A Paralyzing Situation
By Shawn McDonald
After 20 years of motorcycle racing, and 34 years of life, I broke my first bone. I used to brag to my racing friends that I was like Gumby when it came to falling down, always able to bend back to original form. I of course told them this when they had a brace surrounding their legs or wrists with stainless steel pins protruding out of the skin.
Twenty years ago I became what a racer fears most, a paralyzed racer when I broke my C 7/8 vertebrae in the 1991 New Zealand National Road Racing Championships. A terrible first choice for breaking a bone, but I didn't have a choice. I was very aware of the dangers of racing after having seen racers over the years die on the track, and other racers become paralyzed. I sent nice letters to the families showing support and money to help them out, but I never actually talked to any racer who was paralyzed. I didn't know what to say to them, because I didn't understand what happened to them.
In theater, they say that drama is easy, but comedy is hard. For motorcycle racers dying is easy, living is hard. If you die on the racetrack, you will never have to worry about house payments, car payments, VISA bills, going to work, getting married or divorced, having children. You won't have to think about anything because you will be dead. The hardest thing for a racer or anyone to do is to live with the closest thing to dying, and that is living.
A severe nerve disruption is living without actually dying. That means brain damage and/or paralysis. Severe in brain trauma terminology means having a severe blow to the head that limits your brain functions to a 6th grade or lower level for the rest of your life. That’s if you’re lucky. Because of the improvements in helmet structure in the last three decades with SNELL certification and full-face helmets, there have been very few severe head traumas in motorcycle racing over the years. The word paralysis wasn't uttered in the racing world until the late 70's when Motocross racers started crashing from the dizzying heights of newly designed double and triple jumps. Meanwhile roadracers still died on the track, because as the bikes got faster and stopped quicker, the tracks and their safety problems didn't change. From the time they first started racing motorcycles in the 1900's, racers have died. They died at an alarming rate. Every year a few world championship racers died with many more in the sportsman ranks. Every year a few more were added to the list. The numbers were written in a book somewhere and filed; after all racing is a dangerous occupation! In the last 10 to 30 years there have been major innovations and significant improvements in helmets, safety gear, track safety, Medic One ambulances, life saving emergency drugs, air safety fences, and air ambulances which has allowed more racers to live today.
What happens today to the living is that they became paralyzed. It used to be that the head trauma, internal bleeding, waiting for medical care killed the racers in first few hours after an accident, instead of the paralysis. Today we live. In the past few years the motorcycling community has had 3 time World Champion Wayne Rainey, Jimmy Button and a host of lesser known riders join that small elite group of wheelchair pilots because of paralysis from a racing accident. Let us not forget David Bailey, Danny Chandler, Tony DiStefano and our own local Pat Jacobson. 12 years ago at Elkhart Lake, Wisconsin on a 4 cylinder 1000, Bruce Hammer, co-founder of Team Suzuki, became a quadriplegic. At the end of August 1994, Jemal Mfundshi crashed at the WERA National in Portland and joined the list. A few years ago Troy Rose crashed at the PACE Portland race and stupidly joined the gang. These are just a few of the racers over the years that have become paralyzed. It has been said that if you don't think about it, it won't happen to you. Whether you think about it or not, it COULD happen to YOU.
So what is it like to be behind that face that you used to know and be a person labeled a wheelchair pilot, a gimp, disabled, handicapped, a cripple? At the beginning when the crash occurs you may be conscious throughout the entire accident and emergency care, and live through the pain. When you do wake up, you begin your life again in a new way. A lifestyle change you might say.
All those memories of being fast on the track and beating your friends are just memories now, because you will never be able to do them again. It doesn't matter what you accomplished in the past, you will now be judged on what you do today and into the future. People who face any extreme amount of stress may go through stages of denial, anger, depression, acceptance, and growth after an occurrence. Some people face stress through years of self-abuse with drugs and alcohol and even suicide. Recently a study showed that a large majority of paralyzed patients do not exhibit severe depression, and actually accept their new lives and move on. The point to make for anyone who is paralyzed is that in dealing with psychological or medical judgments everyone is different.
Some ex-racers dream of racing motorcycles again. The truth is the chance of a full recovery from a SCI (Spinal Cord Injury) is 7/10th of 1%. Everyone has stories of their great aunt or 3rd cousin on your mother’s side of the family who was paralyzed and made a full recovery. Those stories are not true; you will not race a motorcycle again until a cure is found. From 1990 to 1994, according to a University of Alabama at Birmingham study, there are between 183,000 and 203,000 people that have a Spinal Cord Injury in the United States. Statistics utilizing the National SCI database showed that 60% of the injuries happened between the ages of 16 to 30 with a average age of 30.7. 82.2% were male, 56.3% were Caucasian, and 29.9% were African American. Of those injured since 1990, 38.1% were injured in automobile accidents, with 25.1% from violent acts, 20.2% in falling, and 8.8% in sporting activities. That is a drastic change from earlier reports that showed violent acts accounting for a percentage in the low teens. Using numbers accumulated since 1980 of 16,024 SCI patients, they have the sporting categories led by diving at 8.2%, followed by motorcycle's at 5.9% (Includes dirt bikes, street bikes, and all forms of racing), bicycles 0.9%, and then football at 0.5%.
The largest obstacle an ex-racer has to face on a every day basis after an accident is not in dealing with their fears and anxieties about the injury, but in handling the fears of everyone who sees him including their families. Not knowing something about anything makes people afraid. If they are afraid they will withdraw from the situation. To give you the information so that you will be less afraid of a ex-racer in a chair, here are some questions that I am normally asked at National and local events and even by children:
Bench Racer: Are you getting any better?
Shawn: After the injury you experience a steep recovery rate in the first few weeks that starts to slow down after a month and a half. After 3 months you strain your mind to feel any change in your body. Some small changes in your wiring system may take years to occur, like sweating.
BR: What do you mean sweating?
Shawn: Most quadriplegics and some paraplegics do not have the ability to sweat to control the temperature of their bodies. The bodies run at a constant temperature for weather of about 70 degrees Fahrenheit depending on the weight of the individual. The lighter weight the easier to deal with the heat, the higher weight the easier to deal with the cold. If the weather gets in the 80's or 90's you have to take out the umbrella to cover yourself and cool off with ice, water, or sit at home with the air conditioning on. If the weather is cold you have to bundle up to keep away hypothermia. Paraplegics also cannot control the temperature of their paralyzed bodies from their injury level on down, though they sweat from the waist up.
BR: But I've seen you snow ski and race your Honda Pilot in the wintertime?
Shawn: That's because I wear long underwear, pile pants and coat with a Gore-Tex expedition suit on top. I also wear an electrical vest that I turn on when I start to shiver too much. You can either get heat stroke or hypothermia if not prepared for weather changes.
BR: Can you move anything?
Shawn: I can't move anything voluntarily except for a few back muscles from mid chest level down. Some people are able to move a toe or raise their foot a few inches it depends upon each person. Each vertebrae controls different levels of physical ability, a higher-level injury gives you less ability. Each spinal cord has billions upon billions of electrical fibers that connect your brain with your body. Depending whether you severe, break or bruise the spinal cord may give you a complete or incomplete injury.
BR: What does complete and incomplete mean.
Shawn: A complete injury would be from a severing of the cord. No electrical impulses can be sent from your brain to below your vertebrae injury level. Complete means that your body will progress no further than the injury level. An incomplete injury comes from a bruising or slight break in the spine. Some of your wires may be crimped or frayed and still be sending signals to below your injury level. My injury level was a C-7/8 at the time of injury and has progressed down to a T-4, which brought me from being a quadriplegic to a high level paraplegic.
BR: What can you feel?
Shawn: I can feel everything from about mid chest level up. For some reason people feel their feet first. If you grab a toe, I know which one your grabbing. I can also feel them scratching the bottom of my feet, but only about 25% of normal feeling. My calves and the back part of my thighs have about 25% feeling. The tops of my thighs have no feeling at all. I have burned my legs twice from putting a hot plate on my legs. I couldn't feel it! My rear end has a lot of sensitivity. It either feels like when your foot falls to sleep and then the blood starts coming back, and you can't move your foot but it feels like the whole thing is on pins and needles, or just slightly on pins and needles. Being that it is fairly sensitive it tells me when I've been sitting down to long. Some of my wheelchair friends who have higher injuries than I do have more feeling on their rear end, where others who have lower injuries have less feeling than I do. It really depends upon each person, but normally you cannot feel a whole lot.
BR: You just said that your Butt talks to you?
Shawn: Yes Bevis it does. I have to do what they call a pressure release for my rear end about once every twenty minutes. A pressure release is where you may see me grab the wheels of my chair and raise my rear end off the seat for a few seconds. That is to allow new oxygenated blood to reach the muscle tissue you have been sitting on and constricting the blood vessels. If you don't do these releases the muscle tissue will deteriorate from blood starvation, and the results are pressure sores that can be from blisters on the skin, to holes in your skin down to the bone. It's one of the worse things you can get from being paralyzed. Imagine yourself sitting in a chair for 16 hours without moving or shifting your weight. Ouch! A 900-mile motorcycle ride on plywood.
BR: Sometimes I see your leg jumping up and down; I thought you said you couldn't move?
Shawn: I can't move my legs. What they are doing is going through muscle spasms, or what I call the Jane Fonda involuntary exercise program. Not only can you not tell your lower body what to do, your lower body cannot tell your brain what's going on with it. It cannot tell you about heat or cold as we discussed, it can't tell you it broke a bone, has internal bleeding, a pressure sore, lacerations, and so on. These situations send signals to your brain telling it to do something quick, except your brain has a busy signal and will not answer. Therefore the signal gets circulated around and around to anyone who will listen causing spasms or dysreflexia (causes fever, chills, headaches, etc). Spasms can range from none to severe. My spasms are fairly active which makes my legs look fairly normal. I do take a few muscle relaxant pills and stretch my legs in the morning to calm them down. If you have severe spasms you may require a pump surgically installed inside of you to give you muscle relaxant drugs. No spasms give one a pencil leg like look. There is no good or bad spasm everyone is different.
BR: How do you take care of your bathroom needs?
Shawn: Good question, but a lousy answer. Remember that you cannot voluntarily control any of your lower extremities including your bowel and bladder. For bladder maintenance you can either use an intermittent catheter, leg bag catheter, or condom catheter. The intermittent catheter is the most widely used drainage system, it is 15 inches long and every 4-6 hours you get to insert it into your penis until the urine flows out. The penis usually has the sensitivity of the rest of your body so that it may or may not be painful. The leg bag catheter is for quadriplegics with little hand control. The catheter and bag are changed weekly; the bag is drained throughout the day. For bowel movements you have to relax the rectum by digital manipulation to allow your large colon to contract until the movement is complete. This usually takes 1/2 hour to an hour every 2 days.
BR: Do you ever make a mistake?
Shawn: As my friends tell me "I am not perfect". When I don't listen to my body through bladder pressure, slight dysreflexia, or waiting to long, I will leak in my pants. Denial of a symptom for any form of injury or sickness is something that can cause more problems. While in the Hospital as your body is trying to reacquaint itself with its self, you can experience bowel control problems. After the Hospital you may have a problem once every two years or several a month. For the last few years I haven't had any mistakes because my body finally caught up with my brain and tells me when it's time to go. Once again as every person is different in life so are the results of a paralyzing injury.
BR: You mentioned that your penis has not that much feeling. Can you have sex?
Shawn: Why, yes these are Bugle Boy Jeans. The answer is yes I can have sex, but once again in a slightly different way. Because the mind controls most of a mans erection, and my mind has a wire cut short down there, I rely on other methods. Physical stimulation works for me to a certain degree and then I need help from a little blue pill to keep it erect. Some people will have no erections, while some are closer to normal. Many Quad's and Para's have had children naturally, or by laboratory help. Ejaculations are possible, although sometimes you feel like you will have a heart attack when having one. That is because your mind knows what's going on, but your lower body is clueless. When you become physically stimulated the signals go wild. The woman will usually take the dominant position and do most of the moving about for different positions because of the difficulty of you moving. For some reason high-level quadriplegics like Christopher Reeve have more spontaneous natural erections than lower level paraplegics. Sex is different and more mentally stimulating, but not any worse than normal. You just plan for it.
BR: How long were you in the Hospital, and how much did it cost?
Shawn: They kept me in the hospital for about 90 days or 3 months. In 1991 I was considered a star for getting out so quickly. Today they are shortening stays to close to two months for paraplegics. 20 years ago you might have stayed in the Hospital for 5 - 9 months. Except for the healing process, there is no real reason for staying in the Hospital longer than 1 1/2 months. The cost for a high-level quadriplegic injury today for health care and living expenses in the first year is $417,067; with a lifetime cost if injured at the age of 25 is $1,349,029. The costs drop in the first year for low-level quadriplegics at $269,324, and paraplegics at $152,396. The living expenses cost (which are not usually covered by insurance) comes when you get out and purchase a car or van, a wheelchair, modified bathroom and shower, accessible ramps for your home, personal assistants for high level quadriplegics, if they need them. A new van that is wheelchair accessible can cost $40,000 with a lift and hand controls. A standard manual wheelchair costs around $3,000. These costs are hard to recoup because the average employment for paraplegics 8 years after the accident is 34%, and for quadriplegics it is lower at 24%.
BR: You must have some pretty strong arms pushing that chair around!
Shawn: My Lats are fairly strong, but my arms are just a little larger than normal. Quadriplegics at about the C 6 injury lose their Triceps and have a difficult time raising their arms above their head. One problem to watch out for from doing to many activities is tendonitis or tennis elbow, which can cause pain every time you push the chair. High-level Para's and Quad's have lost their abdominal muscle control and do not have full breathing capability. They will get into Quad coughs and sneezes, which are small because you cannot blow out a full breath. Loss of abdominal muscles also gives you a Quad belly, which can stick out like a beer belly if you don't watch your diet. Even if you watch your diet and excercise you will get a belly.
BR: I could never go through what you've been through, I would probably kill myself. You are such an inspiration to me!
Shawn: The only way to know if you can handle it is to get paralyzed. Then you have a choice to live with it or not. Racers hopefully have the determination to overcome any obstacle on the track or in the pits to be the best they can at the finish flag. We were racers and have that same attitude about life to be the best we can. We did not die on the racetrack, and we are glad to be alive. There are people from all walks of life that inspire me, people in chairs that rock climb to racing cars, my friends Bruce Lind for racing at the age of 59. You chose your own inspiration.
The attached spinal cord illustration demonstrates the different vertebrae and their classifications. A cervical injury is classified as a quadriplegic injury. If you had a C 4 injury you could move your head and neck, with some shoulder movement. You could not move your arms or hands and would need an electrical chair with a chin attachment to control the chair. You would also be dependant on assistants for bathroom/shower and food. Dropping down a few vertebrae to a C 7/8 will give you all movements in the arms and hands with some weakness in either hand. You can use a manual chair, drive a car, need no assistants, cook for yourself, and live independently. A T 6 injury, or paraplegic, (Wayne Rainey level) has all movements of the arms and hands with partial trunk movement. The lower down the vertebrae you go the more function you recover.
Seeing an ex-racer in a chair is frightening, because it puts right in your face that this to could happen to you. Racing is a dangerous occupation, it always has been. If you think it is to dangerous then you should get out of the sport, if not stay and enjoy your life. Paralyzed racers are still people, they are still racers in their hearts and minds. Do not ignore them.
After 20 years of motorcycle racing, and 34 years of life, I broke my first bone. I used to brag to my racing friends that I was like Gumby when it came to falling down, always able to bend back to original form. I of course told them this when they had a brace surrounding their legs or wrists with stainless steel pins protruding out of the skin.
Twenty years ago I became what a racer fears most, a paralyzed racer when I broke my C 7/8 vertebrae in the 1991 New Zealand National Road Racing Championships. A terrible first choice for breaking a bone, but I didn't have a choice. I was very aware of the dangers of racing after having seen racers over the years die on the track, and other racers become paralyzed. I sent nice letters to the families showing support and money to help them out, but I never actually talked to any racer who was paralyzed. I didn't know what to say to them, because I didn't understand what happened to them.
In theater, they say that drama is easy, but comedy is hard. For motorcycle racers dying is easy, living is hard. If you die on the racetrack, you will never have to worry about house payments, car payments, VISA bills, going to work, getting married or divorced, having children. You won't have to think about anything because you will be dead. The hardest thing for a racer or anyone to do is to live with the closest thing to dying, and that is living.
A severe nerve disruption is living without actually dying. That means brain damage and/or paralysis. Severe in brain trauma terminology means having a severe blow to the head that limits your brain functions to a 6th grade or lower level for the rest of your life. That’s if you’re lucky. Because of the improvements in helmet structure in the last three decades with SNELL certification and full-face helmets, there have been very few severe head traumas in motorcycle racing over the years. The word paralysis wasn't uttered in the racing world until the late 70's when Motocross racers started crashing from the dizzying heights of newly designed double and triple jumps. Meanwhile roadracers still died on the track, because as the bikes got faster and stopped quicker, the tracks and their safety problems didn't change. From the time they first started racing motorcycles in the 1900's, racers have died. They died at an alarming rate. Every year a few world championship racers died with many more in the sportsman ranks. Every year a few more were added to the list. The numbers were written in a book somewhere and filed; after all racing is a dangerous occupation! In the last 10 to 30 years there have been major innovations and significant improvements in helmets, safety gear, track safety, Medic One ambulances, life saving emergency drugs, air safety fences, and air ambulances which has allowed more racers to live today.
What happens today to the living is that they became paralyzed. It used to be that the head trauma, internal bleeding, waiting for medical care killed the racers in first few hours after an accident, instead of the paralysis. Today we live. In the past few years the motorcycling community has had 3 time World Champion Wayne Rainey, Jimmy Button and a host of lesser known riders join that small elite group of wheelchair pilots because of paralysis from a racing accident. Let us not forget David Bailey, Danny Chandler, Tony DiStefano and our own local Pat Jacobson. 12 years ago at Elkhart Lake, Wisconsin on a 4 cylinder 1000, Bruce Hammer, co-founder of Team Suzuki, became a quadriplegic. At the end of August 1994, Jemal Mfundshi crashed at the WERA National in Portland and joined the list. A few years ago Troy Rose crashed at the PACE Portland race and stupidly joined the gang. These are just a few of the racers over the years that have become paralyzed. It has been said that if you don't think about it, it won't happen to you. Whether you think about it or not, it COULD happen to YOU.
So what is it like to be behind that face that you used to know and be a person labeled a wheelchair pilot, a gimp, disabled, handicapped, a cripple? At the beginning when the crash occurs you may be conscious throughout the entire accident and emergency care, and live through the pain. When you do wake up, you begin your life again in a new way. A lifestyle change you might say.
All those memories of being fast on the track and beating your friends are just memories now, because you will never be able to do them again. It doesn't matter what you accomplished in the past, you will now be judged on what you do today and into the future. People who face any extreme amount of stress may go through stages of denial, anger, depression, acceptance, and growth after an occurrence. Some people face stress through years of self-abuse with drugs and alcohol and even suicide. Recently a study showed that a large majority of paralyzed patients do not exhibit severe depression, and actually accept their new lives and move on. The point to make for anyone who is paralyzed is that in dealing with psychological or medical judgments everyone is different.
Some ex-racers dream of racing motorcycles again. The truth is the chance of a full recovery from a SCI (Spinal Cord Injury) is 7/10th of 1%. Everyone has stories of their great aunt or 3rd cousin on your mother’s side of the family who was paralyzed and made a full recovery. Those stories are not true; you will not race a motorcycle again until a cure is found. From 1990 to 1994, according to a University of Alabama at Birmingham study, there are between 183,000 and 203,000 people that have a Spinal Cord Injury in the United States. Statistics utilizing the National SCI database showed that 60% of the injuries happened between the ages of 16 to 30 with a average age of 30.7. 82.2% were male, 56.3% were Caucasian, and 29.9% were African American. Of those injured since 1990, 38.1% were injured in automobile accidents, with 25.1% from violent acts, 20.2% in falling, and 8.8% in sporting activities. That is a drastic change from earlier reports that showed violent acts accounting for a percentage in the low teens. Using numbers accumulated since 1980 of 16,024 SCI patients, they have the sporting categories led by diving at 8.2%, followed by motorcycle's at 5.9% (Includes dirt bikes, street bikes, and all forms of racing), bicycles 0.9%, and then football at 0.5%.
The largest obstacle an ex-racer has to face on a every day basis after an accident is not in dealing with their fears and anxieties about the injury, but in handling the fears of everyone who sees him including their families. Not knowing something about anything makes people afraid. If they are afraid they will withdraw from the situation. To give you the information so that you will be less afraid of a ex-racer in a chair, here are some questions that I am normally asked at National and local events and even by children:
Bench Racer: Are you getting any better?
Shawn: After the injury you experience a steep recovery rate in the first few weeks that starts to slow down after a month and a half. After 3 months you strain your mind to feel any change in your body. Some small changes in your wiring system may take years to occur, like sweating.
BR: What do you mean sweating?
Shawn: Most quadriplegics and some paraplegics do not have the ability to sweat to control the temperature of their bodies. The bodies run at a constant temperature for weather of about 70 degrees Fahrenheit depending on the weight of the individual. The lighter weight the easier to deal with the heat, the higher weight the easier to deal with the cold. If the weather gets in the 80's or 90's you have to take out the umbrella to cover yourself and cool off with ice, water, or sit at home with the air conditioning on. If the weather is cold you have to bundle up to keep away hypothermia. Paraplegics also cannot control the temperature of their paralyzed bodies from their injury level on down, though they sweat from the waist up.
BR: But I've seen you snow ski and race your Honda Pilot in the wintertime?
Shawn: That's because I wear long underwear, pile pants and coat with a Gore-Tex expedition suit on top. I also wear an electrical vest that I turn on when I start to shiver too much. You can either get heat stroke or hypothermia if not prepared for weather changes.
BR: Can you move anything?
Shawn: I can't move anything voluntarily except for a few back muscles from mid chest level down. Some people are able to move a toe or raise their foot a few inches it depends upon each person. Each vertebrae controls different levels of physical ability, a higher-level injury gives you less ability. Each spinal cord has billions upon billions of electrical fibers that connect your brain with your body. Depending whether you severe, break or bruise the spinal cord may give you a complete or incomplete injury.
BR: What does complete and incomplete mean.
Shawn: A complete injury would be from a severing of the cord. No electrical impulses can be sent from your brain to below your vertebrae injury level. Complete means that your body will progress no further than the injury level. An incomplete injury comes from a bruising or slight break in the spine. Some of your wires may be crimped or frayed and still be sending signals to below your injury level. My injury level was a C-7/8 at the time of injury and has progressed down to a T-4, which brought me from being a quadriplegic to a high level paraplegic.
BR: What can you feel?
Shawn: I can feel everything from about mid chest level up. For some reason people feel their feet first. If you grab a toe, I know which one your grabbing. I can also feel them scratching the bottom of my feet, but only about 25% of normal feeling. My calves and the back part of my thighs have about 25% feeling. The tops of my thighs have no feeling at all. I have burned my legs twice from putting a hot plate on my legs. I couldn't feel it! My rear end has a lot of sensitivity. It either feels like when your foot falls to sleep and then the blood starts coming back, and you can't move your foot but it feels like the whole thing is on pins and needles, or just slightly on pins and needles. Being that it is fairly sensitive it tells me when I've been sitting down to long. Some of my wheelchair friends who have higher injuries than I do have more feeling on their rear end, where others who have lower injuries have less feeling than I do. It really depends upon each person, but normally you cannot feel a whole lot.
BR: You just said that your Butt talks to you?
Shawn: Yes Bevis it does. I have to do what they call a pressure release for my rear end about once every twenty minutes. A pressure release is where you may see me grab the wheels of my chair and raise my rear end off the seat for a few seconds. That is to allow new oxygenated blood to reach the muscle tissue you have been sitting on and constricting the blood vessels. If you don't do these releases the muscle tissue will deteriorate from blood starvation, and the results are pressure sores that can be from blisters on the skin, to holes in your skin down to the bone. It's one of the worse things you can get from being paralyzed. Imagine yourself sitting in a chair for 16 hours without moving or shifting your weight. Ouch! A 900-mile motorcycle ride on plywood.
BR: Sometimes I see your leg jumping up and down; I thought you said you couldn't move?
Shawn: I can't move my legs. What they are doing is going through muscle spasms, or what I call the Jane Fonda involuntary exercise program. Not only can you not tell your lower body what to do, your lower body cannot tell your brain what's going on with it. It cannot tell you about heat or cold as we discussed, it can't tell you it broke a bone, has internal bleeding, a pressure sore, lacerations, and so on. These situations send signals to your brain telling it to do something quick, except your brain has a busy signal and will not answer. Therefore the signal gets circulated around and around to anyone who will listen causing spasms or dysreflexia (causes fever, chills, headaches, etc). Spasms can range from none to severe. My spasms are fairly active which makes my legs look fairly normal. I do take a few muscle relaxant pills and stretch my legs in the morning to calm them down. If you have severe spasms you may require a pump surgically installed inside of you to give you muscle relaxant drugs. No spasms give one a pencil leg like look. There is no good or bad spasm everyone is different.
BR: How do you take care of your bathroom needs?
Shawn: Good question, but a lousy answer. Remember that you cannot voluntarily control any of your lower extremities including your bowel and bladder. For bladder maintenance you can either use an intermittent catheter, leg bag catheter, or condom catheter. The intermittent catheter is the most widely used drainage system, it is 15 inches long and every 4-6 hours you get to insert it into your penis until the urine flows out. The penis usually has the sensitivity of the rest of your body so that it may or may not be painful. The leg bag catheter is for quadriplegics with little hand control. The catheter and bag are changed weekly; the bag is drained throughout the day. For bowel movements you have to relax the rectum by digital manipulation to allow your large colon to contract until the movement is complete. This usually takes 1/2 hour to an hour every 2 days.
BR: Do you ever make a mistake?
Shawn: As my friends tell me "I am not perfect". When I don't listen to my body through bladder pressure, slight dysreflexia, or waiting to long, I will leak in my pants. Denial of a symptom for any form of injury or sickness is something that can cause more problems. While in the Hospital as your body is trying to reacquaint itself with its self, you can experience bowel control problems. After the Hospital you may have a problem once every two years or several a month. For the last few years I haven't had any mistakes because my body finally caught up with my brain and tells me when it's time to go. Once again as every person is different in life so are the results of a paralyzing injury.
BR: You mentioned that your penis has not that much feeling. Can you have sex?
Shawn: Why, yes these are Bugle Boy Jeans. The answer is yes I can have sex, but once again in a slightly different way. Because the mind controls most of a mans erection, and my mind has a wire cut short down there, I rely on other methods. Physical stimulation works for me to a certain degree and then I need help from a little blue pill to keep it erect. Some people will have no erections, while some are closer to normal. Many Quad's and Para's have had children naturally, or by laboratory help. Ejaculations are possible, although sometimes you feel like you will have a heart attack when having one. That is because your mind knows what's going on, but your lower body is clueless. When you become physically stimulated the signals go wild. The woman will usually take the dominant position and do most of the moving about for different positions because of the difficulty of you moving. For some reason high-level quadriplegics like Christopher Reeve have more spontaneous natural erections than lower level paraplegics. Sex is different and more mentally stimulating, but not any worse than normal. You just plan for it.
BR: How long were you in the Hospital, and how much did it cost?
Shawn: They kept me in the hospital for about 90 days or 3 months. In 1991 I was considered a star for getting out so quickly. Today they are shortening stays to close to two months for paraplegics. 20 years ago you might have stayed in the Hospital for 5 - 9 months. Except for the healing process, there is no real reason for staying in the Hospital longer than 1 1/2 months. The cost for a high-level quadriplegic injury today for health care and living expenses in the first year is $417,067; with a lifetime cost if injured at the age of 25 is $1,349,029. The costs drop in the first year for low-level quadriplegics at $269,324, and paraplegics at $152,396. The living expenses cost (which are not usually covered by insurance) comes when you get out and purchase a car or van, a wheelchair, modified bathroom and shower, accessible ramps for your home, personal assistants for high level quadriplegics, if they need them. A new van that is wheelchair accessible can cost $40,000 with a lift and hand controls. A standard manual wheelchair costs around $3,000. These costs are hard to recoup because the average employment for paraplegics 8 years after the accident is 34%, and for quadriplegics it is lower at 24%.
BR: You must have some pretty strong arms pushing that chair around!
Shawn: My Lats are fairly strong, but my arms are just a little larger than normal. Quadriplegics at about the C 6 injury lose their Triceps and have a difficult time raising their arms above their head. One problem to watch out for from doing to many activities is tendonitis or tennis elbow, which can cause pain every time you push the chair. High-level Para's and Quad's have lost their abdominal muscle control and do not have full breathing capability. They will get into Quad coughs and sneezes, which are small because you cannot blow out a full breath. Loss of abdominal muscles also gives you a Quad belly, which can stick out like a beer belly if you don't watch your diet. Even if you watch your diet and excercise you will get a belly.
BR: I could never go through what you've been through, I would probably kill myself. You are such an inspiration to me!
Shawn: The only way to know if you can handle it is to get paralyzed. Then you have a choice to live with it or not. Racers hopefully have the determination to overcome any obstacle on the track or in the pits to be the best they can at the finish flag. We were racers and have that same attitude about life to be the best we can. We did not die on the racetrack, and we are glad to be alive. There are people from all walks of life that inspire me, people in chairs that rock climb to racing cars, my friends Bruce Lind for racing at the age of 59. You chose your own inspiration.
The attached spinal cord illustration demonstrates the different vertebrae and their classifications. A cervical injury is classified as a quadriplegic injury. If you had a C 4 injury you could move your head and neck, with some shoulder movement. You could not move your arms or hands and would need an electrical chair with a chin attachment to control the chair. You would also be dependant on assistants for bathroom/shower and food. Dropping down a few vertebrae to a C 7/8 will give you all movements in the arms and hands with some weakness in either hand. You can use a manual chair, drive a car, need no assistants, cook for yourself, and live independently. A T 6 injury, or paraplegic, (Wayne Rainey level) has all movements of the arms and hands with partial trunk movement. The lower down the vertebrae you go the more function you recover.
Seeing an ex-racer in a chair is frightening, because it puts right in your face that this to could happen to you. Racing is a dangerous occupation, it always has been. If you think it is to dangerous then you should get out of the sport, if not stay and enjoy your life. Paralyzed racers are still people, they are still racers in their hearts and minds. Do not ignore them.
