Surprisingly, or perhaps not, I am often approached by strangers and asked if I will ever walk again? Or, I’m told I will walk again if I just work harder or pray. If we are just talking science here for a minute … I think it’s important to unpack what actually causes paralysis when an individual experiences a physically traumatic event damaging the spinal cord.
What Makes You Paralyzed?
In 2010 I broke my neck in a shallow water diving accident. But what do I mean when I say I broke my neck? The vertebrae (bones) in your neck surround, for protection purposes, your spinal cord. Your spinal cord is comprised of nerve bundles, which are really sensitive. The vertebrae encapsulating the spinal cord is for protection purposes. If you just touch a nerve bundle in your spinal cord and injure it just a bit, this is what really causes paralysis.
You can take a shallow water dive and break the vertebrae and, if you are really lucky, not injure any of the nerve bundles inside. This is a scenario when you would see someone walking around who said they broke their neck and had a miraculous recovery. Not really. It’s just that they broke all of the bones around their spinal cord and somehow got lucky by not damaging the nerve bundles.
When I was in rehab there is a young woman who also broke her neck, C6 injury, and within several months she was up and walking around. I was very jealous at the time, but didn’t really understand what makes you paralyzed.
Let’s Break it Down Further
When you injure nerve bundles it creates a bruise in simple terms. You may be thinking to yourself, well, a bruise heals. True. However, when you hit your arm, you start to see the bruise swell over a few days before it starts to heal.
If you injure the nerve bundles in your spinal cord and this bruise starts to expand it will expand upwards towards your brainstem. This will kill you. As a result, your body has a protection mechanism that stops the bruise dead in its tracks (this is scientifically complicated, but you get the idea) so it doesn’t move upwards to kill you. Unfortunately, the bruise is permanent.
Complete vs. Incomplete Injury (How Paralyzed are You?)
Some people who break their neck or back can move a leg or a few fingers, and others are fully paralyzed from the level they were injured down.
Why?
You can bruise your spinal cord 360° around = this is called a COMPLETE INJURY.
This means there is generally no movement below that level of injury. This is not a great outcome unfortunately. What this means is the chances of functional movement recovery are much less or non-existent unless one has the potential to engage in a multifaceted regenerative medicine combination. This is another topic for another time and there is science out there, but it’s not widespread to the masses yet unfortunately. Think of a block of solid cheddar cheese.
Now, if you bruise your spinal cord in certain locations, think of a block of Swiss cheese — this is good. This means the way in which you bruised your spinal cord there are still, let’s call them holes like Swiss cheese, areas around the bruise that looked like holes. These “holes” allow nerve signals to get above and below your level of injury. This injury is called an INCOMPLETE INJURY.
This leads many folks with an incomplete spinal cord injury to have a higher chance of functional recovery because signals are getting through the bruise.
EXAMPLE:
- I am a complete C6 quadriplegic. I have no function or feeling below my breasts, paralyzed triceps, paralyzed hands, and limited upper body mobility.
- I have a dear friend who is an incomplete C6 quadriplegic. She has the ability to move a few fingers, has sensation in her legs, and can even move a few toes.
(We both can say we are C6 quadriplegic’s, but we bruised our spinal cords in different ways. We both have had spinal surgery with metal rods put in around the crushed vertebrae to create stability, but have very different qualities of life and functional movement. She’s physically able to live alone and I am not)
CAUTION: I am frequently sent articles on how quadriplegics regain function. It’s not impossible, but they never seem to state in these scientific articles if the person has a complete or an incomplete injury.
NOTE: The leg muscles like the quadriceps or the hamstrings are actually quite basic muscles. Scientifically speaking, it’s much easier for them to start working through different scientific alternatives. However, when you think about the hands — there are dozens and dozens of ligaments, nerves, and muscles that need to work and fire simultaneously together in order for you to simply pinch your fingers closed. I bring this up because there are so many studies that show paraplegics, paralyzed from the waist down, who regain the ability to walk. Surprisingly, this is a hell of a lot easier than trying to get your finger to simply pinch close together.
The last time I “walked” was on a machine called a Locomat when I was engaged in a scientific study when I was first injured. They weren’t sure yet if I was going to be complete or incomplete… I still remember the feeling though 🙂
HOPE
Hope is important. Hope is how some people get up and get through their days. There are others who are more in the realist camp and just want to live their best life in the now. For me, I’m in the realist camp. However, I truly appreciate, whatever camp you may reside in, the different techniques we each apply every day to simply get up in the morning at times.
I would be remiss not to point out that promising too much hope to individuals who are trying to adjust to daily life and hinge their hopes & dreams upon a doctor telling them they have a high chance of recovery in 5 years — can result in negative psychological ramifications for quality of life. Why do I say 5 years? Well, personally I have heard this for decades and I’ve spoken with hundreds of others who said even in the 1980s their surgeons kept saying a cure was just around the corner.
I think it’s important to maintain cautious optimism, but I would be disheartened for someone to miss out on living the best life possible despite life’s unfair circumstances at times because they are holding out for something tomorrow that may take 20 years. What about your life right now?
While I Walk Again?
Personally, no, I don’t think so. Even if an amazing therapy comes out in the next 5 years I would likely have to do a combination therapy of sorts that would take years of my life of rehabilitation.
I am 41 years old. I want to live the best life I can live right now, but that’s my decision and I respect your decision.
Truthfully, paralysis is quite easy. My chronic pain is what affects my quality of life most. Being paralyzed, I pretty much just sit there all day. Yes, I appreciate the secondary complications associated with just sitting all day. However, I would be more interested in therapies that reduce chronic pain.
Chronic pain, quite literally one of the most common ailments in the world, is not only debilitating, but can lead so many down a very dark path & has a high probability of addiction to various substances.
Most people cannot believe when I say I live in chronic burning pins and needles each day 24/7 and I literally feel like I’m being burned alive. I’ve created my own coping mechanisms, but it is a cruel cosmic joke because if you’re going to be paralyzed, I should at least be able to not feel anything. Unfortunately, this is not the case.
Summing Up …
It’s only natural human beings that we try to empathize or sympathize with those who are going to something really challenging whether that is physical or mental. However, it’s quite easy to offer an opinion on someone’s life when you do not know what they’re going through or have not been there yourself.
I really understand that people are trying to be positive with telling me or others that if we just keep working at it things will get better. This likely them feel better, not the person they are saying it to.
Honestly, life is not fair. We all know this. There are times when just working harder at something will not necessarily make it better. I work really hard at exercising to stay healthy with my level of injury, but no matter how much I wish it or keep trying to do is sit up each day … The probability of me walking with my level and type of paralysis are quite low.
I’ve accepted this. It still sucks. However, I have learned how to adapt and thrive in ever changing circumstances… And trust me, your medical circumstances can quite literally change in 24 hours such as going septic from a urinary tract infection because I couldn’t feel the symptoms before they came on.
It can be quite psychologically “paralyzing” to offer advice or your thoughts/opinions to someone who is still trying to find their way through a complex medical diagnosis.
The best thing you can do and probably some unsolicited advice would be: Just Listen. Let the person know you are chatting with that it must be hard to be going through what they are, you are there for them, and are just there to simply listen. We know we can’t fix other people’s problems, but we can be supportive. This is where I believe it should be a high school requirement for graduation for teenagers to have empathy training for their life just as they should probably be taught how to balance a checkbook or learn some practical skills in life. Food for thought for your day … 😊
