Spinal Cord Injury and the Importance of Gravity Dependence in Nerve Regeneration.

Complete Spinal Cord Injury Case1:  John Mason

On the 7th of June 1997, I met John at his home where we discussed his improvements and he assessed them at 60 per cent. It is now almost 14 months since we started. Against the prognosis from Salisbury Odstock Spinal Unit, John now lives in a flat and has become fully independent.

Pre intervention.

For two years following his accident John had observed considerable deterioration and had recovered no sensitivity or function. John fell from a two-storey building and sustained a complete spinal cord injury at T9 and T10 resulting in two severely damaged vertebrae’s. So severe was John’s injury that his daughter was told by his consultant that it was not possible to operate as his spine was smashed to smithereens.

John was also told by Doctor's Grundy and Tromans from Odstock Spinal Unit In Salisbury, UK that he would always be dependent on others.

John also suffered a stroke, which caused him to lose most of the use in his left arm and hand. The stroke also affected the left side of his face (slightly causing him to dribble). His left shoulder causes him some considerable pain, which John says is unbearable. When he tries to raise his left arm a loud clicking noise is heard. He is unable to rotate the left arm or raise it above shoulder height and is unable to push with any degree of force.
The main vein in his arm had collapsed and he was told that blood could not be taken from his arm because of it.
Because of the severe problems he has with his left arm, hand and shoulder it was decided, at the spinal unit that initially treated him and he attended for regular check ups, that it would not be possible for John to use a manual wheelchair and should therefore use a motorised wheelchair.
John has lost all sensitivity and voluntary movement below the injury. He is unable to maintain his body temperature, feeling cold continuously. He has no control over bowel or bladder function, and suffers severe oedema in his legs and feet. He also has a large burn on his left leg, caused by being too close to a gas fire and his absence of sensitivity to heat.
His legs are firm to touch with the skin taught and in his words; "they don't resembling living limbs".
John is unable to maintain an upright posture as abdominal muscles and upper body strength is very weak and he exhibits little control with his posture leaning heavily towards his left side. The extent of muscle wastage throughout John’s body was obvious to me as I had known john prior to his accident. He was very muscular and fit, and worked as a roofer in Paignton.

Additional problems

Muscle spasms during rest, aches and pains, poor circulation, lethargy, feeling cold in bed, irritability, fidgety limbs in bed, loss of sensation and loss of mobility due to the accident. Night sweats are a constant problem, eyesight poor, ongoing problems with urine / bladder infections, which flares up around once a week and does not appear to respond well to antibiotics. John feels the urine infection makes him shiver all of the time, causing him to become lethargic, followed by a high temperature and loss of appetite.

He wears a thick overcoat all of the time, even in the summer, because he is unable to maintain his own body tmeperature, (a common problem for people with a spinal cord injury)
John suffers from fits, which causes his head to shake violently from side to side and his left arm spasms outward.

Intervention: To avoid horizontal bed-rest and poor sitting posture by sleeping on an inclined bed in excess of five degrees.

The idea is to allow gravity to continue acting upon the fluids within the nervous system in one direction, that being downward from head to toe to influence the direction in which nerves grow in relation to gravity.

The following notes were taken from John following regular inteviews, with myself and a fomer nurse who looked after him.

Pilot Study Notes:

25-4-1996 Week 1 Muscles started to soften, leg tissue softer and upper thigh feels different, "Like they are there now". Back aching (moving up and down the spine), Felt lethargic and had lighter sleep.

2-5 Toe and fingernails improving muscle and skin on legs, more supple, urine, clear but smelly or stronger. Felt warmer in bed. Night sweats stopped.

9-5 Burning up. Urine still improving. Sensation of inner warmth at the top of legs. Muscle spasms improved. Thighs feel strange. Replaced catheter had no infection

16-5 Reported progress to physiotherapist at Torbay hospital. More even body temperature. Strength improving. Felt tightness in pelvic area. Had more muscle spasms, which lasted 4 days. Sensation of warmth moved to calves. Floating pain in spine. Felt stronger and better in myself. Finger and toenails still improving. Noticed sensation when pinched, in left side abdominal area is now three inches lower than the right side. Hair seems to be improving.

29/5 Easier to transfer etc. Using left arm and hand more, (more control). Developed half moons on nails. Warmth in calf muscles. Noticed increased sensitivity 3 inches lower than right side on abdomen. Funny feeling in thighs now gone. Muscles in arms aching. Stiff neck, warmth in feet and swelling on left leg has gone down. Feel pressure of pillow between legs at 4pm and at 5pm feeling a lot stronger from knee to ankle. increased warmth in lower legs. Now have warm sensation in tummy.

21-6 Noticed indication of nerve connection in toes? Now able to hold and maintain an upright posture. Oedema in legs very much improved.

26-6 When lowering legs from the bed to the floor, Penny and I noticed that there was some evidence of self support as my legs did not drop to the floor as they had done previously

1-7 Lime-scale in urine increased.

16-7 Following pins and needles sensation in his legs, John is now able to feel a pillow placed between his calf muscles. 3-8 Toes responded to movement after massage and left leg had normal reflexes when tapped on the knee. Right leg still has no reflex. No spasms when standing in the frame.

12-8 John has now moved from the guest house to a flat. This is a big step for John and means that he is no longer dependent. He could not have made this move when we first met.

6-8 Legs feel as if they want to itch? When in the standing frame, no more spasms. Note: Some days John’s link to his toes is less obvious and shows little signs of control. Adapted to new environment OK.

13-9-96 John visited Odstock, Salisbury’s spinal unit for an examination. During his visit he was accused of weight training, because of his now huge muscle bulk. He has now sustained a broken knee on his right leg, caused by levering his leg against the joint while trying to move from his chair. Xrays revealed bone formation 2 inches below the damaged area of the knee.

17-9-96 Visited John who reported that now, when he sits down he actually feels like he is sitting down. He is now able to feel the pressure from his catheter strap. He can also feel a pillow when it is placed between his feet, while resting. Left hand has improved vastly. When I pressed his toe firmly, he could feel the pressure. His right toes have been responding by moving when trying to move them. The left toes are also responding but not as much. No urine infections. John is unable to use the standing frame because of his knee injury.

25-10 John told me that his catheter leaked, but this time he could feel that his foot was wet. I tested this in front of Mrs Penny Meredith, by placing an ice cube in his sock. After a minute he could feel both the cold and wetness. Also dramatic changes in muscle spasms, now only evident in toes.

2-11 John confirmed that he had had an erection, he also confirmed that his bowels are functioning properly and can now push his stools out by muscular control. Penny Meredith (Nurse), was first to point this out and said that his stools now had shape and looked normal, which indicated that muscular control had returned to his bowels.

8-11-96 Sensation on left side now moved down to pubic area. "And it’s pretty strong". Burn mark on leg appears to be getting smaller.

28-3-97 Met John, who is now convinced that his legs will be moving within 4 months, so strong is the feeling in his legs that on occasions he has kicked out while trying to do so. It is not like a spasm, which he used to get, this was completely different. He also feels he may be able to hold his urine back and he is intending to try a normal catheter. His eyesight has improved to the point where he is now able to view the television properly.

15-5-97 John told me today that when he uses a bladder-wash (consists of a small clear bag of fluid, which he attaches to his catheter. He is now able to physically push urine and the liquid used in the wash bag from his bladder, up the tube and into the bag, whilst holding it above his abdomen. He is achieving this by consciously using his muscles, which indicates bladder control may also be returning.

7-6-97 Met john at his flat. His bowels are functioning OK now. He still feels like his legs want to itch, but they don’t. Over the last two months he has had pains in his kidney area, which caused a severe ache. John feels that because of his right knee injury, (which has not yet been operated on?), he is unable to use the standing frame any more.

He has developed very large muscles in his upper body. Still able to push bladder wash back into the bag, by controlling his bladder. Increased vitamin C to 1000 mg per day and urine is still clear. Furthermore, he has not had a urine infection since he began sleeping on an incline. The development of inner warmth in both legs and is more intense and now feels like he has used a deep heat type of treatment. This sensation is always in his thighs and calves and on occasions runs right through to his toes. Over the last two weeks John has begun to feel pressure on his bottom when lying on the bed. Before he could feel pressure only when sitting in his motorised chair. Hips very tight and getting a lot of headaches recently.

When asked how far he thought he had improved since we began this therapy, he answered sixty per cent. I then asked john if he still had problems with his left shoulder. He is now able to fully rotate the arm and can push with it. The strength has increased by up to seventy per cent and he has no pain from it at all. I then asked john if he thought he would be able to use a manual wheelchair and he replied "Yes". This is a significant turning point for John, as he would obviously benefit from additional exercise. When asked about his fits, John told me that he no longer has any problems, other than an occasional slight spasm in his left arm, which he is now able to suppress.

Paignton
Devon,

UK

13/10/1997
S.I.A (Spinal Cord Injuries Association)  https://www.spinal.co.uk/
76 St James,s Lane
London    N10 3DF

Letter From John D Mason (T9 and T10. )


Attention of Lyn Punchard, Editor of Forward And Vivienne Davies
Dear S.I.A.
In response to your recent letters to Mr Andrew Fletcher and to the article you included on page 18 of the July-August addition of Forward, my  own improvements while which included an account  of participating in his trial and research.

The Article

I had a conversation with Lyn Punchard and discussed in detail how this simple therapy has helped to stimulate sensation of touch well below the damaged area of my spine, which is at T9 and T10.

I made this quite clear at the time of the telephone interview and also know that Mr Fletcher would not have told S.I.A that my injury was T11 and T12. The fact that sensitivity of touch has now reached my pubic area since I started sleeping with the head of my bed raised by 12 inches should be pointed out clearly in a future article in order to present an accurate account of the benefits gained from this therapy.
There have been many positive improvements in my physiology, some which could only be attributed to stimulation of the damaged nerves in my spine. Which were confirmed as a complete spinal cord injury by Dr Grundy of the Salisbury Spinal Cord unit.

Could you please call me at my home which I have found in this treatment to discuss the main benefits?

Your letters dated 24th September and October 6th are very negative considering that little or nothing is on offer for spinalcord injured people! I do not understand why you have adopted this attitude towards this exciting research. If I had adopted a negative attitude then the benefits which I now have, which enable me to live in a flat as a self sufficient adult would undoubtedly have remained a dream.

Julian Boustead whom I have known since we were at Odstock together following spinal cord injury is also concerned that the SIA attitude to this research is far to negative to say the least.
I do hope that you will adopt a more positive attitude as we the injured depend on organisations like yours to make sure that the very latest developments no matter how insignificant are made available to us immediately in order that we may judge for ourselves what is worth exploring.

Sincerely  John D Mason.

Inclined Bed Journal - Colin M.
Atlanta, GA

05-06-2007, 11:48 PM

Hello, I'm a C-5 incomplete spinal cord injury who was injured on July 10, 2004. My recovery has been hopeful but has not significantly changed my quality-of-life. Trace movements continue to be awesome signs of hope but have yet to be strengthened. I have now begun a new journey of recovery and expect to make significant gains in the near future.

I discovered inclined bed therapy during my first visit to Center IMT in Atlanta, Georgia. I began implementing the theory on April 22, 2007. I also dedicate myself to many other types of therapies including brushing techniques, neuromuscular and threshold electrical stimulation, using a chi exercise machine, sacral wedge, and a vibrator beneath my feet. On June 1st 2007 I plan on moving to the Atlanta area for an indefinite amount of time to participate in Center IMT's "first step" program along with Shepherd Center's "beyond therapy" program. In this journal I'm going to try and focus on the various effects I believe inclined bed therapy has on my body but because of the variety of techniques I'm using to enhance recovery, it is difficult to prove what is doing what.

Week One
-I raised the head of my bed 4 to 5 inches.
-The first night I began getting hot flashes.
-My legs, feet, and hands felt very warm during the night and when I woke up in the morning.
-Within a couple days my complexion was improving, my energy had gone up, and people began commenting on how healthy I looked.
- I also felt mentally sharper. I felt more communicative and my vision seemed more clear.
-Several days into the therapy , I began to feel very achey and sore in my shoulders and neck area.
-I thought I was sick but then read about a period of detox which occurs initially.
-A couple days later the soreness was gone.


Week Two
-Increased energy began to feel less noticeable.
-Complexion still improved and extremities still felt warm at night.
-No more hot flashes at night.
-Anxious to speed up the process I decided to raise my bed to the recommended height. I struggled to discover a way to do so without causing the bed to be unstable. I ended up having to buy more bed risers and doubled the height. I would have liked to ease into it more gradually but didn't think much of it.
-Three nights sleeping at the new incline, I have not slept well, and my energy has been low.
-spasms increased at night.
-I get frustrated at night as I slowly slide down the bed each time I turn.
-The weather has turned cold and my ability to keep warm has not seemed much improved.
-I've now discovered that the incline I am at is more than the recommended 5.5 to 6°.
-I plan on reducing the incline tonight to start off week three.
-My overall impression of this type of therapy is very optimistic so far. I can feel the weight of gravity taking it's effect as I sleep and my legs just feel different. Any change is a good thing in my opinion

Hi Colin

Your report follows the predicted pattern from tilting the bed. The increased spasm is generally a good sign that the nervous system is responding and has been reported many times by others as an initial symptom from sleeping inclined and may explain why you are sliding down the bed.

This is going to take several more weeks before you experience the full benefits from the bed.

Many thanks for helping me with this research.

Andrew

Week Three

Week Three: 05-14-2007, 12:56 AM

-I lowered my bed down to about 5.7°.
-the new positioning made a ton of difference and I am much more comfortable.
-I'm not sliding down the been nearly as much at night.
-Early in the week I began to get headaches and soreness. Detoxing I figure.
-I noticed my toenails are looking healthy. Never had much of a problem but slight ingrown toenails have improved.
-I'm no longer bleeding during my bowel program from haemorrhoids.

-other improvements not directly related to the incline bed include:
-increased tricep strength mostly from electrical stimulation.
-more sensation in the lower legs while using my foot vibrator.

I believe everything I am doing is playing a role and the inclined bed will most likely serve as a basis for much of my improvement soon to come.

Week Four 05-21-2007, 02:02 AM

Week Four:
-I feel like I'm slowly getting adjusted to sleeping inclined.
-I feel as if I have a lot of energy and I am tired at the same time. Kind of weird.
-The extension spasms in my right quad has kicked in. In the past it has only been the left and now both legs are doing it.
-I noticed in my toe nails that there are two definite colors. Towards the edge of my toe nail is a dark color while towards the base of the toenail is a light pink as if a new healthier nail is pushing the older nail out. I will know for sure as time passes on.


Not much else to report at the moment. Andrew, I was wondering what the most effective way of sleeping is? Right now I sleep on my side in a curled position. It is the most comfortable.

Hi Colin and thanks for updating your diary.

The toenail improvements have been reported by lots of people trying the inclined bed, and clearly indicate a very positive change in circulation to the nail bed. Also, the emergence of half moons on both finger and toe nails has been observed by many people. Improved nail growth has also been duly noted, all of which indicate improved circulation.

The recent changes in spasm you have noted follow exactly the same pattern as other people with spinal injury who have inclined the bed. But yours appear to be kicking in sooner than most, again indicating some changes to your physiology may follow sooner than expected.

To get the optimum benefit from the inclined bed, if possible stretch out rather than curling up as this according to the theory may prove to accelerate your progress. Sleeping on your side may prove marginally more beneficial as it increases the angle of the spine, although people sleeping on their front or backs have experienced significant positive changes.

Have you noticed a change in your urine output? change in colour or odour or clarity?

Andrew

Colin
I unfortunately cannot say for sure whether there has been a change in my urine. I feel as if there has, but nothing has jumped out at me enough to point it out. My urine outputs have always been very erratic so it's hard to tell when there has been a definite change. There is a chance that my urine has gotten darker and smellier, but once again I cannot be sure.

I will try and stretch my legs out more. I don't think I can sleep well on my back and definitely not my stomach.

Week Five: 05-27-2007, 08:11 PM

-I was getting headaches at the beginning of the week especially after being in the sun.
-I feel as if I cannot take as much of the suns heat as I used to. I seem to get overheated easily.
-by the middle of the week the headaches disappeared.
-I'm no longer getting sore aching muscles for no reason other than the incline.
-I have been getting some faint dizzy spells, as if my blood sugar level is low.
-The past few days my legs feel as if they are constantly vibrating. Tingling sensations are also occurring. It is not a sudden occurrence of sensation because I have had similar sensations for awhile now, but they have significantly increased. The sensation has also increased in the genital region.
-Along with the increased sensation I get the antsy desire to get up out of my chair and move around. Once again I have felt this way for awhile now but the feelings of increased.

I expect more to come in the near future so stay tuned.

Week 9 06-24-2007, 10:46 PM
So it's been four weeks since my last entry. That would put me at week nine. I'm to the point now where it's going to be harder and harder to tell what exactly the sleeping inclined is doing for me. My progress is going to be a collaboration of many forces. At week six, I do remember noticing an increase in the tingling in feelings of vibration in my legs. Weeks seven and eight were spent taking part in two programs for spinal cord recovery. Center IMT in Atlanta, Georgia, and beyond therapy which is also in Atlanta. I spent week nine visiting a spiritual energy healer who did healing on me once a day for five days.

Overall, I feel myself recovering and I do believe sleeping inclined is playing a role. I cannot stand sleeping flat anymore and was always desperate to find a way to incline the beds at the hotels that we stayed in. I had to sleep flat one night and didn't care for it at all. When I sleep inclined I can feel sensations pouring into my legs and it feels like healing is taking place. I just feel stagnant when sleeping flat.

I have no miraculous reporting to tell but the overall awareness of my body is magnifying and I feel connections being made. More and more so I feel as if I'm going to jump out of my seat. In a couple weeks I will permanently be in Atlanta to speed up my recovery process.

Week 13 07-20-2007, 06:57 PM

At this point I believe sleeping inclined is actually helping to increase the bulk and size of my muscles. A couple weeks ago my parents began to tell me that my legs looked bigger. Following, a couple of people outside of my home also said the same thing. I had thought my legs seemed bigger but I did not know for sure until others began to notice it as well.

My upper body is also getting a lot bigger especially in the chest, shoulders, and back. I believe this is also due to electrical stimulation and muscle recovery.

My dad told me that a couple months ago he was actually worried about me because of my health and the apparent degeneration of my body. He said he saw me getting thin, struggling with my energy and such and was not happy about it. He now tells me that he is no longer worried and sees a much healthier individual when looking at me. I too agree and feel much healthier. It is most certain that inclined bed therapy along with my other methods is changing my entire physiology. This will allow healing to be directed towards the nervous system where it is needed most.

10-05-2007, 01:06 AM
I have now been sleeping inclined for about 5 1/2 months. I continue to believe that it is having a major impact on my recovery, however, it is becoming difficult for me to exactly pinpoint what the effects are. Starting in June I began a dedicated plan of recovery, going to two different rehab programs and visiting a spiritual energy healer every two to three months. I have another thread which follows some of these experiences...

https://sci.rutgers.edu/forum/showthread.php?t=82068

My improvements as of recently have been the most dramatic since my injury back in 2004. I've had some major stabilization occurring in my scapular muscles and I can actually see the muscles begin to fill in around the shoulder blades. My chest muscles and triceps are also firing more consistently and increasing in size. My truck muscles and pelvis muscles have also increased in strength and I can actually keep my hips tucked in while doing assisted standing. I am also feeling increased sensation and awareness throughout my body. Energy and health also seems to be constantly improving.

So what is inclined bed therapy doing for me? I believe it is serving as a basis for my health and in so my recovery. I'm addicted to sleeping inclined now and when I lay down to sleep at night I have a confidence that the incline is encouraging recovery and neural growth. I do not think that sleeping inclined alone is enough. But the combination along with integrative manual therapy, exercise, and energy healing will lead me to walking again.