Falling down-what to do about it?

[Charley123]

This year I've fallen several times-mostly outside.  There's no warning...my right side just collapses.  On New Year's Eve  my husband and sister took me to the ER.  I fell in the living room and hit my head pretty bad.  I probably passed out for about a minute or so.  All the tests were fine, so I came home the same night.  

I don't know what to do about this.  I joke about training wheels...helmets..rubber body padding, but this time it really scared me and I couldn't joke at all.  I'm back to using my cane.  Totally frustrating!

I don't want to be in a wheel chair..but I don't want to fall down any more either.  What do all of you who also fall do to minimize falling?  

I was diagnosed with probable MS, am on Copaxone (which has helped with many symptoms) and am now going to a new Neurologist in a couple of weeks because my old one wants another opinion because he thinks that it is now a waste of my time to come and see him.  My lesions are not in the right place for him to say definite MS.  I have been tested for everything up the gazoo...and everything was negative except an for inflammatory disease which often shows up with MS.  

Thanks, a very frustrated Charley

[Wobbly]

Hi there.. I started a Wii program at home and do what I can to help with balance and movements.  Parts of my body feel like it's really helping...doesn't help with dizziness or numbness in my left leg though.. (wish it did)...

I'm getting a scooter or power chair to use.  I use my Walker in the house now on bad days or when my leg is weak or I'm tired.

take care, let us know how things go...

wobbly
dx

[jensequitur]

>  How about those commercials you see now to "tone" a six-pack by wearing a belt with electrical stimulation?  What about the way my muscles contracted with the outside source of electrical stimulation in PT after my knee replacement?

I believe that you could use external stimulation through a tens unit to exercise that muscle.  I don't know if it builds muscle, or just causes the muscle to tense up.  This is why they have those walk aids for the ankle - it helps drop foot by zapping the muscle that's supposed to lift the foot.  Kinda like a cheap version of the Bionic Man.

So yes, definitely everybody should try PT.  Or failing that, just exercise!  It'll build core strength and help you to get round.

[Charley123]

Thanks for the input. Now I know what to ask the doc next week.  I like the idea of hiking poles.  I wonder if they work in the snow.  I'll look at ebay.  Thanks, Charley.

[Eyesnlegs]

Hi Charley123,

Just my small contribution:

Falling ***** I have done some permenant damage to myself falling. I know my right shoulders took a lot of damage but I now discover that MS had weakened my right shoulder so that when I fell I was unable to save myself as well as someone without a weak shoulder.

2 things I want to suggest:

I have recently discovered hiking poles and have bought 2 that have the same shaped top as a walking stick to allow me to lean on them as I have issues with balance and tend to fall and also have troubling standing for any length of time. The poles have small springs in the base and as you walk they help to propel you forward, plus you can also change the ferrell for walking on soft ground like sand. I can now walk more safely and faster (but my faster is still slow) than I have in years.

The sticks help me balance, but also help keep me straight so that my body isn't out of line which helps with avoiding developing other problems related to walking with one cane. They also look trendier than a cane as everyone uses walking poles these days. The price was just £5.99 each on ebay. I'm not sure what that is is dollars but knowing the current conversion rates probably less than $5 dollars each. So cheap enough to try.

I bought 2 with straight handles to start with but I can't lean on these as well when standing - so guess what - my other half uses them when we go out walking so I don't feel so alone and we look like hikers - well sort of - except for my limp etc. lol.

My neuro PT has told me that although I cannot strengthen weak muscles, quite often the muscles are weak as the brain is not sending the correct signals to that part of yoru body. For example the muscle that supports my right shoulder has dropped completely and is no longer supporting my shoulder as it should. She has given me lots of exercises which are intended to help my brain re-route the messages and relearn how to use / hold particular muscle groups. It has helped a little so far but I haven't been doing it long and it may be worth a try. It may be simply holding back time but I will try anything - lol.

Be well and take care

Pat

[essdipity]

I think all diagnosed MSers and  those with possible/probable MS should have a PT evaluation. It was a real eye-opener for me. There are therapists who specialize in MS work, and these are what you should look for. They will not force you beyond what you're capable of and thus make matters worse.

We've had lots of discussions on PT, so a check of the forum archives or a search should bring up some helpful responses.

If damaged nerve pathways are causing muscle weakness, there's no way that can be restored, but there are ways of compensating, and of keeping other muscles strong. Also, PT is great for balance issues, and these can really improve. Better balance equals fewer falls.

Physical Therapists have Master's degrees at least, and those being trained now are getting doctorates. Obviously this is a complex specialty, and I'm not knowledgeable enough to say how it all works, that's for sure. But most primary docs will refer someone for at least an evaluation, so insurance should cover that much. Often it's on-going, provided various hoops are jumped through, but that's life.

I would say, though, that most neuros would not be impressed by a PT report for diagnostic purposes, so get that out of the equation and go just to help yourself function maximally.

Good luck.

ess

[Charley123]

I'd like to know more about physical therapy too.  I tried it 5 years ago when I had a knee injury and only some muscles improved and most didn't.  That was at the time I discovered that I might have MS.  

Are there PT's who specialize in MS?  Hugs to all, Charley.

[twopack]

I'm new to all this but I'm not sure I'm prepared to believe that statement.  

I believe it is true that you need signals from the nerves to move the muscles and make them stronger.  Quix has told us that we experience limb fatigue because the signal to the muscle weakens or is slowed.  And I have seen that an unexercised muscle will shrink away.

Couldn't the muscle still be strengthened?  How about those commercials you see now to "tone" a six-pack by wearing a belt with electrical stimulation?  What about the way my muscles contracted with the outside source of electrical stimulation in PT after my knee replacement?

Now, it's been over a year and that knee still isn't feeling very strong lots of days but it still continues to get better if I keep working at it on my stronger days.

I still believe we can build muscle until/unless total paralysis sets in.   Muscle strengthening may not prevent all (or even any) collapsing falls but it can keep us prepared to make the most of the good physical days we have.  

I do understand that no matter how strong a muscle is, it becomes useless when it doesn't receive a signal from the brain to MOVE.  But I'm thinking there are other benefits to the body, mind, and spirit that make this pursuit worthwhile.

I am interested in how PT can help us learn not to fall.  Can you share what you know please?

[jensequitur]

If the muscle is weak, then you can't make it stronger - it's a neurological thing.

However, PT might help with other conditions, and will help you learn not to fall.

[Charley123]

I checked out the shoes and they looked great...except for the price.  I'll have to save up for a pair or two.  

Quix..thanks for the input.  I'll look into a walker.  I see my doc next week.  I think I can get my insurance to pay for it if she agrees.  I also see the new neuro next week.  It's hard to get my enthusiasm up for that one.  Right now my enthusiasm is at an all time low for dealing with yet, another new neuro.  I'll have to work on my attitude before I see her.

Pastor Dan, I'm so sorry you fell.  Hope you are ok.  I've fallen a lot but have not, until this last time, passed out.  

Jensequitur, my right side does just collapse. I think your comparison to a folding chair with a broken leg says it just fine.  My right ankle also just folds over and I think that is why I fell a couple of times outdoors.  I'm thinking that some sort of physical therapy might help.  I hope the docs agree.

I'm having a hard time getting my inner strength back into focus today.  It does help to vent here. ♡  Hugs to you all, Charley

[jensequitur]

Charley, is your right side just suddenly collapsing?  Like a folding chair with a broken leg?    I have this specifically in my right knee.  There's a muscle in there that's either weak or non-existent, and the knee will fold up without warning.  

I've gotten used to catching myself, and I walk with my foot turned out much of the time.  Sometimes because of spasticity it's more comfortable to walk that way anyway!

[PastorDan]

Late wife used MBT shoes for a few years, after her 2005 foot surgery.  She loved 'em.  Yes, they were mighty pricey.

I nearly always buy good quality shoes anymore, my experience as a greeter and a cashier several years back having pretty much made it necessary, in order to avoid further injury.  I have SAS, New Balance, and Clark's shoes that I use most often.  My 11EEEE feet don't make it easy.

I've resigned myself to the cane long ago.  For a while there, I was considering getting a second, perhaps with some kind of elbow brace or something -- whatever I was thinking of is probably more along the lines of a crutch, if I could think it through.  Lately, though, I had been doing a little better most days, albeit not lots.  Then I fell Friday night; very few marks left, & broke none of household belongings in Nancy's brother's basement spare room.  Not on the upswing, balance-wise, since about this time last week, I think.  I lose track.

Peace & b lessings.

[essdipity]

Don't want to sound like a commercial here, but I've found that DSW has a big selection, including athletic shoes. Their regular prices seem to be about 25% less, and they have a lot of mark-downs too. It's always good to try on several pairs if you can.

ess

[twopack]

Charley, go ahead and try some different shoes IN ADDITION to the walker.  I believe the cane helps with balance but it seems you need more right now to keep you safe and sound.  I sure hope the new neuro gets you where you need to be.

Quix, I tried a pair of the Sketchers but the sole is just too thick and soft for me to trust.  The feel of walking on clouds was great until it added to balance problems.  I almost felt like I was bouncing and being propelled forward faster than I was comfortable with.  I also tend to pronate and I could feel my right foot rolling in.

You are so right about the $$$ but when something works it becomes worth it.  I'm stumbling less and as a bonus, my plantar fasciitis has stopped hurting.

The brand that has worked best for me is Alegria.  They have a thick sole too but it is firmer and I feel more secure.  They have less of a rocker bottom and more a well cut back sole at the toe.  I will warn that shoes with these types of features may not work for people who tend to roll over easily at the ankle.

I haven't seen the Alegria brand in stores but then I don't go shopping much.  I ordered online from a place that charges a little less than stores and still manages to offer free shipping (even on returns!).

Fitting can be a little tricky as they are sized by European standards that have no half sizes.  They seem to run a little wide which is great for my old spread out feet.and easily numbed toes.  With the free shipping both ways you can afford to take a chance.  They paid all the shipping for me to try three sizes before I got it right and never uttered a chirp of complaint.  I'd be glad to share the web addy privately with anyone who wants it (don't know policy here on posting links).

Mary (who's hoping you weren't expecting the short answer)

[Quixotic1]

You must take action on this.  The simplest of falls can be fatal.

You got some great advice.  I think you should use a rolling walker - called a rollater/rollator.  These really can help with the problem.  I also suggest you get a referral for physical therapy to analyze your gait and muscular strength.

Mary was right-on when she said that your brain is more vulnerable now to further trauma - meaning a little bump can do a big amount of damage.

Mary - I'm going to try the rocker bottom shoes.  I was going to try the Sketchers, but the MBT looked good too.  They're so darned expensive, though.  What kind of shoe do you wear?

Quix

[Charley123]

That's good advice.  I'm going to look for some shoes like that.  I'm still pretty off-centered from the fall and am trying to pay attention to my feet.  Yesterday I almost fell again and it was the right leg that didn't respond to walking.  I think the shoes might help, thanks, Charley

[twopack]

I've found that shoes with a rocker type sole help me.  Since they are cut back under the toe, there is not so much to trip over if I fail to pick up my feet/legs.  I don't know that this would help with the collapsing fall you described though.  

I can relate to your fear.  I've been getting more scared about falls too. A recent bone density scan showed osteopenia.  This increases my risk of fractures and gives me one more reason to prevent falls.

Christmas Eve of '08 I fell straight forward (BAM) on my way into work.  I ended up with a broken foot, soft tissue trauma around my 4 month old knee replacement (thank God no break there) and a mild burn on my wrist.

Still, I was better off than the festive gingerbread men I was carrying.  They drowned in the large BK-Joe of coffee that pooled in their plate as I fell.  Perhaps that was a better fate than the beheading they were destined for had they met up with my co-workers?

(anyway....)  I've had many stumbles through the past year and a few falls aborted by the presence of a convenient wall or object.  Here and there one of those objects was damaged but I escaped further injury myself until late summer of '09 when a fall on gravel chipped my other (natural) kneecap and the skinned area became infected.

A movement specialist I consulted noticed that when I flex my feet, the little toe side lags behind the big toe side and may increase my tendency to trip.  I've tried exercises and consciously training myself to be more aware of lifting my feet when I walk.  Unfortunately, I tend to forget about this when I'm motoring well.  It usually takes a stumble to remind me :{

Sorry to go on and on.  Thanks for tolerating my rambling.  I hope you find a solution and that it is only needed temporarily.  Please be especially careful right now as your recent head trauma could make you more prone to falls and may also cause your brain to be more vulnerable to big damage from small insults for a while.  Hopefully, 2010 will be kinder to you.

Mary

[Charley123]

I've been thinking about a walker.  I'll look into it.  For now I have only my cane.  My neuro is a 2 hour drive.  I'd like to find one closer but so far no luck with that. I can handle most things connected to MS but the falling, especially this last one, is really making me upset. Thanks for your input, Hugs, Charley.

[Guitar_grrrl]

On the days when my balance is off, I use my stick.  I keep it handy even on days I feel OK.

I hope you feel better, SOON!
Guitar_grrrl

[meg321]

Hi Charley,

I used to fall down a lot but it was from dizziness and poor balance, my body somehow learned how to fall..lol

I suggest  a  walker until you get better, at least it would help.  Good luck with the new neuro..Do you have an MS specialist close to you? Or within driving distance?
I went to one at UCSF and it is a 3 hr drive but it was so worth it.

hugs, meg