4:15 am: Bouncing in Bed

Not as exciting as one's mind may conjure from the title's description.

4:15 am and something is not right.  I feel a rocking motion but I'm not dreaming about sailing on the ocean.  Spasms!

Last night I had to wait for the creepy, buzzing, sparkling electrical feeling, above and beyond the constant burning sensation, in my bouncing, spasming right leg to subsided before I could fall asleep.

Now at 4:15 am I am awakened by my spasming left leg.  It is no use.  I can't get back to sleep; put the coffee on.

Right leg becomes "creepy" where it feels as if it inflates and a swarm of bees with extended stingers bounce around the hollow interior of my calf.  The sensation may also feel like the leg is filled with hot bubbling soda water with bubbles bursting as the touch the interior surface of the skin.  Or perhaps those Christmas sparklers which erupt in sparks when lit, each burning spark hitting the inside of my calf.  Then there are the rhythmic contractions; the pumping spasms - contract and relax, contract and relax, contract and relax - for up to six hours at a time.  Spasm may originate in the thigh but the calf is where the torment ultimately presents itself.

Left leg differs from right as the injury is not symmetrical. It seems as if the back gets tight and contracts tugging (stretching) on, or perhaps compressing the sciatic nerve.  These spasms can be of the simple variety as in contracting and relaxing or they can now be of the "atomic" variety where the leg contracts quickly and violently, trying to go past the range of motion that the joint was designed to offer.  These spasms may be so explosive and violent that they rival the speed at which an automobile air-bag would deploy as they try to disjoint your limb from its socket!  They can lift you up and even throw you from bed.

An interesting observation is that left and right never occur simultaneously (ie only one side spasms at a time).  There may be a momentary crossover when they change sides, but they really only happen on one side at a time.  Some sort of neurological pathway property??

Things aren't suppose to change so late post injury.  It was only last year, the ninth year post injury, that spasms woke me up.  They would run their course in the late evening and be done with until the following night.  Now they often wake me, extending their torment until dawn.

So too with the "atomic" spasms -the ones that try to disjoint you.  They started only in the ninth year (March) and have continued since.  Why so late when nothing else in my routine has changed?

So, running on about 4+ hours of sleep today.  Spasms can occur anytime, but they come with a vengeful force every nightfall.  I wonder what tonight will bring?

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Torment Carries a Timepiece

(or How do Spasms know it is Nightfall?)

Spasms seem to know when the sun is setting as they start up in earnest once evening arrives.  Another torment a spinal cord injury brings with it which in my opinion is worse than the paralysis.  Just when the day is over and you think you can relax. your physiology won't let you.  For me it starts with an increasing creepiness in one leg or the other.  The burning 'pins and needles' sensation increases to very uncomfortable levels - I don't know where to run...and I can't run anyways.  A tell-tale sign of what is about to follow.

Soon after the first spasm arrives.  A quick jerk of the leg.  The knee may just rise up off the bed slightly.  Soon after it is followed by another, and another and another as they grow in intensity.  At full throttle the entire leg can lift off the bed and crash back down, over and over and over.  Sometimes there is as little as 5 or 6 seconds between spasms, sometimes 10 or 15 seconds.  They are almost always rhythmic, uniformly keeping the period and the amplitude of the spasm.  I look at my leg and am reminded of a freshly caught fish jumping up and down on the dock, writhing in discomfort.

Spasms can last a few minutes but have lasted up to six hours.  If I tried to do leg lifts for six hours I wouldn't be able as fatigue would set in within a few minutes, yet the spasms seem to draw on some perpetual energy and keep on going, and, going and going.

How do you sleep when your leg is lifting itself off the bed repeatedly?  How do you get rest for work?  How do you keep your sanity?  I have thought of getting a knife and jamming int into the thigh muscle in hopes of turning off the mechanism!

The spasms have been so explosive and violent that they have thrown me from my bed.

So what causes them to occur?  An electrical impulse across nerve endings?  A persistent drip of neurotransmitter?  Does the spinal cord injury disrupt some sort of control or 'feed-back' mechanism which disperses the instigating cause when not intentionally needed by the person?

Why do they seem to start up at will and then after some variable period, shut down at will?  And most of all, why do they always seem to come on in force at nightfall?  Is there some change in body physiology that causes them to begin?

• It doesn't matter if my legs have been in a sitting position or lying down on a bed all day, they will still come on.  I thought it might be some fluid accumulation that causes the muscles to contract to disperse this fluid.  Whether I drink lots of fluids or few, it seems to have no bearing on whether the spasms arrive or not.
• Exercise also does not seem to affect the arrival, intensity or duration of spasms.  Whether I went to the gym, or walked with the walker, the spasms still occur.
• temperature (circulation?) - at times my legs have felt normally warm or unusually cool but this does not seem to be linked to my spasms.
• diet, weather, stress
• putting pressure on the foot sometimes seems to lessen the spasms, other times seems to have no effect.
• Why are spasms unilateral?  That is, only one leg will spasm at a time (thank goodness!), however there may be a few on alternate sides as they cross over if the don't end but decide to change sides.
• What other factors am I missing? 

Baclofen, a drug taken for spasticity seems to have little or no effect on the 'jumping leg spasms'.  When I tried to gradually reduce the dosage, I found an increase in overall stiffness but the "spasms" remained the same.

I now dread the setting sun knowing that my leg will become creepy and start jumping over, and over, and over.....

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