About SCI
My
Injury | MyMobility | About
SCI | SCI Facts | Research
| FAQs | Links
Here is some information
on spinal cord injuries; things that come with a spinal cord
injury and some of the most frequently asked questions of a
spinal cord injury.
Spinal
Cord Injury
Unlike
what most people believe, living with a spinal cord injury is a
lot more then just not being able to walk. A spinal cord injury
is when a person's spinal cord becomes damage. There are two
types of injuries, complete and incomplete. When the person's
spinal cord is severed or completely cut, it is known as
complete or ASIA-A. When it is incompletely cut it is known as
an incomplete making it ASIA-B. The higher up the spinal cord is
damaged, the less function a person would have. The upper part
of the spinal cord controls everything from breathing, to arm
movements, while lower parts control leg movements. There are
three sections of the spinal cord. They are the cervical,
thoracic, lumbar and at the bottom is the sacrum.
Not
many people know this but it is not only the inability to move
your arms or legs but also bowel and bladder control are lost
too (in most cases.) This is the worst part (I think) of the
injury. A person with a spinal cord injury must train there
bodies to go at certain times. In order to urinate since the
muscles that control the bladder contractions are lost
(depending on the injury) one must catheterization which can
lead to UTI's.
Catheterization involves inserting a small tube into the penis
or vagina that goes into the bladder where the urine is sucked
out and into a urinal or bag depending on the catheter
used.
[top
of page]
What
is Spinal Cord Injury?
Spinal Cord Injury (SCI) is damage to the spinal cord that
results in a loss of function such as mobility or feeling.
Frequent causes of damage are trauma (car accident, gunshot,
sports accidents, falls, etc.) or disease (polio, spinal
bifida, spinal tumors, etc.). The spinal cord does not have to
be severed in order for a loss of functioning to occur. In fact,
in most people with SCI, the spinal cord is intact, but the
damage to it results in loss of functioning. SCI is very
different from other back injuries such as ruptured disks, or
pinched nerves.
A person can "break their back or neck" yet not
sustain a spinal cord injury if only the bones around the spinal
cord (the vertebrae) are damaged, but the spinal cord is not
affected. In these situations, the individual may not experience
paralysis after the bones are stabilized.
[top
of page]
What
are the spinal cord and the vertebra?
The spinal cord is about 18 inches long and extends from the
base of the brain, down the middle of the back, to about the
waist. The nerves that lie within the spinal cord are upper
motor neurons (UMNs) and their function is to carry the messages
back and forth from the brain to the spinal nerves along the
spinal tract. The spinal nerves that branch out from the
spinal cord to the other parts of the body are called lower
motor neurons (LMNs). These spinal nerves exit and enter at each
vertebral level and communicate with specific areas of the body.
The sensory portions of the LMN's carry messages about sensation
from the skin and other body parts and organs to the brain. The
motor portions of the LMN's send messages from the brain to the
various body parts to initiate actions such as muscle movement.
 bone called vertebra. These bones constitute the
spinal column (back bones). In general, the higher in the spinal
column the injury occurs, the more dysfunction a person
will experience. The vertebra are named according to their
location. The eight vertebra in the neck are called the Cervical
Vertebra. The top vertebra is called C-1, the next is C-2, etc.
Cervical SCI's usually cause loss of function in the arms and
legs, resulting in quadriplegia. The twelve vertebra in the
chest are called the Thoracic Vertebra. The first thoracic vertebra,
T-1, is the vertebra where the top rib attaches.
Injuries in the thoracic region usually affect the chest and the
legs and result in paraplegia. The vertebra in the lower back
between the thoracic vertebra, where the ribs attach, and the
pelvis (hip bone), are the Lumbar Vertebra. The sacral vertebra
run from the Pelvis to the end of the spinal column. Injuries to
the five Lumbar vertebra (L-1 thru L-5) and similarly to
the five Sacral Vertebra (S-1 thru S-5) generally result in some
loss of functioning in the hips and legs.
[top
of page]
What
are the effects of SCI?
The effects of SCI depend on the type of injury and the
level of the injury. SCI can be divided into two types of injury
- complete and incomplete. A complete injury means that there is
no function below the level of the injury; no sensation and no
voluntary movement. Both sides of the body are equally affected.
An incomplete injury means that there is some functioning below
the primary level of the injury. A person with an incomplete
injury may be able to move one limb more than another, may be
able to feel parts of the body that cannot be moved, or may have
more functioning on one side of the body than the other. With
the advances in acute treatment of SCI, incomplete injuries are
becoming more common.
The level of injury is very helpful in predicting what parts of
the body might be affected by paralysis and loss of function.
Remember that in incomplete injuries there will be some
variation in these prognoses.
[top
of page]
Quadriplegia
Cervical (neck) injuries usually result in four limb paralysis.
This is referred to as Quadriplegia.
 Injuries above the C-4 level may require a
ventilator for the person to breathe. This is because the
diaphragm is controlled by spinal nerves exiting at the upper
level of the neck. The well documented horse riding
accident of Christopher Reeve (Superman) resulted in a
'complete' spinal cord injury above C3 and he now has to use a
mechanical ventilator via a hole in his throat to breathe.
C-5 injuries often result in shoulder and biceps control, but no
control at the wrist or hand. C-6 injuries generally yield wrist
control, but no hand function. Individuals with C-7 and T-1
injuries can straighten their arms but still may have dexterity
problems with the hand and fingers.
[top
of page]
Paraplegia
Injuries at the thoracic level and below result in paraplegia,
with the hands not affected. At T-1 to T-8 there is most often
control of the hands, but poor trunk control as the result of
lack of abdominal muscle control. Lower T-injuries (T-9 to T-12)
allow good truck control and good abdominal muscle control.
Sitting balance is very good. Lumbar and Sacral injuries yield
decreasing control of the hip flexors and legs.
Besides a loss of sensation or motor functioning, people with
SCI also experience other changes. For example, they may
experience dysfunction of the bowel and bladder,. Sexual
functioning is frequently impaired or lost with SCI. Men
may have their fertility affected, while a women's fertility is
generally not affected. Other effects of SCI may include
low blood pressure, inability to regulate blood pressure
effectively, reduced control of body temperature, inability
to sweat below the level of injury, and chronic pain.
[top
of page]
My
Injury
If you are still reading this hopefully you will now have a
greater understanding of Spinal Cord Injury and its effects.
Every Injury is unique, particularly so with incomplete lesions.
Recovery from an incomplete injury can continue for up to 2-3
years post accident. However spinal cord nerves do not
repair themselves so 'all' damage to the cord is permanent from
the time of the injury.
My Injury is described as 'C4-5 incomplete Quadriplegic'
Although my spinal cord was damaged at that level after much
hard work and time recovering I am not able to walk or feel
below my armpits For any traveling I use a powered
wheelchair. My right arm is somewhat weak and my left arm
does not really move at all. I'm able to use what function I
have well enough to get by pretty independently.
Clearly the outcome of my injury could have been so much worse, I
am thankful to be alive and honestly regard myself as very
fortunate to have recovered to my present state.
[top
of page]
Pressure
Wounds
Another
bad part about spinal cord injuries is lack of feeling in the
parts below the lines of injury. In some cases this is good but
in others it can be VERY bad. An example in which it is good is
you can't feel pain if you break your leg, but the bad part is
one may not know they broke their leg. This can be bad in which
the injury will remain and get worse if not properly treated.
Another bad part about having no feeling is pressure wounds.
These ulcers form on a part of the body which was laid on or had
pressure on it for too long without moving it. In a non injured
person they would automatically change their position without
thinking in order to relieve pressure.
Someone
with a spinal cord injury must do pressure releases in order to
relieve pressure. If a part of the body is pressured to much a
pressure wound is formed and goes through the skin (stage I),
through the fat tissue (stage II), through muscle (stage III)
and even to the bone (stage IV). These can be very dangerous and
in some cases fatal. In order to avoid this one must relieve
pressure and regularly check their bodies to make sure there is
no redness.
[top
of page]
Sexuality
Another
part that goes along with the loss of sensation is sexual
function in some cases, and lost of sensation in the penis or
the vagina. I could see how this could be bad but me being 16 I
haven't had sex, and guess I don't miss it hehe. Anyway
ejaculation in some paralyzed men, is backwards which it goes
into the bladder (killing the sperm) instead of leaving the
penis.
Other
men have normal ejaculation. One way to achieve fertilization is
to catheterize, insert a special substance that can be used to
"catch" the sperm, use a stimulation device on the
penis to stimulate ejaculation, and grab the semen out from the
bladder and use that to achieve fertility. Since getting an
erection in some cases is just like having a spasm, the problem
is some men cannot keep an erection for long. Viagra (yes viagra)
was made with paralyzed men in mind.
Other
methods include penile injections, which sounds painful but
isn't, for someone with a spinal cord injury or a air pump.
In women some concerns are loss of vaginal lubrication and loss
of sensation. I do not know much on this subject (not being a
women) so I can't really go far into depth.
[top
of page]
Spasms
Ever
see a person with a spinal cord injury and see their legs or
arms twitch or jerk in a fast or repetitive motion? Don't worry
they aren't faking the spinal cord injury, it is called a spasm.
A spasm is caused by a build up of lactic acid in the muscle.
The muscle moves in order to move around and get rid of the
lactic acid. Spasms can be quick and repetitive or slow and
intense. Spasms that are small and repetitive usually happen
with someone's leg going up and down real quick which looks
almost like a nervous twitch or someone stomping their leg to a
beat. Other spasms consist of strong ones (I've almost been
kneed in the face a couple of times) in which the leg jerks up.
Some
spasms are painless, but when spasms happen to much, become
painful, or get in the way of transfers, they can be treated.
Two types of medicine used are Baclafin which is an older
medicine or Zanaflex which is newer. Baclafin can be taken
orally or pumped into the spinal cord. Zanaflex is taken orally.
Spasms can increase with autonomic disreflexia, a serious of
symptoms to let a person know if something is wrong with their
body (I.E a broken leg), a UTI,
or after spinal shock. Spinal shock is what the body goes
through when a person first has an injury. The spine swells up
which can cause even more damage, and it is when the body first
gets used to the injury. After about 5 months spinal shock ends
and idea of what the person is left with start to show.
[top
of page]
Urinary
Track Infections (UTI)
 <-----
O'Neil urinary catheter. Helps prevent UTI's
One
of the most difficult things to deal with in my opinion. A
urinary track infection is an infection of the bladder in which
bacteria grows and reproduces in ones bladder. Some symptoms of
a UTI include, leaking, foul smelling urine, chills, high fever,
and an increase of spasms.
Once
the body gets used to having UTI's the bacteria can colonize
which means the bacteria will be at high levels but your body
can fight off symptoms. Some ways of treating UTI's are using
antibiotics. Some used are Cefton, and Bactrum. Also something
known as Hiprex can be used which increases the acidity in the
bladder, and when combined with vitamin C or cranberry juice, it
will keep the bladder to acidic for bacteria to grow.
Some
ways to prevent UTI's are good hand washing techniques, using
provider wipes on the penis, be sure not to let the catheter to
touch anything before going into your bladder, and to keep the
catheter cleaned. Drink plenty of water to clean out your
system, and have some cranberry juice pills too.
[top
of page]
Words
of advice
A
spinal cord injury will be devastating on a person. It changes a
person's life style and many things a person can do, can no
longer do. A normal person with a spinal cord injury can go
through a state of depression for a while, even up to a couple
of years. Loss of sexual function, not being as mobile as
someone else, loss of sensation, and the overall loss of control
is very hard to cope with.
I
was injured December 18th 1986. I was 19 at the time and I have
missed out on a lot of stuff. Here is some advice I can give a
person with a spinal cord injury.
Always
strive to do your best, don't get discouraged on what you can't
do and try to set goals for yourself. Know your bodies limits
and learn to live with them. Do not grieve over your injury for
too long and ask "Why me" or "This can't be
happening". Life happens and what's done is done. It is a
good idea to get into shape, build up your upper body if
possible in order to be more mobile and it will make life a lot
easier.
Attend
meetings or join a support group, no one says you have to cope
with it alone. Just remember the situation could be worse. I
always tell myself, look at Christopher Reeves, he lost nearly
everything and he still strives to live. Just because you have a
spinal cord injury doesn't mean your life has to be over and you
have to give up. Remember never to lose hope, it has been proven
that a spinal cord injury can be recovered from through
operations. Although the "cure" isn't out yet in the
US, doctors in other parts of the world have had success. One
day the cure will be around and all of your effort and hard work
will pay off.
I
have become a better person because of my injury, I used to
waste my life away abusing drugs and writing gloomy poetry. Try
to live your life to the fullest and don't look back, you can
only look towards the future. I was depressed about 2 weeks,
that's it. Get on with your life at all costs don't mope and
feel sorry for yourself.
Good
luck, if I could do it anyone could.
[top
of page]
For
More Information Please Visit
For further very detailed information about all medical aspects
of a spinal cord injury please visit www.spinalnet.co.uk
a new website with a very comprehensive SCI medical section
[top
of page]
|
