Saturday, 31 October 2009

Wheelchair Weight Gain

Wheelchair Weight Gain

It’s a curse. Especially if one is waistline challenged pre-spinal cord injury.

It appears to me that there are at least three possible demons that tug at the waistline post spinal cord injury, threatening to plus size the wheelchair occupant.

1. Inactivity - even if active in your pre-injury life, activity probably decreases once one exchanges running shoes for a wheelchair. Not too many calories can be burned exercising one’s thumb and forefinger on a joystick. Even a manual chair doesn’t provide the constant movement of walking, repeated sitting and standing or even standing in one spot for prolonged periods of time. I suppose one can go to the gym for an hour per day and even join a wheelchair sports team to raise the heart rate, but it may not be as intense or sustained as simply being on the go for an entire workday. If you don’t burn the calories, they accumulate around the waist

2. Boredom - for many activity becomes limited as one finds themselves planted in front of the TV set for days on end. As you stair at this “box”, the other box you find entertaining is the refrigerator. You stare at it as it stares back, enticing you with all sorts of goodies to help you alleviate the boredom, ease the pain and pass the time. Nothin’ else to do…let’s eat! Once it goes on, it’s hard to get off! Now that your activity has decreased (above) and you’re not burning off the calories, you find yourself adding even more calories to your idling engine.

3. Drugs - several may have an effect on metabolism however one that is often prescribed for spinal cord nerve pain is Lyrica and it has been implicated in weight gain. There is probably fluid retention due to the fluids not being pumped as vigorously by moving legs and other physical action etc. Some drugs (Lyrica) are removed from the body by renal excretion and if renal function is impaired by injury or the drug itself, fluids might accumulate. This my translate as swelling in the legs, hands and/or feet.

So, once a spinal cord injury occurs, the fight to keep weight off may be a problem. This of course depends on one’s metabolism, severity of injury, health prior to injury and self discipline both pre and post injury.

Saturday, 3 October 2009

Workdays - A Month In

It has been an interesting return to the workplace following a three year absence. As discussed in a previous post, navigation around my work area remains a challenge with narrow aisles, stray chairs, carts and discard bins. They always seem to migrate into the middle of the aisle making travel a challenge. Three hands would be most useful - one to hold work/supplies/items, one to push obstacles out of the way and the third to operate the joystick, powering the chair through the maze. Still my colleagues have been most patient and helpful.

It has amazed me how quickly the 'rust' comes off with old routines remembered and new ones acquired. Mentally it feels great to be back. Physically, the only challenge is the injury related pain. Searing nerve pain continuously burns from the knees downwards and on occasion the sciatic nerve pain makes sitting difficult. Legs dangling to the floor without much movement seems to accentuate the pain. I stand up and stretch out periodically to relieve the pressure and increase circulation somewhat. Still, it isn't the same as if one was to walk around the room or head off to coffee. Difficult to ignore the pain but can put it in the back of my mind somewhat in order to concentrate on my work. It seems to me that the Lyrica does nothing for the pain at my current dosage of 50 mg tid.

Core tightness remains a nuisance and with the continuous reaching, stretching, twisting and bending, the back muscles in particular, tend to get quite sore. I'm hoping that this eventually loosens up however at this time it almost seems as if the muscles rebel and try to tighten up even more in direct response to the stretching.

My workplace has always had rather poor ventilation and I have inherited the hottest corner of the department. The heat frequently results in perspiration and a dry mouth. Because this is a microbiology lab dealing with infectious agents, eating & drinking are not permitted in the lab. I'm trying to find an appropriate balance of fluid intake as too little may lead to dehydration while drinking too much fluid would have me going through a somewhat tedious* decontamination ritual in order to leave the lab and travel to the nearest wheelchair accessible washroom outside of the department.

*okay, not that tedious but when I want to leave the lab I have to;
  1. Stand up and take off my lab coat - without scattering my scissors, forceps, pens, markers, ruler & post-it notes all over the floor, as has occasionally happened.
  2. Replace the foot rests/supports as I wheel around the lab with the foot rests off and my feet raised. This allows me to get into tighter spaces, reach objects by standing up without having to toggle the supports out of the way, and allows me to spin in a tighter radius when turning around in the narrow aisles.
  3. Wipe down the wheelchair armrests, joystick controller and other parts that may have been exposed to possible contamination with a Virox (TM) antimicrobial wipe. Because of the harshness of the antimicrobial compound, non-latex gloves are recommended when handling the wipes. A step I tend to ignore.
  4. Travel to the dedicated hand washing sink, holding the joystick with the antimicrobial wipe so as to not recontaminate it, I then wash my hands for the recommended 15 seconds.
Then it's down the hall, out of the department and into a fairly decent wheelchair accessible washroom. On my return, having washed my hands, I take off the leg rests once more and don my lab coat to resume work. So, I try to minimize my excursions out of the lab area.

I have surveyed the hospital for all the wheelchair accessible washrooms as I know that sooner or later I'll encounter "my" washroom 'out of service' or occupied. Best to have a 'Plan B' before faced with a desperate situation.