Anatomy Lesson

I went to PT at the UW yesterday and saw my physical therapist, Whitney. She was ecstatic about the fact that my toes are moving! She said people will often come in and say their toes are moving, and she has to be the bearer of bad news and let them know that it's actually just a spasm. But when she saw my toes and that I can obviously control them, she was thrilled, showing it to all of the other PTs that I worked with while I was at the U.

Yesterday was a great day with Whitney. In addition to learning how to do wheelies, I also learned more about my recovery. Of course she prefaced everything by saying that being able to move my toes does not mean for sure that I'll start walking again....blah blah blah.

I am able to move four of the toes on my left foot. I cannot move the little one yet. I can move the toes up, and I can also curl them under. These actions are controlled by L5 in the spine. My injury was at level T6. The little toe is controlled by the sacral spine. The muscles get fatigued pretty quickly which is typical. The first time I move my toes is much more pronounced than the 5th, etc. I'm doing toe exercises three times a day now to work them out enough, but not too much so as to burn out the nerve.

It does not make sense to me, even after going over this with Whitney, why my toes would work first. But somehow the nerve connection to move the toes is shorter than the connection to move my quads or butt or something like that. If anyone truly understands this maybe you can explain it to me! But either way, before people start walking again the first movement is usually with the toes. It's the easiest connection for the body to make again. This diagram gives you a better idea of which areas of the spine control which muscles.

She expects the progression to continue up my left leg, and the next thing to kick in would be my ankle. As soon as my left leg is working again I can start walking, with a brace on the right leg. I've always expected the recovery on my right leg to be a little slower because that was the leg I was having problems with for over a year. That leg went through quite a bit more trauma than the left did.

My legs were spasming like crazy - she asked why. I told her that ever since I was prayed for last Saturday (the 11th) my legs have been spasming much more than usual. She said "I didn't realize that was part of your story - no wonder you've been able to remain so positive throughout this experience." I let her know that was the only reason I've been able to remain positive, because I KNOW that I'll walk again, there is no doubt in my mind.

Whitney and the doctors are kind of like drug pushers - maybe they get a commission for getting me on meds, who knows! Every week she's trying to get me to go on meds to control my leg spasms. How do I make it clear that unless I am being thrown out of my chair by spasms, I will not be taking them?? She insists that things like transfers out of the chair will be easier. I'm sure that's true, however, the side effects of the medicine to control spasms are awful. I've been told by the doctors and therapists that you basically feel like you are loaded all the time, and you have no motivation to do anything. Sounds fun. Whitney mentioned yesterday that if I were on meds to control spasms, we wouldn't know that my toes were able to move. I wonder how many people's recovery is masked by the meds they are on?

Whitney did a thorough check of my legs yesterday, where she isolates muscles and checks for any sort of movement. She wasn't getting much response on the right side. On the left side she was much more hopeful. If I was trying to pull my leg up to my chest and she started the movement for me, the leg would continue. It was a spasm, not a controlled movement. But it's a good sign that my legs are spasming into the position I want them to be in - at least they are thinking about it. It's not spasming in some other random direction. She said "I think we are going to have other things moving soon." You bet we are!

I've talked with several people who started walking again, and the first step was the toes. I am thrilled that we can finally see the miracle at work!