Another Milestone

This post may require some imaginative visualization to understand. Alternatively, you could get a transfer board and try some of this stuff. Your call.

It would appear that my core muscles have deteriorated to the point where I can no longer sit up without some sort of support, be it a wheelchair back or using my arm to grab my M-Rail or bracing on the armrests of my couch or chair. This has become particularly apparent in the last few days, with the usual side effects of muscle cramps and fasiculations. The muscle cramps are the worst, happening as they do in my side muscles around my trunk.

There are other implications from this weakness in my core muscles, especially when combined with my weaker arms. For example I can no longer make an up-slope transfer using my body alone. I need a push from someone else, or I need something to hold on to. Only if the slope is more than just the tiniest bit, I tend to slide back down regardless; my arms are not strong enough to hold me in the up-slope position. This is how I slid while getting into my truck; this is how I broke my foot.

The potential for risk here is higher than ever. This morning in the midst of a transfer my transfer board was not well positioned. It didn't push down the edges of my wheelchair seat cushion. The cushion is a Roho, a very expensive cushion with four separate air chambers and up to 120 separate balloon components which make up the seating area. These various components allow the cushion to change shape depending on how you sit, providing resistive support where needed.

The problem comes when my transfer board only rests on one of the quadrants. The quadrant in question pushes down while the opposing quadrants remain full height, creating a barrier to sliding off of the end of the transfer board. This has not been a problem up until now. In the past, I would simply push myself up slightly, forcing my rear end fully onto the cushion. These days I can't do that. The cushion wall is too much for me to surmount.

This morning I did that, placed my transfer board onto the front left quadrant without noticing. I was in a hurry. I slid down and hit the cushion edge. Unable to lift over that edge, I tried sliding back up onto my bed. I barely made it, using the wheelchair as a push point to get me going. Now, pushing on a wheelchair while trying to transfer is never a good idea. It went sideways. Fortunately I noticed and stopped everything.

There, sitting in mid-transfer, I simply flopped over so that I was laying on my bed, an easy thing to do with no core muscles. Then I grabbed the upper edge of my mattress and pulled myself up the transfer board as far as I could. Finally I used the M-Rail to return to a sitting position. I took a rest for a moment, or perhaps two, then re-positioned the transfer board to depress both the front left and right quadrants, and successfully made the transfer.

This is all new territory for me, being sufficiently weak that I cannot lift past the edge of a cushion quadrant. I've known it was coming; this is part of the reason I can no longer transfer off of my toilet. The angle of attack meant the cushion was in the way, and I am no longer strong enough to lift over it. Still, the inability to safely use a transfer board, one of the core tools of my daily existence, is deeply troubling.

Fortunately I have slings in place in the two critical transfer areas for my world, one in the living room and one in the bedroom. I am using them more and more. This is a trend which will continue. I am getting weaker. That's the way it goes.