When do I call an ambulance? How low do I let it go before I dial 999? I used to think it was amusing when my blood pressure dropped. “There it goes again,” I’d chuckle. Now it’s serious. 56/36 is no longer a joke. It is sickening. It is life-threatening. I can’t go on like this. It’s like I’ve been disembowelled, the contents of my abdomen scooped out and flung to the floor. Frightened to move. The more I exert myself the lower it goes. On my own here. No help available. Got to survive. Scratch my legs! Yeah, try and hold something and drag it along my thigh. Hope it causes a spasm. That’ll raise my blood pressure a bit. Just a little spasm. Need a big spasm really, but a small one will do. Anything to get my blood pressure up. Okay, I’ve wedged a large pencil in my hand, digging it into my right thigh now. Dragging it along. Ah … bliss! Yes, a small rise. Phew! Just enough to keep me going. Let’s try the left leg now. Wedging the pencil between my fingers, under the index finger, over the next two and under the little finger. Just about gripping it. Dragging it up and down thigh again. Pressing the pencil as hard as I can without it falling from my grip. There. Yes, another little spasm. Such sweet pleasure. It’s not enough, though. Blood pressure keeps dropping. Somebody help me for Christ’s sake! I need a guardian fucking angel here. I need someone to walk in the door and tip my wheelchair back, head down, feet in the air. Got to do something to get this blood pressure up. Maybe I need more fludrocortisone? Maybe an escort girl dressed in stockings and high heeled shoes, walk in through the front door, do a slow pirouette and then parade herself provocatively in front of me. “Do you want some of this, Michael?” — bending over tantalisingly and wiggling her arse. “Or would you rather have these?” — leaning forward, tits spilling out of her bra. Gawd ‘elp us! Hah! No chance! Wife would go berserk, but then again so would my blood pressure. Ha, ha, ha! It’s what I need to do though. Definitely what the doctor ordered. Yeah, good dose of medicine, that. No chance of getting an erection, though. Haven’t had one for thirty-five years. God-damned injury! Anyway, with my blood pressure so low, the blood rushing to my cock would kill me. It’s almost funny. Ha—! Can’t win. Catch-22 whichever way I look at it. Hang on, what’s going on here? Legs spasming a bit more than I anticipated. Christ! Blood pressure shooting up now. Oh fuck! I can feel my heart pounding. Oh no, another spasm. Shit! Vision disturbance. Black pulses in my eyes. Throbbing to the beat of my heart. Jesus Christ! Blood pressure going berserk. Oh fuck … I’m having a full blown dysreflexia attack. If this carries on I’ll have to take nifedipine, squirt it under my tongue. Jesus my heart is thumping. I can feel the pressure in my throat, and now my head is aching. Blood-pressure must be sky-high. Frightened to move but I’ve got to get the gauge, put the cuff around my arm and see how high it is. Terrified when it’s low and terrified when it’s high. That’s spinal injury for you. Complications! Infinite! No end to it all. One minute I’m dying of low blood pressure and the next it’s so high I’m in danger of a heart attack or stroke. What a rollercoaster ride. A cactus up the arse would be easier to take than this. Ha, ha, ha … that’s funny. Got to laugh or I’d cry. Ha, ha, ha, ha!