Monday, 29 January 2007

Paraplegia (Introduction To)

So, where do I begin?

Suddenly I have too much time on my hands. Never thought I would ever be afflicted with that problem, however, another unfortunate problem has forced boredom upon me.

It started last April with what I thought was just another sprained back. I had not yet found a family physician after my doctor had given up his practice. Dragging myself to a local ‘walk-in clinic’, the doctor quickly concurred with my assessment and prescribed pain killers with muscle relaxants as I was ushered out of the office..

I am still unsure how many days passed before I awakened into a hazy consciousness with a sickening realization that my legs refused to move.

An ambulance ride to a local hospital emergency department was followed by numerous tests which ultimately determined that I had a bacterial infection (1). The little buggers had made a home for themselves on my spinal column resulting in an abscess. Placed on antibiotics I was whisked off to a major Toronto hospital where after a period of time it was determined that surgery would be required. The abscess at the T5 (2) level of the spinal column was excised and drained and a laminectomy (3) was performed. Surgical insertion of a ‘Port-o-Cath (4) was performed which would facilitate the six weeks of additional antibiotic therapy required to ensure complete eradication of my bacterial companions. A journey to the ICU followed.

Once again, time evaporated and I spent much of the next month drifting between semi-consciousness and a very vivid and real morphine hell. I did not dream these horrific fantasies, I lived them! What I experienced I may reveal later however, suffice it to say that I never wish to be trapped in those tortuous emotions again. How anyone can use that drug or any of it’s derivatives recreationally is beyond me.

My wife tells me I was swollen like a balloon that refused to deflate in spite of the assortment of IV s and drainage tubes protruding from my body. My return to consciousness was slow and it was painfully obvious that my movement was not returning. The prognosis was the worst news I could possibly have heard. Permanent paraplegia.

Policy is that I be returned to my originating hospital for recuperation when no further invasive procedures are required. Having been stabilized, I was delighted to be discharged from this institution, albeit on a stretcher, as it was rather filthy, staffed with surly nurses and offering inedible food.

Being back at my original hospital was a pleasant change, however, in my case it was serving as a “human filing cabinet” while waiting for the slow moving wheels of bureaucracy to have me admitted to a spinal cord injury rehabilitation facility. Six more weeks in limbo had my joints seizing up due lack of motion and six cancellations of admission by the rehab taxed me mentally.

High hopes prevailed as I was finally shipped off by ambulance to “The Rehab” which, from all accounts had an admirable reputation. There I was once again worked over and reassessed , having so many blood tests that I thought anaemia would surely result. Staff may have been well intentioned however politics, bureaucracy and miscommunication were equally at home in this facility.

All stumbling aside (pun intended), I was instructed on a personal routine which I would need when discharged. The cost of twenty-four hour room and board was borne by the Canadian taxpayer yet really amounted to a meager one hour of physiotherapy per day, weekends excluded. Not a very good rate of return on the health care dollar. The physiotherapy I received was directed more towards undoing the damage and seized joints created by months of bedridden inactivity rather than to help me achieve any mobility.

Perhaps it was the drudgery of the daily nursing routine, the toll of having to face patients dealing with life altering situations, or just my luck of the draw in being assigned a particular staff member, but indifference and negativity frequently seemed to lurked below the happy veneer. Negative to the point where, with my discharge date approaching, I chose not to reveal a slight flicker of movement in my legs. Fear of being smiled at, patted on the head and dismissed with a “that’s nice” was my expectation.

Discharged after almost half a year of hospitalization, I now have to adjust to life in a wheelchair within my quickly renovated home. Having had the entire hospital grounds open to me while institutionalized, my world now consists of a thirty foot run between two rooms, two televisions and two computers. For someone who was previously always on the go, this abrupt change is as mind numbing as perpetual pressure is butt numbing!.

Community provided physiotherapy is less frequent than that offered as an inpatient and really only consists of instruction for self directed therapy. At my assessment I found the confidence to show my physiotherapist that since my discharge I had worked on and regained some movement. While sitting I can now easily move my knees in and out over a normal range, kick my legs out from a sitting position to just short of horizontal and lift my feet off of the wheelchair supports with lessening difficulty. In bed I am able to bend my knees and slide my heels back and forth as well as do “the scissors How far I can take this is yet to be seen but I am a stubborn SOB and will continue to fight. After all, I have no other alternative.

My wife has made it painfully clear that she is growing tired of seeing me shake my fist at the television screen while engaged in one sided conversations with that medium. So, with all of this time to kill, I thought I would inflict my rambling thoughts and opinions on the unsuspecting world.

And so it begins…..


(1) In Particular, Staphylococcus aureus thankfully however, not the highly resistant MRSA strain.
(2) T5 refers to the Thoracic 5th vertebrae of the spinal column and the various levels determine the extent and severity of the injury. Very simplified, paraplegic vs. quadriplegic .
(3) Laminectomy refers to the removal of bone on the spinal vertebrae.
(4) Port-o-cath is a small device implanted below the skin which allows the infusion of antibiotics and other fluids into the body for a prolonged period of time where a conventional IV would be impractical.
* * *

No comments: