A significant aim of our blog is to encourage people with spinal cord injuries to maximise recovery by continuing aggressive rehabilitation many years after the injury happened. But sometimes it’s difficult to keep going with repetition after repetition, day after day, especially if there are no signs of progress. What you need is a story from someone in a similar position to refresh your motivation. So we decided to contact a number of people around the world to hear their stories.
We start with a dear friend of ours, Kamal Farhat, who we met in the summer of 2016 at the Zentrum der Rehabilitation in Pforzheim, Germany.
Can you tell us when and how you were injured, your level of injury and the initial diagnosis?
It happened in September 2013, in Ghana, on a day trip to the seaside. I ran into the water, planning to dive into a wave, but the next thing I knew I was unable to lift myself out of the water and I was basically drowning. Luckily Lea (my wife) saw me and pulled me out. I was injured at the C4-C6 vertebrae, and was diagnosed as being incomplete (ASIA classification missing, but we suspect ASIA B).
Can you briefly outline your experience from the point of injury to the point of returning to a home environment (i.e., where you were, what initial rehabilitation you received, and how you think this may have affected your long term outcome, both physically and mentally)?
The medical support in Ghana was pretty bad; there was barely any treatment. I had to wait 7 days until I could fly back to Lebanon (my homeland) in order to have surgery to stabilise my spine.
One month later I went to Ulm, Germany for 7 months of therapy; it was quite basic, focusing mainly on controlling a wheelchair etc. My expectations of trying to regain bodily functions were not fulfilled. For example, my fingers were taped together to create so-called ‘functional hands’. Back then I was not totally convinced it was a good idea, and today I am working hard to reopen them.
After my stay in Germany, I returned to Lebanon for 18 months, where I had therapy at home 3-4 times per week. The goal of the therapy was to keep my joints supple and to avoid muscle atrophy.
What are the hardest parts of having a spinal cord injury that most people do not see?
The complications that are a side effect of the injury (e.g., digestion problems, using the toilet and bladder infections).
Many medical professionals say that improvements in sensation or movement will plateau after 12, 18 or 24 months. Can you describe improvements you have had after 24 months, if any?
- I can extend and flex my hips, so now I can voluntarily swing my legs a little while practising walking in therapy
- My right knee has regained some function so that the therapist no longer needs to support it as much in standing positions
- My tricep and pectoral muscles have come back strongly, to the point where I believe they will eventually assist me with independent transfers in and out of the wheelchair etc.
- When I am sitting on a therapy bench in a high seated position, I no longer need support for my knees. Initially I would have slid off the bench.
- In my everyday activities, I see improvements in eating on my own, controlling the wheelchair more skilfully and for longer distances. Moreover, I’m able to sit more upright, on a normal dining chair, and do activities with my arms while balancing my upper body.
What type of exercises, equipment or therapy do you use to optimise your recovery, and, in your opinion, which of these has yielded the best results?
I use a standing frame to keep the feeling of standing and the blood circulating. For passive exercise, I use a Motomed bike every day on my arms and my legs. I also practice as much as I can on a therapy bench, sitting freely without back support at both normal and elevated heights, for balance and to convey information to my legs.
Of all the therapies, I would say my stay at the Zentrum der Rehabilitation in Pforzheim, Germany was the most beneficial. There I learnt a totally different type of therapy, which helped to re-motivate me and restore my hope. I would like to stay there more often, but it’s a big strain on finances.
What is your long-term rehabilitation goal?
To be able to live independently, e.g., transfer into and out of bed, use the bathroom alone, etc. Until now I need the support of Lea with these activities. I hope in the future that I will be able to spend a whole day on my own. It would be cool to learn how to drive again, and therefore I wish to take at least two steps to make the transfer easier.
What have you achieved so far in your rehabilitation?
I am able to sit in my wheelchair in a stable position, move it without electric support, and use my mobile, tablet etc. I can now eat almost everything on my own. Besides the return of muscle functions, I can sweat again, and I can feel my organs and my joints, which helps me to position my body correctly and to notice possible problems.