I just got back last night from Atlanta where I participated in the Beyond Therapy program for one week. The trip kind of got off to a rough start at first. I was at the CMC rehab hospital last Friday and was picking up a backup supply of antibiotics in case a urinary infection happened to strike while I was on the road. I swear, it hadn’t been five minutes since grabbing a prescription from the nurse that I began to feel bladder spasms, my first stage of getting a urinary infection.
A couple weeks ago I began taking this new supplement called D-mannose which has shown to really help people who constantly get urinary infections. Most often it is the E. coli bacteria which are responsible for infection and it happens to easily bond with fatty molecules contained in the bladder lining. D-mannose is a fatty molecule which forms an even stronger bond with E. coli so theoretically the E. coli doesn’t bond with the bladder wall but bonds with D-mannose and gets flushed out. My new supplement seemed to be working at first but unfortunately there are other types of bacteria which cause urinary infections. I went ahead and got the antibiotics but waited a couple days to see if I could clear up the infection naturally. I could tell the D-mannose made my symptoms less severe but when Sunday, the day of our expected departure arrived, I began to involuntarily leak, so I turned back to my old friend called drugs.
The drive down was anything but comfortable as 75% of the time I could feel my bladder spasming followed by an intense feeling that I would wet my pants. I figured the drive down would be a piece of cake being that I made it all the way down from Cleveland to Charlotte, but it ended up being much more difficult and I found myself anxiously watching the minutes tick by.
By the time we got to the hotel thankfully my bladder spasms had stopped but I felt completely out of it and was not sure how things were going to go the next day at therapy. I had to wake up at six o’clock in the morning so after my dad and I ordered some Chinese takeout I quickly hit the sack. Normally I would have been up half the night anticipating the event but I was so tired I slept rather peacefully and awoke the next morning feeling refreshed.
Having just been to Project Walk and being so totally pumped about their program, it was hard for me not to go into this past week without some preconceived notions. I honestly couldn’t imagine Beyond Therapy surpassing Project Walk, but I did my best to clear my mind and fully participate in all of the activities. The two programs I found are very different from each other, but overall contain the same goal which is the neurological recovery of spinal cord injuries. The goal is the same, but the path to get there varies.
The Beyond Therapy program uses a wide variety of techniques to encourage the awakening of the nervous system. Each technique has been proven through research and studies to provide some sort of benefit for paralysis. Two of these techniques which Project Walk does not embrace is electrical stimulation and pool exercises. It is the stance of Project Walk that electrical stimulation confuses the nervous system because an outside foreign signal is being sent to the muscle overriding the natural signal of the nervous system. Instead of using electrical stimulation they try and initiate spasms and then get you to work along with the tone that is created. Pool exercises are not encouraged because they believe that weight bearing and increase of muscle tone is the key to neurological recovery. Both of these elements are mostly eliminated while in the pool and their theory is that muscle spasms and tone are the predecessor to real movement.
In the eyes of Beyond Therapy electrical stimulation provides the contraction of a single muscle group which allows you to send a clear signal to that muscle group instead of a spasm affecting more than one muscle group at a time. This sequence of contraction and trying to use the muscle at the same time could promote muscle memory and recovery. Electrical stimulation has also been proven to increase the amount of oxidative cells in the muscles creating healthy muscle tissue prepared for recovery. The pool is seen as good exercise because it provides a weightless environment for new movement to take place in, as well as the constant stimulation of water and hydrostatic pressure. They agree that muscle spasms and tone have many positive aspects to them and in some cases can be a sign of future muscle return. However, they do not believe it is necessary to increase muscle spasms in order to gain recovery. Just as Project Walk believes using electrical stimulation for recovery confuses the body, Beyond Therapy believes using spasms to gain recovery confuses the body.
The two methods for recovery creates two very different programs. On one hand you have Beyond Therapy which uses a variety of techniques all proven to help a person with a spinal cord injury in some way or another. This includes the locomat machine, the giger machine, repetitious exercises, core strengthening, electrical stimulation, and pool exercises. On the other hand you have Project Walk which directly emphasizes the importance of weight bearing, repetitious exercises and increase of muscle tone in order to gain recovery. Vigorous exercise is the focus, most of the time strengthening the core while constantly reminding the body what it is supposed to be doing. There is no factual evidence besides the success stories. It is simply a program developed by someone with innovative ideas for people with spinal cord injury.
I thoroughly enjoyed my week at Beyond Therapy. The style may have been a bit different than Project Walk but once again every day I was pushed to my limits to discover what is possible. I was also able to try out some of the best equipment available at the present time. The locomat machine is a gate training device which puts you in a full upright position over top of a treadmill. Robotic arms are then attached to the legs and you are lowered down to the surface of the treadmill. Then the robotic arms take your legs through the walking motion putting weight through the legs exactly as if real walking was taking place. Needless to say, it was an absolutely incredible feeling. Looking in the mirror I saw myself taking perfect strides and I felt the weight go through my knees and into my hips. After more than two years of not taking a single step, there I was walking better than I ever have in my entire life. With each step I worked with the machine and could feel the connection in my thighs, hamstrings, and gluts trying my hardest to remind my muscles of the process. This is one major advantage beyond therapy has over other programs. They have a lot of money coming in to provide their patients with the best technology available.
Beyond Therapy did a lot more muscle evaluations with me than Project walk. I usually get pretty frustrated with evaluations but I was quite surprised at the outcomes. Apparently I have muscles firing all over my body and into my legs. Trace movements are not only present in my left leg as I once thought but are also present in my right leg. Because of these trace movements my therapist decided to take a chance. It was getting towards the end of a very long day and I was lying on the mat kind of confused about what I would be doing next. When someone came over and told me I’d be doing some standing I took it as a joke. But before I knew it, I had three people all around me, and I was standing in front of a walker with my forearms resting on a flat platform. One person was blocking my knees and another was keeping my hips and body straight. I knew it was hard work for them to stand me up but I loved the aggressive approach and believe that this type of aggression is what my body needs. With a smile and a chuckle I asked them when I would be walking around the gym, and the reply was quite shocking. Next we would try and take steps.
I’m not sure exactly how it happened because I couldn’t really see it but with the help of three individuals, I walked 25 feet with a walker. My therapist supported my rear has she lifted 1 foot at a time as I worked with her assistance. Taking the actual step was very difficult for me but I did feel myself somewhat being able to transfer my weight from one leg to the other. Two years ago, if I saw someone doing what I was doing I would have been very jealous and there I was, training my self to walk. It was fantastic. Unfortunately the camera was gone that day.
I’ve become known as the inquisitive one at the Shepherd Center, always analyzing what I’m doing and questioning all that is involved. My therapist also worked with me two years ago in the day program and she knew I’d be full of questions, especially having just been back from Project Walk. We went back and forth about several issues mostly concerning what is best for my recovery. She was very helpful in allowing me to clearly see the whole picture and all the avenues of rehabilitation I can take, but unfortunately at this time I have no resolution. In two weeks I’ll be in San Diego to begin a two-month long stay with Project Walk. After the stay I will once again survey my situation and make a decision. There’s really no telling what that decision will be. I may go back to Beyond Therapy, I may decide to move to San Diego, or maybe even stay in Charlotte. I’m just taking it step by step in exploring all that God is presenting to me. I must trust that I will make the right decisions.