vertical challenge

Candice explains how a paraplegic and a quadriplegic differ in exercise response.

As part of the Annual CSEP Conference, I was invited to give an hour talk on our rock climbing efforts.

Presenter 2: Brad Zdavinsky (VerticalChallenge.org)
•Overcoming Obstacles: The Story of a Tetraplegic’s Drive to Beat the Odds and Challenge Beliefs in His Pursuit to Climb (15:00-16:00)

(not my title)

My slides as a PDF (NOTE: is 30mb file, so “save as”)

I found this to be a very well run event (great staff really makes the difference). My slides were more of a story about living with SCI and having goals outside of the normal rehabilitation parameters. So I chopped out many charts and graphs.. and glad I did. The hour went quickly and had just enough time to take a few questions. (Thank you Candice for running my slides)

Thanks again to Dr. Warburon for the invitation to present my point of view on rehab, education and risk taking.

I’ve seen “Dr K” at his clinic and recommend him to anyone dealing with Autonomic Dysreflexia (AD). I’ve copied an article here to make sure it doesn’t disappear.

http://www.webcommunications.ubc.ca/ubc2010/2009/04/28/researcher-aims-to-end-paralympic-boosting/

DR ANDREI KRASSIOUKOV

Dr. Andrei Krassioukov wants the International Paralympic Committee to change how athletes are evaluated – Photo by Martin Dee

If Dr. Andrei Krassioukov gets his way, the days of some Paralympic athletes putting their lives in danger to increase their athletic performance may be over.

Despite an international ban on the practice, some Paralympic athletes with spinal cord injuries are using a dangerous technique called “boosting” to increase their blood pressure in the heat of competition.

Dr. Krassioukov, aDr. Krassioukov studies autonomic dysfunctions, which are dysfunctions in the parts of our bodies not under our conscious control. People with spinal cord injuries experience not only paralysis and loss of sensation, but often have trouble with autonomic functions such as blood pressure, heart rate and bladder and bowel control.
Consequently, during competition a wheelchair athlete’s heart rate doesn’t increase according to the body’s demands, leading to low blood pressure, fatigue, poor performance and a loss of endurance.

“That’s a big disadvantage to people with spinal cord injuries,” he says.

Yet many athletes learn they can subvert these cardiovascular dysfunctions by causing some pain or discomfort in the area below their injury. Known as autonomic dysreflexia, the process stimulates the spinal cord and boosts arterial blood pressure.

It also puts their life in jeopardy.

Some athletes will tighten or block their catheter, a tube used to drain urine from the bladder through the urethra.

Some men will break their big toe before the competition. Others will sit on their testicles during a match.

“They know if they sit on their genitalia, their blood pressure will go up,” he says.

Others use less dramatic methods: abdominal binders or pressure stockings on legs that help increase blood pressure.

Despite documented deaths and the potential for a stroke or intracranial hemorrhage, some Paralympic athletes injure themselves just to improve performance, Dr. Krassioukov says.

“Unfortunately the physiological condition of the body predisposes them to poor cardiovascular responses to exercise, but they’re trying to ameliorate or improve their exercise with these horrific measures.”

The International Paralympic Committee condemns the practice, yet it’s difficult to enforce.

Last year, Dr. Krassioukov and his colleagues submitted a proposal to the International Paralympics Committee to develop additions to Paralympic classifications that would include an evaluation of a Paralympic athlete’s autonomic functions. (Presently, the committee reviews only a person’s physical capacity, such as hand functioning, range of motion and balance in a wheelchair).

To this effort, researchers last year examined five Paralympic rugby teams, from Canada, Germany, Russia, Britain and Australia, during competitions in Burnaby, just before the Beijing Games. Basketball players are next on the agenda.

This year, Dr. Krassioukov has proposed an assessment of members of the sledge hockey and curling teams at the upcoming 2010 Winter Paralympic Games.
The findings will be used to make recommendations to the International Paralympic Committee regarding the addition of autonomic components to athlete classifications.

“If we will introduce an autonomic component to classification, maybe this will allow a more fair and safe competition for all Paralympians,” he said.

Amira (able bodied and a swimmer) sets the record for women at icord and gets close to the times of a T4 para in an everyday chair. She is using Pat Anderson’s Basket Ball chair here). Ward of brainhealthhacks.com follows here and keeps time on his iPhone.

See more results here

More about her work at icord:

Pat Anderson sets the record for iCord Ramp Sprint at 42 seconds!

Well, it happens. Sometimes our partners let us down sexually, but a vibrator should never fail, should never leave you pent up and stressed. The low end (under 100 dollars) vibrators are reliable because in the volumes they sell there must be quality control. But in SCI (spinal cord injury) we get the shaft. Small population of users, so highly priced equipment. The lower volume of sales, means the manufacturer requires higher margins — basic economics. The best solution is a mass produced device that works for everyone with simple adjustments, but that is asking for allot actually.

Reading about vibrator quality from a male quadriplegic seems a touch odd to you? Well, that is why I’m writing about it. After a spinal cord injury we really just want to feel normal, and the basic bodily functions are a always affected. Worse, some folks with spinal cord injuries simply cut off sexual activities because they don’t dare mess with Autonomic_dysreflexia (AD), or are embarrassed about the topic in general. (quads are strongly warned about AD in rehab)

The good news is that even long after in injury, the body can be retrained. With the right feedback, this can be done safely and gets easier over time. I’m almost 15 years into my injury and only getting a proper education now, and I’ve had to do much on my own because apparently this is taboo. Yes it may sound strange to overhear a few guys in chairs talking about their erections, volume and color of loads, but really… that is what much of our happiness and fears center around. Stay tuned on this thread and I’ll give advice on how to get away from relying on the blue pill on date nights. Think able bodied sex can be intimidating and nerve wracking regarding performance, well SCI adds a whole new level of complexity and potential risks (AD, embarrassment)

Enter the Ferticare: an over-priced vibrator that will let you down. At 800 bucks, this is a painful purchace and even worse thing to RMA. If you are used to the medical benefits of ejaculation, not having your device for a few weeks, or even months, is a real problem. It is not the motor, but some cheap battery and charger parts and charging issues. So, the warranty is up on mine, it won’t charge so… WE FIX. Because this is considered a “Medical Device” it can’t use power from the wall, but there is no reason to skimp on power — clearly more power is better? No, actually not. What makes this vibrator different is the ability to change both the frequency and amplitude to tune it to the signal that works for you. You should see your Doctor before inducing AD (see Boosting).

So, this page will hold the efforts to make a smarter vibrator for Quadriplegics, and I’ll give away a hint… controlling the speed of the device from Heart Rate and Blood Pressure is the key to being able to successfully ejaculate regularly. (must be on a regular basis to get the benefits). I will post my Heart Rate and Blood Pressure data here as I test if ejaculation is better than Boosting. In other words, does this routine help fitness? Most say it makes them tired, but what it does do is limit muscle spasm when I reach my max heart rate of 120 beats per minute. This lets me continue when I’d ordinarily get shut down. We already know that vibration stimulation can raise pressure in the arteries for a short time and this can mitigate OH (dizziness when sitting up, common in rehab). Also, regular ejaculation helps prevent “retraction” as well. Retraction really freaks people out because with AD setting in, the penis can be pulled right inside one’s body. In many cases this means the person’s condom drainage pulls off and they wet their pants — very embarrassing.

More info in this article on disaboom regarding SCI and Sexual function

Please share links to SCI forms on this topic if you have them,Thanks.
Brad

Related devices:

1. sex chair
2. erection support device
3. sex positioning pillows
4. real touch (world’s first robotic vagina)
5. TED talk on Medical Inventing

OK, some nerd rage ahead, but also few tips on JavaME development.

Long story, but the ZephyrOpen code project was first running on chips as meager as the TINI java chips. Growing power and java support on cell phones made these boards obsolete for my needs while Rock Climbing. So, now a mid range cell phone has everything I need up there, including a video stream. (original system, batteries and camera) But, not an easy choice these days, new phones coming out almost weekly (and the new LG phones look great too and have extremely good cameras ).

Not one mobile device has it all, but some are better at blue tooth and java support. Others are just development headaches waiting to happen (code, compile, transfer the jar files and test — too long a proccrss to be effective programming time). The “write once” promise of java didn’t come true. The fragmentation was unavoidable even with the JSR’s, but it is still way much more portable re-usable than C/C++ code. For my needs I had to get a phone with solid bluetooth and WIFI. I also needed an App Store to eventually offer services via an Open Source App.

Easy right?

I fumbled around on a Black Berry (has a good market place also) for a few weeks. Tested my app and all was working, but I hated the 8100. I had to get something could actually type on. Mind as well get GPS and all the other cool sensors like accelerometers and such while I’m at it. The Iphone has great App store, but *was* blocking bluetooth access and serial port access. The new G1 also had bluetooth API problems (but has a brand new App store). So really my only option was good old Nokia. They have been around longest and have large developer base and support. I liked every Nokia device thus far, so…

… get the “Bat Man Phone” then.. it has what I need, and will let me test out all the interesting Python libraries I’ve been reading about. The 5800 is not offered by the cell companies in Canada yet, so needed to get it early from NCIX. All I can say is that I’ve never installed, re-installed and done it all over again to get a software update… and I’m still not able to get my XP box to connect to my phone. (I do get USB access to the memory card to transfer files, so the cable is fine). You need to upgrade the firmware and setup the Music, Maps, Photos and OVI. Without this update, good luck installing Python and any of the new accelerometer games!

Ensure you have the version 20 of the firmware, I had to RMA my phone and stop coding for over a week. Now that I have version 20, I still get errors trying to install python for S60.

Few links to get started developing for S60 here (this is what sold me on Nokia):

LWUIT (“mobile versdion of swing “)
S60 Sensor Framework
Java Libraries and Documentation
Getting started with J2ME

Very disappointing from one of the biggest players n the business. A USB and driver issue.. gimme a break. My crappy BlackBerry 8100 will sync on the PC without fail (and even from ANT or Command line no less) I went with Nokia because they have been around a long time and allow you to unlock the phone free of charge. But.. remember that Nokia has many, many version of hardware and software out there.. this fragmentation just might be their Achilles Heel. Watching Polar and Nokia join forces in heart rate devices was a big news in the industry, but I am hard pressed to say anything good about these two giants — save for that fact that they both have the lion’s share of the market.

You can follow more of this screw up on engadget. I’ll get the python and other apps going on it soon, just rather be coding than futzing about.

But, what is good on the phone you might ask? Well, the MIDP support and bluetooth are solid, and that is what I bought the phone for after all. The emulated buttons for the old school phones is also good. The GPS is ok, but I’d use an external receiver for anything really important like climbing. Screen and typing is not bad either, and I’ve got almost no hand function, so.. that says something. I use my thumb nail mostly, so the resistive screen is fine for me. (but iPhone’s capacitive screen still wins on this score)

Finally, the camera quality is pretty good for video too. Here is a clip from the first quad rugby games to be held in the new Olympic skating oval in Richmond BC.

Now we are in a European Disability Sport Magazine. The Author has given me a rough translation in English. I’ve found many good articles in this magazine, and found that Google translation to be good enough to get the main points. It was great getting more press around the world. There are so many good rehab and sports programs and publications in Europe, it would be great to take the rig there and do more after Elcap.

Thank you

Janke Bondam of ryk.dk
Copenhagen
Denmark

The Cliff Hanger

It is only the imagination that puts a boundary for what the sport of extremes can consists of, where it can take place, how it unfolds and who does it. And what only the very few could ever in their wildest imagination think doable, the extraordinary climber, Canadian Brad Zdanivsky, made possible in the summer of 2005.

The achievement was the climbing of The Grand Wall which was literal speaking a vertical 700 m high mountainside called The Chief near Squamish in West Canada, and the fact was, that Brad Zdanivsky is a quad after a car crash. How this climbing actually was done, you could that summer read in The Globe & Mail.

Brad Zdanivsky, who is 32 by now, was 18 when he broke his neck. Before that he was a keen climber, and from the age of 15 he had reached the first stages of what you could call advanced climbing. He had it in his genes, climbing was for him like renewing the oxygen in his blood. So what do you do when you break your neck and still want to be a climber? You put you thinking cap on and start to solve the problems.

Brad and his father, who was a keen climber himself, designed after years and years of thorough researches and checks – and a lot of money – a climbing “thing”, which they got a professional company to construct so both security and comfort was in order. It consists of a frame with a seat. Above are two bicycle-like wheels and underneath on the inside is a smaller wheel to prevent him from banging into the mountain side. He is fixed to the climbing “thing” – as he called it – and with his tied hands he can pull himself up with some pulley-device. About 30 cm for every pull.

When Brad climbed The Grand Wall in 2005 a team of volunteering climbers and friend was with him making it possible for him to climb the vertical mountain side. He started early in the morning, and fourteen hours later he had reached the top. An extremely exhausting achievement. A helicopter brought him down again. Even for an experienced climber The Chief is said to be an ordeal of the rather heavy ones. The feeling of victory after having achieved the goal not only made his climber-heart beat but it let project Vertical Challenge come into being, whose goal is to “start a movement that will see more quadriplegics enjoy adventure sports—a realm where people with higher-level spinal cord injuries are currently denied access” which can be read at their web site verticalchallenge.org.

RYK! Magazine has been in mail contact with Brad Zdanivsky to hear more about his climbing.

- I have been climbing since childhood. I always spotted out the highest trees and the steepest cliffs, and from the early teens I saved money for rope and other climbing gears. I started to meet other climbers and by and by the challenges in climbing became more and more difficult. All this amounted to countless adventures in the mountains which naturally game me a deep sense of connection to nature and being out in the wilderness, which has never left me. This is one of the reasons why it is a bit of a challenge to land in a wheelchair, because the outdoor life in the wilderness became practical a close country for me.

I read on a climbing-chat-site that someone had written this quote from Camus “In the midst of winter, I found there was, within me, an invisible summer”, is that something you can relate to?

- Yes, definitely: my climbing is my invisible summer. When I in ’94 crashed with the car I remember that my first thought, that night I was lying helpless across the steering wheel, was, that I will never be able to climb again. The first months in the hospital and later at the rehabilitation centre passed with starring up at the ceiling. The mountains that now needed to be climbed was all about learning to sit upright, get dressed myself, eat by my own doing and a lot of other daily things. The hardest thing for me was to forget who I once was and start trying to concentrate all my energy to return to college, but not even the best academic readings could compensate for my need to be outdoor. So it did not take long before I started to speculate if it was possible for me to return to the walls. I first started with some rappelling which developed more and more like the climbing gears got more and more refined and tailor-made for me, so I was able to use every bit of muscle power I had left. The culmination of all these efforts was reaching the summit of The Chief. Finding my way back to the wall became my invisible summer.

Why do you climb – what do you get out of it?

- Every climber hates that question … we climb because it is fun, is our immediate answer. Being on a challenging adventure in the raw wilderness with friends is really rewarding. Training and organizing to reach a certain goal is what ignites me. I climbed before my accident, so it is only natural that I continue. It is not the same as before concerning grace and power but I am up there on the wall with my friends and that is a fantastic experience. It is the mix of the great efforts, the concentration and the danger that keeps you focused on the here and now, which gives the whole thing an unsurpassed kick.

I can deduct from what I have read about you, that you have it in your blood, – that there is a thrill unmatched by hanging suspended in mid air, – that you simply must be out there, or rather up there. Is it the genes, which are calling?

- Yes, it is worse than this. I feel obligated to do this, that I really have no other choice. That the challenge is so obvious that to not pursuer climbing, would be mean I was beaten. That I’d loose some of my own self-respect. And in many ways you get close to life – being alive – up there on the walls. It is all about hard work, about focusing; focusing on the wall, the next little step and nothing more. It is a slow and calmly activity which has something spiritual about it. The adrenalin is present, needless to say, but you have to have the danger under control. It is extreme presence you sort of get addicted to. And then I have not mentioned the view and the wide open spaces. So maybe one could say that I have something to prove to myself, but really … I want to make this equipment so others can go out and surpass the work we have put into this. But doing this all safely is no small effort.

Have others followed your footsteps; other quads climbing walls?

- Some of my friends in wheelchairs have tried a bit of climbing, but I want to create a program for others to use regularly, as well as make the equipment for others. It is a very low volume sport for those in chairs, simply because mountains rarely have wheelchair access. Worse, the costs are extremely high to design and throw away new gear all the time.

Do you have future climbing plans?

- Yes, the biggest wall I’ve always dreamed about: El Captain in Yosemite National Park in California. It is a life long goal and I will be making attempts soon. We need to control breathing and blood pressure for a quadriplegic in this wild environment. This climb makes the Chief look like cake and ice cream, and literally keeps me awake at night.

RYK! Magazine wishes Brad Zdanivsky all the best of luck with his wild and daring project. We will keep an eye on him and hope he will succeed.

The iCord building (Blusson Spinal Cord Centre, VGH) has a 3 story ramp and is a perfect test of wheeling ability and fitness.

DR. Andrei Krassioukov measures change in Blood Pressure and Heart Rate in a quadriplegic vs a paraplegic.

Combined Results

T4 Data (normal response)

C5 Data (Post Exercise Hypotension)

Background information on Post Exercise Hypotension

More Information:
Open Source Heart Rate Monitoring
iCord