Toe Up to 10K: A Journey of Recovery from Spinal Cord Injury

By Steven Fujita

In June 2012, Steven Fujita went to the emergency room, and was diagnosed with meningitis. As a result, he had suffered spinal cord damage at the T4 level. At the very start of his ordeal, Fujita could not speak, eat, breathe independently, control bodily functions, nor move his legs.

In this book, he takes the reader on a journey of recovery from a spinal cord injury.

• Language: English
• Publisher: BookBaby
• Release date: Aug 11, 2014
• ISBN: 9781483534688

Book preview

References

Preface

I hope readers currently recovering from spinal cord injury will gain from my experience.

I am not a doctor, a nurse, nor any other type of medical professional. I’m just a person who experienced an injury to the spinal cord. One of the frustrating aspects of my recovery was not to know what to expect. I tried to find information by going through books and doing searches on the internet but, as a layperson, information was difficult to find. Although each person’s recovery from spinal cord injury is unique, I want to share my reflections and observations. I don’t know how accurate my observations are, but this book records the way I perceive the events connected with my ordeal.

For some of the events I describe in this book, I also relied on a review of my hospital record and recollections of those who were present.

In order to preserve privacy, I refer to individuals by their first names, initials, or profession.

Shout outs go to all the doctors who have dealt with me: Dr. M and Dr. H at the hospital, Dr. Y and Dr. V at both the hospital and follow-ups after discharge, Dr. A, who is my primary physician, and Dr. R, my urologist.

Many people shared in my recovery: doctors, nurses, nurse’s aides, therapists, social workers, my parents, brother, relatives and friends. They are too many good people to name, and I feel guilty because I name some, and not others, in the body of this work, and most who are named are those who I interacted with while a patient in the rehab unit. That said, the partial list includes those in ICU, whose names and faces I can’t remember, but you were there for the most critical part of my care; to the Critical Care staff (especially Joe) and the rehab unit; those who were assigned to me regularly: Jen, Saida, Rubie, Dony, Laurence, Tiffany, Pat, Clinton, Lena, Toni, Matt, Barry; to Carmen, whom I called regularly with requests; and to the therapists: Cheryl, Ernest, Gabby, Roger, Aaron, Brian, Kelley, Carlos. And I’m sure I’ve left out a lot of people – and for that, I apologize.

I am deeply appreciative of everybody who has helped me during my recovery.

CHAPTER 1

The Headache That Would Not Go Away

I opened my eyes. Mom had been calling me. I had no memory of how I got there, in the Intensive Care Unit (ICU). I looked down at my body and found myself resembling a marionette. Tubes uncomfortably invaded my nostrils, and also were attached to my neck, my arms and other parts of my body. My fingers, swollen like air-filled balloons, were flexible enough to bend forward a little but not enough to make a fist. I could not move my legs nor wiggle my toes. Yet, I smiled.

It started with a headache that would not go away. Two Sundays previous, at bedtime, I had a slight headache, so I took two aspirins. The headache had not gone away by Monday morning, but it wasn’t bothersome enough to keep me from going to work. The ache was dull; more of an annoyance than unbearable.

That Monday morning, before reaching the office, I stopped by a Ralphs supermarket to buy some food for a surprise birthday party for my department’s June birthdays. I ended up skipping my morning coffee. Since I often develop headaches when I don’t have my morning coffee, I attributed the continuation of the previous evening’s headache to the lack of caffeine in my system.

For me, caffeine-deficiency headaches are often resolved by taking a couple of aspirins. This time, the medicine did not help; I took two aspirin tablets every four to six hours, until I went to sleep that night.

At this point, nothing indicated I’d experience a newsworthy health issue. I grew up in Torrance, a suburb 20 miles southwest of downtown Los Angeles, attended college at George Washington University, in Washington, D.C., returned to Southern California and worked in an office setting for the past 19 years. I left for work each morning and commuted home each night.

Like many post forty-year-olds, I battle high blood pressure and high cholesterol, but these conditions were under control via prescription medication.

For most of my life, I aspired to make a living as a novelist, but I really meant the fictional characters I created to suffer through obstacles and hardship. Drama, for me, was trying to find a way home from work when the light rail mass transit system broke down.

On Tuesday, I went into work with the same dull pain. By mid-morning, my head started throbbing and I decided to go home. I took the light rail from downtown Los Angeles, where I worked, to downtown Long Beach, where I resided. The one way trip, approximately 25 miles, took about one hour. I sat by myself in the middle of a car, not wanting to be near anybody. It seemed my head throbbed extra hard each time as the train stopped and started again at every station.

A Vons supermarket is on my walk home from the train stop, so I stopped by there and bought lemons, apples, cereal, yogurt and hummus. I thought I had caught a cold, and planned on eating my cold-killer diet and drink lots of tea.

I usually get sick in February and March, at the first sign of spring weather, with a sinus infection. It was generally the only time I used up continuous days of sick leave at work. I rarely catch colds, especially summer colds, and Memorial Day had passed. I thought I was safe until the following winter.

However, in 2012, I spent the early June days bundled up in warm clothing and blankets as I lay down on the couch with the television tuned onto a station which aired classic shows of the ‘50s-‘70s. I thought all I needed to do was lie on the couch, rest, and that I’d be able to return to work the following week.

W-R-O-N-G!

Instead of feeling better, my condition worsened. I remained fatigued, had no appetite, and was constipated and nauseated. I developed muscle aches, facial pain and a fever. Later that Tuesday evening, and a couple of times on Wednesday, I vomited. Because of the facial pain, combined with the other symptoms, I now thought I had a severe sinus infection and resolved to go to an urgent care center if nothing improved by Thursday. After doing research on the internet regarding my symptoms, I briefly considered meningitis, but quickly discarded that notion.

One of the signs of meningitis is sensitivity to light, which I did not experience. Based on my history of sinus problems, I was pretty sure I had only a sinus infection.

I had not improved by Thursday afternoon and I went to an urgent care center. The doctor thought my symptoms stemmed from a sinus infection and prescribed antibiotics. She warned, however, that if the fever did not go down, or if I didn’t have any improvements, I had to go to the emergency room. While picking up my prescription at the pharmacy, I also purchased a couple of boxes of cold and sinus medicine. I stopped taking the aspirin and switched to the cold and sinus tablets. Between Thursday evening and Sunday morning, I had taken approximately 12 tablets (or one every six hours – the maximum recommended dosage).

The next day, Friday, I developed chills and the fever continued. I was able to break the fever several times, but only temporarily. Each time I broke the fever, after a while, it returned.

The vomiting had stopped, but I developed two new symptoms: dizziness and difficult urination. I decided that if I didn’t improve by Sunday mid-morning, I’d go to the emergency room. On Saturday night, to make sure I wouldn’t forget any symptoms, I made a list of all my symptoms and when they occurred.

On Sunday morning, I was unable to urinate at all. This was the last straw that broke down my reluctance to go to the emergency room. This would be the third time in my life I went to an emergency room. The first time, in 1989, while living in D.C., I experienced symptoms similar to food poisoning, but was diagnosed as a gastro-intestinal ailment of an unknown cause. The second time was about 13 years ago, when I woke up one Sunday morning with pink eye.

For 15 years, I had passed by Long Beach Memorial Medical Center twice a day, to and from work in downtown Los Angeles. It is one of the largest employers in the city of Long Beach, California. Several sources consider Long Beach Memorial a top rated hospital. Of approximately 430 hospitals in California, U.S. News and World Report ranked it #19 in California, including 11 designations of high performing specialties.¹ What was relevant to me was that one of these specialties is Neurology and Neurosurgery.

I signed in. I was prepared to sit for hours. However, I was seen quickly and I gave the doctor a rundown of my symptoms. To make it easier for both of us, I handed him the list of symptoms I had written down the night before.

I was sent into a room and made to lie down on a bed. A Foley catheter was inserted into my penis to combat the urinary retention. Needless to say, this hurt. Add to that, the doctor ordered a lumbar puncture (also called a spinal tap).

The lumbar puncture is a procedure to collect cerebrospinal fluid from the spine. It is the primary way to diagnose meningitis. I lay in a fetal position and my back was prepared with a local anesthetic. The doctor then inserted a looong needle into my back until my spinal fluid was collected. Afterwards, I had to lie flat on my back for over an hour. Later, I learned this was to minimize the chance of developing a headache from the procedure.

I know current memories are always the sharpest, but at that time, I couldn’t remember two more painful procedures ever done to me consecutively. After a while, the results were in – viral meningitis. I was immediately admitted into the hospital. This would be the first time I would spend overnight at a hospital due to an illness. Previously, the major acute illnesses in my life were pneumonia when I was seven years old, and shingles, when I was in my thirties.

Meningitis is an infection of the membrane covering the brain and the spinal cord. Several things can cause meningitis, including bacteria, viruses, fungi, tumors, parasites and even drug allergies. Generally, meningitis caused by a virus is much less severe than one caused by bacteria. Meningitis caused by bacteria is more apt to cause long-term neurological and brain damage.

At this point, I still wasn’t worried. I thought I would spend a couple of days in the hospital, until the fever went down, and would be sent home for further rest. I called my parents and asked them not to visit me since I thought it was contagious – after all, it probably came from a cold virus – and told them that I would take a bus home (both the hospital and my home are only blocks away from a major metropolitan bus line). I informed my employer that I would be taking a few days off. That’s the last I remember until about a week later when I woke up in the ICU.

¹Best Hospitals in California, U.S. News and World Report, accessed April 26, 2014,

CHAPTER 2

The Lost Week

I don’t remember anything from the morning of June 11, 2012, to Sunday, June 17, 2012. However, according to my hospital records, I was doing fine between June 11 and June 13. The Foley catheter was scheduled to be removed and was removed on June 13. I was scheduled to be discharged on June 14.

I experienced deterioration on several fronts between June 13 and June 16: my body temperature dropped, my mental state declined, and my organs began failing.

Wednesday, June 13, 2012

This day started out great. I felt much better; the Foley catheter was scheduled to be removed, and I would most likely be discharged from the hospital the following day.

As the morning progressed, my sodium levels dropped to a numerical value less than 125, a level considered severe. 135 is the low end of a normal range. Symptoms of low sodium levels include confusion, lethargy, muscle weakness, and if not reversed in time, it can lead to seizures, coma and death. Adding to these complications, a rapid restoration of sodium can lead to nerve damage. At this time, I was still alert, but a clue to my mental state is found in the nurse’s note stating that I refused to have the Foley catheter removed. The way I feel about catheters – that would be way out of character!

Nevertheless, the Foley catheter was finally removed, but my output was still insufficient. I voided less than 100 cc, and a scan revealed that over 560 cc remained in my bladder. The Foley catheter was again inserted later that evening.

At 12:00 noon, my body temperature was 98 degrees. By 3:35 P.M., it had dropped to 95.4 degrees, and by 9:00 P.M., down to 94.9 degrees. An extra blanket was provided to keep me warm.

Apart from the possible foreshadowing of my mental state through the catheter episode, as of 7:30 P.M., I was still exhibiting clear, spontaneous speech.

Thursday, June 14, 2012

Overnight, my body temperature remained below 95 degrees. By the next morning, I exhibited a symptom of moderate to severe hypothermia called paradoxical undressing. This happens when the person becomes disoriented and confused, and then sheds his clothing, causing him to lose more body heat. In my case, I kept removing my blanket and gown. It is estimated that between 20-50 percent of hypothermia deaths are related to this action. Fortunately, I was inside a hospital, and not outdoors on