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Parapunter
19th Sep 2008, 22:23
I've pulled this off another board I read daily. This is, as you will see is from a very worried sister, whose brother is badly hurt from a flying accident a very long way from home. If any medical guys can offer reassurance or even home truths, I'll post them up.


Dear all,

A request for help: On 15th of September 2008, my brother, Paul Roberts, had a paragliding accident whilst on holiday in Pakistan. He experienced a collapse close to the ground and couldn't recover the wing in time. He hit the ground hard, fracturing his L2 vertebra. After the accident (2 days ago) he has not been able to move or feel anything below his waist.

If anyone on this board has knowledge or experience of repatriation, surgery, recovery and rehabilitation following similar injuries and could give us some advice regarding best practice - what worked and what to avoid etc., then we would be really thankful.

He was attended to immediately by his friends who were paragliding with him, was immobilised as best as possible, and airlifted off the mountain to a hospital in Islamabad. Here X-rays, MRI scans, and various other tests were done and an emergency surgery “Posterior internal fixation titanium rods with pedicle screws" was performed. The surgery was successful in reducing the pressure from the fractured vertebra on the spinal cord, stopping the pain, and stabilising the back, but he still cannot move / feel anything from the waist down. My brother will be flown back to the UK for further treatment in about 3 days.

Just in case there are other pilots in Pakistan and you are worried that I might be talking about them, then my brother's name is Paul Roberts (from the UK), though his friends call him Paulo or The Silver Fox. He was flying with Brad Sander (who has been absolutely brilliant at organising everything in Pakistan - doing the work of 5 people and remaining calm, reassuring and resolute). Oriol (a Spanish paraglider & fire-fighter) has also helped out a lot in Islamabad. My thanks go out to them. If you do know Paul, then the good news is that he is his usual self, chatting and joking as normal, and he has no other internal injuries.

Any advice you could give would be most appreciated, many thanks,

Seldomfitforpurpose
19th Sep 2008, 22:29
No words of advice but fingers crossed it all works out for your brother :ok:

Parapunter
19th Sep 2008, 22:39
Not my brother! He's in a different kind of shit right now!

Sir George Cayley
19th Sep 2008, 23:10
Did your bro' take out any medical insurance for the trip that included flying?

Has anyone informed the UK Consulate in Islamabad?

As a UK subject the Govt can help with incidents abroad and if insured repatriation to a specialist unit might be possible.

Best wishes to both you and Paul.

Sir George Cayley

Parapunter
19th Sep 2008, 23:20
It's not my brother!! Just a cut & paste from another forum. I'm grateful for the advice, I will pass it on to the people concerned. I only wish to help someone who is in a bad situation far from home.

Freefall38
19th Sep 2008, 23:38
Parapunter... perhaps they're not responding to you personally, but rather just wishing the author best wishes?

con-pilot
20th Sep 2008, 00:30
From my limited experience, two days is way to soon to assume permanent paralysis and/or damage.

I believe that the best source here at Pprune would be Mac the Knife.

Personally the only thing even close to this type of injury I have ever suffer was falling on a flight of cement stairs one early ice/snowy morning. My back landed on the corner of the bottom step. The corner of the step hit the dead center of my spine. I laid there in the snow for over an hour before I could move. When I was finally able to move I could only use my arms to crawl toward my car. Fortunately an Air Force pilot that lived next door came out and saw me. He came over, checked on me, covered me with a blanket and called the base hospital. By the time the ambulance arrived I had feeling back in my legs and the x-rays showed no damage.

When nerves are traumatized they more or less go on strike and quit working. The worse the trauma, the longer the strike last.

Let us hope that is the case with your friend's brother. Tell them best of luck.

Loose rivets
20th Sep 2008, 04:24
Cases like this are very alarming. I always feel saddened hearing of injuries like this, especially to young people that have the courage to go out and do these kind of sports.

So much has been done already. In simple terms, to affix those rods, huge amounts of muscle and some 'hardware' have to be moved/removed. I would be deeply concerned about just who did the work, but it does sound as though some very skilled surgery has been done.

As con says, it's far too early to tell if there has been lasting damage. I would guess that with the MRI etc any fragments would have been spotted.

At that age, the contents of the intervertibral disc are still fairly gel-like and this substance can sustain a pressure via or even through a long ligament that runs in front of the spinal cord. Perhaps they didn't want to go into a disc that had to be held together.

It all depends on whether the surgeons were attempting to complete the job, or just get the patient home. My feeling is that it was probably the former, but I don't know.

The very fact that they were trying to get the pressure off the nerve is a good sign, it sounds as though there's hope that it is in tact.

Solid Rust Twotter
20th Sep 2008, 08:07
I underwent pretty much the same surgery after losing mobility in my foot (drop foot), strength in my leg and having constant pain. The pain relief was immediate but the weakness remained for a few days. A bit of physio saw to that and my back is close to bulletproof at the moment. It was pretty heavy surgery with the chancre mechanics going in through the abdomen in front as well as the back in order to place six pedicle screws, two titanium cages to stabilise the spine and two titanium rods on either side to hold the whole lot together where my first two lumbar vertebrae were in effect bolted to my pelvis. No regrets and it all worked out fine with a First Class medical being issued six months after surgery.

The immediate relief was from pressure being removed from the spinal chord. It also restored mobility and strength just about instantaneously. The surgeon mentioned that if left alone it would have deteriorated. In the case of this person I wonder if severe bruising may not have incapacitated his spinal chord for a while. Hopefully it will recover with rest and physio. Was any mention made by the surgeons of physical damage to the spinal chord? The MRI scan and possible physical inspection during surgery may be the answer.

Wishing him all the best. It's a scary thing but modern techniques can work wonders. Hopefully all goes well for him.

Parapunter
20th Sep 2008, 08:07
Loose, I posted your response on the other board & looking in there, it seems to chime with the views of others.

I don't know the guy concerned, but it's clear his sister is very worried for him & the reassurance you & others have offered must be a comfort. It can't be very pleasant to have a busted spine & no feeling below the waist, laid up in hospital thousands of miles from home.

I'm sure the guy will appreciate any words of encouragement.

gingernut
20th Sep 2008, 09:42
Hi PP, difficult to give specific advice about such a complicated case, but I guess the prognosis will be difficult to ascertain at this time.

At worse, the nerve damage could be permanent, at best, temporary. Time will tell. It's unlikely the doc's will make any predictions until the swelling subsides.


Sorry I can't be more helpful, ginge.

ps gotta say it's a fantastic sport, took this yesterday on Mam Tor..
not sure max was impressed...
YouTube - Paragliders on Mam Tor (http://uk.youtube.com/watch?v=JvKAPdcEVL4)
http://img.photobucket.com/albums/v617/gingernut123/DSCN8131.jpg