Paralympic cycle champion Simon Richardson could be looking at a future in a wheelchair after a road crash in which he broke his back in two places.
Richardson, 45, who won two golds and a silver medal at the 2008 Beijing Games, may need back surgery and still has breathing trouble.
The accident as he was cycling near Bridgend, South Wales, in August was his second serious road accident and left him unconscious with a double break to the pelvis and a broken breast bone. He was breathing out of one lung.
Richardson, of Porthcawl, told the Press Association: "Long-term, it might be that I could be in a wheelchair. I could have arthritis in the spine basically as a result of the accident, which has increased the chance of having arthritis in the five breaks in my back (in total, including those from the earlier road accident that originally left him disabled).
"But that is in five or 10 years down the road. The way that I look at it is that I am not bothered. I should have been dead in the first 15 days after the accident. If I am in a wheelchair, I am in a wheelchair - you cannot live on that (thought) now. I am just disabled. I am not a three year-old child who has got leukaemia or something that changes or cuts their lives."
He is seeing a consultant in January to assess what could be the next steps to recovery. He has had an MRI scan on his legs, which produced positive results but no answers about what is wrong. There is also a chest expert to see about the effects of the blood clot and his lungs.
"At the moment, it is all waiting and waiting and waiting - but it has to be done. You cannot rush the body," he said. The way that I look at it is that I came out of hospital in 25 days but I should have been in there for three months. My body recovered so quickly (at the beginning) that it now seems like an eternity."
Being a supremely fit athlete helped the initial recovery. Richardson is frank, positive and overwhelmingly realistic about his prospects, which is even more surprising as he admits he is still in constant pain and is housebound.
He said: "I cannot go anywhere unless my wife, Amanda, takes me. I have still got to wear a body brace. I still do not have the strength to walk properly. I still have got to get help to get into the bath because I cannot manage with my legs. It has got to the point where the recovery has slowed right up and plateaued."
Richardson was no longer on British Cycling's para-cycling squad but was still training when the accident happened. "I went into hospital with 4% body fat. I had no weight to lose, so lost muscle and lost three stones." In a chirpy note to his friends, he later tweeted: "Yep 6ft 4ins and 9 stone. I wish I could race at that weight. Would be a great climber."
He remembers having paranoid dreams while he lay unconscious in hospital but could not remember his wife or the accident when he woke up. "Being in intensive care is very, very traumatic. It is a bit like groundhog day. For me it was like having a light with the word 'die' on it. I kept having the same dream and by the end of it I was trying to switch the word 'die' on. It was because of all the drugs that I was on. It was hard to tell what was real and not real. I was lying there feeling half awake. Amanda said she shouted at me when it was coming close to my 15 days of being unconscious because I was not improving and needed to try harder. I think that was when I was trying to turn the light on and within 48 hours I was off the ventilator."
The wealth of good wishes he received from around the world, including 450 emails in three days, was a big surprise.
"I cannot believe it even now because I just cycle. Paralympic athletes do not get the same attention as able-bodied. It might be easier for the press not to talk about disabled athletes because a disabled athlete or person could be them. This accident could have been anybody. It could have been Bradley (Wiggins) or Cav (Mark Cavendish) or anybody that uses the road. If talking about it and hoping that motorists might be careful helps, then I don't mind talking about it - but I am not sure how much good it will do."
A 16-week-old puppy called Eevee is now one of the key focuses for Richardson's short-term recovery. The job of the border collie and a golden retriever cross-breed, and new member of the family, is to help him learn to walk and be independent again so he can take her for a walk.