Wednesday, January 1, 2014

Code Red

Blue alarm clock
(Photo credit: Wikipedia)
The bedside clock read 6:11 AM, and my brain had engaged, so there would be no falling back to sleep. Being the adequate husband that I am, I didn’t forget that this was Kim’s birthday – her 49th.
Almost every morning for the past several months I have needed Kim’s help to transfer from the bed to my wheelchair. Once in a while I’ve been able to complete this task myself, but it’s become rare. Given that this was her birthday, however, and she seemed to be sleeping so peacefully, I thought I’d give it a try.
I was pleasantly surprised when I was able to swing my feet off the bed and sit up with ease. The next step was for me was to lean forward as far as I could, almost kissing the wheelchair seat which was directly facing me. I marshaled the collective strength in my arms, my torso, and my legs, and in a coordinated if not graceful movement, I raised myself upward. I was standing, so to speak, with my knees against the front of the wheelchair. One hand was gripping each wheelchair arm rest. I took a quick breather and prepared for the grand finale.
This culminating movement requires me to pivot 180° counterclockwise and gently fall back into the wheelchair. In perfect synchronization with the body pivot, I have to move my right hand to the opposite arm rest and move my left hand to the bed. This may seem like a relatively complicated and risky maneuver, but when I’ve made it this far in the process I’m almost always successful with the final step.
I’m not even sure where the failure occurred. It all happened so quickly. I may have missed the bed with my left hand or missed the armrest with my right. Perhaps my legs got twisted or my knees buckled. No matter the cause, I found myself sinking into the gap between bed and wheelchair. I was as helpless as if I had stepped in quicksand on a 1970s TV show.
Front view of a Hoyer lift, used for lifting p...
Front view of a Hoyer lift, used for lifting patients into/out of bed. (Photo credit: Wikipedia)
A fall to the floor is not a good thing. First, I can injure myself. Second, even if I stick my landing (all 10.0’s except a 9.9 from the Russian judge) there is no easy way to get me up off the floor. Our recovery procedure calls for Kim to use an old, portable Hoyer lift that we inherited from my quadriplegic mother. We’ve only done that once before, and it wasn’t pretty.
But on this, Kim’s birthday morning, I hadn’t sunk all the way to the floor yet. If she could help me quickly enough, my transfer might be salvaged, although Kim’s blissful sleep couldn’t.
I yelled, “Code Red!”
Kim groggily responded with, “What?”
Only half awake, she had no idea what unintelligible sounds I was assaulting her with in the early morning darkness. Unwilling or unable to alter my communication strategy, I mindlessly repeated , “Code Red, Code Red!”
If time had not been of the essence, and copious amounts of adrenaline had not been coursing through my veins, I may have used my words to remind Kim of the meaning behind Code Red. A couple of months ago I was transferring from the shower seat into my wheelchair and I was having difficulty, so I called for Kim. I heard her talking to someone on the phone in the next room. After 30 seconds or so I determined that she wasn’t responding to my first call, so I added some urgency and volume to my request. “Kim!”
“Oh,” she said. “I heard you the first time, but I was on the phone and didn’t realize that it was urgent.”
Obviously, we needed a better system – one that didn’t rely on her interpretation of the level of panic in my voice. Here’s what we came up with. If I need Kim only at her earliest convenience, I will simply shout her name. If I need her with some urgency, but it isn’t a critical situation, I will shout, “Kim, code yellow.” When she hears this she will calmly, but without undue delay, stop what she is doing and walk over to assist me. If it is a real emergency, and I’m in danger of falling or in some way becoming injured, I need her to drop what she’s doing and run to my aid with reckless abandon. In this case I will shout, “Code Red!”
It seemed like a workable system. But then, as good luck would have it, no Code Yellow or Code Red situations arose for a long time- until Monday morning at 6:11 AM.
Finally, my urgent calls of “Code Red!” began to register in Kim’s head, and she sprang to action. With athletic prowess, she slid across the bed and wriggled one leg and one hand underneath me, and prevented me from falling further. She and I then began to work in unison to overcome gravity, maybe a quarter inch at a time, until my butt was on the wheelchair seat. “Great save, Kim!” I said in thanks.
I think this incident left a sufficient imprint in Kim’s mind so that when I invoke Code Red or even Code Yellow in the future, she’ll react immediately. In that sense, this near miss wasn’t such a bad thing after all.
Maybe part of the problem is that we need more creative terminology, instead of Code Red and Code Yellow. Suggestions?
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  1. Sorry about your near fall. I've been in situations that require help asap, but it's usually when no one is around. So any number of rainbow codes wouldn't help. And a Happy Birthday to Kim! I hope the rest of the day went well for her.2

  2. Happy birthday to Kim. I'm fortunate that the arms of my chair lift up out of the way rather easily for transfers. I use a specially coated slider board that enables quads to transfer independently. If you're interested, i'll find you the link. I know that slow sinking fall as well as the fast ones. I'm sorry it happened. Your story is unfinished though. Did you have enough energy after Code Red to carry out what you intended to do? I hope so. Happy New Year ;-)

  3. Happy New Year to both you and to Kim, and Happy Birthday to Kim!

    I think a simple "HELP!" works well. I am glad you weren't hurt. (and wouldn't a 45 degree transfer be easier?)

  4. Muffie, Kim did go on to have a nice birthday.

    Weeble, yes, please email me a link about your slider board. I took it easy after my code red for half an hour and I was good to go.

    Webster, the 45° transfer doesn't work for me because I need to have both arms supporting my weight at all times – at least I can't think of a way to make it work with that restriction.

    Everyone, Kim thanks you for the birthday wishes and we both thank you for the New Year's wishes. We hope everyone had a great New Year's holiday.

  5. I appreciate your description of the transfer. it is one of my biggest fears (one of them) to wake up and NOT be able to get out of bed. I keep my cell phone within reach so I can text or call my wife (we sleep in separate rooms). So far so good. I was reminded of a spell we spent in Children's Hospital when my daughter was sick, learning that if we heard over the intercom, "Dr. X, go to bed space 12 at your leisure," (or something like that), it meant it was not an emergency. If they left out the "at your leisure" part, it was an emergency. None of that "STAT!" that we hear in TV. They do this so as not to alarm the patients. Anyway, I'm glad you had Kim there to assist!

  6. Stephen, I won’t get into bed unless I know Kim is home for the evening. Like you, I don’t want to get stuck there. I thought about making our code words more incognito, so as not to concern any guests that might be present, but I can’t think of a phrase.

  7. Mitch,
    I think your code red system sounds very practical.
    Of course in Kim's defense, being in a sound sleep would make anyone less likely to react with a quick response.
    You're just goin' have to make a lot more noise (got any bells and whistles?) ;>)
    Seriously, glad to hear everything turned out okay.
    And would you quit reminding me of all these wonderful day to day experiences of life that we call the MS adventure. Oh the joy!
    So understand what you're saying. Keep your chin up or should I say your bottom up?
    Been there - done that.
    Take care and Happy New Year!
    Dee /OH

  8. Mitch, so sorry to hear about your near New Year's Day tumble. Before reading the comments here, my first thought was that you should get one of those slider board things, which I've heard can be very helpful when making a transfer. So, yes, take Weebles advice and do some investigation.

    Unfortunately, progressive diseases progress. As a proud liberal, I like to associate the word "progressive" with positive things, but in this case it's a decided negative. It would be more accurate to call this disease "Regressive MS".

    Anyway, happy birthday to Kim, hope you had a happy new year despite the near fall, and may 2014 find regression turned to progression for all of us, in the best sense of the word…


  9. Dee, I'm going to keep reminding you of my MS adventures! Happy New Year!

    Marc, I have encountered that semantic problem with civilians before. I said that my disease has continued to progress, and this left them with a very confused look on their face… I needed to clarify that progression is a bad thing in this case. Same problem with a negative test result for say, cancer, being a good thing. Happy New Year!

  10. The name of the slider board is Ultraslick. My naked but will slide across it. You custom order the length, and number of hand holes, if any. I use my hand holes. I've had this slider board for years and it's still really slick. I see with a quick google that it's available on Amazon too. Here's the link to the creator: Hopefully one more device that makes a part of your day easier or more independent.

  11. I second the sliding board comment! Does the place that you were going for therapy have a sliding board that you could borrow to try? Not sure if it would work for you but maybe if you could convince gravity to be your friend and your arms have enough strength it could work. The trick will be getting your w/c lower than the bed. Also, having a swing away arm rests would be helpful if using a transfer board. I'll have to check out the super slick one myself for work.

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  13. Jessica, the therapy place I go to is more geared towards exercise than wheelchair use, so I doubt they have a slide board, but I'll ask. It's going to be difficult for me to get my wheelchair lower than my bed. I think a slide board is in my future, but I'm not sure I need it now. My biggest difficulty is sitting up in bed and getting my feet on the floor without Kim's help. I'll have to do that with my pivot transfer or the sliding board. Other than that one morning I described in the post, my pivot transfer has been working pretty well. it's an evolving situation, and I need to be familiar with all of the tools available to me – so thanks to everyone for the slide board suggestion. I'll definitely look into it.

  14. I recently was given a leg lifter strap from the MSAA, and it was something I had not heard of before, but has become indispensable to me for getting my kegs into and out of bed, and the tub as well. Google it. They are widely available for less than $12.

  15. That would be legs... I leave my kegs elsewhere, thank you.

  16. Webster, my favorite occupational therapist brought over a leg lifter strap for me a couple of years ago, and we couldn't make it work. I think I'm beyond it, unfortunately. I sure wish there was a way for me to get my feet up into bed, so that I didn't have to involve Kim each time, but I've got nothing right now.