Avoiding falls

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Samkl

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Nov 1, 2019
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143
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Lost a loved one
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08/2019
Country
AU
State
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Wollongong
I’ve read everywhere that you should avoid falls as a PALS, and it makes absolute sense. But why specifically is that?
 
A few reasons:

Falls can accelerate progression, as the energy spent in healing "spends down" the body (not the most scientific way to put it, but, I think, true). We know ALS is in part a metabolic disease, where PALS consume more energy for the effort they expend than "healthy" people.

Injuries from falls are slower to or may never heal because of lack of mobility, which in turn affects circulation, fluid balance, and healing. Internal bleeding/external bruising and blood clots are both more likely to stick around when the body is less able to do its normal housekeeping and spends more energy doing it. Suboptimal nutrition related to difficulty swallowing, chewing, and feeding tube compromises also makes healing harder.

These injuries further impede dwindling mobility or cause more swelling/pain in those who are already mobility-challenged, which creates a vicious cycle.

I am sure I forgot something that someone else can fill in --
 
In various falls I have lacerated a palm, broken an elbow, sprained an ankle, broken a toe, and bruised my ribs.

The strange thing about falls is that for me they are absolutely unpredictable. I just go down with no warning. I don't have the ability to anticipate a fall or protect myself when I feel myself falling, so am much more susceptible to injuries.

Not only do the injuries from a fall seem to speed up progression, they also diminish my quality of life as I recover from the injuries. I want to get the most out of my remaining time, and that means I need to avoid these kinds of injuries.

And, I have never had a "serious" injury. That is, I have never injured myself in a life-threatening way. Others have, and some have died from those injuries.

Even though I can still walk a bit, I have been using a wheelchair since shortly after diagnosis. All but one of the injuries reported above occurred in falls that happened while I was being diagnosed. Once the doctors impressed on me the importance of not falling, I have been a faithful user of supportive devices, including the wheelchair, to reduce the likelihood of falling.

Steve
 
Thanks very much for that. I’ve passed those responses on. I know how important it is for a PALS not to fall, but when asked I couldn’t put a convincing argument together🙁. I really appreciate it.
 
Hi,
I totally agree with other comments made.
Avoid falling at all costs and rather play safe.
I fell 3 years ago and cracked facial bones and needed surgery and, because my voice was my first loss through MND, I was unable to speak or explain anything verbally. I managed very basic contact by using a Speech App on my phone.
I also could not eat solid food and the only nourishment I got was chicken gravy, jelly and small yoghurt during my 24 hour stay in hospital. The nursing staff had no idea of how to handle me or my condition.
Shelley (South Africa)
 
Thanks Shelley. I really appreciate your response. 🙂
 
Like Shelley, one of my falls ( this one from the relative safety of a counter stool) required an ambulance ride, broken eye orbit, and stitches. I've had three serious concussions ( depression being the worst outcome), three black eyes, bruised ribs, broke two sets of glasses, and put my butt through the sheet rock in my bedroom. So aside from serious injuries and inconvenience, falls can be costly. And unlike falling when you're well, PALS can't break a fall with our arms or stumble and recover. We go down hard, like a tree.
 
Avoiding falls is a thing that can be controlled with equipment. Everything from a cane to a walker/rollator to a wheelchair. The trick is to not to wait for an injury to transition to the next level of support. It can be hard, but it is vital to stay ahead of the game to not get into danger. Equipment also allows you to use less energy, saving it for fun stuff!
Vincent
 
My Chris never fully recovered from the injuries he sustained in falls because of the addition of ALS. The first fall right onto his already stiff shoulder meant that simply never healed properly and he had a lot of pain for the rest of his life.
He then progressed quickly in many areas after each fall.
The last one result in split head, concussion, broken ribs and many soft tissue injuries.
When PALS fall they can't do anything and go over hard.

We have also lost a PALS who fell, wasn't injured too badly, but then could not breathe flat on the ground. Just awful.
 
I fell two years before I was diagnosed. I was on a run and my foot hit a huge crack. I face planted and was briefly knocked out. I had so many cognitive symptoms I was sent to a neurologist psychiatrist for TBI testing. It lasted all day. My IQ dropped 50 points and I could no longer do special recognition problems. I still suffer some residual effects from that TBI including the inability to read subtitles on TV.

I regained much of what I lost but it was very hard work. My doctor thinks it was a contributing factor in getting ALS.

Falling can definitely mess you up. I was already taking an antidepressant when I fell but I did have Very bad episodes of rage
 
each of my falls weakened my body in some fashion. prior to my last fall i was able to walk short distances with assistance of a walker or rollator. since my last fall i have been confined either to a bed or power chair. thank heavens for a power chair equipped wit a vertical lift function. i really miss being able to sit in a comfy chair or couch !
 
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