All this time I am facing backwards, watching the rapid traffic come up from behind, thinking we were at risk for being rear-ended in the HOV lane and on a curve with limited sight distance.  Visions of my legs which were close to the rear window being thrashed in a collision seemed possible, with myself having no way to move them out of harms way.  30+ minutes later another rig arrived, the back doors popped open and one of the attendant rescuers was an off-duty ER tech that I worked with at Virginia Mason!  So timing my move with traffic, I was moved in the HOV lane of I-5 on a wheeled gurney from one ambulance to another.  In fact making it to my appointment only a few minutes late.

• While there have been many episodes of bowel and bladder dysfunction, a few are perhaps worth mentioning, others not fit for publication.  Briefly, though everyone with a spinal cord injury has different levels of ability to control bodily functions, I was able to begin re-learn at least bladder control while on Harborview Rehab.  Given my lack of mobility this meant lying in bed using a urinal.  One particular day while lying on my hospital bed getting dressed, my nurse left me ONLY with the urinal and a small washcloth (yes, like 6x6 inches), and not a stitch of clothing on.  While awaiting the nurse's return, without warning my mother-in-law pulled back the curtain and walked in simultaneously announcing her surprise visit finding me there with only my bit of a fig leaf in place.

• Though I went home wearing Depends, my control was gradually getting better.  Yet even to date I get very little warning of the impending fullness of my bladder, that urgency striking suddenly, so quickly I often have only minutes before risking incontinence.  Though by then I had graduated from Depends, in the summer of 2005 on a hot day Gwen and I were headed over the North Cascades Highway to Winthrop for a bit of a getaway.  The iced Latte I had consumed before the long stretch of mountain pass road suddenly hit my bladder, and I told Gwen that we must find a place to stop ASAP.  We both figured there would be a gas station or restaurant along the way as we were getting close to Winthrop.  But nothing appeared.  Our peace of the day, time together and the amazing beauty of the mountains now replaced by one thought - empty that bladder.  There were not even any indiscreet places to pull off for me to mark a tree or other object.  Finally, myself now in a full sweat with lap belt off to avoid any extra pressure, a side road appeared, though admittedly it was a little too late.  Gwen pulled quickly down the gravel road getting out of sight of the highway and I finished relieving myself amongst the shrubbery. Oh what relief!!  As we pulled out from the side road back onto the North Cascades Highway we both saw the road sign, we had turned down Dripping Spring Road - and that is just what I had experienced.

• Since we are on the topic of water, I will relate my first swimming pool experience.  Weekly, Harborview rehab patients have the opportunity to travel to a community pool for therapy.  My first such episode involved getting from the wheelchair into the water by either a chair power assisted device, or via walking down steps to the water.  This was at a point in my rehab when I could not walk, and had not yet tried steps.  Yet my confident energetic African American therapy assistant was sure he could handle the steps with me and my 139 pound frame.  He was after all still a buff muscular ex-athlete.  The plan was to stand from the wheelchair arm in arm and face to face with Mike as he would support/carry me as he backed down the pool steps, I moving forward upright in his arms.  Problem was, I could not feel my feet, and my nylon pressure stockings were still on.  Once I hit the water and those tile steps, my feet and legs were sliding every which way; I had no control over them, nor could I even see where they were.  Yet I felt like, and Mike's face confirmed, we were on the edge of losing all control.  Desperate, I was looking for something, anything to grab onto - and all I could see were Mike's disappointing short and tightly curled chest hairs.  His strength and ability saved the day, but I'll never forget the loss of control I felt and the overwhelming desire to grasp at something, anything to achieve stability - with the only option being those black, short, curly African American chest hairs.  Mike and I had a good laugh over that.

As of this date, I am not yet "working" in the typical American sense, but rather have thrown myself into various service activities.  Those volunteer opportunities keep my mind active and enable me to give some of myself and my experience to others, whom in many cases are going through much of the loss and change in identity that I found to be initially depressing.

• Thanks to the invitation and kindness of my spinal cord rehab physician, Dr. Barry Goldstein, I have been involved as a teaching assistant with the University of Washington medical students for the past three years running.  Currently I volunteer as an assistant senior faculty member in 3 classes each Winter/Spring.  Those are specifically Musculo-Skeletal Anatomy with 2nd year students, including assisting in gross anatomy dissection lab.  Also working as a tutor in Problem Based Learning where I work with 9-10 students in a small group setting in which they discuss medical cases; beginning the transition from scientific medical head knowledge to actual problem solving involving clinical scenarios.  With a variety of medical issues to work through in addition to finding a diagnosis, they will touch on refusal of care, cost effective medicine, end of life issues, medical malpractice, and various ethical situations.  As this is in a small group setting, I thoroughly enjoy getting to know each student over the course of those two months.  Lastly, I serve as a senior faculty member in Introduction to Clinical Medicine for first year students as they learn basic physical examination skills.  These three classes are a highlight of my year.  It is extremely satisfying to pass on some of my knowledge and approach to patients that I had learned during my time "in the pit", or the ER.

• I am also part of the Patient Advisory Board at Harborview Medical Center in Seattle which is a group composed of former patients or their family members.  We are involved in everything from patient/family/hospital staff communication, to the layout of the gift shop, to giving opinions regarding artwork chosen for the new hospital wing, to re-evaluation of hospital literature shared with patients and the public.  What is currently termed Rehab Night @ HMC is also an idea formed by this group.  Once a month between 2 to 5 of us meet for a panel discussion, information sharing time with newly injured patients and their families on the Rehab floor at Harborview.  There we share our experiences and attempt to coach others whose lives, like ours, have been completely interrupted and seemingly destroyed.  As a group we have found that the transition time between hospital discharge and re-establishment of life is the most difficult period to process.  My intent is that in sharing our group experiences we can bring some hope to those patients and their families.  We work primarily with those who have a SCI (Spinal Cord Injury), TBI (Traumatic Brain Injury), Stroke or Amputation.

• I also make myself available to mentor to SCI patients, generally those like myself who have sustained incomplete injuries.  By sharing my story with them, and spending time alongside them I intend to bring some encouragement and hope for their own future.  Every single person with an incomplete SCI is very different in many ways; from their level of injury, to which specific spinal cord tracts were dinged and damaged.  So there is no "usual" or "anticipated" level of recovery to be expected or guaranteed for anyone with a SCI; each of us has our own story and our own specific injury which will not only vary from a microscopic level, but also will depend upon numerous other factors at the time of injury.  Every factor and many more including your age, mechanism of injury, potential rapid steroid and/or hypothermic administration, your own support system around you and your personal motivation - ALL these factors, and many many more play a key part in what level of functioning you may come to realize in time.  

• I serve on the NextStepsNW Board of Directors; a non-profit organization which works to rehab those with SCI, Stroke or other forms of paralysis through exercise therapy.  A link to their website is also provided on the right margin of this page.  As a board we concern ourselves with how best to support those with disability and with fund raising strategies for facility maintenance and new equipment procurement.  We have had much success in enabling clients to regain the ability to walk, gain strength and provide exercise/conditioning all in a supervised setting with trainers who themselves desire to bring new movement or strength to weakened or paralyzed limbs.  Our current focus of planning is to purchase a Lokomat, the current state of the art mechanized robotic treadmill support system, which should help many to re-learn to walk again.

• Lastly, I am part of our church's Stephen Ministry team.  The training for this, and the involvement with others in our local community who have experienced loss seems a good fit with all else that has happened in my life.  The purpose of being a Stephen minister is to come alongside those who are experiencing divorce, cancer, family stress, job loss or anything else that may impact your life at a time in which a friend can help by actively listening and bear some of your burdens.  It is sad that so many of us attempt to carry our own burdens and pain at a time when we truly most need the prayers, compassion and support of someone who could come along side us and offer the love of Christ.  This training has been a perfect complement to my work with everyone from medical students to those with SCI or other life traumas.