I feel like I had every medical test that existed during my early hospitalization, yet no reason could be found for my useless hands and legs. I was told that my condition presented itself like a virus attack on the nerves and yet no virus could be identified. The doctors felt that I caught a virus that lingered in my hoarded environment, and my excessive drinking exacerbated the destruction of that virus. The goal then became what could be done to improve my functioning.
To determine how my nerves in my legs and hands were working I endured a test called a nerve conduction study. I say I endured because the test seemed to take a very long time and it was a repetitive uncomfortable procedure done over and over again.
The physician who conducted the nerve conduction study had an extremely good knowledge of the nervous system; what muscle each nerve stimulated and exactly where the nerve was located from the top of the leg to the foot. He would stick two sensors on a nerve pathway one at the beginning of the nerve and one where it ended. I was to identify if I could feel his touch or movement of my leg moved by him, then asked to do the movement my self. The test involved my self report of sensation and movement while the sensors on the nerve pathway revealed about how well the nerve was working, or if a conduction was determined on the nerve. The mundane part of the test was the repetitive requirement to identify whether I could feel or not feel and to raise and lower each part of my legs. There are many nerves in the legs.
Most people know we have nerves to make our muscles contract so we can move as we choose to. Most people know we have nerves that tell us we have been touched and whether things that touch us is cold or hot, sharp or dull, prickly or soft. What most people don't know is that there is a intricate
quagmire of nerves that work in concert together for a simple movement like bending your knee to ascend stairs. I use this example because it explains why I couldn't go up my back door stairs and the stair at the fast food restaurant when I fell. I stood at the foot of the stairs, starting at them because I was petrified to go up them. When I gathered enough courage to take the first step I would collapse on the stairs. I would fall as if I had no bones in my body.
The nerve conduction study revealed the reason why I fell. The nerves that told my brain the position of my body before taking a step were damaged. The brain needs this information to plan the movement. This is called motor planning. The brain conceptualizes and figures out what each part of the body needs to do in order to complete the movement. This happens
unconsciously through nerve pathways developed sense we were tots. If the brain does not know
where the body is before the movement, it cannot innovate the nerve pathway to do so. I knew I wanted to go up a step but my brain did not know how to do it.
Think about what information the brain would need for you to go up a step: how high is the step, how much effort is required of each muscle so not to over or under step, what is needed of the trunk or stomach and back muscles to maintain balance while you are transferring weight between each leg, what the arms should be doing to assist with balance. I explain motor planning very simplistically, but enough to illustrate the impairment I was experiencing.
My brain did not know the position of my body at the point I wanted to go up a stair and therefore could not innovate the of nerve pathways to make it happen. Going up stairs is the first time I noticed
the problem. Imagine staring at a stair and not be able to go up it. I felt like I was frozen. The problem then went beyond going up stairs, I could not get out of bed, then I could not walk
unless I had my hand on a wall or used a walker. When my hands were effected by the same nerve
distruction, I could not pick up a pencil or use a keyboard.
The reason I could walk with a walker while touching a wall was because the walker and the wall gave my brain the information it needed regarding my position at initiation of movement which allowed it to achieve motor planning. While just standing, my vision was sufficient information for the brain to motor plan and keep me standing.
The neural conduction study was completed and the Doctor told me I had peripheral neuropathy, in other words damage to my nerves in my hands and legs. He then moved me on a stretcher to the
waiting area where a porter would come and take me back to my room. Just as he was to leave me he saw another neurologist and called him aside.
"I have a good example of a positive Romberg's Test" he told the other neurologist.
He then asked me if I minded illustrating a positive Romberg's Sign. I did not understand what he was referring to but I trusted him so I agreed. He helped me to get off the stretcher in a standing position with both of is hands holding me at the shoulders.
He then then removed his hands and I remained standing. "Close your eyes" he said.
I was petrified to close my eyes because I feared I would fall over. "I'll fall", I said. "Don't worry" he said, "I'll catch you."
I closed my eyes and immediately started to fall. The Doctor then put his hands on both shoulders and I stopped falling. I needed my sight to compensate for the damaged nerves that provided my
brain with information required for standing. I'm glad the doctor illustrated this to his colleague because I understood what was wrong with me and from then on, developed ways of compensating for my damaged nerves by sight, touching walls etc.
I find the human body amazing. While getting my degree at university I had to do cadaver labs. There were forty students in my anatomy class and so we had eight cadavers to work on. We dissected the cadavers bit by bit to learn anatomy from the muscles and nerves down to the organs. What struck me was that each body was exactly the same. The intricate nervous system was exactly the same. As the nerves left the spinal cord they wove exactly the same in and out of the muscles.
Where you witnessed a nerve emerging from a muscle on one cadaver, it could be found in exactly the same place in another. Some nerves joined and separated and again, and they did so exactly the same way from cadaver to cadaver.
During my training to become a therapist, I learned about all the different kinds of nerves and what their function is. There are ones that tell you if you have been touched and can differentiate between soft and hard, cold and hot. There are nerves that tell your brain the exact position of your body and ones that tell your brain that parts of your body are moving. These last two nerves mentioned are the ones that were destroyed in my body. I never thought about these last two mentioned nerves as they send messages to the brain without me knowing it, but when they are destroyed, they cause movement to come to a halt. As long as the body is healthy and gets what it needs to remain healthy, there are miraculous unsung functions that happen without us knowing it. When the body becomes unhealthy, we become aware of the fact that something is not functioning because we cannot do what we take for granted.
I was told by the doctor that he didn't know if the destruction of my nerves would continue to get
worse, whether they would improve or stay the same. I never thought that the nerve function would stay the same or get worse because that meant I would have to life in a facility and get assistance for all my daily care.
"I am going to get better" I thought without a doubt. I was sure I would get better. I was in denial of my condition. Why, when my body craved alcohol I could not deny it; but when in sober reality I experienced disaability I did not listen to what it was telling me?
All the years I worked with clients who suffered with brain injury, Parkinson''s disease, MS, ALS, stroke, and Alzheimer's Disease, I would thank God for my health daily as I drove home from work. It was ironic that I find my self in this position. The irony of my disability is that while I was thankful for my health, I was destroying my nerves by living in a hoarding environment and excessive drinking.
