Merry Christmas!

Upward and Onward at the Gym

This is a great recovery story: a paralyzed New Britain man goes to the gym to work out . . . and carries his wheelchair up the stairs while walking on his own. 

Ryan Straschnitzki's Progress and Electrical Stimulation

Sharing exciting videos about an experimental spinal surgery and an ongoing recovery story.  Ryan Straschnitzki was one of the Humboldt Bronco hockey players injured in a very serious bus accident in Canada last year.  Fourteen people were injured; sixteen were killed.  Ryan sustained a spinal cord injury in the accident and has been diligently pursuing physical therapy since then.  Recently he underwent surgery in Thailand to have an epidural stimulator implanted in his spine.  The device is designed to stimulate nerves below the site of his injury.  The results are pretty incredible, as you can see from these videos: when the stimulator is turned on, he's able to move his leg, and therapists are now helping him work on taking steps.  Please keep Ryan Straschnitzki in your thoughts and prayers for continued progress.

As for the epidural stimulator technology, it's been in the news multiple times in the last few years.  I thought readers might be curious to know more about what it entails.  I am not a medical doctor and have not tried this technology, but according to reports, the internal stimulation process goes something like this: surgeons place a device called an implantable pulse generator (IPG) in the user's back or elsewhere in the body, and connect that device to electrodes put on the tissue around the spinal cord.  They can program electrical currents sending signals to the IPG and, from there, to the electrodes.  "The idea, in very basic terms, is to stimulate neurons" when the electrical stimulation is activated, as reported by a CBC News article (see here for the complete article).  If you're interested in learning more, Wings for Life's site features more details and an info graphic.

There is a non-invasive version of electrical stimulation that has also seen some amazing results.  This technique, known as transcutaneous stimulation, involves placing the electrodes on the skin of the user's lower back and then activating the electrodes with external electrical stimulation.  An NIH news release notes that by the end of one study, the users "were able to move their legs with no stimulation at all and their range of movement was — on average — the same as when they were moving while receiving stimulation."  (Click here to read the full 2015 NIH release.)

All in all, these strategies have the goal of reactivating dormant nerve pathways or creating new ones altogether.  Life-changing outcomes.

NB: For more, you can read my older posts on related studies happening at the University of Kentucky: September 2018, January 2018, and November 2017.  Thanks to Susan Harkema and Claudia Angeli for their work in Louisville!

In Remembrance and Thanks for Our Veterans

"In Flanders Fields"

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.
We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved, and were loved, and now we lie
In Flanders fields.
Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

- Major John McCrae, 1915

Paralyzed Officer Stands for National Anthem

A good story that has drawn attention this week: fourteen years after sustaining a spinal cord injury, Officer William Weigt was able to stand for the National Anthem and present the American Flag at the Special Olympics Arizona this week.  Officer Weigt is also a veteran of the United States Army.  Thanks to him for his service!

Video: Truck Transfer with Unlocked KAFOs

Getting in and out of a truck with KAFOs.  This is an older video with classic braces which I don't use anymore, but since there aren't many videos about everyday life with KAFOs/ long leg braces, I hope this upload will help others who are figuring out vehicle transfers.

At release from rehab, before leg braces and still in recovery from extensive upper body damage, I was told that it would take 4-5 people, a slideboard, and a bedsheet for me to get in and out of a truck.  Much healing and many steps later, what a major difference from the initial prognosis.

(Note: This video is from almost two years post-injury, with both KAFOs completely unlocked at the knees.)

Supporting Ben Abercrombie

An update on Ben Abercrombie's progress as he returns to Harvard University while working at recovery from cervical spinal cord injury.  Please keep up the thoughts and prayers for Ben and his family. 

Aggie Recovery Story

SCI recovery story: an Aggie walks again after paralysis.  (To find out what an Aggie is, you'll have to look up Texas A&M University.) 

Exoskeleton Update

A big story on all of the news outlets this week:
"Paralyzed man able to walk with mind-controlled exoskeleton suit"

From applications in medicine to industry to the military, exoskeletons are big news right now.  This interesting review, "The Human Exoskeleton comes of age," was released only a few days before the story of a new mind-controlled exoskeleton came out. 

SCI Awareness Month

September is official "Spinal Cord Injury Awareness Month."  If you're looking for statistics or other information related to SCIs, you can follow this link to learn more.

I don't have any particularly profound insights to add in commemoration of the month, except to quote the reported axiom of Benjamin Franklin: "An ounce of prevention is worth a pound of cure."

While an ounce of prevention cannot guarantee against injury (if it could, a lot of us would have a lot of ounces), and while a pound of SCI cure is not necessarily available (if it were, a lot of us would also be availing ourselves of a lot of pounds), doing your best to prevent a spinal cord injury is smart when you can do it.   

Thanks to Bryan Camacho, Army Sergeant

Veteran Bryan Camacho (Army Sergeant) was paralyzed twice, once in Iraq and once in the U.S.  His story, featured in the news as he is receiving a new home from the non-profit Home for Troops, is a reminder: please be thankful for our veterans and the lasting sacrifices they make.

Emotions and Physical Recovery

Hmm . . . emotions may directly affect recovery after spinal cord injury.  (I'm not sure how I "feel" about that!) 
In all seriousness, this conclusion seems sensible enough, given the general importance of mental and emotional health for anybody's physical health.  It remains to be seen what the next step would be following this type of a study. 

NervGen Pharma Trials and Scar Tissue

For readers who are watching NervGen Pharma, here's an update on upcoming trials for people with spinal cord injuries and multiple sclerosis.  If you're new to NervGen, they're working on a peptide (NVG-291) that will allow nerve regeneration in spite of scar tissue.  You can read more about NervGen and NVG-291 here. 
I've talked about scar tissue and various treatments of it several times before: using an EpiPen for SCIs, eating blue M&Ms (yes, M&Ms), injecting nanoparticles, and inserting an internal scaffolding.  All of these different methods tackle the situation of scar tissue which blocks regeneration.  The blue M&M seems like it would be most popular, and I'm keeping an eye on it . . . but it's not that simple!  Caveat lector. 

Video Update: Working with the LifeGlider

The LifeGlider

The latest addition to my PT line-up: the LifeGlider.  I was excited to try out this new type of walker, and hope that it will help in the retraining process as my brain and body continue to reconnect.  The LifeGlider is designed to realign the center of your balance as you walk.  The first half of this video was taken in July, going slightly downhill on a smooth surface; the second half in August, on a carpeted, level surface.  Here, as you can see in the video, I'm focusing on walking backward. 

Forward videos to come soon.  For now, I think it's encouraging to see the improvement over time.  In the spirit of Psalm 126:3: "The LORD has done great things for us, and we are glad."  As always, thank you to everyone who has rendered support and been a part of the larger path forward!

Video Update: Rowing Machine

My latest video update comes from May 2019: working unassisted at the rowing machine!  It isn't perfect form yet, but I've come a long way since not being able to move the weight without help.  I also have a new therapy device that I'm trying for walking and adaptive exercises.  Video of that soon to come. 

Cheering for Ben

I’m a Yalie, but Ben Abercrombie is a Harvard man worth supporting.  He is returning to Harvard two years after sustaining a severe spinal cord injury, and is still working hard on his recovery in the meantime.  Please keep Ben and his family in your thoughts and prayers as he goes back to school this fall. 

The EpiPen is Mightier than the Spinal Cord Trauma?

I've posted on some fascinating technology and treatments in the past, but this development is an eye-catcher.  Scientists at the University of Michigan discovered that an injection of non-pharmaceutical nanoparticles after a spinal cord injury can redirect the natural immune response and support nervous system repair.  This "EpiPen" for the SCI would minimize or possibly even prevent dangerous inflammation and promote regeneration at a critical time, maybe inhibiting the growth of scar tissue that could (literally) stand in the way of nerve regeneration.
Nanotechnology in medicine sounds like science fiction, but it isn't.  It's part of a much larger conversation about safe, responsible application of nanoparticles in contexts ranging from spaceflight and bioethics to car manufacture and food production.  SCI EpiPens are an incredible entry into the debate.  Practically speaking, they could change a lot of lives.  Order yours today?

Update: Devon Gales and Family, Home

I was so glad to see this article about Devon Gales and his family!  Devon was injured in a football game four years ago, and has worked hard on his recovery.  His family has faced a lot of hardships while waiting for a new home that could accommodate them and allow them to be together after long times apart.  They finally have their new house . . . and hopefully even bigger and better things ahead.

Nerve Transfer for Regaining Movement

Nerve Transfer is an up-and-coming treatment to help with regaining some arm and hand movement after spinal cord injuries.  It has been shown to have pretty amazing results for restoring critical motions (e.g., grasping, pinching), as you can see in the research videos attached to this article.  Something to be aware of for anyone who is looking into alternative options. 

Video Link: Summer SCIs

Just an informative little video about spinal cord injuries caused by summer activities. 

More Research in Louisville, KY

This is a pretty exciting article about more of the results coming out of the University of Louisville.  Researcher Susan Harkema is doing some great work there.  I appreciate her tenacity and her general attitude about SCI research.  She seems to recognize not only that even the smallest changes are worth tracking, but also that they have the potential to change lives for the better in big ways. 

6 Years Later: SCI, PhD, and Video Montage: 6 Years in 6 Minutes

Today is the sixth anniversary of the car accident that caused my spinal cord injury, and therefore marks six years since the beginning of my recovery story.  This spring also marks a happier milestone: in May, I had the privilege and blessing of graduating with my PhD in Classics from Yale University.  I began the PhD program the year before the accident and was visiting family over the summer when a distracted driver rear-ended our car.  Thank you to everyone who has helped along the way to graduation — most especially to those at Yale University, Yale Classics, and BiofitKC.  I'm excited about the next stage of my journey: working with Cordical LC; continuing recovery along with research, writing, and speaking; and hoping to encourage others.  The best is yet to come!

To follow my journey so far, see this montage uploaded today to YouTube:
6 Years in 6 Minutes: Spinal Cord Injury and Path to PhD

Cordical's AccessiRep: Working to Solve a Repeated Problem

Ever since my injury, I have worked hard to get back on my feet.  But unfortunately, regular pedometers and trackers don’t measure much of my activity, if they register any of it at all.  When I was first beginning to walk regularly, charting progress became more and more important.  I counted steps to judge distance and improvements, but with a spinal cord injury, it’s difficult enough simply to focus on taking steps, much less count them at the same time! 

Fixing that situation has been one of the goals of Cordical, a technological start-up founded by me and an extremely talented computer scientist, who happens to be my brother.  Together, we designed AccessiRep, a step counter and activity repetition tracker.  I can launch the application on my phone and put it on a walker, and the app will track my motion and count my steps for me.  It registers activity on a chart and will count aloud if desired.  We are excited to release AccessiRep on Apple’s App Store for $2, and hope that others will see the app’s potential for use in many settings, with disabilities or not.  Since this is our initial release, we also would like feedback on user experiences as we look forward to improving AccessiRep and making it even more personalized and adaptable.

AccessiRep is not a therapy device so much as it is a fitness tool.  Its present features include calibrating for different levels of sensitivity to support multiple types of activity detection, a graph showing movement duration and intensity, private access to past results, and an optional audio counter that will count your exercise repetitions out loud as you work.  Basically, AccessiRep can be put to work for many creative purposes and programs.  In many ways, it’s been a game-changer for me personally.

To learn more about Cordical, follow this link to our website, and to see more on AccessiRep or to purchase the app, follow this link to the App Store. 

Tre Lawson's Ongoing Recovery (Walking the Track)

Just a great video, with great things to come for Tre Lawson!

A Note on Locomotor Training

This study on locomotor training (LT) caught my eye because I was able to have a few sessions of this type of training soon after my injury, but was released due to lack of improvement.  LT involves being supported in a harness (often above a treadmill) and having manual assistance at standing and stepping, among other things.  My limited experience with it was before I began walking with a walker and braces all of the time.  (That was not possible at the time I was released from LT, but you can see videos on my YouTube channel.  Hopefully they will encourage others not to give up.)
But back to this study.  Eight centers gave 120 sessions of this training apiece to people with SCIs — and saw positive changes.  As the study concludes, "Delivering at least 120 sessions . . . improves recovery from incomplete chronic SCI."  The hope is that if insurance permits more LT early on, then there will be fewer hospitalizations and complications later. 
Even better is to see what the results actually were.  I came across a write-up published by Kate Willette, wife of one of the participants.  Apparently many of the people in the study did not have "significant improvement" until at least 60 visits, with some seeing nothing until after 80 visits.  She explains that the study involved 69 people with ASIA C or D injuries, meaning that they have some muscle function below the site of injury (the ASIA scale is best left for another post, but can be used as a common shorthand for how much function or ability someone has after a spinal cord injury).  Of those 69 people, 42 could not walk at all at the beginning; at the end, 20 of the 42 were able to manage with rolling or standard walkers, crutches, or canes. 
All of this is pretty amazing.  More than that, although it again shows how slow and tedious recovery can be after an injury like this — and frequently needing external help or equipment — it is not necessarily impossible.  The people who took part in the study had incomplete injuries and were at different stages in their recovery, but many of them did see improvements.  More to come!

Post-Injury Effects of Pre-Injury Fitness

At least one study is showing how important an active lifestyle before injury is for recovery after injury.  I don't have any information about the medication rehabilitation mentioned at the end of the article, but the rest of the study certainly makes sense.  If you have more muscle memory before an injury, it seems to help with rebuilding or retracing neural pathways afterward.  It would be interesting to see more here on statistical differences for exercise types — i.e., when possible, actively or passively retraining post-injury with the kinds of exercises you used to do pre-injury.  At any rate, from what I have seen (and not just in my own case), active or assisted exercises are essential elements for muscle return. 

Ryan Shazier Update (Box Jumps)

Personal update to come soon, but in the meantime, this is a great update on Ryan Shazier's recovery from a 2017 injury.

3D-Printed Scaffolding

3D-printed implants for scaffolding to repair spinal cord injuries.  It sounds a bit like science fiction when you hear that this technology can be printed in minutes, but scientists are doing it. 

Adam Gorlitsky Update

Adam Gorlitsky has made the news before for his long walks with a ReWalk exoskeleton.  It's nice to see that he's still going, and planning on completing the Los Angeles Marathon later this month. 

Ongoing Recovery of Robert Wickens

This is just a really nice article to see about the ongoing recovery of Robert Wickens, injured six months ago. 

iPS cell trial

A big topic in the news this week: Japan has approved trial stem cell therapy/ treatments for humans with spinal cord injuries.  The cells are "induced pluripotents" stem (iPS) cells.  A Nature.com article explains that "IPS cells are created by inducing cells from body tissue to revert to an embryonic-like state, from which they can develop into other cell types" (David Cyranoski, "'Reprogrammed' stem cells to treat spinal-cord injuries for the first time").  This means that your own cells are used in the procedure.  Researchers from Keio University will conduct the trial with four people who have recent spinal cord injuries. 
This is the first clinical trial of its kind for spinal cord injuries (not for iPS cells).  One worth watching!

Video Update, Feb. 2019: Assisted Heel Slides

This video shows a new sort of exercise for me: assisted heel slides from a sitting position.  Position makes a big difference in muscle response.  That's why it is so important to vary exercises while standing, sitting, or lying down.  That's also why it is important (I think) to have as much active physical therapy as possible.  Your brain and body adjust to static situations, and your nervous system easily adapts to doing less work.  Hence therapists say "use it or lose it."  If the muscles are working, if the nerves are trying to trace new pathways, then it's time to find innovative ways to encourage more improvement. 
Easier said than done.  It isn't easy for anyone with a spinal cord injury to go through this process alone.  Not everyone has returns to encourage, and certainly not everyone has a way to follow up with therapy or exercise.  Thank you to all those who are helping me take advantage of the good changes!

Recovery Story of Katie Bivins

A recovery story in progress for Katie Bivins, who is walking again after a serious accident in gym class. 

Video Update (January 2019)

An update: this video is from January 2019.  I couldn't do heel slides last year, so this is a nice way to start off the new year.  It also indicates that more muscles are returning even as others are strengthening. 

Nerve Transfer Research

A new option for restoring arm function: nerve transfer surgery.

Neuroscience News Update

The stimulator implant for spinal cord injuries made this list: "5 Discoveries That Made 2018 a Huge Year for Neuroscience."

SCIs and Internal Clocks

This particular study on circadian rhythms might explain itself.  Or at least, it might explain why it's being posted in the middle of the night.

A Small Note on A Big Technology Type

A personal update to come soon, but this article is a different kind of update: on exoskeleton technology.

Recovery Story (Starting Off 2019)

The first recovery story link for 2019: a walking (and swimming) quadriplegic.

Stimulator Study Follow-Up

Following up on the University of Kentucky's groundbreaking study with e-stim implants.