Hey hey, hep cats. It's back to the city of motors, with tales for all to enjoy/be bored of/skip! Let's dig in.
As you may have picked up by now, I was down in Carlinville for the past week or so, having a raucous time meeting with case managers, getting a haircut, and going to the dentist. We did have some fun - happy 60th anniversary to the Grandparents Link! - but I missed out on Fourth-o-July festivities because I am an infection machine. I did have the opportunity to squeeze in a round of writing splint guitar before the week was over.
Yesterday's physical therapy was Giger-->FES bike-->weights downstairs, working on triceps and the variety of muscles used in rowing during the lifting portion. My triceps, though not functionally useful, appear to be a bit stronger every time :-) We also finished watching Miracle, and I talked to Jonathan Roche and the FlyLady while on the Giger.
Occupational therapy today = picking up various items and moving them to various places within my range of motion. I was a little late and more than a little sore from all the time in the car, so I felt even less productive than usual. There is some major envy of some people, such as a portion of the OT crew, who got to go to Rothbury... *due for my next Primus fix*
As I mentioned, I'm hurting a bit from the drive back and forth. It's anywhere between 9-12h to travel from Point A to Point B. To prevent major repetitive friction issues, I ride this long haul with a small ROHO cushion behind my lower back. However, such eliminates any lateral support from the chair's back rest; thus, I must brace myself with my elbows on the arm rests to keep from falling sideways. Doing so wears pretty hard on my neck, shoulders, and upper back - "coat-hanger" pain, for the shape of the affected regions. It was ouch enough that I had to take some pain meds before therapy, which I feel bad doing (although I really don't have a good reason why). If it counts for anything, though, it was only the children's Tylenol of prescription painkillers... Oh well! Whine whine.
Not much else worthwhile to say. Again soon it shall be. Peace yourselves out.
10 July 2008
09 July 2008
wow
Whatup, friends old and new! Beware: this post is sort of serious.
Allow me to explode with appreciation for - okay, pretty much everyone. Specifically, though, I would like to highlight two people I talked to today, whom you very likely already know.
Jonathan Roche is a personal trainer, double-digit marathon and triathlon competitor, and motivator extraordinaire. He spearheads many projects, such as the Momentum Fitness system and the No Excuses! workout (and more), focusing on helping normal people exercise and improve health without having to rewrite their entire lives. Inspiration level: astronomical. Check out Momentum Fitness/No Excuses, his radio show, and his Yahoo! group.
Next, one quite famously known as "The FlyLady" is another incredible motivator, with emphasis on simple accomplishments and easy daily routines that help people reclaim their lives starting on the home front, again without requiring commitment to unrealistic lifestyle changes. She’s a lifesaver and cheerleader offering free online help, centering on perfectionism, procrastination, and the accompanying guilt. Inspiration level: from 1 to 10, a 37.2. Check out her online resources.
Today my mom and I (mostly mom, as I was on the Giger) had the privilege of talking to this awesome pair on Mr. Roche's radio show on BlogTalkRadio (listen here). We discussed quite a bit of stuff, from my injury to surgery to college to rehab to what may lie in my future. Mr. Roche is swimming+biking+running in the grueling Ironman Triathlon on 20 July 2008, at the end of next week. He is generously donating funds raised from this event to my family to cover medical expenses and my continued rehabilitation. Wow.
You can help contribute, too, by pledging support to Jonathan - simply send a check made out
to "John Link Benefit Fund" to:
Breakthrough Health & Fitness, Inc.
370 Interlocken Blvd., Suite 400
Broomfield, CO 80021
Please include your full name and address. Understatement: your support is very much appreciated.
Let me point out that such people, including you, oh reader, amaze me. To barely know me, yet support so enthusiastically, is unbelievable... I don't want to lapse into too much Brie and Camembert here, but when it so often gets difficult just to keep plugging along, people like this (and you) reveal themselves.
Cheese aside, thanks. l8r.
Allow me to explode with appreciation for - okay, pretty much everyone. Specifically, though, I would like to highlight two people I talked to today, whom you very likely already know.
Jonathan Roche is a personal trainer, double-digit marathon and triathlon competitor, and motivator extraordinaire. He spearheads many projects, such as the Momentum Fitness system and the No Excuses! workout (and more), focusing on helping normal people exercise and improve health without having to rewrite their entire lives. Inspiration level: astronomical. Check out Momentum Fitness/No Excuses, his radio show, and his Yahoo! group.
Next, one quite famously known as "The FlyLady" is another incredible motivator, with emphasis on simple accomplishments and easy daily routines that help people reclaim their lives starting on the home front, again without requiring commitment to unrealistic lifestyle changes. She’s a lifesaver and cheerleader offering free online help, centering on perfectionism, procrastination, and the accompanying guilt. Inspiration level: from 1 to 10, a 37.2. Check out her online resources.
Today my mom and I (mostly mom, as I was on the Giger) had the privilege of talking to this awesome pair on Mr. Roche's radio show on BlogTalkRadio (listen here). We discussed quite a bit of stuff, from my injury to surgery to college to rehab to what may lie in my future. Mr. Roche is swimming+biking+running in the grueling Ironman Triathlon on 20 July 2008, at the end of next week. He is generously donating funds raised from this event to my family to cover medical expenses and my continued rehabilitation. Wow.
You can help contribute, too, by pledging support to Jonathan - simply send a check made out
to "John Link Benefit Fund" to:
Breakthrough Health & Fitness, Inc.
370 Interlocken Blvd., Suite 400
Broomfield, CO 80021
Please include your full name and address. Understatement: your support is very much appreciated.
Let me point out that such people, including you, oh reader, amaze me. To barely know me, yet support so enthusiastically, is unbelievable... I don't want to lapse into too much Brie and Camembert here, but when it so often gets difficult just to keep plugging along, people like this (and you) reveal themselves.
Cheese aside, thanks. l8r.
05 July 2008
repostfest
eek!
To start, you might notice that I reposted all the old stuff from CaringBridge to this site. Everything in May 2008 is a relic from those days. I recommend reading those entries if you have a minute, even if you rocked and kept up with them from the beginning... If you haven't gone through them yet, they contain quite a bit of useful info about me, surgery, and the start of rehab; if you had already glanced over them on the 'bridge, I changed/updated enough when re-posting that it's worth another perusal. Either way, I would greatly appreciate your comments on those entries so I can fill in missing info and start writing better overall.
Moving on, last week's therapy sessions weren't much to write home about - same PT capers as usual, plus stuff in OT that really doesn't seem to excite anyone but me... Lots of faux nerf equipment.
Speaking of home, that's where I've been for a few days and will be for a few more. It's nice to have a little break (and kitties and a subwoofer and constant secure internet), but rehabilitation is what I'm living for, so home is Detroit now. Oh well.
I thought I was going to write something interesting, but now I'm out of time :-( oops. Again soon it shall be. Continue to rock.
To start, you might notice that I reposted all the old stuff from CaringBridge to this site. Everything in May 2008 is a relic from those days. I recommend reading those entries if you have a minute, even if you rocked and kept up with them from the beginning... If you haven't gone through them yet, they contain quite a bit of useful info about me, surgery, and the start of rehab; if you had already glanced over them on the 'bridge, I changed/updated enough when re-posting that it's worth another perusal. Either way, I would greatly appreciate your comments on those entries so I can fill in missing info and start writing better overall.
Moving on, last week's therapy sessions weren't much to write home about - same PT capers as usual, plus stuff in OT that really doesn't seem to excite anyone but me... Lots of faux nerf equipment.
Speaking of home, that's where I've been for a few days and will be for a few more. It's nice to have a little break (and kitties and a subwoofer and constant secure internet), but rehabilitation is what I'm living for, so home is Detroit now. Oh well.
I thought I was going to write something interesting, but now I'm out of time :-( oops. Again soon it shall be. Continue to rock.
01 July 2008
trabajando con manuel
Whatup! To start, I'm headed home for about a week as of tomorrow (Wed) - drop me a message/comment/call/whatever if you will also be in the area, and we can organize some rendezvous action.
Moving on, here come a few mildly interesting points, like needles in a mudaneity haystack.
First, I started occupational therapy last Wednesday! This stuff focuses more on hand/wrist stuff and other fine motor skills as applied real world style. Sessions are MWF afternoons. So far, it's just been evaluation and some experimentation to figure out what to work on. Meetings are only about 45min! After spending 3h at a time up in PT, these sessions barely show up on the temporal radar.
Coolest thing we've done so far: submerged e-stim. Get FES e-stim equipment and a bucket. Fill bucket with water. Stick one electrode in water. Attach other electrode to forearm. Place hand in water. Turn on electricity. Watch magic.
Upstairs at PT, Wednesday was typical Giger-->weights-->FES bike. Woohoo. Friday was out of order; first was Giger, then a cut ahead to the zapcycle for circa 1h15min. Then...
I got to try out a manual chair with special grips to compensate for my lack of, umm, grip. Let me describe poorly. A typical manual chair essentially just has a smaller wheel attached to each of the large back wheels; to move, the user grabs and pushes forward or backward as necessary. You already knew that.
This chair instead had wider, flat, semi-sticky rims in place of the "smaller wheels". Then the idea is that the user may place the palms on the flat rim part, thumbs forward, and use the friction to push around. This eliminates the need for significant dexterity - where a tight grasp is necessary (or at least a huge advantage) in an average Joe chair, fingers aren't used with these flat rims. Gloves with sticky palms further improve the effect. So, someone with shoulder/arm/back muscles but no hand control may implement such a chair to move manually.
I try to be one of those people. I made two laps around the track, extremely slowly and with quite a bit of assistance, for a total of around 200 meters. Pretty pathetic, huh. I'm a wimp. To give myself a tiny bit of credit, though, the grip gloves I was using did not even remotely fit (must acquit!); also, as is evident in the picture, I am enormous and ordinary manual chairs are designed for munchkins. Oh well. BTW, the chest/shoulder wrap is obviously a fashion statement.
This implementation of manual chair propulsion for those with minimal dexterity is relatively common - I had seen chairs with similar flat rims in my time at the RISL. A less common style, which I had assumed to exist but not seen until coming to Detroit, is to have pegs (projections!) coming out of the otherwise-unmodified "smaller wheel" type of grips. I always think of these as being like the wheel at the helm of a pirate ship... Imagine as you wish. With such rims, the user may push the palms or thumbs against these pegs for propulsion. These are what I was and still am hoping for, but no appropriately-equipped chairs are readily available here. According to basic physics, these make more sense than the flat+sticky kind: all of the user's energy is directed tangent to the wheel - the direction that actually causes rotation, and therefore motion - rather than expending some energy non-tangentially to create enough friction to rotate the wheels. Since I'm such a pathetic weakling, I don't really have enough strength to direct some away from movement and still expect to go anywhere. We'll see how it goes, matey.
Pack pack pack. Thanks for checking in. Palabra.
Moving on, here come a few mildly interesting points, like needles in a mudaneity haystack.
First, I started occupational therapy last Wednesday! This stuff focuses more on hand/wrist stuff and other fine motor skills as applied real world style. Sessions are MWF afternoons. So far, it's just been evaluation and some experimentation to figure out what to work on. Meetings are only about 45min! After spending 3h at a time up in PT, these sessions barely show up on the temporal radar.
Coolest thing we've done so far: submerged e-stim. Get FES e-stim equipment and a bucket. Fill bucket with water. Stick one electrode in water. Attach other electrode to forearm. Place hand in water. Turn on electricity. Watch magic.
Upstairs at PT, Wednesday was typical Giger-->weights-->FES bike. Woohoo. Friday was out of order; first was Giger, then a cut ahead to the zapcycle for circa 1h15min. Then...
I got to try out a manual chair with special grips to compensate for my lack of, umm, grip. Let me describe poorly. A typical manual chair essentially just has a smaller wheel attached to each of the large back wheels; to move, the user grabs and pushes forward or backward as necessary. You already knew that.
This chair instead had wider, flat, semi-sticky rims in place of the "smaller wheels". Then the idea is that the user may place the palms on the flat rim part, thumbs forward, and use the friction to push around. This eliminates the need for significant dexterity - where a tight grasp is necessary (or at least a huge advantage) in an average Joe chair, fingers aren't used with these flat rims. Gloves with sticky palms further improve the effect. So, someone with shoulder/arm/back muscles but no hand control may implement such a chair to move manually.
I try to be one of those people. I made two laps around the track, extremely slowly and with quite a bit of assistance, for a total of around 200 meters. Pretty pathetic, huh. I'm a wimp. To give myself a tiny bit of credit, though, the grip gloves I was using did not even remotely fit (must acquit!); also, as is evident in the picture, I am enormous and ordinary manual chairs are designed for munchkins. Oh well. BTW, the chest/shoulder wrap is obviously a fashion statement.
This implementation of manual chair propulsion for those with minimal dexterity is relatively common - I had seen chairs with similar flat rims in my time at the RISL. A less common style, which I had assumed to exist but not seen until coming to Detroit, is to have pegs (projections!) coming out of the otherwise-unmodified "smaller wheel" type of grips. I always think of these as being like the wheel at the helm of a pirate ship... Imagine as you wish. With such rims, the user may push the palms or thumbs against these pegs for propulsion. These are what I was and still am hoping for, but no appropriately-equipped chairs are readily available here. According to basic physics, these make more sense than the flat+sticky kind: all of the user's energy is directed tangent to the wheel - the direction that actually causes rotation, and therefore motion - rather than expending some energy non-tangentially to create enough friction to rotate the wheels. Since I'm such a pathetic weakling, I don't really have enough strength to direct some away from movement and still expect to go anywhere. We'll see how it goes, matey.
Pack pack pack. Thanks for checking in. Palabra.
23 June 2008
offshore scratchiness
Hey hey. I like to make up words. Here goes.
Therapy sessions: last week's sessions were just not so great. I've been a bit sick lately, and thus did not have a good time. Today's session wasn't too bad, though! It was the usual Giger/sitting balance/electrobike schedule, but my usual therapist crew were MIA, so sitting balance in particular was different given the different team. Anyway, I got to do some new arm exercises with neato wrist weights during breaks from uprightness. Weee. Hopefully this week will continue to be quite a bit better.
Complaining: I've been sick. This is where living in Smalltownsville is much more simple/convenient - let's just say the diagnosis and treatment process is fast and smooth in the land where everyone knows everyone else. Here, the most effective way to get things done is to go emergency-style and jump through hoops for a few hours... Blah. BTW, DMC guarantees that you will see a doctor in 29min or less (or something to that effect); this is not the same as being treated/in and out in that amount of time! Oh well, whine whine.
Coolness: First of all, some pals of the awesome variety dropped by on Sunday. Rock.
Also, my "line of irritation" is moving down! Sounds bad already, huh. Here's what I mean. On the edges of areas where I have full sensation, i.e. where "normal" sensation transitions into "limited", I am waaay hypersensitive to touch. It's like having a vicious sunburn all the time in those places. The injury left me with full sensation only above C5, so really just my head and neck have normal feeling. That leaves the line to be along the tops of my shoulders, down to an inch or two below the collar bone, as well as on my deltoids and upper arms. Now I've noticed that the line has crept down my arms, into my forearms on both the radial (thumb) and ulnar (pinky) sides. My hands don't hurt, but I don't expect them to because their sensation develops very quickly enough to skip that step. This is pretty spiff - if my explanations aren't clear enough (likely!), it means that perhaps I'm making significant gains in advanced sensation... Fancy stuff like temperature and sharp things and whatnot might appear sooner than I thought. As in, ever. I must admit, it's nice to be invincible to needle pokes, but I'll gladly trade that for the possibility of holding your hand and feeling its warmth.
And not wanting to injure you for touching me.
Therapy sessions: last week's sessions were just not so great. I've been a bit sick lately, and thus did not have a good time. Today's session wasn't too bad, though! It was the usual Giger/sitting balance/electrobike schedule, but my usual therapist crew were MIA, so sitting balance in particular was different given the different team. Anyway, I got to do some new arm exercises with neato wrist weights during breaks from uprightness. Weee. Hopefully this week will continue to be quite a bit better.
Complaining: I've been sick. This is where living in Smalltownsville is much more simple/convenient - let's just say the diagnosis and treatment process is fast and smooth in the land where everyone knows everyone else. Here, the most effective way to get things done is to go emergency-style and jump through hoops for a few hours... Blah. BTW, DMC guarantees that you will see a doctor in 29min or less (or something to that effect); this is not the same as being treated/in and out in that amount of time! Oh well, whine whine.
Coolness: First of all, some pals of the awesome variety dropped by on Sunday. Rock.
Also, my "line of irritation" is moving down! Sounds bad already, huh. Here's what I mean. On the edges of areas where I have full sensation, i.e. where "normal" sensation transitions into "limited", I am waaay hypersensitive to touch. It's like having a vicious sunburn all the time in those places. The injury left me with full sensation only above C5, so really just my head and neck have normal feeling. That leaves the line to be along the tops of my shoulders, down to an inch or two below the collar bone, as well as on my deltoids and upper arms. Now I've noticed that the line has crept down my arms, into my forearms on both the radial (thumb) and ulnar (pinky) sides. My hands don't hurt, but I don't expect them to because their sensation develops very quickly enough to skip that step. This is pretty spiff - if my explanations aren't clear enough (likely!), it means that perhaps I'm making significant gains in advanced sensation... Fancy stuff like temperature and sharp things and whatnot might appear sooner than I thought. As in, ever. I must admit, it's nice to be invincible to needle pokes, but I'll gladly trade that for the possibility of holding your hand and feeling its warmth.
And not wanting to injure you for touching me.
13 June 2008
plus a thousand words
Whatup friends! Update on the past few days, sort of.
Therapy:
Wednesday was typical Giger --> weights --> zap bike. Nothing magical.
Today, Friday, saw Giger --> sitting balance --> e-stim bike. Also superficially unentertaining. However,
I sat up slash leaned around with my hands grip-gloved to a bar for 20min at a time! For those keeping score, that's several minutes longer than on Monday, and easily ten times as long as the usual before this week. Total sitting time was about an hour. It was a bit difficult, as I barely have any of the necessary muscles... In particular, the back of my neck hurts from trying to hold my head up perfectly (and failing) for so long. Oh well. No pain no, umm, pain meds? Whatev.
Speaking of feeling like someone slashed my neck open with a knife, it's been more than two months since surgery! Also, if I count correctly, I've been at rehab for... three? Four weeks? No, five wonderful weeks of therapy, ah ha ha ha ha! (Okay, so nobody's going to get that one.) Time is screaming by. Just throwing that out there.
C'est tout pour aujourd'hui. Thanks for reading and commenting and whatnot! You're so incredibly awesome. Rock it.
Therapy:
Wednesday was typical Giger --> weights --> zap bike. Nothing magical.
Today, Friday, saw Giger --> sitting balance --> e-stim bike. Also superficially unentertaining. However,
I sat up slash leaned around with my hands grip-gloved to a bar for 20min at a time! For those keeping score, that's several minutes longer than on Monday, and easily ten times as long as the usual before this week. Total sitting time was about an hour. It was a bit difficult, as I barely have any of the necessary muscles... In particular, the back of my neck hurts from trying to hold my head up perfectly (and failing) for so long. Oh well. No pain no, umm, pain meds? Whatev.
Speaking of feeling like someone slashed my neck open with a knife, it's been more than two months since surgery! Also, if I count correctly, I've been at rehab for... three? Four weeks? No, five wonderful weeks of therapy, ah ha ha ha ha! (Okay, so nobody's going to get that one.) Time is screaming by. Just throwing that out there.
C'est tout pour aujourd'hui. Thanks for reading and commenting and whatnot! You're so incredibly awesome. Rock it.
09 June 2008
dysreflexia with a smile?
Whatup! Good enough day of therapy to warrant an update before I forget, but you'll have to dig in pretty far to get to the happy part.
The day actually started out not so great. I woke up around 4:30a and couldn't get back to sleep - that means maybe 3.5h of z time, slightly reminiscent of school... Then we started getting up at 7:00 to be on time for the typical Monday's bummer of a 9:00 session. Blah.
---[don't be worried in this part]---
Commence Giger. Pedal pedal pedal. After a little while - not even 1000 revs, as the resistance was up perhaps just a bit too high - I could feel my blood pressure creeping up. I was having a rather difficult and rather not fun time on the Giger already, so once the BP jump started, I wasn't sad to ask to get out of the machine. Good idea.
Feel free to e-mail me questions (thejlink at gmail dot com) or post in the comments if the following is incomplete, confusing, or flat out incorrect. For that matter, I'd appreciate confirmation that I have a clue what I'm talking about...
Quick medical lesson: Autonomic dysreflexia (AD) is a syndrome that troubles many spinal cord injury patients with higher injuries, including me. The deal with AD is that the brain/body (the "autonomic" part) misinterprets and therefore incorrectly responds to messages sent from stuff below the level of injury (the "dysreflexia" part). Common messed up signals are temperature extremity/irregularity, needing to go to the bathroom, and anything that should cause pain, among others. Common reactions are nausea, sweating, body temperature change, a dramatic increase in blood pressure, redness, headaches, dizziness, eye pain and more. Severe dysreflexia, not treated right away, can cause stroke and death and stuff. Don't be scared! It's not a big deal, and even useful on occasion, as long as everything is under control. Treatment involves (1) fixing the reaction and (2) removing the stimulus that is causing the problem. That wasn't a quick medical lesson at all!
In short, the patient has to go to the bathroom or whatever, but instead of communicating "I need to go!" with the normal recognizable feelings and signs, the brain cranks up the blood pressure knob, causing headaches and redness and such. To fix, the patient must be moved to as much of an upright position as possible, fetch ice packs, take the appropriate drogas if necessary, and do whatever else may be done; then, hopefully at the same time, the patient needs to empty the bladder, get off the pressure sore, find a cooler location, or stop whatever else is causing the dysreflexia.
Another note before we continue: The Giger is just about the worst position to be in when this happens. If you're lying on your back with appendages up in the air, your circulatory system doesn't really want to bother pumping blood up against gravity, so most of the blood just flows around in your head/torso. Throw in some distal vasoconstriction, and there is more fluid divided by the same volume equals higher pressure. Uh oh.
Yet another: I was prescribed an abdominal binder last week to help boost the BP, and I've actually been wearing it. As far as we're concerned, the binder is a medical corset.
So anyway, that's where I was, strapped into the inverse turtle equipment and starting to get dysreflexic. The therapists are of course very familiar with this stuff, so I was develcroed, debindered and upright at top speed. They even took my shoes off, a trick I had forgotten. To monitor pressure, I was equipped with the "angry nurse" automatic digital wrist sphygmomanometer. She loses some accuracy as pressure strays from 120/80, but this time she measured a ridiculous-but-dramatic 240/160 [corrected: thanks]! Eek! That's about four times my usual measurement, and even double that of the average human... There's no way my BP was that high, but it was ludicrous and temporarily frightening enough to evoke some therapeutic language from those around me.
No really, 240 systolic is a guaranteed stroke, and I'm still alive, my eyes didn't explode, and I'm, umm, as coherent as I get... The angry nurse is a sensationalist. Dysreflexia typically means catheter time for me, ooh yay, so that was taken care of and all was well. Game on, end scary.
---[stop not worrying]---
Here is where the rehab session was smiles. Getting back on the Giger would have been fear-provoking and a waste of time, so we moved on to mat work. Usually after the cath my BP drops back down to the point of nonfunctional dizziness... Not today. I went straight to sitting upright at the edge of the mat with no intermediate rest period, and I was able to stay upright and lean side to side with my arms on giant exercise balls [insert AC/DC song here] for about 15min without stopping to recline! This usually only lasts for 1-2min at a time before I get dizzy, with pretty heavy neck pain after two or three bouts of uprightness. Eeee! I ended up taking only two breaks total during my entire time on the mat, racking up about 30min of sitting without blood pressure loss or neck ouchness. :-)
Okay, that probably doesn't sound very exciting to you, but I felt slightly less abnormal, at least for those few minutes...
I also interrogated my main therapist about her trip to Alaska during the short sit, albeit not very well because it's a bit hard to breathe with the abdobinder. Then it was time for e-stim biking and Wii watching to round out the session. Last week someone Wii-bowled a 279. Wow.
The rest of the day was also pretty good. I even squeezed in a tiny nap.
I have no idea why this all worked out as such, but it was quite serendipitous. Hmm.
The day actually started out not so great. I woke up around 4:30a and couldn't get back to sleep - that means maybe 3.5h of z time, slightly reminiscent of school... Then we started getting up at 7:00 to be on time for the typical Monday's bummer of a 9:00 session. Blah.
---[don't be worried in this part]---
Commence Giger. Pedal pedal pedal. After a little while - not even 1000 revs, as the resistance was up perhaps just a bit too high - I could feel my blood pressure creeping up. I was having a rather difficult and rather not fun time on the Giger already, so once the BP jump started, I wasn't sad to ask to get out of the machine. Good idea.
Feel free to e-mail me questions (thejlink at gmail dot com) or post in the comments if the following is incomplete, confusing, or flat out incorrect. For that matter, I'd appreciate confirmation that I have a clue what I'm talking about...
Quick medical lesson: Autonomic dysreflexia (AD) is a syndrome that troubles many spinal cord injury patients with higher injuries, including me. The deal with AD is that the brain/body (the "autonomic" part) misinterprets and therefore incorrectly responds to messages sent from stuff below the level of injury (the "dysreflexia" part). Common messed up signals are temperature extremity/irregularity, needing to go to the bathroom, and anything that should cause pain, among others. Common reactions are nausea, sweating, body temperature change, a dramatic increase in blood pressure, redness, headaches, dizziness, eye pain and more. Severe dysreflexia, not treated right away, can cause stroke and death and stuff. Don't be scared! It's not a big deal, and even useful on occasion, as long as everything is under control. Treatment involves (1) fixing the reaction and (2) removing the stimulus that is causing the problem. That wasn't a quick medical lesson at all!
In short, the patient has to go to the bathroom or whatever, but instead of communicating "I need to go!" with the normal recognizable feelings and signs, the brain cranks up the blood pressure knob, causing headaches and redness and such. To fix, the patient must be moved to as much of an upright position as possible, fetch ice packs, take the appropriate drogas if necessary, and do whatever else may be done; then, hopefully at the same time, the patient needs to empty the bladder, get off the pressure sore, find a cooler location, or stop whatever else is causing the dysreflexia.
Another note before we continue: The Giger is just about the worst position to be in when this happens. If you're lying on your back with appendages up in the air, your circulatory system doesn't really want to bother pumping blood up against gravity, so most of the blood just flows around in your head/torso. Throw in some distal vasoconstriction, and there is more fluid divided by the same volume equals higher pressure. Uh oh.
Yet another: I was prescribed an abdominal binder last week to help boost the BP, and I've actually been wearing it. As far as we're concerned, the binder is a medical corset.
So anyway, that's where I was, strapped into the inverse turtle equipment and starting to get dysreflexic. The therapists are of course very familiar with this stuff, so I was develcroed, debindered and upright at top speed. They even took my shoes off, a trick I had forgotten. To monitor pressure, I was equipped with the "angry nurse" automatic digital wrist sphygmomanometer. She loses some accuracy as pressure strays from 120/80, but this time she measured a ridiculous-but-dramatic 240/160 [corrected: thanks]! Eek! That's about four times my usual measurement, and even double that of the average human... There's no way my BP was that high, but it was ludicrous and temporarily frightening enough to evoke some therapeutic language from those around me.
No really, 240 systolic is a guaranteed stroke, and I'm still alive, my eyes didn't explode, and I'm, umm, as coherent as I get... The angry nurse is a sensationalist. Dysreflexia typically means catheter time for me, ooh yay, so that was taken care of and all was well. Game on, end scary.
---[stop not worrying]---
Here is where the rehab session was smiles. Getting back on the Giger would have been fear-provoking and a waste of time, so we moved on to mat work. Usually after the cath my BP drops back down to the point of nonfunctional dizziness... Not today. I went straight to sitting upright at the edge of the mat with no intermediate rest period, and I was able to stay upright and lean side to side with my arms on giant exercise balls [insert AC/DC song here] for about 15min without stopping to recline! This usually only lasts for 1-2min at a time before I get dizzy, with pretty heavy neck pain after two or three bouts of uprightness. Eeee! I ended up taking only two breaks total during my entire time on the mat, racking up about 30min of sitting without blood pressure loss or neck ouchness. :-)
Okay, that probably doesn't sound very exciting to you, but I felt slightly less abnormal, at least for those few minutes...
I also interrogated my main therapist about her trip to Alaska during the short sit, albeit not very well because it's a bit hard to breathe with the abdobinder. Then it was time for e-stim biking and Wii watching to round out the session. Last week someone Wii-bowled a 279. Wow.
The rest of the day was also pretty good. I even squeezed in a tiny nap.
I have no idea why this all worked out as such, but it was quite serendipitous. Hmm.
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