|Vitae - The James Marshall Story|
February 11 continued..
I went by ambulance to Sharp Memorial Hospital from QUALCOMM Stadium and it continues here:
When I initially arrived to the hospital they began a ton of CT scans as well as MRIs all over the body. As they were specifically concerned with my Central nervous system as all the signs lead to a spinal cord injury up to this point. We had done so many different scans I can't remember them all except for one in particular. I was lying on my back and they raise my arms above my head. As my arms are straight up above me before I slid inside the machine, it felt as if my arms were straight out in front of me. Right then is when I understood, fully, that my life may change forever. I had left from the radiation room and headed back to my room for the painful part. I remember a really bright light shining down on my face and them beginning their procedures.
The on scene surgeon wanted to put me in traction immediately. So they drilled a horseshoe into each side of my skull to begin the process. Using an 8 lb weight over the head of the bed to hold the traction. While we waited for the on-call surgeon (head Dr.), faces from within our industry began to come in one at a time and look down upon me to give their encouraging words of wisdom, support and hope. That really meant a lot to me and I will live with that memory until the day I die. Not just that they came to show their support but for 1, they had been at the stadium since from as early as 6 AM and 2, a hospital always reminds you of where you can end up in a bad position. So I was very grateful to have that level of support so early within the injury. At this point, still not releasing the extent and severity of the injury to anyone.
Once my on-call doctor arrived, he immediately took me out of traction. He removed the weight off the end of the bed connected to the horseshoe and put me into a regular neck brace collar while removing the Horseshoe as well. It was the most gruesome pain I may have ever been in. The horseshoe was putting so much pressure on my skull & temple area that this was easily the most pain I'd ever experienced. And never having anything drilled into your skull before really puts things into perspective. They were analyzing everything that was going on with the damage in my spinal cord at cervical 5 & cervical 6 area. In search for our next plan of action.
They began getting me my own private room set up and with all the correct medical supplies and other things I would need towards my injury. A foley catheter, ventilator, foot drop boots, suction machine, bed bath equipment as well as import emergency medical supplies, etc. Basically a short term private room that I would call home. While everything was going on here in San Diego, my family had just boarded a flight to come out & be with me.
My operation had to wait a few days because of the swelling on the spinal cord itself. I "believe," that you must let the swelling subside and then you can perform the operation to the spinal cord. In my case, they chose to fuse cervical 4 through 7. And there were a few other operations that were performed that may have been avoided with better overall management. But everything, and even still to this day, is very foggy and hard to remember. As they performed the fusion, they went in through the back of my neck into the lower area of my hairline. Somehow (still not sure to this day how), they ended up having to open up the front left side of my neck and after they sewed me up, I ended up forming a fistula from my esophagus coming out the side of the scar. The hole started out at a pretty decent size. The correct healing process began so the Dr.'s were packing it on a multi daily basis (which was pretty painful. More annoying than anything but definitely pain involved). So I figured at the rate it was healing, it would continue to get smaller and smaller then heal fully just like any other type of scar or sore. But this was the first time I would face any type of sore in a wet spot of my body. This was a whole new experience for me considering the healing process is totally different from what you are typically used to. It was mind blowing.
They began to dope me up on some extremely high tolerance pain medication this far in, so this is where things begin to get a little foggy in my mind & memory... But I will never forget when my nurse and my surgeon walked in the room and explained to me that I would never walk or ride a dirt bike ever again. They explained that the chances of a full recovery were very slim to none, depending if the injury was a complete or incomplete. Things began to get tougher & tougher day by day. They explained to me of how my life would never be the same from that point forward. I would have limited use in my hands and nothing below the chest and most to almost all of my progress would lie within the first two years of the injury. I would use catheters to drain my bladder and have to schedule bowel rituals. This news really hurt me. It hurt my pride, my spirit and of course touched my soul including my families. Just tough...
But I did have a few positive moments in the beginning of my injury. One of my best childhood friends, Fred Cramer, would come and stayed with me a lot as he was stationed in Southern California as he had joined the United States Marine Core a few years back. We would try to make jokes to pass the negative moments and create positive thoughts and memories by bringing up funny times. I remember one day I had an extremely huge booger in my nose! And I mean this thing was deep in my nostril and gargantuan! So we went on a mission and grabbed a medical Q-tip and dug that sucker out! And if you know me personally, you know that I cannot stand having my nostrils messed with. That was a very funny memory that will never go away!! So, Thank you Freddy.
But for whatever reason, I still could not shake the negative thoughts during my depressing times (everything was still sinking in). I wanted my life back. My positive thoughts out-weighed the depressing ones but there were still tough times. Even though I had guys like Andrew Short, Steve Hudson (does chapel service at each Supercross) & Dr. Bodnar (to name a few) come by when they could which was an extreme blessing to have & would come stay to sit with me on different days for the amount of time they could possible. Andrew would come all day each Sunday! This meant so much to me. So by all means, the support system was through the roof. I could not have been more blessed to have received that type of support. It was slowly coming in from all angles, as R2R, Road 2 Recovery was handling my fundraising efforts.
A few weeks into it, Josh Grant came directly from the airport from St. Louis, Missouri to my hospital room when he won his first 250 main event. At the time, he raced for Sobe, factory connection Honda. He wanted me to see the race right at that very moment and began putting the film in the VCR because he had dedicated the win to me. We were all ecstatic with being able to share this special moment with one of my best friends. We all trained practice together, it was like we had all won in St. Louis! He even left his jersey from the main event as a special item so I could have to remember that precious moment for the rest of my life. Josh is a great friend!
But there were other issues I was still having… like breathing. This was my biggest struggle at this point. Of course I was intubated but I refused to have a tracheostomy in hopes that my diaphragm would catch up. Which in all reality, I should have chosen that route in the beginning. So intern, with not having a tracheostomy, I could not speak having a tube down my throat. My lungs would fill up with mucus and I would not be able to breathe. So the anesthesia team would come in to prep me then stick a suction tube down my throat and suction my lungs clear. Though I was asleep, it was still painful on me as I woke up. Somehow, I briefly remember times of waking up in the middle of this procedure because they would not have enough anesthesia to keep me fully asleep. It wasn't unbearable but extremely far beyond uncomfortable. I used an alphabetical charts and people would point letters and I would blink once for yes and twice for no. It was definitely out of the ordinary but we did what we had to do get by with what I had to work with. And just like any other normal human being in their first stages of any catastrophic injury, I began having moments of deep depression. I just never told anyone and did my best to hide it deep inside. I don't think many people saw that side of my injury… Not even my folks! I had plenty of ideas and wishes to ask of people around me but I could never find the courage. Thank God I couldn't.
Over time we began seeing signs of improvement. Very small levels but still, it was improvement. I remember my dad would sit at my bedside and tell me to breathe deep and push myself as hard as possible. But I was simply worn out. We would work our way up from breathing on my own for 15 seconds to around 30 seconds, then one minute and so on and so forth.
After around 6 to 8 weeks I began to breathe on my own, but I was beginning to get extremely homesick thoughc. I was seeing a little light at the end of my tunnel. And under my own expectations and though it was very early in my injury, my ultimate & long term goal was to get to a level to where Jimmy Button is today, (he was injured at the San Diego Supercross in 2000 racing for factory Yamaha) able to walk, use my hands, control my bowels and bladder, drive a car, etc. In my eyes, if he could do it than what was stopping me? Even though when Jimmy walks, it may not look that pretty, but I wanted to reach that level of independence. I wanted nothing less and I was willing to put in the work and effort with full unrestricted commitment. My discipline to get to this goal was going to be tougher than any training I have ever done before. For any other test, training for a race or anything else I may have faced in my short life.
Up to this point, they simply had me in a regular neck brace where they had the brace so that it would keep my neck isolated. The somewhat funny part, is the rear of the neck brace was upside down and began rubbing a bald spot in the back of my head! But, once we straightened the rear of the brace, it felt amazing! Since I could still use my neck muscles themselves (though very little), I would still nod my head for yes or shake my head for no. Which, a lot of you may or may not know, but I also broke cervical 2 (luckily there was no spinal damage at this area) but the bones were headed towards my spinal cord which would have worsened the extent of my injury. As we continued monitoring my spinal cord by taking x-rays daily, finally we realized that the cervical 2 bones were headed towards my spinal cord. This would have left me on a ventilator with less function and sensation so they decided then to put me in a halo. I didn't think much of the procedure because I figured they would put me under anesthesia and mount it. Well… come to find out, they don't put you under anesthesia for this. They give you a small shot of anesthetic in each of the four spots where they drill the screws into your skull and get meds on board while you are fully conscious & grind away. I was still only 21 years old and this had just past the horseshoe to become the worst pain I have ever experienced to this day. I could feel the screws as he would tighten them down into the bone. You could literally feel the threads of each screw going a little deeper and a little deeper with each swift turn of his wrench clamping down into my head.
The gentleman who mounted my halo showed up with a big bag which included my halo and his tools as well as a drill. The procedure went as follows: they marked the spots with a sharpie and then gave anesthetic shots down through the skin and then begin to drill! It was horrifying or living hell. Luckily, it only last a couple hours. Considering everything that was going on in my life at that moment, it wasn't too bad.
At this point, we were in the San Diego hospital for around 8 to 12 weeks, I was over being on the West Coast. I was homesick, I wanted to see my friends and ultimately be back in Houston where I felt I belonged. Just to be in my hometown.. Though we would still go outside and catch the fresh sun light and laugh and joke, I still wanted to be home. But only if I knew what I was leaving.. The care was amazing in California.
We transferred back to Houston by chartering a jet for $20K to have the flight crew, medical staff aboard and all of our medical equipment in case of an emergency. When we landed, there was an ambulance waiting to transport us to Memorial Hermann Hospital located in Houston, Texas (it was much smaller back then and only in the medical center). When we had finally arrived at the hospital, we waited… Then we waited a little longer… And no one was coming to help us. We finally began to get a little irritated with the situation and demanded help. We finally got a few of the things that we need like a private room to start. Then we got an air mattress that rotated to keep my lungs clear from filling up with mucus and prevention from any pressure sores; which was an extremely big hazard for someone in my state at that moment in time. But you would not have believed how tough it was to get these items initially! Let's just say that the West Coast was looking a little bit more comforting right at that moment!
As I have mentioned before, no doctors would take the time or risk to operate on my fistula because there was such a big risk involved (with the throat staying wet & never drying out, it is an extremely tough piece to heal). Each ear, nose and throat doctor we spoke with said that they would not touch it. Finally, along came a "plastic surgeon" who claimed he was willing and capable of fixing me. I was very skeptical and so was my family on this operation since so many doctors refused to do the procedure. And we almost took the doctor’s advice by not having a procedure done anyways. I guess we didn't understand the complete risk that it involved.
The first procedure was somewhere around my birthday in May (I believe). Then, we would have to wait six weeks later we would do a test by swallowing die under an x-ray machine to see if it was successful by going down my throat would hold up to not let any food or water escape out the fistula. After what seemed like a century, the six weeks was up and it was time for the test! And knowing me, I was super optimistic. The first surgery was unsuccessful.
After the surgery I was extremely sore and did not want to have my bed on automatic turn. So I laid there with the bed off for a few hours which was one of the worst mistakes I could've made throughout this entire process. The diagnosis was as follows: my lungs filled back up with mucus and I woke up unable to take in oxygen. Therefore, my father began to use the bag to push oxygen back into my lungs. When they did I was able to exhale but unable to inhale. It was frightening and I was extremely scared. The nurse rushed in and took my vital signs which she said that they were fine and that I was ok too but I literally could not take in any air. It was frightening. Horrifying. I eventually blacked out as they were taking me back to ICU. I woke up a few days later with a tracheostomy and no one in my room. It seems like I was asleep for a few days. But that wasn’t the case. I’d wake up once a day then look to my left to see if anyone were with me but I was alone each time. I guess there was an issue when I blacked out so no one was allowed in the room to stay with me. When they were allowed back in the room I had been infected with staph so you had to wear a big gown, cap and mask to stay in the room with me. I had staph infection in my lungs therefore the air that I was breathing was very contagious so it was a hassle to even come in the room to visit. However, my girlfriend and my mom would stay most of the time. The times that they didn't stay we would have someone else come and be there overnight.
We went back and diagnosed the problem and tried to find a new route to get it fixed. We stuck with the same doctor because we figured the issue was not his fault already known not previous operation the best. So we got prepared to go back under the knife with another six week recovery time post op. And like the first operation, everything went fine with the procedure! But the outcome after the next gruesome recovering weeks remained the same. Unfortunately, unsuccessful.
My family, friends and myself were all very upset and puzzled of why my throat was not healing. We were doing everything correctly (as my doctor had instructed). However, up to this point I would put sips of different sodas or tasteful foods (mostly ice cream, Sprite or a Fanta) just so they could hit my taste buds to keep my sanity but then have them suctioned out of my mouth. It is a suction machine just like you would see at the dentist office. There was an option for round three operation and he said he had all bases covered. He knew what was going on, wrong and he would not make any more mistakes; I would be healed, no questions asked. So we all sat and thought... It was tough on me physically. It was always risky with the anesthesia. Then, we always had the thought in the back of our minds when the first doctors said "we won't touch it. Let it heal on its own." There were so many risk and so many variables to be taken into consideration.
Round three: We opted for the surgery for the last and final time. This would be our last operation whether it was fixed or not (with this doctor, at least). The doctor sat down with everyone and went over everything that went wrong in the prior procedures and what was going to fix it this time & why he'd be successful in his final attempt. And although he had gone in two times prior and were unsuccessful, we went back into the procedure room and gave it one last shot. With eight weeks to recover because this operation was going to be the grand finale! it was going close the fistula. Which it felt like time would never elapse. The eight weeks seem to go a little slower than the previous recovering weeks. Not just because of the want and desire to end this grew that much stronger, but time seemed to drag along more and more and grew stronger every day. Because if you think about it, I hadn't eaten anything orally since February 11 around 5 or 6 PM that day. So I was craving some food and thirst horrifically! Outcome: our last and final try to close the fistula was once again unsuccessful.
But after the surgeries on the fistula in the neck area it was time to remove the halo. I was scared to death… I remember how bad it hurt when they put it in and even when they would just sit me up in bed, the screws would wiggle a little inside my skull and it eliminated me from being able to do a lot of small things. The biggest thing being just sitting up in bed. That put so much pressure on my skull and brought me to tears a few times. As the guy proceeded to remove the halo, it was not near what I was thinking it would be. He remove the screws with not too much pain and I was able to move as free as I liked. But it was the sketchiest time in my life to move my head the slightest little bit. I did not move for a few days more than just a few inches left or right, up or down! Considering it had been a little over four months since I have moved my neck, I took it extremely easy to say the least!
Since I was still battling insurance issues, I began to get used to being in a hospital setting. After a while I began looking at the clock on the wall and counting with them. I would watch the calendar... the numbers would go up & up, then change the page for a new month; then start the counting process over again. Dry erase boards became one of the first things I would look at in the morning to see who my nurses and nurse aides were. The things that I got used to, were not of the norm. Nothing you would typically think of on a daily basis. Not an abled body minds regular thoughts. But that's just the way my mind was training itself to think being in that state on a day to day basis. My grandmother stayed with me a lot because she would just sit with the kids and babysit or do something in the nature of helping out the family. When people would come by to visit, I would slightly open my eyes but not enough for them to notice I could see them then shut them and pretend to be asleep from being overwhelmed by staying in the hospital for that long. It was tough having anyone around. This wasn't me… This wasn't James Marshall… The athletic, training hard, riding dirt bikes, doing work around the house, making moves in every area of life type of James Marshall. And it still hurts deep to this day.
I laid in the hospital bed in Houston forever it seems like. Unfortunately, I was waiting for my Medicaid to kick in so I could attend rehabilitation. But that took forever and I think I stayed in the bed for around two months. And there was so much more going on than just a young man with a broken neck. There were family issues… my parents were having a tough time at that point in their relationship. But honestly who wasn't having a tough time? I think everyone was doing some sort of suffering. Considering my little brother passed to shaken baby syndrome in 2003 at only the age of almost 4. There was a TON of emotion during this time whether it was my parents, siblings or friends. We were all suffering a little at the least in our own ways.
My friends would come stay the night with me every now & then and those were fun times! We would stay up late talking and watching movies and that alone made my day. Just to be sitting next to the ones who I called my friends made me feel loved. Just to be sitting next to the ones who I called my friends made me feel loved. It reminded me of the support group I had & what support would be there throughout this whole new learning process in life.
By the time I left memorial Herrmann Hospital, including my past surgeries (prior to SCI), the operation count was somewhere near 24 or 25. Crazy numbers with too many knives that had gone through my skin while I was asleep.
I was finally admitted into TIRR Rehabilitation (The Institute for Rehabilitation and Research) center in downtown Houston located in the middle of the medical center. It was just an eye-opening experience for numerous reasons. One, I was out of bed up in my Wheelchair dressed and working out on a daily basis. Two, I had a team of experts to help me get fitted into the right chair that I would need as well as a ton of my peers that were quads or paraplegics were finally around me to understand more of what my injury would consist of as well as others to speak with about our injuries. Remember that all spinal cord injuries are just like individuals, no two are just alike. Three, there were a ton of things to do! If I was not in the gym working out or on the hand cycle, there was the zoo right across the street that was always a ton of fun to go to considering that it was still summer at this time. The body world museum came to town so I hopped in my power chair and drove over and checked that out. Four, I felt like a normal human being again. Showering on a regular basis was absolutely unreal!!! I cannot go into enough depth to give you the understanding of what it felt like two bath consistently like this. Getting up and getting dressed each and every day gave me energy, gave me spark and made me feel alive again. But still the most important piece to me being revitalized and back out of the hospital was just simply driving outside when I wanted. Any time that I was outside breathing fresh air and able to maneuver my power chair on my own, it was like heaven. I cannot give a better description of what simply going outside of four walls make me feel like! Simply unreal. There's no better way to describe it.
My girlfriend at the time would come and spend most of her time with me at the facility. We would always watch movies and be cracking up doing something together! We had a ton of laughs and probably drove a ton of people crazy staying up late watching movies and learning how to live again. However, she was the biggest support group that I had. And being truly honest, she was there just about every single day. Without her, I may not have made it so good off.
We stayed at TIRR Rehabilitation center for 7 weeks but my first trimester had run out. And think about this. It was time to get ready to go home. And I honestly was not ready for this transition considering I would get help throughout the night and my folks were still working full time so they didn't have time for me to call on them multiple times if I needed them. Which I typically had someone sitting with me during night hours at the rehabilitation center but I was excited in some ways about going home and very nervous in others.
We had packed up and headed home. I was thrilled to be where I was at at that particular moment, right then, right there. I'll never forget, front seat of my truck, headed to my own bed. We got home and began to unpack all the stuff. Well, I should say they unpacked all the stuff! With a smile on my face, we pushed through the front door and right then it Hit Me like a TON OF BRICKS… there was no occupational therapist to train me. No physical therapist to help me continue building up from the little movement I had. I was scared, frightened and close to hitting a rock bottom point. Depression was inside with no one to assist with exercise and all I wanted was to get stronger and find my independence that I once held earlier that year. Slight depression kicked in and I cried, I cried. I cried while I hand cycled. It was terrifying…
A few months later Dr.Parke, an ENT, performed an operation on my fistula and closed is on his first attempt. I had a subway sandwich 2 weeks later.
Next chapter, Therapy. To be continued..
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As a young kid I was fascinated by motorcycles in general. I got my first dirtbike at the age of 8, but not after a few four wheelers and my parents trying to talk me out of it. It was a ’91 Yamaha YZ80. Although I thought it was all that and a bag of chips, it was slightly worked. I putted around some trails by the house but soon found out about a local track, “Skeeter.” Not long after I made it out for a Sunday practice. But that was all it took, I had the poison in my veins! I drank, ate and slept motorcycles. In my mind nothing else mattered. The next weekend my dad took me to my first race in Bastrop, TX. It was muddy; I had never ridden the track and ran number 4 to represent my childhood hero, Damon Bradshaw. But no excuses, I was lapped 3 times but despite the embarrassment I thought I did awesome!
It's been six years later and San Diego races on my 6th anniversity. That's a really scary, emotionally unstable day for racing in the same stadium I last walked and lived a normal, healthy, racing dirtbikes lifestyle. But before we go there, let's rewind and start on Feb 11 so you can get an idea of what has happened since "that day." I thought it was some sort of shock. It was nothing, I thought. My mind told me, "You're a Machine, nothing can touch you." because of my training regimen. I began spitting up blood while I was laying there. But I still thought, it's nothing; You're the man."
They red flagged the race of course, but the Astrisk Medics were to me already. I wanted answers FAST, but Doc Bodnar reminded me that everything was going to be perfectly fine. I was breathing fine, talking fine so I was thinking it was some sort of shock that my body took due to something I was unfamiliar with. I had zero pain, so I had nothing else to rely on. Tom Hudson put a phone to my ear, my father's voice said, "what's wrong?" I replied, "nothing, I'm in some sort of shock." I let him know to not come out because Dave and I were coming home the next day (plus, that's a long trip with him; I'd end up beating him up before we got out of California!!) so don't waste the money, plus I'll be fine. They talked (Tom and my Dad) and decided it come out (Dad, Mom, Sister's and Liam) to make sure it's not a Spinal Cord Injury (SCI). The EMS and I spoke back and forth in this super tense situation. They asked me to "move my toes," "I am," I replied and then they asked again and I tried of course and gave the same answer. Silence.... "Is everything ok?" They said "Yes!" You're fine. I knew they were lying to keep me calm. It made me more anxious and more scared, really. The ambulance raced to the hospital. They got me in a CT Scan first. They needed specific pics of course so they placed my arms above my head while lying on my back.. It felt like my arms were straight out like a "'mummy." Right then is when I knew.
Next, the neurosurgeon on hand put me in traction. It was horrifying. He drilled a horse shoe on each side of my head. That combined with the eight pound connected to it hanging off the bed was bad news. Possibly the most pain I've ever endurded.
The specialist was on his way. While I waited on him I saw faces that I could have very possibly never see again. Jeff Edwards, Surge, etc. We talked individually about fond memories. Road trips, races won and races lost, crashes, basically anything to keep my mentality on a different level.
Disappointing. Heart sinking. Dream crushing. Road 2 Recovery began my Fundraising (thank God I had them). To Be Continued...