Monday, 1 August 2016

I Fell

I fell last night. I fell out of my wheelchair. Yes, it is possible. No I was not drunk. Yes I was sober. Even in the best of conditions, this kind of thing can happen, and last night it did. I had just made the transfer from my couch to my manual wheelchair. I was not quite squarely in position. I can't get squarely into position until my feet are up on the pads of the leg rests on my chair. So I leaned forward to adjust the foot pad, something I do several times every day. This time, however, I was wearing my sports pants, not my jeans. My sport pants are slippery. My balance is bad. Between the two of them, I went forward full tilt and onto the floor.

I wasn't injured, although my pride took a hit. As I was falling I yelled loud enough that Adam thought there might be a fight on the street below. Then I called him for help. He bounded out of his bed, onto the scene, and asked the most important question first. Was I hurt? No. I was a bit twisted up and my head hurt a little from the jarring, but I was basically unharmed. So I slide over to my sling track and we used the sling to lift me back into my wheelchair, whereupon we both returned to our evening of rest.

This incident, though, is important for reasons beyond a bit of an over-reach and slippery pants. For some time now I have been talking about the hidden progression of ALS, the loss of muscles unseen. This is particularly true with the loss of my "core muscles". These are the muscles in the middle of my body, the trunk. My version of ALS has been moving upwards from my lower legs to my thighs. It has wreaked havoc on my core muscles, leaving them substantially weakened, and is now moving into my shoulders.

These core muscles, and the loss of them, are hidden to most. They are the muscles that help hold you upright, that stop you from tipping over. They are the muscles that help you defecate, and for women they push out babies. Essentially they are everything between your shoulders and your legs. Major muscles included are the pelvic floor muscles, transversus abdominis, multifidus, internal and external obliques, rectus abdominis, erector spinae (sacrospinalis) especially the longissimus thoracis, and the diaphragm. Minor core muscles include the latissimus dorsi, gluteus maximus, and trapezius.

These are the muscle that hold your posture. I can just hear my Dad in my head these days saying "Sit up straight." I can't. Nor can I stop myself from falling over once I am past my center of balance. Those muscles are no longer strong enough to stop me. And that's what happened last night. I moved past my tipping point, and over I went, out of the chair and onto the floor. No stability, No strength. No balance.


  1. Thats horrible richard, glad you werent hurt. You said you feel its attacking your core muscles now eg your diaphram. How is your breathing going do u use a bipap machine? And also i have read your previous blod entries. You said at one point in time i cant remember when, if they found a cure to stop the progression of als would you takr it now at the stage you were at - at the time, and you said yes. Do you still feel this way?

    1. My breathing is good, virtually unchanged since the beginning of ALS. No bi-pap. Today's blog might answer your other questions.

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