Cane and Able

IMG_1844_dewarpI’ve arrived at the steps to my office building. It’s a somewhat unattractive 1950s carbuncle, but defines who I am and where I belong.  I’m feeling ready for the fight, although more recently the fight has become more challenging. It’s ever more difficult to conceal things.  The dizziness, the staggering, the vertigo, the muddled vision.  But I feel that I’ve become adept at fooling others.  Life has become a performance – a game of deceit: pretending to the outside world that everything is under control but at the same time knowing inside that I am in crisis.

I take the first few steps upwards towards reception, being overtaken by late arriving students.  Let’s be honest, I don’t really take steps but rather – ‘staggers’ – as I move my centre of gravity from side to side.  But I’m keeping up appearances.  My eyes are in topsy-turvydom, although I do detect a general sideways pincer movement in my peripheral vision. Uniformed security men appear to be rounding on the reception from both my left and right. What vagrant or miscreant has caught their attention? They move pensively in an orchestrated manner.  But before I know it I realise that I am the cause of their attentions.  It falls to the rather reluctant younger security guard to confront me:

‘Are you going somewhere sir?’

‘Yes,’ I reply, ‘I’m going to my office.’

The security guard then awaits further explanation…

‘I work on the fifth floor, I’m Professor Finch’

By this time I am surrounded by a gaggle of security men.  It’s apparent that further explanation is required and I realise that they think I have turned up to work in an inebriated state.

For a moment I quite like the piquant individual that they imagine.  I could be the maverick professor, like Michael Caine in Educating Rita, who has grown cynical of university life and all that it pretends to be.  A witness to the university sector’s version of ‘quantitative easing’ which has seen a 30% rise in the number of professors in the last 10 years and the unfettered assignation of university status.  The currency of education has become abundant: abundantly impoverished. Yes, I rather embrace the conception of myself as a drunken, self-pitying  don who had become a thorn in the side of the establishment.  But I’m not about to ‘bugger the bursar’.

‘I suffer from multiple sclerosis, perhaps my staggering has caught your attention, I’m not drunk…!’

Clearly at this point the security team feel embarrassed and perhaps disarmed by the situation.  This does not appear on their list of likely incidents.  They may have feared a reprimand in Senate.  But I wasn’t angry, just deflated by the realisation that I was no longer able to conceal my disability.  Henceforth, things would have to be different.

walkingstickSo from this point on I would need to use a cane or walker.  Not because it necessarily helped me to walk or scale the stairs.  No, the cane would not be for me: it would be for other people.  It would simply be a message to tell them that although I was incapacitated – I was not drunk.  I knew that a walking device would do little to alleviate my struggle, but at least I could share the struggle with other people.

My short reminiscence is not unique. I think fellow sufferers often use walking aids to alert other people to their predicament. Difficulty in walking is only one of the challenges facing us – yet it is the one that is conspicuous and plain to see. It seems to me that walking aids are used for many reasons other than simply getting from A to B.  Frustratingly, this fact seems to have escaped the research community.  Research papers often highlight walking aids as being a risk factor connected with falls. This assertion seems to be bad science. There is a difference between being a ‘causal’ factor and being an ‘association’.  Falls are not surprisingly more common amongst those disabled people that require a walking aid.  That is because they are a self-selected sample who are invariably more prone to falls than those not using walking aids.  To confuse causation with association would suggest that walking aids increase the likelihood of falls.

mobility-walker-250x250For me, as my walking has become more ‘challenging’ (euphemism for crappy), the risk of a fall has had to be weighed against the risks that attend my rootedness (sedentary behaviour).  The likelihood of a fall is uncertain but the effects of remaining static – whilst being less dramatic –  are more insidious.  It is a choice between using a walking aid or not walking at all.  The walking aid has ceased to be a means for getting from A to B.  Instead it has become a remedy to all of the symptoms that arise from being stuck in a wheelchair.  The lungs find room to expand, the spine uncurls, and the digestive system finds its own voice!

A small circuitous lap around the room simply brings me back to where I started.  It’s a seemingly futile undertaking, but after all, aren’t most things in life like that. They bring us back to where we started.

 

Further discussion

Published research literature on the use of walking aids conveys mixed messages.  Some of the research would have us believe that using a walking aid actually increases the risk of falls.  Take, for example, research reported in the Journal of Geriatric Physical Therapy.  The purpose of this study was to  “To investigate the use of walking aids as a risk factor for future falls among older adults living in residential aged care facilities and to identify spatiotemporal gait parameters that mediate the potential relationship between walking aids and falling.”  Put in layman’s terms, the study sought to establish whether a person’s walking style combined with their choice of walking aid gave rise to particular risks of a fall. Well, the study seem to suggest, perhaps not surprisingly, that using a walking aid was often associated with a higher risk of falling. Indeed their conclusions were “Using walking aids is a risk factor for future falls among the older population living in residential settings.”  Sometimes I am embarrassed to admit my academic background given that such self-evident conclusions are made.  What about the risk factors associated with not using a walking aid (i.e. not walking at all)?  Somehow this research seems to have missed the point!

Understanding the Relationship Between Walking Aids and Falls in Older Adults: A Prospective Cohort Study.

Other References

I’ve had it up to here with… “I’m not drunk, I have MS”  (This article argues vehemently against the type of explanation that I have described in my blog.  But I would defend it.  It only articulates what is unspoken in the minds of ‘spectators’ and provides a great opportunity to inform the uninformed.)

Falls in people with MS—an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States

Fall risk and incidence reduction in high risk individuals with multiple sclerosis: A pilot randomized control trial

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