Before The Fall

Posted by Allen Rucker in Life After Paralysis on June 22, 2015 # Health

I fell the week before last, and it scared the bejesus out of me. I was sitting on the edge of a swimming pool, drying out, when suddenly my upper torso fell straight back and hit the limestone pavement behind it with a thud. My neck jerked back, but only grazed the pavement. My back hit squarely with nothing to break the fall. I was stunned but maintained consciousness. Like most people in that situation, paralyzed or not, I immediately announced I was okay -- no problem, just a bump on the back, let’s move on. It did seem that I was fine, just a little shaken, but no piercing headache or blood coming out of my ears. It took three or four hours before I was hit with a dull but constant headache, a frightening lack of balance, sporadic dizziness, and elevated fatigue.

I didn’t go immediately to the ER because no one wants to show up there with nothing but a mild case of hysteria. If it had been a false alarm, I wasn’t ready to face a young ER intern with a patronizing smile saying, “Now, you’re just fine, pops. Anyone to look after you at home?” Knowing what I know now about the mysteries of concussions, I should have gone.

I also take Coumadin, which can accelerate any bleeding anywhere. I waited three days for the symptoms to pass. They didn’t. When I finally talked myself into going in, they took me seriously. As they were checking a non-functional heart anomaly, they lined up the Big Bertha CAT scanner to determine if there was any observable damage or bleeding in the brain, up to and including an epidural hematoma (bleeding under the skull). Given the fact that I’m sitting here writing this, you’ve probably guessed that the tests were negative. They stuck me in the hospital overnight, cured the headache, help stabilized the instability, and told me to wait out the fatigue. I went home with a mild to moderate concussion, laid low for another five-six days, and now I’m fine.

Hey, everyone falls – so what’s the big deal? Remember the death of actress Natasha Richardson in 2009? If that wasn’t a “teachable moment,” I don’t know what is. She was on a baby slope in a ski area and fell back and hit her head. For three hours she seemed fine. That period, when it occurs, is called the “lucid interval.” Then the excruciating headache, off to the ER, and in Ms. Richardson’s case, there was apparently nothing that a series of surgeons in a series of major hospitals could do. A few weeks later, she died of an epidural hematoma. She was 45 and otherwise in excellent health.

Falling runs in my family, to put it crudely. My own father died from an accidental fall. On a wintery night in my hometown of Bartlesville, Oklahoma, he slipped on an icy step and hit his head on the brick surface. He was himself a doctor, so he made a self-assessment that he was fine and headed off to bed. He died in his sleep. He was thirty-six.

According to a recent report in the New York Times, falling can have serious or deadly consequences at any age, but after sixty-five, it’s a constant reality. One out of three of this group falls each year, and some 25,000 die of traumatic brain injuries. As you age, your balance goes south. At least in my own T-12/L-1 condition and my own level of clumsiness, paralysis seems to be an easy way to fall. Ever fallen in the bathroom and bumped your head on something porcelain? There’s a hematoma waiting to happen.

What to do? Slow down and be conscious of every movement is a good place to start. And remember the “balance training” you might have received in early rehab? Sitting up with no backstop, moving your arms up and around, throwing a beach ball back and forth, and other activities that improved your balance? Take a refresher course. In one research study, the Times reports, dancers, gymnasts, and figure skaters score much higher in the area of “motor cortex plasticity” than endurance runners and cross-country skiers. Operating on autopilot, or unconsciously, is very common in long distance running and cross-country skiing. There is no autopilot for a dancer. They are constantly balancing and rebalancing. Unconscious movement is usually when a fall occurs. Your mind is somewhere else, you tilt your chair a little too much this way or that way, and down you go.

I have yet to return to balance training, but I felt pretty good after they gave me battery of tests to see how my brain was functioning. Okay, here are a couple of examples to try out at home. It’s fun for the whole family.

• Spell the word ‘world’ backwards.

• Count down from 100 in sevens.

• Name the President before the current one.

• Name the Vice-President before the current one.

The last thing I learned from this head-banging episode was that there is no accurate measurement, or piece of high tech equipment, for determining the extent of a concussion. It’s measured backwards from your condition after the fall. And given the possibility of a grace period, or lucid interval, before the real effects kick in, how stupid is it not to go to a doctor or ER to get checked out?

In my own case, pretty stupid. Falling kills. I dodged a bullet that was just slightly off the mark. My father and Natasha Richardson didn’t dodge that bullet. In each case, it was only a matter of inches.

In the immortal words of Dirty Harry: “Do you feel lucky?”

© 2015 Allen Rucker | Like Allen on Facebook



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The Best Seat in the House:
How I Woke Up One Tuesday and Was Paralyzed for Life