Be Careful Out There

Posted by Allen Rucker in Life After Paralysis on January 30, 2023 # Lifestyle

Every morning when the alarm goes off, the first thing I do is unstrap my legs, which are bound together, resting on a pyramid of pillows, in a nightly attempt to heal or ward off problem wounds on the outside of my ankles and calves. Like many of you, I have the lifelong scourge of contracture, or shortening of the muscles in both knees, meaning they are locked in an acute angle, meaning they flop to the side while sleeping and cause pressure sores.

With the straps off, I then raise my high-low adjustable hospital bed to a height higher than my wheelchair to slide into it with ease. The bed is one I only discovered this summer after shoulder replacement surgery. It goes from six inches off the ground to the height of my shoulders. When I go from chair to bed, I lower it so I can transfer back, again, without having to leap from one surface to the next. I love this thing. It reduces the risk of injury while transferring to almost zero and these days, reducing all risks all the time is my number one health concern.

caution sign

More at age 77 than ever before, falling is my greatest fear. It runs in the family – my father and older brother died from the consequences of falls. Just last year, I fell backward in my chair, injuring my right shoulder. I thought nothing of it at the time, since I was two weeks away from surgery on my left shoulder, long ago the victim of some distant accidental spill or two. They are both slowly healing but not 100%. Mentally, I still don’t trust them for heavy use. Most other transfers I now make using a sliding board. It takes a second person to hold it in place, but it reduces my chances of missing my mark and slipping, falling, or scrapping by 90%. I also try to limit the frequency of transferring. I’ve cut down on the “fun” transfers, like a Saturday visit to Costco. Those hot dogs are good but not worth a trip to the ER.

A few years back, the Pulitzer Prize-winning scientist and author, Jared Diamond, came up with a simple formula for surviving old age. His thesis: what kills and injures us are not front-page catastrophes like serial killers, plane crashes, and head-on car wrecks. What we forget are the statistically much greater risks of simple, mundane activities we do repeatedly. Things like slippery showers, ladders, uneven sidewalks, staircases, loose rugs, even a mishandled cup of hot tea.

The Diamond formula: Low risk + high frequency = much higher risk.

Let’s do some math. As a midlevel para, you might make 20 transfers a day, or 7300 a year. Diamond puts the odds of himself slipping in the shower at 1000-1. That means you’ll fall, bump, slip, or break the skin an average of 7.3 times a year. You may think you are still 30, but you are not. Any one of those could end in a concussion, a life-threatening contusion, a broken limb, or a problem wound that takes a year and a half to heal.

Obviously, this kind of fearful thinking is not healthy and can turn you into a wuss who never leaves the house or maybe a skittish, slow-moving old codger who yells at people who bump into him at the grocery store. A total risk-free life borders on death. You have to be double-minded. You can still take all kinds of risks – go on a blind date, write a smutty novel, stand on the perimeter of a big political demonstration and yell – but part of your brain has to always be on the lookout for hazards.

The trick is to be free-spirited, spontaneous, wary, and two steps ahead of every potential pothole. I got the wariness down. Now it’s time to cut loose!


Allen Rucker was born in Wichita Falls, Texas, raised in Bartlesville, Oklahoma, and has an MA in Communication from Stanford University, an MA in American Culture from the University of Michigan, and a BA in English from Washington University, St. Louis.

The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.