By: Jean Johnson for Back1
Part One | Part Two | Part Three | Part Four | Part Five
Constance Smith fell asleep before the airplane took off and slept the entire flight. “It was a hard landing, and we bounced. That’s what woke me up to a whole new life.”
| The American Spinal Injury Association and the American Psychological Association are on record for encouraging physicians to assess psychological factors related to spinal injuries that may contribute to depression. |
Some patients will have difficulty coping because they:
Blame themselves for their injuries
Have unresolved conflicts from previous traumas
Have pre-injury psychological impairments
Have grief associated with the injury
"While the sophisticated reader would see the need for psychological services to treat people with spinal cord injury and depression,” stated Timothy Elliot, Ph.D., APA member, and associate professor of physical medicine and rehabilitation at the University of Alabama in Birmingham, “many primary-care physicians might just prescribe education and not refer the patient to a mental health professional, leaving out an important psychosocial aspect of treatment."
There were many things that drew Smith to Denver. The leaves hadn’t started changing yet when she arrived, and the temperatures were in the 80s so she was able to watch her grandsons play football. Mostly, though, she was grateful for her daughters and their husbands who did their best to help her through what Smith – with an endearing and poignant understatement – calls “an emotional time.” Still, she had to go it alone a fair amount. Since she was still in a wheelchair and needed a large bathroom with grab bars, she lived in an extended-stay motel for two weeks until she found an apartment.
“My daughter and grandson and his girlfriend took me out to look, and he pushed me around like he was a NASCAR driver. I was relieved because he seemed perfectly fine with the wheelchair. No qualms. Still my heart wasn’t in it, and I just wanted to go back to Portland – to what was my home for 13 years,” Smith said. “So after they left I just started crying. It was more than I could comprehend at that time and I just kept thinking, ‘oh my god, I’ve left behind everything.’ I cried that first night, and many a night and day since, let me tell you.”
Smith did find an apartment, with lots of light, five minutes from her daughter’s, but after having endured two long weeks in the confines of the motel, her emotional health was at least as bad as her physical. As the rehabilitation director of the hospital where Smith did her post-surgery therapy, Molly Hoeflich, M.D., noted it takes patients some time to come to terms with the emotional toll.
“What happened was it finally dawned on me how much my life had changed,” said Smith. “In the beginning I thought everything happens for a reason, but that all went and I was having dark, dark emotions and anger too.”
And of course, during all this, Smith had to make arrangements for a new raft of physicians and care providers, not to mention take taxis to her appointments because her daughter was working.
“I had an appointment with an orthopedic surgeon to see have my knee evaluated, and he informed me my records hadn’t arrived. I said I had requested them but that he might have better luck. His comment was, ‘that’s your job, not mine.’ He was just out of med school and so arrogant that quite honestly I wanted to slap him,” she said. “Unfortunately it didn’t get any better when I went down for an X-ray. The radiologist was extremely perturbed that I needed help to stand up and said that if I needed assistance, that next time I should bring someone with me.”
The cab ride home was in keeping with Smith’s iffy introduction to Denver’s community. “The driver was a guy from Morocco, and I asked him to stop and get a package of cigarettes for me. That was no problem, but he came out of the store with two packs, one for him and one for me. Not a word. Nothing. Just sort of the way it was, I guessed.”
Taking things in stride, though, only lasted so long, and once in the privacy of her own quarters, Smith broke down.
“I must have cried three hours straight. The cab driver took advantage of me, that’s true, but it was really the doctor and radiologist and even their holier-that-thou nurses. I will never go back there again,” Smith declared. “Besides, I don’t need the knee replacement that he suggested. You learn to live with the pain. I’ve got fibromyalgia too, and when I get upset that just takes off and runs with it. But even with that, you just learn to with the pain.”
Pain she might have endured, but independence became an increasing realistic goal as Smith’s body continued to repair from the effects of her fall. “I spent the weekend at my oldest daughter’s while my younger daughter and her husband moved my things into the apartment, and my grandchildren ended up commandeering my wheelchair. By then I could walk some, but I did even more that weekend since the kids always had it off somewhere trying to pop wheelies.”
She explains that once back at her apartment she started walking by just using the walls for support. “The problem there was that for me more is always better. So the first day I over did it, and then I got to spend the second day down with leg cramps,” Smith said. “But that aside, it felt so good to walk in the apartment and see some of my pictures hanging on the walls and my own furniture and rug. My daughters even filled the freezer and pantry for me.”
While having her own digs certainly helped temper some of the grief she was trying to manage, it only went so far. To learn how Smith dealt with the emotional roller coaster she found herself riding, continue on to Part six, the final installment in The Long Road Back.