MEDICAL PROBLEMS IN SPINAL CORD INJURY: OVERVIEW OF SPECIFIC PROBLEMS
A spinal cord injury has an effect on nutrition because your appetite goes up and down according to how you feel and how active you are. "Good" food means a better you - you'll look better and feel better. To stay healthy, you must have enough food of the right kind. In the section on Nutrition, you will hear quite a bit about what is best to eat and drink to keep all your body systems as healthy as possible and to prevent too much weight gain.
Loss of feeling or sensation means you have lost the warning system that helps protect your body. Also, because you cannot move easily, you can develop problems from being in one position too long. We will pay a great deal of attention to your skin, as much as or more than any other part of your body. We are always watching your skin and turning you to change positions. In the section on Skin Management, we will teach you to check you own skin and to relieve pressure, thus preventing problems from arising.
Immediately after spinal cord injury, some calcium and minerals often leave the bones. Eventually, these minerals may be deposited in the urinary system causing calculi, or "stones." Activity will slow down this process. Therefore, we try to get you out of bed and encourage you to be as active as you can. If you have no feeling or sensation, you don't know when your bladder is full. Frequently, the muscles in the bladder are so weak that it cannot empty completely. You can also not control the starting and stopping of the flow of urine. Therefore, early in your treatment, we put in an indwelling catheter or use intermittent catheterization. Later, the muscle tone may improve so that an indwelling catheter will not be necessary. To keep your urinary system healthy, keep as active as possible and drink liquids within your fluid allotment. It is also important to use scrupulous care in cleanliness and when carrying out procedures to prevent urinary tract complications. We describe how to do all this in the Urinary Tract Management section.
The bowel is affected when the nerve path is broken, as well as by loss of activity. You may have lost the sensation of having a bowel movement, and you probably cannot tighten your muscles to stop one happening. You may get constipated because you aren't active. We will help you to control your bowel in the Bowel Program section. You will hear a lot about drinking plenty of fluids to keep well hydrated. One of the main reasons is to prevent constipation. We will help you learn which kinds of food and fluids are best for bowel health in the Nutrition section.
Your lungs are not injured by a spinal cord injury, but the muscles which control your lungs and help you breathe deeply and cough may not work well. Inactivity also affects the health of your lungs. Some patients receive special treatment by respiratory therapists. Others just need to learn ways to breathe deeply and cough to clear out normal secretions. We will teach you how best to care for your lungs in the Respiratory Management section.
Sexual function may be affected in varying degrees by a spinal cord injury, but how you feel about yourself may have as much effect on your functioning as a sexual person as the paralysis and sensory loss. Many aspects of sexuality are the same after SCI as they were before. Again, the effect on function and movement will depend on the level of injury and whether damage to the spinal cord is complete or incomplete. We will discuss this further in the section on Sexuality.
In tetraplegia, the interruption of the autonomic nervous system can cause episodes of "autonomic dysreflexia", also known as "hyperreflexia" or muscle spasm. Spinal reflexes, in general, remain intact after a SCI, but in SCI the brain can no longer modify and regulate these actions. In other words, these previously normal reflex actions are increased and exaggerated in SCI. You will find additional information on autonomic dysreflexia in the section on Complications.
Blood Pressure, Temperature, and Bone Problems Other complications of SCI include:
Further information on each of these conditions can be found in the section on Complications.
Not only your body is affected by a spinal cord injury -- your emotions are very much a part of the rehabilitation process. It probably helps to know that most people with SCI go through several emotional reactions. You may be down and really depressed … you may be angry … you may ask, "Why me?" … Sometimes you won't feel like doing anything at all. For some people, one of the worst things is not being able to do everything for themselves. It can be very upsetting when you have to rely on other people to do things for you or to help you help yourself. Further information on your emotions and the emotions of your family members and others can be found in the Feelings and Reactions section.
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