Ryan Paul Johnson's Story, That Time I Broke My Neck.

As I got to thinking about it, I realized that a lot of people don’t know the story of what happened to me. What you have here is an abridged version of my accident and recovery story. I don’t mention anyone by name that was there for me; there were a lot of people. I know that I wouldn’t have made it without all the help & support I received from my friends and family. No one is a self made person.  We all have other people that help to open doors for us. If you have been one of the many people who has been there for me, please know that I’m forever grateful. Thank you to everyone who has supported and prayed for me along the way! I’d have been lost without you! Now...onto my spinal cord injury story. 

    I started snowboarding in the winter of 1996. I was 16 years old & ready for adventure. I grew up in the Valley of the Sun, so snowboarding wasn’t the easiest recreational activity to participate in. I probably went a total of 6 times during the winter of 1996/97. The following Winter I maybe went another 8 times. In the winter of 1998/99 --  when my accident happened -- I had probably been snowboarding less than 20 times.

    In January of 1999 I went on a snowboarding trip with Arizona Community Church’s college group. There were about 15 of us in total on the trip. The plan was to drive up late on a Friday, board all day Sat and Sun, then drive home Sunday evening. On January 15th, 1999, we piled into 1 van and drove from Tempe to Bear Mountain in California. We arrived at the cabin we were renting very late Friday evening. We all chose which uncomfortable surface we’d be sleeping on and went to bed excited, for tomorrow’s adventure. 

    Saturday, January 16th, was the last able-bodied day of my life. We got to the lifts right as they opened at 9am. The bottom of the mountain was like a neglected ice rink. Our boots crunched along loudly as we approached the lifts. It hadn’t snowed for a while so the mountain was covered in a layer of solid white ice. Being from AZ, bad snow conditions were pretty much the only snow conditions I was familiar with. I felt right at home.

    We rode the lift as a group, to get a picture for the church bulletin. I exited the chair lift and my board scraped loudly as the icy snow was crushed below the weight of my board. We grouped up together and smiled for the camera. As soon as the photo was taken I turned and headed straight for the snowboard park. 

    I fell hard on my very first jump of the day. The ground was a lot harder than I’d expected. I tweaked my ankle, but not bad enough for me to call it quits. I just tightened up my laces and bindings to fix it. Looking back on the whole day, I wish I’d have babied that ankle.   

    My final run of the day started just after noon. I remember the time because we were going to stop for lunch after a few more runs. I was riding through the snowboard park. There were a series of 3 jumps that all lined up so you could take them one after another. On the run prior I tried taking all 3 jumps in a row, but it didn’t go well. This time I would skip the 2nd and just bomb the 3rd with a head full of speed. Plan was going great. I started up the 3rd jump with a lot of speed. Too much speed maybe, I panicked a little bit. I tried to check my speed by digging in the heel side of my board. The problem, however, was that all my momentum, and the pitch of the ramp, made it impossible for me to get back on the heel side of my board. What actually happened was that the toe side of my board caught on the pitch of the jump. If you’ve ever caught an edge on a snowboard or a pair of skis, you know it's never a nice fall. You normally end up slamming yourself to the ground like a whip cracking -- except your head is the end of the whip. 

    It’s been 18 years since I took that fall, but I can still see the snow piling up on the toes of my boots. I ended up throwing myself head first off of the jump and landed on the top of my head. I imagine it looked a little Superman-ish in the moment before I smashed into the solid ice on the back side of the ramp. As soon as I hit the ground my whole body fell asleep. It was that pins and needle feeling you get when your foot falls asleep. If I’d have just taken the jump without second guessing it I’d have been fine. I may not have landed perfectly but I would have been in a much better position. I’ve spent years reliving that split second panic, wishing I’d have been brave in that moment. 

    I ended up lying on my stomach with with the right side of my face in the snow. I couldn’t move a muscle. I could barely breathe. In the moment, I thought I was having an asthma attack. What had actually happened was my chest muscles were paralyzed and I was only breathing using my diaphragm. I was told later that I’d crushed and exploded my 4th cervical vertebrae and I’d cracked the 5th. I laid there in the snow surrounded by my friends waiting for the ski patrol. It didn’t seem to take too long for them to get me cut out of my gear and strapped onto the backboard they would use to toboggan me down the hill. I was at a loss for what was going on with my body. 

    I had a little wave of recognition as they were loading me into the ambulance. My right arm had fallen off the side of the gurney. It was dangling in such a way that they couldn’t get me into the back of the ambulance. The EMT at my feet started coaching me to get my arm up. It took me a moment to figure out what he was talking about. I realized he was talking to me at the same moment that the other EMT, managing the head of my gurney, told the other foot soldier, "He can’t move.” I realized that this guy was also talking about me and that I in fact couldn’t move my arm. I remember thinking, "Oh shit, I’m in trouble.” 

   I nearly died in the ambulance. At least I think so. There were 2 EMT’s in the back of the ambulance with me. One of the guys started yelling urgently, "he’s crashing! he’s crashing!” I’m not exactly sure what they did to fix me, but it worked. The Ambulance drove me to a helicopter pad to hand me off for the next leg. As they loaded me into the helicopter I started to cry. I didn’t know what had done to myself but I was sorry about it. I thought of all the people in my life and as I sobbed I just said, “I’m sorry,” over and over. The lady who was now sitting at my side managing me as we flew to San Bernardino County Medical Center saw my distress. She told me they didn’t know what was wrong with me, but it was going to be ok. They were taking care of me. It was comforting. 

    The helicopter landed on the roof of the hospital, and I was wheeled to the emergency room. The next 18 hrs were spent running me through machines and X-rays. The CNA who was assigned to push me around the hospital had just got a new motor cycle. He’d taken it out for the first time the day before, so I got to hear him tell the story to every new person he saw as we rolled through the hospital. 

     Once they’d scanned me with every machine possible to establish how wrecked I was, they formed a plan. Phase one of the plan was to put me in traction. In AZ, everyone I met who'd broken their neck was put into a halo vest. Traction wasn’t nearly as bad as a halo. A halo is a hard plastic vest with a  metal ring that is attached to your skull with with 4 screws. For traction, they only screwed two bolts into the sides of my skull, and then hung weights off of the back of the bed to elongate my compressed spine. The goal was to bring down the swelling in my spinal cord. I had 20 lbs hanging off of the top of my head overnight for 12hrs.  

    On Sunday morning, it was determined that the swelling in my neck was not going down. They were going to have to operate on me if they were going to fix me. The plan was to open me up at the throat and get out all the chunks of my 4th cervical vertebrae. They would then make a new vertebra for me out of bone harvested from my left hip. Once the new vertebrae was put into place, they’d fuse the C-3,4 &5 vertebrae by putting a plate on the throat side of my spine and 4 screws to attach it. 2 screws in C-3 and 2 in C-5. Also, during the surgery they planned to put a feeding tube in me. This tube was placed up my nose and terminated in my stomach. During the surgery I stopped being able to breath on my own. They placed a second tube up my nose which was attached to a ventilator and terminated in my lungs. The surgery took hours to complete, but in the end was a success.      For the first 18 hours after my fall I’d been able to breath on my own.  After the surgery, I was completely dependent on a machine to breath for me, and I couldn’t talk anymore. I developed pneumonia the day after my surgery. I couldn’t cough so fluid was gathering in my lungs. I had a bad infection and an outrageously high fever. I was placed in the ICU with little hope of survival. 

    Over the years I’ve been told by many that they were sure I was a goner. The doctors spent the next ten days trying to stop the pneumonia from killing me. I was put on a bunch of antibiotics and wrapped with ice bags to bring down my temperature. Every few hours a respiratory tech would come in and hook a vacuum up to me. The device simulated a coughing action. For thirty minutes or so they’d work on trying to get fluid out of my lungs. It was uncomfortable, to say the least. They were able to clear out most of the blockages in my lungs this way. All but one spot. For the last one they poured a chemical into my lungs called Mucomist. It did the trick, dissolving the last blockage -- but it nearly killed me. My lungs completely shut down. As a counter measure, they poured liquid albuterol into my lungs. Albuterol is an anti-inflammatory drug used by asthmatics around the world. It’s what is in rescue inhalers, and we’ve been using them since the Goonies. I have no idea exactly how much they gave me but it sent my heart rate to over 200 beats per minute and it made me shake uncontrollably for the next 2 hours. For a lot of that time, there was a person standing over me with a blue football sized breathing bag, which they squeezed every 5 or so seconds to force air into my lungs. It wasn’t pleasant, but it did the trick. The pneumonia was gone and I was going to get to go home.  

    Before they sent me home they had to do another surgery on me. My nostrils were getting too stretched out b/c of the tubes shoved up them. 18 years later, and my right nostril is still larger than my left. I was also having acid reflux, which due to my situation, was very bad. The fear was I’d aspirate and get stomach acid into my lungs. They performed a few minor operations on me right there in the ICU. They cut open my abdomen and wrapped the top of my stomach around the bottom of my esophagus. This constricts one of the 2 muscles that the body uses to get bad food out of your system. The surgery basically gave me an iron stomach and stopped my acid reflux. It also made it impossible for me to vomit. A feeding tube was permanently punched into my lower abdomen and I was given a tracheotomy for the ventilator tube. My face was finally free of tubes.

    The surgery was all done while I was unconscious. Due to a miscommunication, the team who did the surgery thought I had no feeling below my neck, and didn’t give me any extra numbing or pain meds. I woke up from the surgery about an hour later to the worst pain. It felt like someone was actively cutting me open. It didn’t take too long for everyone to figure out what had happened. They quickly knocked me back out with a shot of morphine for the pain and rohypnol for my nightmares. My mom told me years later they “roofied” me a lot during the first couple weeks.  

   After 2 weeks in the ICU at San Bernardino county medical center, I was healthy enough to go back to AZ. I was flown back to Phoenix in a private medical transport jet.    

    I arrived in AZ and had my first rounds of assessments. The initial prognosis was: I’d be in a power wheelchair. I’d always need a machine to breath for me. I’d have to be fed through tube. It was a lot for me to take in and process. My situation would wash over me in waves as I was faced with the circumstances of my new life. The first day they put me in a power wheelchair is a good example. 

   Getting me into a power chair would give me back some independence. As I sat in it for the first time, a new level of understanding hit me: I was going to be in a wheelchair forever. 

    The chair was set up so I could drive it with my left hand and arm. I’d been able to start moving my left arm at the shoulder but I only had “gross control” of the moments. This meant I could get the arm to move, but I couldn’t really control the movements. My first day in the power chair was a dark one. While I had the ability to move my left arm, the movement was so haphazard that I could not drive the wheelchair. I could crash it without much effort but using it to get around was not happening. I completely broke down. I couldn’t even operate a joystick controlled wheelchair. My life was over. I cried and whisper raged and cried. They put me back to bed. I refused to let the hospital staff into my room. In reality I couldn’t stop them from caring for me but I demanded to be left alone. 

    I was never really alone. At every phase of my hospitalization people came to support me. It’s not easy to be a support person. Mostly because there is nothing really anyone could do for me, or to me, that would fix it. Having to watch someone you love struggle and being powerless to change anything is heartbreaking. I know people felt this. I’m so grateful to all the people who did come and sit with me. There are too many to try and name without forgetting anyone. Please know how thankful I am to everyone who came and endured watching me recover.

    It was small, but  I was making progress on a daily basis. Each day they’d test me from fingers to toes. Everyday, there was something new for me to fire. Over the first 2 weeks I was back in AZ, I made big progress! 

    I got off the ventilator. They did this by weening me off it a few hours at a time.  The first full day I was off the ventilator I begged them to put me back on. Breathing was so difficult and exhausting. The nurses just laughed when I asked to be put back on. Progress, they told me, wasn’t going to be easy. 

    With the breathing tubes gone I was able eat again and so the feeding tube came out too. I was ready to be transferred to the Barrow Neurological Rehabilitation Unit to continue my recovery. My Doctor gave me an evaluation the night before I was to be transferred. She told me with the amount of muscle movement that was beginning to return I’d probably be able to walk a little someday. She told me I’d still need a wheelchair to get around but if I worked hard in rehab I’d probably be able to take a few steps when transitioning from wheelchair to whatever new chair I wanted to sit in. I didn’t pay attention to any of the limits, I only heard “walk someday.”

   For the next 4 months, I lived in the neuro-rehab unit. I spent between 5-7 hours each day doing different type of physical & occupational rehab. It was a lot of hard work. My biggest mental breakthrough came at the end of February. It was the end of the rehab session. They wanted to see if I could support any weight with my legs. The first try, with help, I was able to push myself about half way up. They were very happy with the first time, and wanted to try it again. On the second try I pushed harder and stood all the way up. I stood there for less than 30 seconds leaning on my 2 therapists. All three of us smiling from ear to ear. We were all surprised! Standing there that day I knew, eventually, I’d be walking again. It took another 2 weeks, but on St. Patricks day 1999, 2 months after the fall, I took my first steps. Two steps forward two steps back.

    Every spinal cord injury is different. Doctors didn’t know why some people make a  comeback while others don’t. The movement in my legs returned more quickly than my arms and hands. I had what they called central cord syndrome. While I was making good progress on general mobility, I wasn’t progressing much on my ability to take care of myself. I was scared. I thought what if my legs come back but I still can’t move my arms? My focus had been walking. I realized walking was far less important than the ability to use my hands and arms to take care of myself. I’d been using a power wheelchair to get around the hospital for over a month. I had the wheelchair tech turn it up to full speed. It was fast & I could out pace people easily. It was fun to zip around the hospital and have staffers yell after me to slow down. I decided fun time was over, I had them switch me from the power chair to a push chair. 

    I was much slower in the push chair but the extra work paid off. My hand and arms began to get stronger. Soon, I was able to hold a fork and get food to my mouth. I was slow but also able to be pretty much independent again. 

    When I was released from the hospital it was June of 1999. I was sent home with a loaner wheelchair and a walker. I was still primarily using the wheelchair to get around. I quickly discovered that the loaner wheelchair didn’t fit through any of the doors in my house. I could roll down the hallway to my bedroom but I couldn’t get the chair into my bedroom. Inside the house, I switched from the chair to using the walker exclusively. Similarly, my wheelchair would hit into a lot of my friends’ cars. I started to use the walker exclusively for getting around. Again, It was slow going, but also just what I needed. By the time I started going back to college in the fall of 1999, about 9 months after my accident, I was able to get around without using the walker.   

    It’s been over 18 years since I fell down that day. Looking back makes me proud at how I tackled getting back into life. I can’t say that I felt brave while I was going through it. In fact it’s the exact opposite. I was scared and anxious at every next step in my recovery but I've done my best to give it my all. It was a moment of fear & panic that landed me in the hospital. I wasn’t going to let fear win anymore. I would force myself to follow through on every new awkward situation. 

    My default worldview is that I’m not very special. I think everyone put in my situation would respond identically as I did. I tend to discount my achievements as inevitable mile markers everyone would pass walking the road of my life. It’s just that very few people get a chance to walk on my road.  One night, while reflecting on my journey, it struck me. I’d become a brave person. Despite being scared, I had responded bravely to my accident. I now own bravery as one of my character traits, and it continues to push me forward. 

    As I got back into life, I put myself into scary & uncomfortable circumstances. I’d be very afraid, but I’d soldier on because I didn’t want the fear to win. Now, when I find myself up against a new challenge that I have to conquer, I don’t dwell on the fear and anxiety. I recognize and acknowledge it -- but I tell myself, “Ryan, based on everything you’ve done so far, you are a brave person. Brave people aren’t afraid to take the next step.” 

    I think we can all point back to situations where we’ve behaved bravely in the face of some unknown fear. We are wired for survival, which seems to mean our brains use fear to keep us safe.  I don’t think we need to let fear win. Rather, I prefer to take the advice of America's greatest comedic coach Del Close, "Follow the fear because it will lead you to greatness!"

Ryan Johnson