Opinions strongly requested on this case

Hi Coolguy,

I'm a walking C5 incomplete, injured in 2006. I have bladder control but urination is much a gravity driven event. If there was one thing I would wish for, it would be freedom from the BP.

As the posts before mine state, every injury is different. My injury received Proprioceptive Neurological Facilitation (PNF), a form of physical therapy that has the therapist manipulate limbs while the patient attempts to command the movement that the therapist wishes. As this was explained to me, while in treatment, the movements are the same that a baby makes when it is learning to move. The goal is to re-teach one how to move. For the first week to ten days of treatment, I had no sensation of movement occurring but the therapists indicated that they could feel the muscles firing. Frankly, I thought this was BS. But as the swelling around the spinal column receded, some small measure of control began to return. At one point, my right arm was placed in ice water for several minutes, and when pulled out, I experienced the first meaningful movement for just a minute or two. The PNF continued, and one day I was placed on a lift table and moved to a vertical position while strapped to the table (much like Frankenstein). As soon as I got vertical, I lost my breakfast and the attempt was abandoned. The next day had this done again, and upon reaching the vertical, a half dozen therapists suddenly appeared and the straps were removed while the therapists supported me. We moved to horizontal bars, and from there, I was taught to walk again. I was released 1 month post injury, and walked out with a hemi-walker. This was with a very poor gait, almost no endurance, and very precarious control. Regardless, being able to stand and look someone in the face was a huge event. I was told that I might expect further improvement for no more than 18 months. In reality, I experienced continued improvement for almost 8 years. Much of the late improvement was due to better muscle control and improved stamina (a lot of which I attribute to getting a dog, which increased physical demands beyond what I might have pushed myself to).

What is walking like? Everyday is different. Gait varies in a manner that is not proportional or linear with walking difficulty. For the first 20 to 30 minutes each morning, my function is at its best, but the day always starts feeling like weights are on my feet (If you've walked with toddlers riding on your feet, that would be the best analogy for an AB person). Each day ends with the feeling of more weight on the feet than on the start of the day. On a good day, the start of the day might feel like 10 lbs weight on each foot and end with 20 to 30 lbs weight. On a bad day, the day can start feeling like 40 lbs weight and end at more than 100. There is no indication when fatigue will occur, and when it does, ability falls off extremely rapidly (I can walk into a store but may shuffle out and barely make it back to the car). I still take my wheel chair if I'm going to do an activity that might push me over the edge, and often will use the chair to increase mobility and hold off the fatigue. Often I will walk well into the fatigue zone though, and this is because my left arm remains weak and using it in the chair can be difficult with a side slope or even traveling in a straight line on a flat surface.

I write this to advise you that use of legs and walking, even when it returns, may not be of the quality that it once was. Also to make you aware, if you aren't already aware, of PNF. I'm absolutely convinced that I would not be walking without PNF.

I wish you and your family member all he best.

Big fan of PNF and dogs!