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more photosGary Graves performs a rehab exercise under the instruction of physical therapist Erik Zamboni at Living Well Physical Therapy Clinic in Bend last week. After breaking three vertebrae in his neck in a mountain biking accident in December, Graves is fast approaching a full recovery.
Andy Tullis / The Bulletin
A firm base of support
With a lot of grit and a little help from friends, Gary Graves has overcome a horrific bike accident. This is his story.
By Markian Hawryluk / The Bulletin
Published: August 13. 2009 4:00AM PSTFor many of Central Oregon’s outdoor enthusiasts, the realization that another long Central Oregon winter is fast approaching can trigger a final flurry of activity, trying to get another hike, another ride, another climb in before the snow hits. So last year, when unseasonably warm weather stuck around into December, Gary Graves decided to get his riding buddies together for a mountain bike outing.
“We knew the weather was changing. I can remember calling my friends and saying, ‘You know, I think we have the chance to get one last ride in this year. We ought to take that opportunity,’” Graves said. “It turned out to be pretty prophetic.”
Barreling down Phil’s Trail, Graves, 57, and his three riding companions turned onto the KGB trail, heading toward the Tetherow Crossing development. They passed the more difficult, or technical, portion of the trail and had entered an area new to Graves. Free of trees and rocks, he was enjoying the series of S-turns heading downhill. He never saw the small mound that launched his bike into the air.
“I remember going airborne, trying to do all the right things: shift your weight back, steady your arms,” he said. “When I hit I had this sensation of the front wheel not turning at all. Then, of course, in a millisecond, I was over the handlebars.”
Graves was rocketed headfirst in front of his bike, landing on his side. The impact broke three ribs, his clavicle and three vertebrae in his neck. But what his friends, rescue personnel and doctors did next probably saved his life. Nine months later, he has made almost a complete recovery, largely because of all the things they did right.
“I had one really tragic event happen, and I had this multitude of miracles that really allowed me to survive,” he said. “And not only survive, but to be totally functioning the way I was before the accident.”
All the right moves
Cloyd Robinson, the owner of Great Harvest Bread in Bend, was one of the riders out that day with Graves. He was leading the group down the trail, and he, too, was caught off-guard by the mound.
“We all hit it a little faster than we should have,” he said. “We’re old guys, so I try to stay really close to the ground. I was very worried when I was sailing through the air with both wheels off the ground. I had time to think about it.”
When the second half of the foursome didn’t show up, the riders went back to investigate. They saw Graves lying on the ground in the middle of the trail and the fourth rider next to him dialing 911 on his cell phone.
“He was very coherent. He really knew he was seriously hurt,” Robinson said. “He insisted we get AirLife out there.”
Graves’ first instinct was to roll over on his back, which he thought would be more comfortable. But Robinson, who grew up in a logging town, knew enough not to move somebody after such a serious accident. He urged Graves to remain motionless as they waited for help.
“I felt I really wasn’t OK,” he recalls. “I was lying out there in the woods, and my arm and my hand were going numb. I remember moving it continually because I didn’t want to get to the point where I couldn’t move it.”
The riders gave up whatever clothing they could spare to keep Graves warm. Robinson kept Graves immobile, while another ran down to the road, only a quarter-mile away to help emergency personnel find them. The fourth rider manned the cell phone and kept everyone in contact.
It took an hour for the EMTs to arrive. “It seemed like an eternity,” Graves said.
They were about to put him on the stretcher, when one insisted they first put a splint on his neck.
At the hospital, it would become clear how crucial those initial actions were. X-rays showed the bones in Graves’ neck where not only broken, but out of alignment. He had suffered what’s known as a “hangman’s break,” a fracture of the second cervical vertebra that can occur when the head is snapped back violently, such as from a hangman’s noose. The top vertebra — essentially a ring of bone — had broken into pieces.
The neck is built around the cervical vertebrae, the top seven bones of the spine, labeled C1 through C7. Each has an opening through which the spinal cord runs. With damage to C1 and C2, the structure protecting the spinal cord in Graves’ neck was no longer intact.
“If he had moved his head, he could have easily taken himself out,” said Dr. Raymond Tien, the neurosurgeon on call that day at St. Charles Bend.
Nerves from the spinal cord in that area control breathing. Any movement could have damaged the cord and stopped his respiration. He came to the brink of losing his life. He arrived at the hospital with little feeling in his right arm and hand but no other apparent neurological damage.
Tien scheduled Graves for surgery the next morning but told Graves’ wife, Mimi, she might want to gather the family just in case.
“The hardest part was not knowing whether you were going to live or die,” Graves said. “My son, who came over from Portland, and my wife, I really felt bad for them, thinking I may not be around much longer. That was probably the toughest part.”
A reconstruction
The surgery the next day went relatively well. Tien tried to fuse the second and third vertebrae so that the broken bones in the second could heal. It would give Graves the best chance of maintaining mobility in his neck.
But within days of the operation, the metal screws connecting the two bones pulled out. Tien realized there was likely damage to the third vertebra, C3, that kept it from supporting the hardware.
Four days after his first surgery, Graves went back to the operating room for a more involved fix.
Tien took out the third vertebra and used a bone graft from Graves’ hip in its place. He put in nine screws, two posts and two metal plates to help stabilize the area and to allow the fracture to heal.
Graves spent 2½ weeks in the hospital. At one point, he had difficulty swallowing and had to be fed through a tube. The staff at the hospital worked to help him regain the ability to swallow so he could feed himself at home. They got him up and moving, starting the initial process of learning to walk again. They taught him how to get in and out of an extensive brace that immobilized him from the top of his head to his lower back. He could take it off to sleep but had to put it back on if he needed to get up.
At home, Graves stayed in a hospital bed in his living room on the ground floor. His wife, a school teacher, had to go back to work, so she left a sign on the door, “Don’t knock, just come on in. He’s in the living room.”
Each day, she’d leave the door unlocked when she left, and a multitude of friends and family would come by with food, conversation and support as he recovered.
“It was amazing,” he said. “There was hardly a day when I was rehabilitating that people didn’t stop in and bring us food or stop in to see how we were doing. We’ve been in Bend for 20 years. It was one of those things where people really came out of the woodwork. People just showed up and did what was necessary to help.”
He wore the brace for 16 weeks, allowing his bones to heal. Finally taking off the brace was one of the first big milestones in his recovery. Then there was walking the half-mile to his mailbox and being pain free for a full five minutes. While he continued to improve over time, there were ups and downs along the way.
“Trying to heal from a broken neck is like waiting for summer in Central Oregon,” he quipped. “You know you’re moving in the right direction but sometimes you have setbacks. You have to look really at the long run.”
Thriving with rehab
Graves’ active lifestyle probably helped his recovery. He enjoyed being active and looked forward to returning to the recreational activities he enjoyed, particularly road cycling.
Tien called Graves “the perfect patient” for his willingness to do whatever it took to get back to where he had been before.
“Everyone who works with him knows they’re going to get 100 percent effort out of him,” Tien said. “He is so motivated to do well.”
When his hospital rehab problem ended, Graves went to visit Erik Zamboni, a therapist with Living Well Physical Therapy Clinic in Bend. He could walk and drive at the time but still had a long way to go to resuming his active lifestyle.
Zamboni devised a program that would help Graves return to form, without compromising the healing process in his neck.
“Probably the biggest challenge was that C2 to C4 area wasn’t completely fused yet, so we really had to make sure we were working on levels below that, helping him to function better and not putting a load on that area,” he said. “He was one determined guy to overcome what he’s gone through. A lot of people with such a severe injury wouldn’t be here.”
Zamboni and Tien both maintain Graves should be able to do just about anything. Maybe no more leaps on mountain bikes or bungie jumping. But there’s no reason he shouldn’t be able to do most other active pursuits. He’s already been cleared to run on soft surfaces, but he’s really looking forward to resuming road biking, probably next year. (His mountain bike, he said, survived the accident much better than he did and is sitting in his garage.)
At some point, Graves would like to compete in the Pole Pedal Paddle again, possibly as soon as next year. He’s set a goal for returning to his previous level of activity within a year of his accident. Of course, he wouldn’t have even had the chance if not for the help of all his friends.
Tien said Graves’ case is a good example of why mountain bikers should never ride alone and why people heading into the backcountry should have some first aid training.
“His friends recognized that he had a significant fall, and he potentially had a cervical spine injury,” he said. “I can’t say that for everybody, that they would know to immobilize him. He was with a fairly sophisticated group and a group determined to keep him down.”
Robinson said he now realizes the group was riding too fast down an unfamiliar trail.
“We were riding down a trail that we had been down many times, but it had probably been two years since we’d been down it,” he said. “We were just a little overconfident and riding too fast for conditions. It could have been any of us.”
With a full recovery in sight, Graves said he feels lucky to have had such great care and so much support from family and friends.
“The story for me is there were just a lot of people who were rooting for me and made sure my wife, Mimi, had a support group to help her with the whole ordeal,” he said. “It was great to have those kinds of friends.”
Markian Hawryluk can be reached at 541-617-7814 or mhawryluk@bendbulletin.com.
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