Tuesday, June 25, 2013

How Far I Have Fallen

English: Drawing of a falling/floating man
(Photo credit: Wikipedia)
One day last week during a transfer from the toilet seat to my wheelchair, I felt my body suddenly pitch forward, and I knew I was fucked.

It had been a couple of years since I had fallen. Back when I was a semi-walker, cane user, or scooter rider, I would fall more frequently because I was upright more frequently. Now that my only two positions in life are sitting or lying down, I rarely fall. It’s one of the paradoxical benefits of my creeping paralysis.

My most complicated transfer is that one from the toilet to my wheelchair. It is the long division of transfers, the Rubik’s Cube of disabled maneuvers. My movements are well practiced, however, and when properly executed this process goes off without a hitch. At this house, with this toilet, I enjoyed an unblemished record until last week.

The critical step in the process is when I reach with my left hand for the left armrest of my wheelchair. When that connection is made, all I need to do is pivot my body a little and drop backwards into the chair. Once, about six months ago, my hand slipped off the arm rest, but fortunately I fell right into the wheelchair. I wasn’t so lucky this time.

When my hand missed the armrest my entire body began nose-diving toward the hard bathroom floor. There was nothing for me to do except mentally brace for impact. I landed flat on my front side. I was somewhat shaken up from the fall and literally buzzing from the shot of adrenaline coursing through my veins. Nevertheless, I calmly began to solicit status reports from different parts of my body. I noted several areas of discomfort and irritation. Amazingly (if I was religious I might say miraculously), I didn’t sense any significant pain. Apparently, I had survived the fall very well.

As luck would have it my son Zach was home on his college break, and he responded to my request for assistance. The first thing I asked him do was pull up my pants so that my bare ass was no longer exposed. I’m not sure which of us was more relieved when that was taken care of. Next, I had him roll me over on my back and place a pillow behind my head. I reached in my shirt pocket, pulled out my cell phone, and called Kim at work. I knew that it would take two people and some ingenuity to get me back into my wheelchair.

imagesThe three of us brainstormed for configurations that might get me off the floor. Zach and Kim did some pulling and tugging on me, but it always resulted in pain in my shoulders or lower back. My body has become very stiff over the years, and any pressure applied in an unusual direction is not well received. Eventually I remembered that after my mother passed away five years ago we had taken possession of her portable Hoyer lift. My mother was a quadriplegic and used this device to transfer from her bed to her wheelchair and back again. I thought that someday I might need it for my own routine transfers. That day hasn’t arrived yet, but it was time to try out the Hoyer lift to solve this particular conundrum.

Kim and Zach rummaged through the attic and the shed, found all the parts, and assembled the unit. Kim rolled me on my side and laid the canvas sling under my butt. Ever so slowly Zach worked the lifting lever while Kim supported me. It wasn’t pretty – we didn’t really know what we were doing. But eventually I was high enough so that we could slide the wheelchair underneath me, and release the lift. We uttered a collective sigh of relief. Kim went back to work. Zachary went back to his video games. I went back to my beloved computer.

Perhaps a normal person would have been flustered, embarrassed, or disheartened by this experience. I’m glad that I’m emotionally stunted and not a normal person. As I’ve written before, I have a genetic predisposition toward emotional resilience. For example, at several points in the Hoya lifting process, much to Kim’s annoyance, I would call a time-out and have Zachary shoot a picture with my iPhone. Even in that stressful situation I was thinking ahead to this future blog post. In my mind, I imagined I would come off as outwardly composed and reasonably handsome throughout the whole episode. However, the photos instead revealed an old, fat guy who looked and felt like a beached whale. So I deleted them all. MS has taken so much from me, but a smidgeon of vanity remains.

So, how far have I fallen? An isolated event such as this one doesn’t necessarily signify new disease progression. In fact, given the complexity of this transfer, a fall was statistically overdue. I’ll simply try to be more careful during that critical part of the transfer, and maybe buy a couple more years before I fall again. If I’m wrong, and I am losing my ability to execute this transfer safely, then we’ll simply need to get creative. It won’t be the first time or the last time we’ve done that.
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  1. Mitch, I'm so sorry you took such a nasty spill. I know for myself -- still somewhat ambulatory -- I have to pay attention to my every move or I'll fall. At least you weren't seriously injured.

  2. How nifty to actually have a lift in the attic! Another option is to call the (non-emergency number of the) fire department. In most jurisdictions they'll send hefty guys over to haul you up.

  3. I, too, am glad you weren't hurt, and that Zach was home, and Kim works nearby, and that you had all the parts of your Mother's old hoyer lift readily available.

    If it were me, I'd opt for the burly firemen. They're only a mile away. Actually, I should pay them a visit one day and discuss how they should enter my house without breaking in. Our yard is totally fenced except for the front locked door.

  4. Oooh, been there, done that, no fun. Glad you weren't hurt. Like you, I stopped falling when I stopped trying to stand up and transfers became a two-person affair. Since then, I've had one 'controlled slither' to the bathroom floor. I was relieved and somewhat surprised that Scarecrow was able to get me back in my chair. Most of the time we can still manage a quasi-stand-and-pivot transfer, but getting a body off the floor is a whole 'nother thing.

    We have a Hoyer lift and we've tried using it a couple of times, mostly to see if we could. We'll have to get a whole lot better at it, and transfers will have to get a whole lot harder, before that starts looking like the way to go.

  5. last time i fell it was at the top of the stairs, and i was able to fall backwards - back of my head to the floor-level radiator - and not the long, fast, and painful way downstairs. i also slipped out of an easy chair, and had to call the local rescue to come heave my fat ass back up. sometimes i wonder if, like deciding to give up driving, there comes a time to choose to give up walking. if only to avoid future humiliation.

  6. Muffie,

    I certainly was lucky!

    Katja and Loretta,

    I'll keep the firemen option in mind, but I know lots of people who live within a few miles. But if I were a lady...I hear what you're saying ;-)


    I think an appointment with a physical therapist might be time well spent for you. With some instruction and practice you'll find a Hoyer lift is rather straightforward. It was for my mother and her helpers, anyway.


    You were lucky with that fall! I remember thinking the same way as you when I could still manage a little bit with forearm crutches and a scooter. I almost looked forward to the day that I would be restricted to a wheelchair, just to make life simpler and safer. I got my wish!

  7. My EXACT transfer from loo to power chair---when I can get "lift off." I too have fallen into the chair, but rarely can right myself. I live in an assisted living home now or I'd need a Hoya Lift around too. Falling is no fun, but I'm still only in my 50s...no broken bones yet. I'm afraid falling is a side effect of MS. Glad you were not hurt. We roll on!

  8. Diane, in recent days I have made some adjustments to my procedure. I raised the toilet seat 2 inches, and I now position my wheelchair differently. I think this will do the trick – for now. Sorry that you are also having trouble but misery does love company ;-)