Life on Wheels (32 page)

Osteopathic doctors are conscious of the movement of cerebrospinal fluid around the brain and down the spinal column. They are attuned to the four diaphragms in the body—the pelvis, the abdomen, the chest, and the brain. They are concerned with the freedom of movement of the ribs and practice a mode called craniosacral work, which senses the relative movement of the sections of the skull.

People’s bodies absorb toxins from the environment and foods. These elements become held in our tissues and can weaken the body or immune system. Metabolic waste from the contraction of muscles gets trapped between the muscle fibers, leading to stiffness and soreness and limiting the full strength of those muscles.

The goal of massage therapists—no matter what style they employ— is to rub the muscles to release toxins and allow the bloodstream to carry them out. Massage therapists study anatomy, so they know what muscles they are working on, how they are connected to the skeleton, and how they should feel under their hands when they are normal and healthy. They will generally work toward the heart, to help the blood carry toxins into the kidneys and out in the urine. It is a good idea to drink plenty of water after a massage to help this process of elimination.

There are many types of massage. Some are very gentle. It is quite wonderful to be rubbed gently, in a peaceful, trusting setting. Touch is itself healing, as even traditional physicians increasingly recognize.

Other types of massage can be deep and intense. Many massage therapists will say that it is important to work deep, even if it is a bit painful, in order to release the locked tissues and clear the toxins. For example, “Rolfing” is a style of very deep massage therapy called Structural Integration, developed by Dr. Ida Rolf. Good Rolfers are able to start gently and work down deeper.

Homeopathic doctors see illness as a message trying to tell you something about your life. Homeopathic doctors want to determine what your body is telling you. They believe the symptoms exist for a reason, and conventional treatment might not work if the root issues are not addressed. Even an injury can raise important questions about what led you to that moment.

At the initial visit, homeopathic doctors will do an extensive interview about your life. Practitioners treat with granules—very small doses of certain substances, usually herbal, but processed commercially. These granules are microdoses of the disease you are suffering. According to the homeopathic view, homeopathic medications attempt to stimulate the body’s own reaction to the illness, much in the same way that a vaccine works by putting a small amount of a disease into you.

Steve and Aviva Waldstein, homeopaths in the Denver area, write:

Homeopathic medications are now widely found in health food markets and are extremely popular in Europe. Homeopathy is the primary approach to health in some countries.

Life itself is a degenerative process. But you still have considerable control over the quality of life as you age. When you understand the innate changes in your body over time, you are better able to craft a lifestyle to maintain optimal health and reduce the chances of catastrophic problems.

It is common to lose muscle mass, although this is largely the result of less activity. Range of motion becomes limited as muscles shorten and tendons and ligaments become less elastic. Some degree of arthritis might affect the joints. Muscles remain responsive to exercise and stretching but require regular use to prevent significant, functional weakening.

The skin becomes less elastic and thinner, bringing with it increased risk of bruising, cuts, and skin breakdown from pressure.

Bones become more brittle. Osteoporosis is common in elderly people, particularly women. You are at higher risk for breaking bones as you age is because your bones have lost calcium and therefore break more easily.

As you age, your senses lose sensitivity, reflexes slow down, and coordination is reduced. Ultimately your short-term memory becomes less acute, although longer-term memories typically remain intact. Recent research indicates that mental acuity when aging is maintained by regular mental activity, including playing games or writing a journal. Energy levels get lower, and you need less sleep.

These facts of life are not inevitably limiting. For nondisabled people, quality of life can be maintained by keeping active.

Aging is a mix of psychological losses and gains. There can be sadness over the loss of youthful health, fear of approaching death, regret over certain life choices or missed opportunities, the loss of friends and loved ones, and increasing dependency on others. Aging also can bring increased maturity, wisdom, perspective, certainty of one’s identity, joy in reaching a point of completion, and peace. Psychological benefits can help offset physical decline.

The lost muscle mass that normally occurs with age becomes a greater issue when muscles are already weakened by paralysis or a genetic disorder, such as a muscular dystrophy. As you age, you need to continue to exercise moderately to maintain relative strength as muscle mass declines so that you can function as independently as possible. The ability to transfer to and from your wheelchair is probably the greatest concern. Loss of this ability is a key reason why a previously independent chair user might require the use of attendant services.

Chair riders are already at increased risk of skin breakdown from sitting because their skin becomes thinner and more brittle with age and increases this risk. As you age, you will need to take extra care with keeping your skin clean, doing pressure-relief pushups and changes of position, possibly changing your cushioning strategy, and being vigilant about maintenance of your wheelchair and cushion to ensure proper pressure distribution and support. Since aging increases susceptibility to other heath problems such as pneumonia and flu, you might find yourself spending more time in bed. If so, change positions often and consider using a different mattress or cushion.

As a chair rider, you must rely on the remaining parts of your body that you are able to control. The arms and shoulders take on a lot of the work once performed by the legs, whether pushing your chair, transferring yourself in and out of it, or adjusting yourself in bed or in a favorite recliner in the living room. The shoulders are forced to do much more than they were designed to do. After enough years of extra work, there is a high risk of chronic pain or joint overstrain. A young chair rider able to push long distances over sloped or rough terrain might discover in his 50s that he overused his shoulders and has to switch to a power wheelchair.

For a person with a disability, it is vitally important to manage the aging process. Drs. Gale Whiteneck, PhD, and Robert Menter, MD, write:

Most aging studies look at both the age of onset of the disability and the length of time one has a disability. People who acquire disability when they are older tend to recover and adapt less effectively than do younger chair riders. When older people are injured, they are already dealing with some results of the aging process, which make adjustments to disability more difficult. The length of time you have a disability is another factor that affects the degree of change you might encounter as you age.

These two factors sometimes have opposite effects. Pressure sores, for example, are found to increase with the age of the person but decrease with the length of disability. The skin is frailer when people get older, but a more experienced chair user will have better skin-care habits and skills.

Other conditions more closely related to an older age at onset are heart problems, pneumonia, respiratory infections, kidney stones, fainting, and headaches. A longer period of time after the injury is more associated with musculoskeletal overuse strain, tendon and joint pain and stiffness, hemorrhoids, and urinary problems among men.

In general, signs of aging occur earlier in the disability population than in ablebodied people.

Your ability to stay healthy and have a full life might rely on being assisted with certain tasks. The kind of support you might require could be as simple as some light cooking or running a few errands or as significant as help with your bowel program, getting dressed, and getting into and out of your wheels. A PA might also administer an injection or perform simple physical therapy tasks such as range-of-motion and stretching exercises. Certain tasks might need to be performed by a registered nurse; some states require this for catheterization, for instance.

The basic questions to ask include the following:

How much support do you need?

Who will do it?

How do you find these people?

Will it be a family member or friend?