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Fatigue and Falling

June 2, 2012
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The topic of discussion on the CPSA group this morning has been falling – not only the fear of it, but the actual consequences of it. Fatigue is so common among us who have suffered some type of “brain injury” that there might as well be some kind of special club, where we could all hang out. We’d understand when someone else fell into a narcoleptic trance during a conversation, or left a game or other event for a nap of several minutes or a few hours.This fatigue isn’t limited to those of us who have suffered strokes or brain injuries; it is the inevitable consequence of continuous, considerable pain. Pain is exhausting. By the end of the day, many of us are both strung out from the bone-deep weariness, yet unable to sleep because the pain has gotten so much more intense as the day has progressed.

But there is extreme danger that accompanies the  fatigue, and it’s not that we will fall asleep at our desks. It is that we will fall, period.The stories that were traded this morning were from members that fell and could not get up – and who had to lie there for hours, because there was no one to help them. Here’s Ursula’s story, the one that started the thread:

DURING THE NIGHT I FELL.  I WELL KNOW THAT I CANNOT GET UP ON MY OWN, WHEN I AM FLAT ON THE FLOOR.  I DID NOT KNOW HOW AND WHERE I HAD LANDED, BUT AS I FELT AROUND, I REALIZED I WAS UP AGAINST THE BACK WALL OF THE BATHROOM, CONFIRMED BY THE FALLEN “RAISED” TOILET SEAT THAT LAY NEXT TO ME.  WHILE STARTING TO SLIDE SLOWLY BACKWARDS AN INCH AT A TIME, I NOW BEGAN CALLING FOR MY HUSBAND AND BANGING THE TOILET SEAT AGAINST SOMETHING, I STILL DON’T KNOW WHAT.  DEEP SILENCE!. I LAY THERE FOR ABOUT TWO HOURS, FROM TIME TO TIME SHRIEKING “DAD, DAD”. I HAD FINALLY, PAINFULLY WORKED MY WAY TOWARDS THE DOOR OPENING AND LAY NOW ON THE CARPET OF MY BEDROOM, A ROOM CLOSER TO MY HUSBAND.  I WAS IN UTTER DESPAIR, WHEN I RENEWED MY SCREAMING.  HIS BATHROOM IS ON THE OTHER SIDE OF THE HOUSE.  I HEARD THE COCO CROWING 4 TIMES, AND THOUGHT “SOON IT WILL BE MORNING.”   MOUTH SO DRY, I FIGURED I SHOULD HAVE SPARED MYSELF SO MANY SOS CALLS, WHEN FINALLY I HEARD SOUNDS OF LIFE – THE TOILET FLUSHING IN PHIL’S BATHROOM.  WITH RENEWED, NOW JUSTIFIED HOPE I STARTED MY OUTCRIES AGAIN, AND IT FINALLY HAPPENED: MY HUSBAND CAME IN.  I SAID “CALL 911 – DO NOT TRY TO PICK ME UP.”  HE WAS RELUCTANT, BUT FINALLY GAVE IN.  THEY WANTED TO TALK TO ME.  AFTER I ASSURED THEM THAT I DID NOT NEED TO GO TO A HOSPITAL, THEY SAID THAT THEY WERE ALREADY ON THEIR WAY.  SHORTLY AFTER, THE BLESSED KNOCK ON THE DOOR.  TO MY SURPRISE, INSTEAD OF TWO HUSKY MEN, TWO HUSKY, CHEERFUL WOMEN WALKED IN, AND THEY MANAGED TO PICK ME UP AND PUT ME TO BED. I SLEEP IN THE NUDE, BECAUSE I CANNOT STAND A NIGHTGOWN TWISTING AROUND ME IN BED. IT ONLY WOULD HAVE BOTHERED ME AS I WAS SCRAPING MYSELF BACKWARD ALONG THE BATHROOM FLOOR.
I REALIZE NOW HOW IT HAPPENED.  MOST OF THE TIME I AM SO TIRED WHEN I GO TO THE BATHROOM AT NIGHT THAT I ALMOST GO TO SLEEP, WHEN I SIT THERE.  I MUST REALLY HAVE NODDED OFF AND SLIPPED OFF WITH THE SEAT IN MY SLEEP, SO VERY TIRED THAT I DID NOT KNOW WHERE I WOKE UP.
Zooky responded with: “Last week I was out working in the yard when I fell.  Like you, I cannot get up by myself.  I was about to reach for my “panic pendant” which would have set off the alarm in the house and automatically dialed 911.  But, suddenly I had neighbors, seemingly coming out of the woodwork, rushing over to help me.  My wife was in the house saw what was happening, and also rushed out to help me, too. One just never knows when a fall will happen………”
Debra also had her testimony: “I know how you feel. I fall sometimes too. One time, I was feeling okay so I went out to the garden to pick tomatoes. Well, the tomatoes went everywhere when I fell. I can not get up by myself. My husband was on the tractor by the garden but he is hard of hearing. I yelled out, waved my arms in the air- he did not see me. Luckily, I had my cell phone on me. I phoned my parents and oldest son, hey were not home. I kept trying and finally got a hold of my oldest son after 2 hours. My son and step-father came over and got the attention of my husband. It took two to get me up and into the house. I could not move from the waist down, was incontinent – it was a mess. finally got feeling back into lower half of my body and could move legs. I used the wheelchair for few days straight.”
All of us have different causative illnesses, but we all suffer from the same exhaustion. We all suffer from fatigue, which affects our balance. We might stumble and fall; we might be suddenly become so weak and tired that we land on the floor. II have had to teach myself how to fall, after a few very scary incidents due to medications. The tizinidine, in particular, affected me so strongly when I first began to take it that I took several very bad and sudden tumbles that injured me. My leg muscles felt as if they had turned to water; they were suddenly rippling, completely unable to support me. I collapsed – once so badly that I bruised my face when I hit the floor. It can still happen to me when I’ve done too  much physical exertion in the course of the day, and then stayed up for too long after taking my last day’s pills. The combination of tianzidine, amitriptyline, and now the klonopin , mixed with the lack of physical reserves, is like a cosh to the back of my head.
At least I can recognize that cosh-like rapid descent these days, and can prepare. I am exceedingly cautious when going up and down the stairs, even going so far as to creep up the stairs on my hands and knees if I think my muscles can’t hold me. This is made even more imperative because a friend of mine died of head trauma when hurrying down a staircase just like ours, tripping and tumbling.  I’ve gotten up from my chair, and felt so weak that I’ve immediately sat down again. On the nights when I don’t think I can make it, I will crawl to the couch if I have to. There are even the times when I am not even able to make it to the couch. Two weeks ago, the exhaustion came upon me quickly, as it often does, while I sat at my desk about 1 A.m. “Time to head upstairs,” I thought, and began to make my way. First I had to collect the next day’s pill box, the iPod, and anything else I was bringing upstairs. Then I realized that the kitchen light were still on. Between the time I walked to the kitchen, shut off the lights, and then emerged to pass through the dining room, my legs went wobbly. I knew I couldn’t even make it to the couch. Suddenly I realized I couldn’t even stand up anymore. I lowered myself to the floor, and crawled under the dining room table, where the carpet is cleanest. That is where I slept until 5:30 in the morning. But at least I didn’t fall.

Those are the falls that I can predict. The ones that truly worry me are these that take place out of my rotten sense of balance. Stepping onto uneven surfaces, even so much as a branch in the yard or sidewalk  pavement that has shifted, is enough to bring me down if I am not very careful. The cane is useful for stability, but perhaps a walking stick would be even better. It certainly wouldn’t give me that “worn-out old granny” feeling, which is doubly pronounced when I look at my intractable gray hair popping out from the still-brunette!.

There is also the fact that the extra weight I am carrying makes the odds of falling higher, as well as making those falls more dangerous. I am determined to keep losing weight; I’ve lost almost thirty pounds since Christmas 2010. All the drugs make it very difficult. I have learned that I must eat as much protein as possible, and that simple carbs of *any* kind – sugar, flour, rice and potatoes – make me immediately gain. It makes it difficult to eat sandwiches or burgers! At least I was able to segregate the cookies, treats, and chips into a separate kitchen cabinet, which I never open. What’s even more difficult is rejecting my husband’s frequent entreaties to “Here. Just try this one bit,” of the ice cream or the cookies that he loves – and that he knows *I* have loved. That proffered spoonful of Ben and Jerry’s looks so delicious!  But developing the ability to say, “No, thank you,” is like working on lifting weights: the more I practice, the easier the load becomes.

 

 
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