no sooner ask than done. this  is kyles origional post.







I had an interesting visit Friday with a "new" (to me) physiatrist who is
the Dept. Chair of Physical Medicine at Ohio State University.

The condensed version of his diagnosis, prognosis and treatment plan as it
could relate to others in the same boat:

On the subject of aging (paraphrased):

Doctor:    "Yes, Kyle, because of the spasticity, your musculo-skeletal
system is aging much faster than someone your age without CP.  This is a
given.  Muscles that are less affected by the brain lesions have learned
over the past 40 years to adapt and take on the roll of those muscles more
affected.  The problem is, your bones and joints are subjected to stresses
outside their designed scope (no news here).  40 years of spasticity have
also deformed bones and joints, exacerbating the problem.

Me:   "I've seen my abilities decrease markedly in the past few years.  Am I
looking at further degredation?"

Doctor:   "Yes"

Me:   "You're not telling me what I want to hear."

Doctor:   "This is the deal:  Your level of spasticity and pain will
increase as you age.  Any physician or therapist that tells you otherwise is
lying or God.  This is the hand you've been dealt and the cards will not
change.  Don't add denial to your list of complaints. This is not to say
that we can't help you and that you cannot continue to walk, function
independently and live to a ripe old age."

Me:   "What can I do to slow this process?"

Doctor:    "A better question might be, 'What can I do to decrease the
spasticity which is causing my pain and fatigue?'"

Me:   "Okay."

Doctor:    "Okay, what?"

Me:    "Okay, what can I do to decrease the spasticity which is causing my
pain and fatigue?"

Doctor:   "Good question:  Now, spasticity in CPers is exacerbated by the
four "F"s:    Fatigue, Fronts, Fight/Flight response, and sitting on your
Fat arse.

Me:   "Please explain."

Doctor:   "Fatigue:  Studies have shown that neural firing rates increase
with fatigue.  In the spaz, both gross and fine motor movements are
accentuated.  Let's say your normal extension of the left elbow is a
baseline155 degrees.  If you get 5 hours sleep/night for 5 nights, your
extension will decrease by 5-10%.  Moral:  No less than 7 hours sleep at
night.  Take a break when you're tired.

               "Fronts:   Humidity doesn't affect spasticity, cold and
barometric changes do.  We're not certain why, but I believe this to be
true.  Some researchers have said there is no link, but for thousands of
years, people have complained about aches during weather changes.  I tend to
side with them.  My theory is that when the barometer rises or falls, the
synovial fluid in the joints can't change it's own pressure quickly and it
exerts positive or negative pressure on the nerve endings until things reach
equilibrium.  Moral:  Move away from the Midwest, or any other area prone to
cold fronts, as fast as you can.

            "Fight/Flight:   The more primitive reflexes are still present
in CP adults:  Babinski, Moro, etc.  Being startled, angry or frightened
causes muscles to tense--even more so in the CPer.  Moral:  Learn to relax.

            "Fat Arse:    Kyle, your body fat content is a remarkably low
11%, but if you want to take stress off those joints you should be thin
almost to the point of emaciation.   Six feet and 168 lbs is ok for a
'normal' person, but you should be about 150 or lower (I weighed 126 right
out of college).  CPers are sometimes blessed by a fast metabolism that
helps keep them thin.  You're one of the lucky ones.  Moral:  low-impact
aerobic exercise, poolwork, biking, eating like a bird.

Me:  "Anything else?"

Doctor:  "Yeah, we'll get you on 'Williams Flexion' PT (anybody know what
this is?), pool work and massage.  Might put you back in a brace."

Me:  "Forrest Gump model?"

Doctor:  "Yup."

So, in a nutshell, that was my visit.  Thought I'd let y'all know what he
said.

-Kyle