Back in July I test drove new devices to see if they would work for me. The Bioness L300 Go are electrical stimulation (FES) foot drop and thigh weakness devices that provide freedom and independence for people recovering from Stroke, Multiple, Sclerosis, Cerebral Palsy, Traumatic Brain Injury, or Incomplete Spinal Cord Injury. The good news was that they worked, but the bad news was that they are costly, and insurance does not cover them. We submitted the claim to our health insurance provider, and we received the denial stating that these devices are not considered a medical necessity. Why is it that devices and/or procedures that can and will improve the quality of life of the patient are considered “not medically” necessary?
This creates a difficult decision of finding a way to pay for the devices at the cost of $5530 each ($11,060 total for both legs) or just doing without knowing that these devices can mean the difference between regaining more independence by improving and rebuilding neuropathways and proprioception. In speaking to the representatives from Bioness, most patients are left in my situation of having to pay for the devices themselves or giving up on their dream of walking with better stability, control, and better overall body posture.
The L300 made walking easy and light not heavy and stiff like it is normally. It senses when my foot and leg are getting ready to push off and move forward. The sensor sends an electrical signal to my foot/ankle causing the device to activate and lift my ankle thereby flexing the foot and lifting the ankle and toes preventing the foot from dragging. Because of the SCI (Spinal Cord Injury) I also lost proprioception along with balance. The signals that go from my lower extremities to my brain and back are interrupted because of the damage to my spinal cord. In order to regain more stability my body must rebuild and create new neuropathways. This where these devices can help. As the devices send the signals to my legs, my brain and body engage via the new neuropathways being developed. Over time these new signals turn into sustained signals allowing the body to adapt and rebuild balance and proprioception. They also allow for better posture and body mechanics as the patient is not hunched over a walker, the hips and thigh muscles are more engaged allowing the legs to do their job reducing the stress on the knees and ankles.
The cost of these devices makes them out of reach for most patients as they are not covered by insurance. There are alternatives such as financing them or paying for them via credit cards. I believe that more patients should have the opportunity to obtain such devices, but until these devices become more affordable or insurance companies start recognizing these devices are “medically necessary” they will remain out of reach for most patients. As for me, my family and I have decided to order my devices and appeal the decision of our insurance company. We know that the likelihood of getting reimbursed is next to none, but the benefits of using the devices far outweighs the cost.
Once I receive my devices I will move on to the next step. I will meet with a representative from Bioness where my devices will be fitted, tested, and set up. I will be taught how to work the devices, how to care for them and charge them. I will also return to physical therapy for about 8 sessions working with the devices making sure that they are set to the right frequency and intensity so that I gain the best possible outcome.
It is my hope that over time I will improve to the point where I will not longer need any devices. But for now, I will continue to keep moving forward, and praying every step of the way. God continues to bless me even through the pain.
It has been difficult to get motivated to write or do much of anything being that I have been more pain than normal. I am having a flare up that has caused by pain to remain high despite medications. My spasticity has also been high making it very difficult to walk and stand. I do my best to stay positive and not get grumpy or angry. Unfortunately, no matter how hard I work at it the guilt mixed with the pain wear me down and I do snap at those around me. Of course, this causes even more guilt. Learning to let the guilt go is hard but necessary. We cannot take responsibly for things we cannot control. We must let go of the guilt and focus on the things we can control.
Flare ups for anyone living with chronic pain, be it from a SCI or an illness like Fibromyalgia, cause not only physical pain, but mental as well. For me it is difficult because it means not being able to take care of my family the way I normally do. It means not being able to do something I love, cook a meal for my family. Heck just getting up, showered, and dressed are major feats. But the physical limitations often lead to feelings of guilt and inadequacy. It is easy to see all the negatives-I can’t make the bed, I can’t get the laundry done, I can’t pick up around the house, I can’t cook a meal, and I can’t…
All these negatives creep in over time, but it is important to change that running line in your head to a more positive one and realize that you really do have an illness. When anyone of us get a cold or the flu we take medications to help and allow ourselves to rest. So why is it that we cannot do this when we have a flare up of symptoms? Admitting that I really do have an ongoing illness continues to be difficult, but through prayer and learning to give it to God I have been able to continue to move forward. Yes, I really do struggle with admitting I have a chronic illness, but my body reminds me every day. I am learning to change the” you’re a failure because you can’t… “story into look at what you are overcoming and continuing to do.
It takes constant reframing of my thoughts. It is so easy to see and hear the negatives. It is important to recognize and deal with what you are feeling.Hiding and pushing your feelings aside only keeps them festering and making the story you hear in your head seem far worse that it really is. By reframing the negative thoughts and feelings we can continue to keep moving forward. For example, When those around you who believe they are being helpful constantly say things like- “Your standing with your knees locked “followed by “you’re not picking your feet up” or ”Get your feet under you , you are leaning to far forward.” And of course, I can feel the issues because my balance is off, my legs buckle and just standing is difficult. Instead of focusing on the negative I do my best to reframe my thoughts to something more like, “Look at you, you’re standing,” or “Wow, you just walked up hill and it was easy.”
It is perfectly okay to Give yourself a pass. Again, understand and realize that you are not choosing to do something. All of us that live with chronic pain/illness must accept that our bodies don’t care if we have plans. Our bodies are going to do what ever they want. So, take the time to rest and recover so that there will be better days ahead.
Be sure to treat yourself with kindness. Reframing your negative thoughts into positive ones helps tell a better story which will impact our emotional state. Remember our brain is powerful and it impacts what our bodies physically feel. Higher stress levels means more pain and a reduction in our ability to deal with the pain.
Reminding yourself and finding the things you can do is also of value. Pain often interrupts our plans, but instead of getting angry and down focus on the things that you have accomplished during the day. We cannot fix the past, but we can adjust and make changes to our future. Find things like painting, gardening, or other hobby to get out and meet others or to relax.
Every step I take is a miracle that God has given me, and it is so easy to lose sight of how far I have come. It is easy to let the negative thoughts and guilt in and start believing them. This affects my mood and my pain levels. Learning to reframe my thoughts, pushing all the yuck out helps reduce my pain levels, makes for a happier day to day life, and makes my mood much better. Stop feeling guilty about the things you cannot control because this only stops you from moving forward. I encourage you to let it go.
Allodynia is a pain response caused by stimuli that normally does not cause pain (i.e. a shirt touching the area, a hug or a brush of a hand). Temperature and/or physical stimuli can cause it to flare. It often feels like a burning sensation. It often happens after injury to the site (i.e. Spinal Cord Injury or amputation of a limb), like in my case.
Allodynia is a pain response caused by stimuli that normally does not cause pain (i.e. a shirt touching the area, a hug or a brush of a hand). Temperature and/or physical stimuli can cause it to flare. It often feels like a burning sensation. It often happens after injury to the site (i.e. Spinal Cord Injury or amputation of a limb), like in my case. (Wikipedia, Allodynia)
There are days when the thought of getting undressed, then showered and then dressed again seems impossible. The burning sensation feels more like my skin is stretched and swollen to capacity then as I move it feels like it is being ripped open. Of course, this is not what is happening, but when you move at all and the neurological response sends the pain to about a 7 or 8 it makes simple daily tasks seem out of reach.
There are three main types of Allodynia. A person may have one, two or all three types of Allodynia. They are:
- Thermal allodynia: Thermal allodynia causes temperature-related pain. Pain occurs due to a mild change of temperature on the skin (hot or cold/or both) For example, exposure to heat like being in the sun can cause symptoms to increase.
- Mechanical allodynia: This where sensation caused something moving across the skin. For instance, bedsheets pulled across a person’s skin may be painful or a towel rubbing the area.
- Tactile allodynia: Tactile allodynia, also called static allodynia, happens when something touches the skin. For example, a tap on the shoulder may cause pain for someone with tactile allodynia. (Pietro, 2017)
Allodynia may occur due to increased responsiveness or malfunction of nociceptors, which are a type of nerve. They are the “pain receptors” nerves located all over the body which includes the skin, muscles, joints, bones and internal organs. The nociceptors respond to pain and send the signal from the body part to the spinal cord and brain. With people who have spinal cord injuries the signals get confused so a touch can be confused as pain. (Wikipedia, Nociceptor)
There are medical conditions which can increase the risk of developing allodynia, such as: Spinal Cord Injury, Migraines, Postherpetic neuralgia, Fibromyalgia, Diabetes, and Complex regional pain syndrome. (Roland, 2017)
There is no cure for Allodynia. Currently the treatment is aimed and reducing the symptoms. The use of Pregabalin (Lyrica) and other medications like it are used to treat other conditions like spinal cord injuries, diabetes, and fibromyalgia and are now being used to reduce the Allodynia pain along with lifestyle changes such as reducing stress. Getting plenty of sleep and keeping stress low as well as eating healthy can all help reduce the symptoms. (Pietro, 2017)
Personally, I have tired various methods and so far, I have not found the magic mixture. I currently 700 mg of Gabapentin for the nerve pain in my legs which does not help the Allodynia. I have tried Lyrica as well to no avail. I have use Cymbalta in the past, but unfortunately, about 6 mos. in it stopped working. I have also tried Amitriptyline. I began using CBD and I have found that it does help. I currently take 10 mg 5 times per day. I still have horrible nights and am searching for better control. I currently use my Oculus Go when the pain is out of control. I find that after about 10 mins. my pain is bearable and in about 15 mins. I can remove the helmet and begin to move around again.
Living in chronic pain takes its toll on the body so it is crucial to find ways to relieve the pain and allow the body to rest. I firmly believe that I will find the answer. Each day I am given I will keep moving forward even if it is just a baby step. God has continued to heal me, and He gives me strength to face each day. I am blessed to have such a great family who love me and support me every step of the way even on the days I don’t treat them as well as I want to. So thankful for their forgiveness and understanding.
Pietro, M. d. (2017). Allodynia: Causes, types, and treatment. https://www.medicalnewstoday.com/articles/318867.php.
Roland, J. (2017). Everything You Should Know About Allodynia. https://www.healthline.com/health/allodynia.
Wikipedia. (n.d.). Allodynia.
Wikipedia. (n.d.). Nociceptor. https://en.wikipedia.org/wiki/Nociceptor. s
Catching a cold normally would not bother me much, but since my spinal cord injury it causes all kinds of issues. I can deal with the sore throat, runny nose, and congestion, but the extra pain and spasms it causes are unbearable at times, sending my pain soring to an 8+ at times. The overall skin sensitivity is also elevated making it difficult to get dressed and move around.
Most people when they catch a cold are still able to somewhat function and don’t have to worry about loosing bladder function. Unfortunately for me, getting a cold means stronger more severe muscle spams in my back which then trigger my bladder to want to empty. Even if I have just gone it will still trigger the response and I have to make a mad dash for the nearest restroom. Just another fun issue associated with living with a spinal cord injury.
Having a cold also reeks on my spasticity. It increases the muscle stiffness and the rate at which my muscle tire. Most people tend to tire more easily when they have a cold, but they can continue to do things like go to work or pick up a bit around the house. For me, it makes just getting out of bed a massive task. The stiffness in my legs is intense and makes them feel like they weigh 100 lbs a piece. Walking becomes more difficult because my legs feel like they are dragging through heavy cement and my balance is reduced even more than normal.
Being sick with a common cold suck for everyone, but it has much more of an impact on those of us with impaired bodies. From increased pain and exacerbation spasticity it is not just a simple cold. The only way to stop it is prevention. I do my part by washing my hands frequently, staying away from those who appear to be ill, take my supplements drink plenty of water and get plenty of rest. Now all we need is for others to do their part-Stay home when you are sick and do not share your germs.
The gorgeous sunset tonight. Enjoying the view while navigating the pain and spams. Have enjoyed the day watching my grandkids and nephew hang out and boogie board. So thankful for the special moments when my pain is down. Ugh!!!!Spams and burning. Man it sucks! The pain often interrupts my life in so many ways. Doing my best to enjoy as many moments as possible. God has painted the sky yet again!
Taking time to relax and rest. After a week of being sick as well as dealing with the daily issue my hubby and I are enjoying visiting our family and relaxing in New Port Beach,Ca. This will be our view for the weekend. Hoping this will bring more healing into my body. Enjoying some of the wonders God has given us!