AgDARE - Agricultural Disability Awareness and Risk Education

Spinal Cord Injury - Supplemental Activity 1

Case Report

Materials needed: Case report (Spinal Cord Injury from Tobacco Barn Fall)

Time required: 15 minutes

Divide the students into groups of five to seven. Tell the students they are going to hear a real story about a farmer with a spinal cord injury. Assign one or two students to read aloud the case report "Spinal Cord Injury from Tobacco Barn Fall."

After reading the report, have the students discuss and answer the following questions as a group:

1. What are some things that commonly cause people to fall on the farm?	ice, uneven steps, missing rungs on ladders, wet surfaces, tripping over objects
2. What precautions can prevent falls on the farm?	good shoes, keeping ladders and steps in good repair, keeping objects put away
3. What are other outcomes of falls that can keep you from working on the farm?	breaking a bone, severe muscle bruising or sprains, lacerations (cuts)
4. Now, consider just the value of Josh's labor on the farm. How much do you think it costs to replace him per week?	about $10 per hour for tobacco work
5. Who has Josh's injury affected besides Josh?	Brenda - his wife (quit her job and stays with Josh), his father and brothers (they have to do Josh's farmwork), his family (put in ramps)

Case Report : Spinal Cord Injury from Tobacco Barn Fall

Background:
Getting tobacco ready for sale involves multiple steps that are weather sensitive. Once the tobacco is "cured" it must be taken down from the barns where it was hung across wooden beams in the late summer. Workers climb up in the barn, one foot on each of two barn rails spaced about 3 or 4 feet apart. Then the sticks of tobacco are taken off the rails and dropped to the barn floor. It is hot, dusty work, and you must be sure footed.

What happened:
In December 1998, Josh Springer climbed to the second rail above the driveway of the barn to drop part of his family's crop. An All-American farmer, Josh knew the barn and the job well. It was old work to him and he had no cause to be concerned. He and his brothers had been raised on this farm and they knew every inch of it. Josh himself had tested the rails earlier in the year and made sure they were in good shape. But that day, for some reason, something went wrong and changed Josh's life forever. Josh took a tumble from 24 feet up and landed in the bottom of the barn. "We put down tobacco in one barn then decided to put down out of another. Then in about thirty minutes, I was on the ground. They said I hit the wagon first. All our rails are nailed in. I don't know how it happened." He remembers his two brothers and his Dad standing over him, then a ride to the hospital.

Josh recalls, "I was in the hospital for two months but I just remember little bits and pieces from the ICU." His wife, Brenda, borrowed a friend's travel trailer and lived in the hospital parking lot so she could be near him during his recovery in the hospital.

Life with a spinal cord injury:
Brenda quit her housecleaning job and her work on the farm; instead she now stays with Josh to help him with his daily activities. Brenda says, "Pretty much our days consist of eating breakfast and doing Josh's exercises in the morning. He has to take medicine at 3 a.m. so he can get his blood pressure up enough that he can be up in the morning. It takes about 1/2 hour for him to be able to get out of bed and in the wheelchair. Every Saturday we go out and eat. That's about it, except for family outings."

"The first year was the hardest," they both say. For Brenda it meant learning to take care of Josh and tackling the medical bills. "We had to get everything done; in the house, the ramps, the hospital bed, the wheelchair. And the van, that was a major expense," Brenda sighs. Medical insurance costs $900 a month but they decided to keep the insurance instead of going on Medicare. "Our insurance at least pays for part of my medicines and Medicare won't." Josh continues. "Just my one blood pressure medicine is over $200 a month and I have to have it just to get out of bed." Their families have helped a lot. They built entrance ramps to the house and made modifications inside so the wheelchair could be used. "Our families have been great," they both add.

Josh reflects on how his injury has affected him and his family. "I didn't like it [being chair bound]. I was missing farming and everything." The crops grow within his view but not his reach. Josh looks out the window at the tobacco, now nearing harvest time. "I watch it sometimes, it's hard." His voice breaks ever so slightly. Even nearly three years after his injury, he longs to be back in the field. Brenda says, "We tried to get him out there but they don't make a wheelchair good enough to get out in the fields." Josh says, "They don't have any shocks and the motors aren't big enough." When asked about the future and his plans, Josh ponders a while before answering slowly, "I just have to wait and see how much [function] I get back. Time will tell, until then I just try to stay in shape." That's Josh and Brenda's work now, to keep him well and in shape. A tractor goes past the house. The farm work belongs to his brothers now.

Case notes:
Josh is a quadriplegic; that means he has no use of his legs and very limited use of his hands and arms. He can barely raise his arms at all. Because of the severity of his injury it is doubtful he will ever return to farming. Josh has been advised to learn about computers but he hates the technology. He is a very shy person and prefers to work alone. For now he is concentrating on his physical stamina. There is promising research about nerve regeneration but like so many others, Josh and Brenda can only wait. No one has really pinpointed a cause for his fall although there are some thoughts about it. The rails were secure and Josh was very familiar with the job, but it only takes an instant for life to change forever.

Josh's advice:
"Always be careful. Being around equipment, you can get hurt so easy."

Discuss these questions with your group:

1. What are some things that commonly cause people to fall on the farm?

2. What precautions can prevent falls on the farm?

3. What are other outcomes of falls that can keep you from working on the farm?

4. Now, consider just the value of Josh's labor on the farm. How much do you think it costs to replace him per week?

5. Who has Josh's injury affected besides Josh?

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