Letting the Chips, or Me So To Speak, Fall Where They May

My falls have occurred with such frequency and severity that I have begun looking for solutions. I have discussed this at great length with doctors, spoken with someone at the United Cerebral Palsy Association of Oregon, participated in physical therapy and conducted networking and research.

One thing I am doing is logging my falls-frequency, intensity and antecedents-what happens immediately prior to them. I try to identify which foot or action gives me more trouble. What environmental factors are more troublesome such as cracks in sidewalks, inclines or declines? This strategy has enabled me to identify patterns in my habits and movements.

I have learned that, when I fall the first time in a month, I can be certain I will have two to four more falls before the cycle stops. It seemed they occurred in association with my period. I was often more fatigued and stressed during this time of the month. However, I am post-menopausal now, and my falls still occur with regular frequency. Stress and fatigue make me more prone to falling. This is so apparent that family members remind me to be careful when I am preparing to travel or they know I am extremely upset. When I am busier, I need to caution myself to slow down, cut back or move with more forethought and planning.

I discovered that my right toe catches more than my left. I determined that backing up and pivoting to turn caused the majority of my falls.

I learned about a surgery that could cut a tendon in my ankle that might improve the way I walk. I went to see an orthopedic surgeon who watched the way I walk and suggested that I try leg braces before trying surgery. Leg braces were designed for me that kept my foot in a more neutral position and didn’t allow my toe to drag as much. After concerted effort and consultation with physical therapists, we determined that the leg braces did not make significant improvement.

My doctors have referred me for physical therapy to try gait training. I have learned some very useful strengthening and endurance exercises. However, gait training and exercise have not cured my propensity for falling. I simply do not have the muscle coordination and reflexes to stop myself from falling.

The United Cerebral Palsy Association informed me that exercise is one of the best ways to minimize falling. It is important to maintain strength and muscle tone so the body does not atrophy and get weak over time. Physical therapists always teach me exercises for strengthening and building endurance.

When I was in my forties, my doctor suggested that I consider using a walker. I was horrified and told her “not over my dead body.” However, it began to appear as though my dead body would be the only solution to ending my falls.

Around that time, my aunt began using a four-wheel walker because she had MS. She urged me to take it for a spin and see how I felt about using it. This was one of the best things I ever did for myself. I found I could move around with greater freedom and control. My uncle informed me that my tendency to wiggle my hips uncontrollably, a great embarrassment to me, was greatly reduced when I walked with the walker. I found that the frequency of my falls was cut down significantly. However, using a walker has not been a fool-proof cure.

Falling has become so troublesome and scary for my family and me that I have begun to question whether I should begin using a wheelchair. However, doctors cautioned that I might lose even more strength and muscle tone if I stopped walking. They counseled that my quality of life would be better if I continued to walk and look for other strategies to keep myself safe.

I have had to come to terms with the idea that as I have grown older, like most adults, I am less agile and fatigue more easily.

I have developed compensatory strategies to help myself minimize or prevent their frequency and severity. I have learned that I must focus on my movements and plan them, which means I cannot be thinking of other things while I am walking. Through consulting with a wonderful physical therapist, I have begun making shorter, smaller turns in the direction I want to go rather than backing up and turning at the same time. I try not to put myself in positions where I have to back up to get out of a situation. I also use self-talk to remind myself of these strategies and that I am over tired or stressed when this is the case. I try not to schedule so many activities in a day. I try to schedule fewer activities on days when I am preparing to travel.

Although my falls have not stopped altogether, and probably never will, these solutions have helped me gain more control over my life and keep myself safe. I am interested in what solutions work for you. I am also interested in hearing about the feelings and experiences of your friends and family members. I am hoping to begin a dialog about our feelings, experiences and solutions.

Falling Again? What the Hell!

Falling in love, or falling on purpose out of a perfectly good airplane, both of which I have done, are terrifying and exhilarating! Falling because of a physical disability like cerebral palsy (CP), is scary; frustrating; embarrassing; painful and inconvenient. The recovery time interrupts my routines and pursuit of goals.

Although I am used to falling, my family and friends constantly worry and urge me to slow down and simplify my life. If falling and pain are not enough to scare me, stopping my activities and staying home surely are.

I remember taking walks, catching my toes on cracks in sidewalks and ruining favorite pairs of pants. I remember running with my friends, tripping and falling on my face. I remember opening heavy doors and almost falling backwards down stairs. I remember walking to classes at college, falling off edges of sidewalks into dirt and having to go back to my room to change my clothes.

Falling at work turns my propensity for falling into a legal dilemma. Do I tell emergency room personnel I fell at work or at home? If I tell them I fell at work, I must prove it happened due to unsafe working conditions. If Workman’s Comp says it was due to my disability, I struggle to convince my medical insurance to pay the bills.

Once I fell on my face at work, incurring a bloody nose and facial injuries. At the emergency room, the doctor probed my injuries and asked me if it hurt. I said “no”, so she sent me home. I learned that I had broken zygomatic bones in my right eye and severely damaged a cranial nerve. The reason I had no pain was because my face was numb.

Since the accident happened at work, I was required to file a Workman’s Comp claim. It was extremely difficult to convince them that they should cover the costs. Their position was that the fall was due to my disability, rather than unsafe conditions at work. Eventually, my medical bills were paid.

After that, everyone at work worried about my falling. I began using my walker indoors as well as outside. This cut down on my falls, but nothing I do will ever eliminate them. Falling is one of the ugly realities of my CP.

One month last summer, I had a higher than usual number of falls. I looked for an explanation for this increase, but the only difference was that I had begun providing full-time child care. However, I have done full-time child care at other times in my life.

One morning, while waiting with my husband and grandson to get into a movie theater, I got tired of standing. Shifting my weight on my feet, I fell backward landing on my head. This scared my husband and grandson and ended any thoughts I had about watching the movie with them. I urged them to stay, and off I went in an ambulance to the emergency room.

That same month I took another severe fall in the bathroom of a mall before a financial class my husband and I were attending. I closed myself in a stall. Parking my walker, I turned to sit on the toilet. Instead, I tripped, flew through the air and struck my side on the seat cover container. This drove the wind right out of me. When I could breathe again, I could hardly speak, sit, stand or walk. The people in the bathroom were terrified because they couldn’t get into the stall to help me. Despite the pain, nausea and concerns of my husband and friend, I chose to stay for the class because it was required as part of a grant program in which I was enrolled. Missing it would have delayed my progress.

Falling is, at the very least, inconvenient and painful. One of these days it could be fatal. I agonize about this aspect of my condition but have found no fool-proof remedies. In my next blog I will share some solutions I have found.

Do you have similar experiences? What are they and how do you cope? How do they affect your family and friends? I would love to hear your stories. Perhaps together we may gain greater control over this aspect of our lives.