Wednesday, 30 March 2016

A Decade Has Passed

A decade has passed.  It was around this time…late March and early April of 2006 when I went to bed with a backache and woke up a paraplegic.

The dates aren’t exact, whether though pain or feverish fogginess.  I don’t wish to remember details.
I thought it was just another severe backache, the third of such that I’ve experienced over the years.  What caused the backache is also uncertain as I had no recollection of having strained my back through any exertion.   As with the two previous episodes, the pain was so severe that it was excruciatingly difficult to lift my legs to step into my vehicle or into the shower.  It was so incapacitating that I literally had to hold onto the wall to inch my way along.  I thought this episode would pass as the other two had.

My doctor had recently given up his practice and I had yet to find another so I had obtained ‘pain killers’ and a muscle relaxant from a walk-in clinic.  No tests were performed.
Still, I had made it to work that ‘last’ morning to complete a task started the previous day - then left early.  I recall painfully stepping out of my van, not realizing it would be the last time I would exit from the driver’s side.  I made it home and collapsed in bed.

Time passed, I’m not sure how many days….all blurred through my fogginess.  I was so painful to even make a trip to the washroom that I had my wife bring me a container so that I wouldn’t have to make the fifteen foot excursion.   My aim wasn’t always accurate and the bed became additionally damp through sweat.  I recall one attempt to make it to the bath tub for a shower, yet unable to lift my leg high enough to climb in, I returned to my bed in defeat.  I now wonder if taking what shower would have resulted in a different outcome…

Sometime in early April I awoke with the realization that my legs would no longer move.   In disbelief I tried again.  Nothing!   I had my wife call for an ambulance and with that trip, my life changed forever.

Approximate Timeline of Significant Events: 
(for a more accurate timeline, individual previous posts can be followed)

Late May – Early April 2006:  Backache resulted in paralysis.  Diagnosis was a Staphylococcus aureus infection at the T-5 (?) and (?) T-7 spinal vertebrae.  (I’ve heard both anatomical locations mentioned)

April 2006; Spinal surgery to drain abscess followed by six weeks of intravenous antibiotics.

May 2006; wait for admission to Rehabilitation Hospital.

June 2006; admitted to Rehabilitation facility specializing in neurological illnesses and related treatment.

June to November 2006; Begin to receive physiotherapy for one hour daily, weekends excluded.

November 2006; notice the slightest movement in my legs.  Discharged from hospital.

January 2007; Inflammation recedes, and motion from core to legs begins to return.

March 2007 to summer 2010; receive physiotherapy about three times a week at my local community hospital. 
2010; Return to work, part time for two weeks, then full time (8 hour day).  Hospital physiotherapy department no longer accepts outpatients do to downsizing, therefore approach a private physiotherapy clinic for additional treatment.

October 2015; Retire from my employment.

Timeline of “Recovery” or at least changes in mobility, flexibility, pain and other medical sequelae of spinal cord injury.  (may seem somewhat redundant)

Late March or Early April of 2006; Spinal Cord abscess  due to Staphylococcus aureus infection at the T-5 and/or T-7 spinal vertebrae results in paralysis.

November 2006; just before discharge, notice slight motion when trying to draw knees together

January (early) 2007; Inflammation from injury recedes and motion dramatically increases in core and somewhat in legs.

January to March 2007; home therapy by visiting nurse comprised of basic exercises.

Sometime in 2007?;  I was discharged from the hospital with both urinary catheters and laxative 'magic bullets' as the belief was that these functions were lost to the injury.  On discharge, no instructions or expectations were offered.  I soon found that I needed neither of these as I could go fairly normally "on both accounts".  While I may no longer be able to hold it "until my teeth float", all plumbing has returned to normal.

March 2007 to Summer 2010; Physiotherapy at community hospital physiotherapy department strengthens legs and balance.  Improve from basic motion to walking with a walker.

2010; Physiotherapy department no longer accepts outpatients due to downsizing so I approach a nearby private clinic to continue therapy after work.  They can only offer simple therapy (stretching, massage, a crowded room to walk in).  Discontinue professional physiotherapy in spring of 2011 as I can do as much on my own in private.

2010; return to work which consumes a great part of my day.  Difficult to find time and energy for any sustained outside exercise or therapy.

2013; join a private gym to try to maintain and improve on flexibility and mobility.  Some improvement is noted.  Discontinue after two years due to time constraint and other obligations.

October 2015 to present; retired.

So Where Do I ‘Stand’ (?no pun intended?) a Decade Post Injury?

Like all others faced with such a catastrophic injury, my first thought was that “with hard work, I can beat this!”

Well, the bottom line is this; I went from total paralysis from my chest downward to now being able to stand upright unsupported if I first stabilize myself.  I can walk short distances with a walker.  ‘Short’ is hard to define as I really don’t have a longer clear, flat and unobstructed stretch where I can walk.  I have walked with the walker when necessary and climbed steps when I can utilize a handrail.

I can move some toes on each foot.  I have fairly good flexibility, but cannot sit back on my heels.  While I can lift my legs up and down while sitting in my wheelchair, I cannot bend them back while sitting in the same chair – I would have to lie on my stomach in bed to make this motion and I am in that position much less daily.  Those muscles, the ones which also would allow me to stand up naturally, without holding on to anything, remain weak.  This also translates into overall stability.

Core Stability and Tone; Muscles run along your entire frame from feet to shoulders and work in conjunction with each other.  When some are not working normally (normal range), other unaffected muscles will try to compensate but simply cannot work to their full capacity.  When I stand, my core stability is such that I always feel that if I tilt slightly off absolute vertical, that I would find it difficult, if not impossible to correct and would topple over in that direction if not for gripping the walker.  That tautness has not returned to hold me absolutely vertical without a struggle.  My core is tight and it there is a good deal of resistance as I try to twist at my waist.  I can however, bend without any difficulty and am able to pick up a sheet of paper dropped to the floor from my chair.

Proprioception returned slower than my basic mobility but it has returned.  I know where my feet are ‘in space’ although the senses may not be quite as precise as before.  Sensations of pressure and temperature have also returned but again may be somewhat muted or slower in being realized when changed.

Achilles’ Tendons; as mentioned in other posts, the Achilles’ are tight and keep my toes pointing downward towards the floor.  I blame the hospital stay for much of this.  Six months lying in a bed with no pressure on the feet allows the Achilles’ to shorten and retract.  Once they have done so, it is almost impossible to stretch them back out if you are not back on your feet constantly.  It’s a ‘catch-22’ as a recovering paraplegic you cannot be on your feet constantly.  Perhaps if they put your feet in some sort of rigid boot which applies a force preventing this from occurring, recovery would be faster.  However, the hospital had already written me off as to never walking again, so limited therapy was offered.  So, I have tremendous plantar flexion (rotating at the ankle to push down) and can stand on my toes, but while I do have dorsi-fexion (rotating my foot at my ankle upwards), it is not nearly as strong as downwards and toes cannot be raised as high off the floor.

Pain; Pain remains one of my greatest problems.  It is an unseen disability and is therefore hard to impress upon others, even doctors.  Pain so severe that it robs you of your concentration, and steals any remaining quality of life which remains post injury.  Anyone who has followed my posts knows I have severe neurogenic leg pain as well as sciatic nerve pain in my left hip –from both there is no escape.  Medication has little if any effect.

Spasms; what changed in my ninth year of paralysis?  Suddenly a second type of spasm manifested itself which I’ve called “atomic spasms”.  The spasms I endured for the first nine years would make their appearance at any time, however, much more frequently in the evening hours.  One leg or the other would repeatedly contract and relax, over and over, sometimes for a few minutes but more often for hours on end.  Once asleep, they would leave me alone until the next day.  In March of 2015, in addition to the regular spasms, I suddenly experienced these ‘Atomic Spasms’ which explode without warning and hold at the extreme displacement of the limb.  They may even sprain the joint!  They have thrown me from my bed and the limb cannot even be forced down pushing with both hands.  You cannot read, sleep or do any meaningful task while you limb is involuntarily bouncing around on the floor or bed during either spasm.  If I awake at night, I’m afraid to move as they may trigger these atomic spasms to start or resume.

Muscle Memory; a term used to explain your muscles recovering from injury.  It is a fallacy with spinal cord injury.  I couldn’t figure out how to turn over in bed and had to teach myself all over again.  Nothing came back ‘automatically’.

So, the bottom line is this; I am fairly self-sufficient in that I can look after myself without much outside input.  I get up in the morning, make my bed,  take a shower, cook and carry out most other functions independently and without any specialized equipment other than my powerchair.  I returned to work for almost six more years, enduring eight hour days not including travel.  I have yet to re-obtain my driver’s licence and purchase an accessible vehicle (van), primarily due to the costs involved.   I regret that my wife has to take over other duties which used to be mine.  She now does the laundry (yes, I used to do my own), we shop together where I often stopped off after work to pick up necessities.  She mows the lawn and takes out the garbage.  I try to step in and help where I can.

What’s to come?
Who knows?  Never in my wildest imagination did I think I would be spending my last days in life bound to a wheelchair.  I am stubborn and thought if I fought the good fight, I would overcome this disability.  I will continue to try to walk more, each and every day.  I should get to a pool where the buoyancy would assist my attempts to walk.  I am hoping to put together a home gym.

Final Note;
I own a two story house with bedrooms on the second floor.  Since coming home from the hospital, I’ve lived in our living room as my bed room.  I have command of three main floor rooms (not counting the washroom). The house was in the midst of repainting and redecoration when I became disabled.  Sadly it remains in that same state today.   Not much for the dreams and rewards of a lifetime of work.  I assembled a terrific woodworking shop in my basement where I intended to spend my retirement.  Not having been downstairs in a decade, my plans mock me.
Regrettably, one of the rooms that is still accessible to me is the kitchen.  Confined to the wheel chair, boredom is always hiding around the corner, and the most vigorous exercise I have is using a joy stick.  That fridge always beckons. 

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