Thursday, February 29, 2024

ALS Update: Sleep medicine and cutting my nails

I have four more falls to report.  Two scared the dickens out my whole family, even me.  One worried them.  The other was an annoyance and a reminder.  I also purchased special nail clippers, an electric toothbrush, and interdental brushes due to increasing loss of dexterity in my hands.


The first fall was under the influence of sleep medicine.  I was having trouble sleeping with the collar and I used the oxycodone I as prescribed to compensate, but I didn't want to renew it for that purpose.  So, my wife picked up two different sleep medications, and I chose to use the Diphenhydramine HCl, based on it saying it was not habit forming and fewer contraindications.  I took the standard dose the first night, and when I awoke for my nightly potty run, I was completely disoriented and fell out of the bed, hitting my head on the open closet door.  Even worse, I tried five times to stand up without success from an all-fours crawling position, once when my eldest son tried to offer me a hand.  My wife and kids were frantic.  Finally, I managed to face the bed, get my hands on the top of the mattress, and use my arms to lift me.  We now have a small bed rail with handles to keep this from happening again.  After that, I only used a half-dose of sleep medication, which was sufficient.


The second time I was alone in the bathroom, and was trying to sit on the toilet, when I slid to the left and landed on my rear upon the floor.  I was able to use the bathtub to lift myself up.  It was a good reminder to always use a hand on something to guide my descent.


The third time I was trying to use a cane on a supposedly short shopping trip.  The trip became longer and longer, sand I broke off from the family to sit and rest.  After they checked out, they came to collect me.  I made the mistake of not using the shopping cart as a walker and of not waiting by the door for the car to be driven around for me.  Five feet from the car, I fell backwards, landing flat.  I was helped up by three people, two sons and a passing stranger.  The back of my head was bleeding, so we went to the ER.  A CT scan revealed there was no fracture, no brain bleed, nothing serious.  I didn't even get a stitch nor a staple, all they found were abrasions.  Still, my wife very wisely purchased a wheelchair for me.


The most recent time was simple carelessness.  I was using a walker and rushing to get out the door.  A walker leg was entangled in a cord from a recliner, and I felt the entanglement, but could not slow down in time, and I took the walker down with me.  I was able to use the chair with the cord to right myself.


Each time, the Miami J collar protected my neck, and there was no additional damage to it in yesterday's x-rays.  Further I was healed sufficiently to be declared fit for work with no restrictions and was told I no longer needed the collar.  After we went home, my wife suggested that I wear the collar anyhow when using the walker or the stairs, and I agreed it was a promising idea.


I can operate standard fingernail clippers, but it is extremely hard to do with my left hand.  So, I purchased clippers designed for people with arthritis.  They turned out to be toenail-sized, and I wound bleeding in five of my fingers trying to use them (they were very good on my toes).  I have ordered a set that includes finger-sized clippers.  I have also been having trouble brushing and flossing, so I ordered an electric toothbrush and interdental brushes for flossing.  My wife has been reading other people's experiences with ALS, and she has described what she read as every time you make an adjustment, you lose another ability and must adjust again.  The description fits what I am going through.


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