Conrad, a 57-year old Swiss border guard, sustained a spinal cord injury as a result of the surgical intervention performed to treat an abdominal aortic aneurysm.11 This occurred shortly before he was set to retire – a fact that would have serious consequences, complicating his financial outlook following rehabilitation and therefore his ability to successfully reintegrate.
At 57, Conrad had raised four children living independently with sons and daughters of their own. He now lived with his wife in an old, culturally protected house almost 2000m above sea level. Beyond his profession as a border guard, Conrad helped his wife run a good sized restaurant on the ground floor of their home. Outside of his remunerative work, he enjoys working and hunting in the natural environment, and generally loves being active outdoors. In addition, he enjoys meeting his friends and acquaintances in his valley for whom he presents a liked and respected individual within the community.
Conrad was set to retire in just under a year at the time his aortic aneurysm occurred. The surgical intervention for this condition unfortunately carries a significant risk of spinal cord injury (see Case Study 5), and in his case, it resulted in incomplete paraplegia below L1 (ASIA Impairment Scale12: C). This SCI resulted in some preserved motor and sensory function below L1 including autonomic dysregulation. In addition, over the course of the following months, Conrad suffered from:
- Symptomatic transitory psychotic syndrome - this was a temporary disorientation to time and place.
- Post-operative ilius (a blockage of the intestine), requiring surgical intervention and use of a colostoma for defecation;
- Rhabdomyelosis (a breakdown of skeletal muscle releasing myoglobin, enzymes and electrolytes), resulting in renal failure that was treated with hemofiltration and later, with dialysis.
- Critical ischemia and “compartment syndrome” of the forefoot, secondary to vascular disease - this was treated with an anticoagulant.
Medical treatment of these conditions continued for six weeks before Conrad was able to be transferred to the SCI rehabilitation center. At that timepoint, his state of health was greatly improved and he had recovered from the aneurysm surgery. Still, there were a number of issues to address with body functions, activities and participation and, of course, environmental and personal factors would play a role.
There were clearly many open questions and a need for social services to work in parallel with the aim to achieve optimal community integration in the long-term. Conrad’s social worker thus played an essential role in the rehabilitative process and a Rehab Cycle was begun to help address these issues among his other SCI-related problems.