A woman fell asleep driving an 18-wheel diesel truck down the freeway and crashed into Mark Aceves’ pick-up. The collision broke Aceves’ back. He woke up in a hospital 10 days later with a spinal cord injury, squinting at the cold fluorescent lights above him.

Doctors said it was a miracle he survived.

“They were telling me, ‘You can still have a full life even though you can’t walk again,’” Aceves said. “This is a guy standing there on two legs. You won’t listen to him. You’re thinking ‘Oh my god, what do I do?’”

Although he was given information on how to adapt to life in a wheelchair, he said that barely any of it prepared him for life beyond the therapy wing doors.

Aceves spent over two months with doctors and physical therapists in a rehab facility.

According to the National Spinal Cord Injury Statistical Center, an estimated 17,000 Americans acquire a spinal cord injury every year. Vehicle accidents like Aceves’ are the leading cause of injury.

Although technology has helped reduce the length of the therapeutic process, shortened rehab time is not enough for patients to fully cope with the lifestyle changes they face, said Jo Crawford, a physical therapist at St. Joseph’s Hospital and Medical Center.

“When I got released, I was scared. I was very scared,” Aceves said. “They have everything for you in the hospital. I don’t have the stuff they have. You have to start from scratch.”

Aceves worked in construction, was an avid hunter and played sports with his grandchildren.

After he left the hospital, he said he witnessed his old life deteriorate.

“I laid around and did nothing for six years,” he said. “I was pretty much stuck at home. Believe it or not, my wife didn’t want to take care of a guy in a wheelchair no more so she left. My friends were telling me, ‘This ain’t you, Mark.’”

“Twenty-three years ago, if you had a spinal cord injury, you would be here for three to four months,” Crawford said. “Now, I think they try to send you out in 28 days—four weeks if you’re a paraplegic. Back in the day, you had time to adjust. It’s sad really.”

Crawford said that because patients are still mourning the loss of their ability, they cannot immediately remember all the information doctors give them. As a result, Crawford said that many find themselves back in the emergency room with preventable complications like bed sores and urinary tract infections.

“Honestly, the hospitals are doing their jobs,” said Jeff Ramsdell, owner of Leeden Wheelchair Lift and Sport. “Most people are just not ready to receive that much information. They’re sensory overloaded.”

Ramsdell said that while every patient is different in terms of adapting, it takes an average of six months to two years for someone to fully integrate back into the community.

Patients who have left rehab facilities without the proper support are susceptible to isolation, depression, and drug use, Crawford said.

Suicide rates for patients are the highest during the first five years after injury, according to a study in medical journal Paraplegia.

“They’re by themselves. They think that no one else has their situation or knows what they’re going through,” Crawford said.

Aceves said that he never considered suicide, but it’s “a big thing.”

“I talked a while ago to another [patient]. He wants to die because he broke his neck. I can understand what he went through. I was there,” Aceves said.

He said that physical therapists and doctors have good intentions, but they will lose patients because they will never understand the full extent of disability unless they experience it themselves.

“How do they know how I feel?” Aceves said. “They can walk. They can go home at the end of the day.”