In probably the fourth or fifth day in ICU, three residents came to administer what is called the ASIA exam. Prior to this injury, I had no idea what the ASIA exam was. This is not an exam to test my geography knowledge nor is it something you can study for. ASIA is an acronym for the American Spinal Cord Injury Association. Without going into too much boring detail, the test is used to document sensory and motor impairments following spinal cord injuries. It is based on neurological responses, touch and pinprick sensations and the results are classified into five categories on the ASIA Impairment Scale. The exam also shows if you’re complete or incomplete, being complete is not good. I won’t post the scale, you can Google it and find it online. In my opinion, this exam is so terribly subjective. When administered by inexperienced medical professionals it can give you a demotivating label. Well, the Rehab residents gave me a brief explanation of the exam… pinpricks, dull, sharp etc.
The last part of the exam is what I will refer to as the pièce de résistance and explores the muscles that apply to the sacral region of the spinal cord. The most accessible muscle that can be explored to be rated is the sphincter muscle. This part of the test requires a glove and two fingers, if you know what I mean. It’s a good thing if you can feel their fingers, it’s not a good thing if you can’t.
Understanding the spinal cord and these types of injuries is very complicated. But what I do understand, the sacral region is way below my injury, which means if I can feel something, signals are getting down the spinal cord. Well, I couldn’t feel shit, no pun intended. I really couldn’t feel much anywhere to be honest with you. At that point I did not even know that there was a complete or incomplete, which was probably a good thing. Thankfully, they didn’t tell me which one I was, but later on I found out they had deemed to be complete.