Fighting the Good Fight
When someone such as Tom Boone says rehabilitation for a spinal cord injury at Shepherd Center was one of the physically toughest, but most rewarding, things he’s ever done, it means something a little extra.
Knowing his title and job helps to explain.
It’s not Mr. Boone; it’s U.S. Army Special Forces Sgt. First Class Tom Boone, 30, a Green Beret soldier stationed at Fort Bragg, N.C.
Tom sustained a C-4 to -5 spinal cord injury (SCI) and was diagnosed with central cord syndrome, which limits function in the upper extremities more than the lower ones. He was injured in an all-terrain vehicle (ATV) accident in September 2010 while attending a family reunion near Nashville, Tenn.
There’s never a good time to flip an ATV and injure your spinal cord. But the timing seemed particularly cruel for Tom. He’d been married just six weeks when the injury happened. And he had just finished two years of Special Ops training and was about to deploy as a Green Beret.
“It’s what I had trained for,” Tom says. “I wanted to get back to kicking down doors and shooting the bad guys. I think I still will get back to the front line and do the job I had trained for.
“If it were not for Shepherd Center, I know I wouldn’t be having a conversation like this, even entertaining thoughts of being able to do things that physical,” he adds. “I’m still in awe at what all I saw and experienced at Shepherd Center.”
Few can understand Tom’s motivation better than Marcos Madrid, 45, of Fairfax, Va., a retired Special Forces soldier and current civilian employee of the U.S. Army. As part of his requirement to stay physically fit for his job, Marcos was mountain biking in July 2010 when he wrecked his bike and sustained a C-4 to -5 SCI. He, too, was diagnosed with central cord syndrome.
U.S. Army Special Forces Sgt. First Class Tom Boone, 30, is a Green Beret soldier stationed at Fort Bragg, N.C. He sustained an incomplete C-4 to -5 spinal cord injury in an ATV accident in 2010. He was diagnosed with central cord syndrome. Today, he has returned to duty as a medic and instructor.
TOM’S ACCIDENT, Rescue and Rehabilitation
For Tom, it felt as if his whole life was in front of him on Sept. 10, 2010. He had a beautiful new bride, and the rigorous, meticulous training required to become a Green Beret was behind him. His personal and professional life seemed set.
Then, on a family reunion weekend in Nashville, Tom’s wife, Meredith Boone, went boating with part of the family while Tom went to ride ATVs with his uncle and cousins.
“For some reason, I had a bad feeling about him going riding that day,” Meredith recalls. “I kept telling him to be careful and check in with me. When his Uncle Bobby called me, I thought he was joking at first. This couldn’t be real.”
Tom was taken to Vanderbilt University Medical Center. The diagnosis wasn’t good – at least not at first.
“I remember them telling me that I’d probably never walk again.” Tom says. “Then this doctor, (orthopedic surgeon) Dr. Clint Devin, who is some kind of superstar doctor, walks in, looks at the MRI and X-rays and said, ‘I think I can fix this guy.’”
Tom had already improved his chances for recovery before he ever got to Vanderbilt. As a trained Army medic, he knew the importance of stabilizing a patient with a spinal cord injury, even if he was the patient. He instructed his cousin and uncle to get the emergency kit out of his truck and to put a neck brace on him and then not to move him.
After surgery, Tom regained some sensation in his feet, and everyone believed it was a good sign. Two weeks later, he was taken by ambulance from Nashville to Shepherd Center. As thankful as the Boones are for what Dr. Devin and the Vanderbilt team did, what happened over the next couple of months at Shepherd Center left them almost speechless.
“Rehabilitation was completely different from the physically taxing things I’ve done,” Tom says, “and I’ve done some things that not many would ever think about doing. The rehab was the most difficult thing I’ve ever had to do, telling my body to do something and having it not do it, then relearning how to make it happen.
“Everyone at Shepherd Center was awesome,” Tom says. “Even on days when I was being pig-headed and wanted to pout, that was not an option. I would throw a little temper tantrum and say I wasn’t going to do something that day, but my treatment team always won. It is because of them, that I can run, climb a rope, go to the shooting range and teach my 10 years of military experiences to young privates.”
Meredith got to witness the spirit of Shepherd Center in a way that only spouses can. In some ways, the spouse gets to see so much more of what is going on around their loved one and in the rest of the hospital.
Watching wasn’t always easy, Meredith recalls. But the outcome was typically good.
“It was amazing,” she says of her Shepherd experience. “At first, you are in shock, then you wonder how all these people are all so happy. You feel like you’re the only one in the world this is happening to until you see this great community.
“At Vanderbilt, they had him standing up before he left there, but his blood pressure was an issue, and he’d pass out,” Meredith recalls. “When he got to Shepherd Center, on the first or second day, they had him walking with a gait belt at the parallel bars. Then, I was the one about to pass out.”
Meredith adds: “When we found out at Vanderbilt that Tom had central cord syndrome, it was heartbreaking. Tom is so strong-willed and self-reliant. Luckily for us, we had Shepherd Center to help. It was extremely hard for him to lose his independence, and when he started to recover, it was just as hard for me to give it back.”
Dr. Elmers says there was never doubt in her mind that Tom would reach his rehabilitation goals. And she thinks his future goals are certainly attainable.
“Patients who have gone through military training are often our best patients and have the best outcomes,” she says. “The training Tom had gone through, it’s obviously not easy. I know soldiers go through a lot in training camps, both physically and psychologically. Their attitudes and work ethic pay off in rehabilitation here.”
MARCOS’ ACCIDENT, Rescue and Rehabilitation
Imagine a tough, veteran Green Beret, and that describes Marcos, Dr. Elmers says.
“What you see in movies about soldiers, Marcos is that kind of person,” she explains. “He has a dry wit, but was very serious about his rehabilitation. He’s the type of patient that we’ll remember 30 years from now.”
The feeling is mutual.
Marcos retired in 2009 after 20 years in the U.S. Army, the last 11 of which were in the Special Forces. In 2009, he became a civilian employee in support of Special Ops. He was about to deploy to Afghanistan when he was injured.
“I was doing some last-minute training before deploying and was riding my mountain bike on a trail I had ridden for eight years, the same route, with the same group,” Marcos recalls. “Somehow, I went over a log, and it drove my head into the ground. I knew it was bad from the moment it happened, but I also remember thinking I would overcome it – and quickly. I couldn’t move anything, couldn’t tell where my arms were, what position they were in.”
Marcos was second to last in his group of 12 bikers on the trails. Had he been last, he’s not sure how quickly he could have gotten help. As it was, he was able to get the attention of the last rider, who stopped to help his friend.
“We were deep in the trail, so it took paramedics about an hour to get to me,” Marcos recalls. “They dragged me out on a back board, then to a Gator (all-terrain vehicle) and then to an ambulance. This whole time, I’m thinking it will go away. I will fight through it like everything else. I had just shocked my system. I thought I’d be running again the next day. It didn’t get any better in a few hours, and I started to realize that it was not looking good. That’s when depression hit.”
Like Tom, Marcos had central cord syndrome. That meant nothing to Marcos, who just wanted to know whether he’d be walking and running again, and when.
“Basically, it’s a crap shoot as to what comes back after the swelling goes down,” Marcos says. “I needed an answer. Was it 50-50? 75-25? But they didn’t know.”
Twelve weeks later, Marcos left Shepherd Center with most of his questions answered.
“When I got to Shepherd, I couldn’t move,” he recalls. “As far as I’m concerned, I couldn’t do anything. Within the first week, my therapists had me standing me up, even though I still couldn’t move. I was on a backboard, and they had me support myself. It was a good milestone. The following week, while I couldn’t control what I was doing, they had me walk in a harness. If I had laid in bed, which is what often happens at other hospitals, I might still be in bed.”
Two Soldiers Back on Duty
Marcos has one regret about joining the Special Forces – that he didn’t do it sooner.
“Definitely I would do it again,” he says. “I wish I had done it earlier. I liked the full-on volunteer nature of enlisting. Everyone is there because they want to be there. No matter what you’re doing, everyone is there because they chose to, and that adds some peace of mind.”
Tom, of course, wants nothing more than to have a shot at what Marcos had – 11 years in the Special Forces.
“I had no intention of making it a career,” Tom says. “I went into the National Guard right out of high school. It was going to pay for college. While in the Indiana National Guard, I worked with some Green Berets. I thought they are a lot cooler than I am. I want to be one of these guys.”
Both Marcos and Tom plan on continuing a career that involves deployments.
“I believe I can do that,” Tom says. “Physically, I’m nowhere near the man I was, but I’m getting closer every day, and I do hope to get back to the frontline fight. I’m a stubborn guy. No one will tell me what I can’t do.”
Dr. Elmers believes Tom can and will do that before too long. As for Marcos, he might have already gone back to Afghanistan and just isn’t saying so.
“I think he thought he was going soon – against doctor’s orders,” Dr. Elmers adds. “But I know that’s where his heart is, too, so as his doctor, I’m fine with it.”
ATV Injury Prevention Tips
- No child under 16 should drive an adult ATV. Buy an age-appropriate vehicle for children.
- Do not drive an ATV with a passenger or be a passenger. ATVs are designed for one rider.
- Never ride a three-wheeled ATV.
- Wear an approved helmet with an eye shield.
- Wear non-skid, close-toed shoes.
- Do not drive on paved roads during the day or night to avoid colliding with vehicles.
- Before riding, attend a local ATV driver’s safety course.
This information was provided by ATV.gov, as well as Injury Free Coalition for Kids.
Bicycle Injury Prevention Tips
- Wear a properly fitted helmet.
- Should not rock forward in front of eyes
- Should not rock back more than two fingers above the eyebrows
- When mouth is opened like a big yawn, the helmet should pull down on the head.
- Make sure your bike seat and handlebars are adjusted properly.
- Road bike: 1 to 2 inches between you and the top tube
- Mountain bike: 3 to 4 inches between you and the top tube
- Handlebars should be at same height as seat.
- Be visible by wearing neon or bright colors day or night. If riding at night, make sure to have reflective clothing, as well.
- Always ride with two hands on the handlebars.
- Watch for hazards.
- Pot Holes
- Broken Glass
- Parked Cars
- Obey traffic laws.
- Go with the flow of traffic.
- Be predictable. Ride in a straight line and use signals to motion where you are heading.
- Children ages 10 and under should ride on the sidewalk.
This information was provided by the National Highway and Traffic Safety Administration.
Share Military initiative provides hope and recovery for wounded Military personnel
Patients who have served the U.S. military have long been an important focus of the medical treatment and rehabilitation programs at Shepherd Center. But since early 2008, after philanthropist Bernie Marcus learned about the gap in care for military personnel with brain injuries, the hospital has served more than 124 service members through the SHARE Military Initiative.
Marcus funded the program initially, but after publicity about its success in helping wounded service members either return to the military or transition back to civilian life, SHARE (Shaping Hope and Recovery Excellence) has garnered financial support locally, as well as nationally.
“It truly is remarkable that we continue to see the generosity in support of wounded service members so these heroes can receive the much-needed private sector care they deserve until the military health care services ramp up,” says Susan Johnson, program director of Brain Injury Services.
Though SHARE initially provided treatment for active-duty military personnel who sustained spinal cord and/or brain injuries either on the battlefield or stateside, the program – based on increasing need – has evolved, Johnson explains. Now, it focuses on comprehensive treatment for military personnel who have sustained mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) while serving in Iraq or Afghanistan.
“They have suffered from numerous blast injuries with subsequent PTSD and have often have been misdiagnosed or untreated, resulting in a number of other chronic issues,” Johnson says.
SHARE participants undergo outpatient treatment in a 10- to 12-week program in which they are housed together in apartments close to Shepherd Center. Services provided run the gamut from physical, cognitive, behavioral and psychological treatment, including family and vocational counseling.
Since its inception, SHARE has collected a lot of outcome data from the treatment program. The data indicate that clients are improving in cognition, depression, PTSD, headaches, pain and sleep, Johnson notes. Once they transition back into the military or civilian life, clients are managed and followed by SHARE’s military services transition coordinator for up to a year – or more based on their individual needs.
The SHARE leadership team has just developed an enhanced transition treatment program that measures the individual success of clients. This model
is individualized using a goal attainment scale that the client determines for monitoring his/her success, Johnson explains. Clients can use outlined strategies to cope based on the ups and downs that may occur during their transition. The pilot program has shown a lot of merit, she adds.
“Right now, we know how many go back to work or return to active duty, but we want to learn more about their day-to-day development after they leave,” Johnson explains. “This new standardized measurement scale will help give us more objective data.”
Meanwhile, fundraising continues for the SHARE Military Initiative. TriCare military insurance covers only some of the costs of treatment. So, funds donated to SHARE fill the gap. The program needs about $70,000 a month to sustain its current patient population of 10 to 12 soldiers at any given time, Johnson says.
Donors continue to give generously to SHARE, and the program is well on its way to meeting its funding goal in the current fiscal year, she adds. SHARE expects to get a boost later this year from funds raised in the hospital’s largest fundraiser of the year – The Legendary Party. It is scheduled for Nov. 3, 2012 at the Ritz-Carlton, Buckhead. Ticket information for the gala event will be available soon at www.TheLegendaryParty.com.
For more information on SHARE, see www.shepherd.org/share.
Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, multiple amputations, stroke, multiple sclerosis, and pain. Ranked by U.S. News as one of the nation’s top 10 hospitals for rehabilitation and the best in the Southeast, Shepherd Center treats more than 850 inpatients and 7,600 outpatients annually with unmatched expertise and unwavering compassion to help them begin again.