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vickyandrianson
03-09-2016, 08:10 PM
I'm currently writing an Adult Romance tetralogy, and as the characters evolve in my head, I wanted the protagonist female of the last installment to be in a wheelchair - at first.
I haven't entirely thought of the concept yet, only that I want her to have a surgery at some point that will give her back function of her legs. I've thought of many scenarios - maybe she got hurt in the car-accident that killed her father, or that she could have a genetic disease passed on from a grandparent - but I haven't allowed myself to think further on that because I don't know what is possible.
Can just her legs be paralyzed or does it have to be from the waist down?
Is it possible to have an accident that can cause temporary paralysis that can be cured with surgery? I've read that even incomplete spinal cord injuries are very hard to heal and every cure is on an experimental level at this point.
Anyway, I know I'm being very vague at this point, but I just need somewhere to start. My imagination will take care of the rest, hopefully!

CindyGirl
03-09-2016, 09:19 PM
I'm not sure what you are asking. Do you mean she was fine, then injured and in a wheelchair for a period of time, then a surgery helped her?

King Neptune
03-09-2016, 10:57 PM
I am acquainted with people are (or have been) in wheelchairs for a time because of injuries, and that should work. Nerve damage in a leg could do tha, and nerves do slowly regrow, so at some point it would reconnect.

Someone in a wheelchair due to a genetic disease isn't likely to improve over the long run, so you probably should avoid that.

nikkidj
03-10-2016, 11:10 PM
What about Guillain Barre syndrome? It causes ascending paralysis, starting in the feet and rising as the disease progresses. Then, as the body recovers, the paralysis recedes in the reverse order. If she is recovering from it, she could be in a wheelchair for a while, and then re-learn how to walk. It wouldn't require a surgery, but intense physical therapy.

Short of experimental stem-cell surgery, there's not much surgically that can reverse paralysis. Recovery is a function of nerve growth, and takes time. However, if it's simply weakness from a bulging disk, surgery might work to repair the damage, but not complete, bilateral paralysis.

nemaara
03-11-2016, 07:17 AM
Neurons do regrow in adults, but to my knowledge, things like spinal cord injury and motor neuron injury can't feasibly be repaired with current medical technology. Guillain Barre syndrome is apparently not understood well, but my instinct as a biology student tells me that it can be caused by neural infection, which could very well occur if some kind of injury has happened.

Alternatively, there are a number of theoretical ways one could imagine for repairing "permanent" paralysis. Obviously these aren't methods that are applicable with current medicine (otherwise we would know about them!), but here are some options:

Stem cell surgery. Most people have heard of stem cells, and even if they might not know the details, it's not hard to imagine that stem cells could do the trick. Of course, in reality, it wouldn't be as simple as sticking a bunch of stem cells into the injury site, but depending on how specific (or realistic) you want to be about the cure, this might work.

Drugs. There are actually a number of transcription factors (proteins) that allow adult neurons to regrow after injury. If the neurons aren't gone completely, it's possible that applying special drugs to the region will allow the neural axons to regrow and let them function again. Similarly, it's known that adult stem cells do exist as well, so a different set of drugs might allow these stem cells to repair the injury naturally. Again, specifics are really hard to say since such drugs don't exist yet, but experiments in smaller mammals (mice!) have shown that these are possible.

Have it be temporary paralysis? You might also have heard of Lyme disease. This can be contracted when ticks bite you, and they happen to be carrying certain bacteria on them. Usually this causes temporary paralysis of the face (I don't know the details of why, though...), but maybe you could just have something similar happen and have it be in the legs instead. It's not unimaginable that if bacteria can cause paralysis in the face, it can happen in the legs too.

Katharine Tree
03-11-2016, 09:57 AM
If paralysis is due to a spinal injury, all parts of her below that part of the spinal cord will be affected. Here is a map (http://seankelleys.com/wp-content/uploads/2011/10/sean-kelley-spinal-cord-map-body-paralysis-big-2.jpg) of what parts of the body are innervated by what spinal nerves. It's worth noting that sending information out from the brain, which is what makes a part of the body move, and sending information from the body back to the brain, which is what allows one to sense touch, temperature, position, and pain, are separate sets of nerves, and sometimes only one set is affected. So it's possible to move a body part without being able to feel it, or alternately to feel a body part but not be able to move it. It is also worth noting that reflexes do not waste time going to the brain; they just loop around the spinal cord and go back to the affected body part. So it is possible for a person with paralyzed legs to flinch when a leg is burned.

But if you want her to be paralyzed and then walk again, I think your best bet is a good old-fashioned somatic symptom disorder ... i.e., it's all in her head. (Note that that isn't the same as saying "she could walk all along if only she wanted to!" because it isn't; it just means there wasn't a motor defect causing the paralysis). If you can make the story work for that.

vickyandrianson
03-11-2016, 04:15 PM
I'm not sure what you are asking. Do you mean she was fine, then injured and in a wheelchair for a period of time, then a surgery helped her?

That is exactly what I meant. My first thought was: Car accident, wheelchair for a while because her mother is a b**** and didn't care to get her the appropriate help for a couple or three years, then the male protagonist meets her, and through his help she meets the right doctors and finds a way to walk again. Only I stopped myself because I have no idea if that is possible. I mean, there are so many holes in that idea that I don't know which one to patch up first. And I'm sort of a perfectionist, so I can't just go with a vague notion.

vickyandrianson
03-11-2016, 05:01 PM
Neurons do regrow in adults, but to my knowledge, things like spinal cord injury and motor neuron injury can't feasibly be repaired with current medical technology. Guillain Barre syndrome is apparently not understood well, but my instinct as a biology student tells me that it can be caused by neural infection, which could very well occur if some kind of injury has happened.

Alternatively, there are a number of theoretical ways one could imagine for repairing "permanent" paralysis. Obviously these aren't methods that are applicable with current medicine (otherwise we would know about them!), but here are some options:

Stem cell surgery. Most people have heard of stem cells, and even if they might not know the details, it's not hard to imagine that stem cells could do the trick. Of course, in reality, it wouldn't be as simple as sticking a bunch of stem cells into the injury site, but depending on how specific (or realistic) you want to be about the cure, this might work.

Drugs. There are actually a number of transcription factors (proteins) that allow adult neurons to regrow after injury. If the neurons aren't gone completely, it's possible that applying special drugs to the region will allow the neural axons to regrow and let them function again. Similarly, it's known that adult stem cells do exist as well, so a different set of drugs might allow these stem cells to repair the injury naturally. Again, specifics are really hard to say since such drugs don't exist yet, but experiments in smaller mammals (mice!) have shown that these are possible.

Have it be temporary paralysis? You might also have heard of Lyme disease. This can be contracted when ticks bite you, and they happen to be carrying certain bacteria on them. Usually this causes temporary paralysis of the face (I don't know the details of why, though...), but maybe you could just have something similar happen and have it be in the legs instead. It's not unimaginable that if bacteria can cause paralysis in the face, it can happen in the legs too.

It's stem cell surgery that I first thought of. But is it plausible? Even though I read many articles about this kind of surgeries, they are not very specific, or clear on the success rate. I mean, it's a fictional novel and I can be a little bolder or more hopeful, but I don't want to exaggerate.
I wasn't planning on being very specific about the procedure, but I would like to be on the realistic side. I'm not planning to describe the procedure at length, but I also can't just bypass it entirely.

talktidy
03-11-2016, 05:11 PM
Do you have to go down the spinal chord injury route? I have no medical training, so this needs to be taken with a pinch of salt, but you might consider/explore serious injuries to her legs and/or even pelvis -- maybe ER doctors doubted her legs could be saved. I think it not unlikely she would require a subsequent round of additional surgeries.

That should keep your protagonist off her feet.

nemaara
03-11-2016, 08:24 PM
It's stem cell surgery that I first thought of. But is it plausible? Even though I read many articles about this kind of surgeries, they are not very specific, or clear on the success rate. I mean, it's a fictional novel and I can be a little bolder or more hopeful, but I don't want to exaggerate.
I wasn't planning on being very specific about the procedure, but I would like to be on the realistic side. I'm not planning to describe the procedure at length, but I also can't just bypass it entirely.

It doesn't exist yet. You could imagine it being possible, but to my knowledge, nobody has done it yet (otherwise they probably would have talked about it in class!). The success rate would probably be fairly low, even if such a procedure were to be devised.

On another note, like talktidy said, it doesn't have to be spinal cord injury. If you think about it, people break limbs all the time. It's not like their motor neurons escape injury if you have a bad break, but usually permanent paralysis doesn't happen. It turns out your body naturally repairs things like motor and sensory neurons in most cases. The things that don't get repaired are your spinal cord and brain. You could have your protagonist be a special case, though, in which her neurons don't get repaired. It could happen by infection, or she could have a genetic mutation that causes her to not heal (or maybe heal slowly; some are actually known).

There are a lot of methods that could be possible (to repair spinal cord injury), it's just that none have actually been done successfully yet. But if you're not worried about what's actually being done, you could maybe tweak the dates a little, or just have some breakthrough experimental surgery (albeit with low success rate) and it would be fairly realistic IMHO.

Nivarion
03-11-2016, 11:44 PM
How long do you want her down for? A severe skeletal or tissue injury could put a person in a wheel chair. It's even possible that you can have an individual who isn't paralyzed in the traditional sense is in too much pain when they try to walk to actually do it. A doctor who can diagnose and treat the cause of that pain could allow them to function normally.

For example, my uncle shattered both hips in the army. He has extreme pain when he walks, but most doctors just brush him off since the xrays don't show much of anything. (at least the VA doctors he's seen.)

atthebeach
03-12-2016, 07:57 AM
Guillain Barre Syndrome mentioned earlier is definitely a good option. I had never heard of it, but doctors said I had it last Feb when I collapsed. Recovery was slow, but by the end of May I was at my best with a walker (out of the wheelchair). Unfortunately and without warning, beginning of June, I started to weaken again and suddenly collapsed completely again. It was then that I learned about the chronic form, a counter-part to Guillain Barre, called Chronic Inflammatory Demylenating Polyneuropathy (CIDP), which I still have, and am still working to get out of the wheelchair (but many people walk just fine after physical therapy).

But since you mentioned 3 years, perhaps a recovery from CIDP could happen that late, but not usually, and not Guillain. Guillain doesn't last that long, I think only 6-8 weeks. So my initial recovery time would have fit if I never went downhill again. And, I did meet someone who had Guillain years ago, and it never came back, so it is possible.

But surgery doesn't fix this, so you would have to factor that in. Maybe he helped pay for physical therapy that the mom wouldn't do? It is hard to get going without therapy (and it can be very painful already plus moving too, so it helps to have motivators like that).

vickyandrianson
03-12-2016, 05:22 PM
Thank you all for your help.
I'm going to have to think about this further, but I think I will either go with the experimental stem cell surgery since I have the time frame to support it, or change the time frame completely and go with a displaced fracture, which would give me enough time during the healing period for the main part of the story to unfold. I was so stuck on the spinal cord idea that I hadn't even considered a simple fracture! I think it's possible my brain has turned into mush!!!
Again, thanks a lot!

Treehouseman
03-13-2016, 05:59 PM
What about psychological paralysis coupled with a benign brain tumour? The crash Might have caused a bleed and shut down the motor centres, but a surgical procedure can fix it.

vickyandrianson
03-14-2016, 07:24 PM
What about psychological paralysis coupled with a benign brain tumour? The crash Might have caused a bleed and shut down the motor centres, but a surgical procedure can fix it.

Tell me more!!!! :D

Treehouseman
03-15-2016, 12:20 PM
Well you could have several stressors that cause: https://en.wikipedia.org/wiki/Conversion_disorder

Maybe a small hematoma from the car crash? (tiny - less than a centimetre). The stress is huge. As it's not necessary surgery, and the paralysis is is psychological, Bad Mom is not going to fix it!

A doctor-psychiatrist believes that a surgical procedure to remove the bleed will cure her. WHICH IT DOES!