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Spinal Cord Injury Support
There are large support networks, not only for spinal cord injury patients, but for families and friends of a spinal cord injury patient. Support sites (online and offline) include resources, information on health issues relating to spinal cord injuries, general information on spinal cord injuries and contacts for help and assistance.
Resources include information on adaptive technology, books, medical supplies, medical equipment, information on traveling, spinal cord injury studies, local hospitals and rehabilitation centers and online magazines and newsletters.
There is also support for spinal cord injury health issues such as autonomic dysrefexia, bladder management, bowel management, skin management, wheelchair (manual and power) set up, pressure sores and urinary tract infections.
While there are many websites with information, http://www.sci-info-pages.com/state-resources.html has a list with links to all of these and more resources, plus listings of support groups that are listed by state.
When at all possible, a spinal cord injury patient should take advantage of the support groups and other information available. This information can help a patient cope with his or her spinal cord injury.
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Spinal Cord Injury Statistics
A spinal cord injury is an injury that happens when sudden force is put on the spinal column, such as in a vehicle accident or a sporting accident. According to the Spinal Cord Injury Information Network, there are about 40 spinal cord injuries per million people in the United States. This means that there are about 12,000 new cases each year. As of 2008, there were 229,000 to 306,000 people living in the United States with a spinal cord injury.
Spinal cord injury statistics report that these injuries occur at an average age of 40 years (since 2005, prior to that, the average age was 28.7 years). Also, 80.9 percent of spinal cord injuries happen to males—though the website does not say, it may be because males are more involved in rough sporting activities and other high-risk events.
Since 2005, 42.1 percent of spinal cord injuries were caused by vehicle accidents. Falls are the next most common cause, then acts of violence (usually gunshot wounds), followed by sporting activities. Over the years, the proportion of spinal cord injuries due to sporting events has declined.
For those with a spinal cord injury, about 58 percent were employed prior to the injury. Only about 12 percent of those who have suffered a spinal cord injury return to some type of employment, though that rate goes up for each year post-injury. By post injury year 20, about 35 percent of spinal cord injury patients are re-employed.
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Spinal Cord Injury Physical Therapy
After surgery, and once the patient is stabilized, the patient must start rehabilitation. The patient will also need supportive care. Family members, nurses and specially trained aids can give supportive care. Supportive care includes helping the patient with daily living activities such as dressing, bathing, and changing positions to prevent bedsores.
Rehabilitation includes physical and occupational therapy and counseling for emotional support. A rehabilitation program is designed specifically for each individual patient, in order to meet that patient’s needs.
Depending on the hospital the surgery was done at, rehabilitation services may be done at the hospital, or the patient may be admitted to a rehabilitation facility. This also depends on the severity of the spinal cord injury and the outcome of surgery. Some patients are able to complete rehabilitation at home or on an outpatient basis.
Physical therapy programs help restore muscle strength, flexibility, mobility, coordination and can also help the patient maintain body functions. Physical therapy consists of exercise, massage and hydrotherapy. It also includes gait training, if needed, and training to use assistive devices if needed.
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Spinal Cord Injury Rehabilitation
Spinal cord injuries prevent nerve signals (messages) from traveling to and from the brain. Injuries can be caused by numerous things, including vehicle accidents, violence, falls or a disease or disorder. The spinal cord injury can cause damage from loss of sensation below the level of the injury to paralysis, depending on the severity of the spinal cord injury.
Spinal chord injury rehabilitation includes physical and occupational therapy, along with emotional support. An occupational therapist evaluates the injured person’s ability and level of functioning, how motivated the injured person is to participate in activities that he or she participated in prior to the injury and identifies changes in roles the injured person may experience due to the spinal cord injury.
Occupational therapy as part of spinal cord injury rehabilitation also provides individualized therapy to help the injured person perform activities of daily living. Adaptive techniques, if needed, are taught so the person can perform his or her daily living skills.
Part of rehabilitation and occupational therapy that crosses over to psychological therapy is helping the injured person cope with the effects of the spinal cord injury. In addition to working with the emotional aftermath of the spinal cord injury, the rehabilitative process implements exercises to strengthen muscles used in eating, dressing, and other home self care tasks.
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Spinal Cord Injury Facts
The CDC shows that as of 1998, almost 200,000 people in the United States live with a disability that is related to a spinal cord injury and that about 11,000 people have a spinal cord injury each year. More than half of the people with a spinal cord injury are between 15 and 29 years of age.
Age plays a part is the causes of spinal cord injuries. In people who are under 65 years of age, vehicle accidents are typically the cause of the spinal cord injury, while falls cause people over 65 years of age to suffer from a spinal cord injury. Of those under 65 years of age, sports and recreation activities are about 18 percent of the causes of spinal cord injury.
A spinal cord injury may also present secondary conditions such as pressure sores, respiratory problems, urinary tract infections, spasticity and scoliosis. Another problem with spinal cord injury patients is hyperreflexia.
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Autonomic Dysreflexia: Definition
Autonomic dysreflexia, which is also known as hyperreflexia occurs in patients with a spinal cord injury at a T-5 level and above. A person that suffers from autonomic dysreflexia has an over-active autonomic nervous system. This condition can come on suddenly and may lead to seizures, strokes and death. It should be treated as an emergency situation.
Autonomic dysreflexia generally happens when an irritating stimulus is presented below the level of the spinal cord injury. An overfull bladder is enough to trigger it. The stimulus of the irritating condition sends nerve impulses to the spinal cord. The impulses travel up the spinal cord, but get blocked by the lesion at the level of the injury. The impulses cannot reach the brain, so a reflex is activated. This reflex increases activity of the sympathetic portion of the nervous system, which then results in spasms and narrowing blood vessels. This, in turn, causes higher blood pressure. The nerve receptors in the heart and blood vessels send a message to the brain, which then sends a message to the heart slowing down the heartbeat and dilating the blood vessels above the level of the injury. Blood pressure cannot be regulated because the brain cannot send messages below the level of the injury.
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Hyperreflexia Symptoms
Hyperreflexia (autonomic dysreflexia) can be caused by anything that may be painful or uncomfortable after the spinal cord injury. An example is an overfull bladder or a bowel full of gas. Hyperreflexia can be a life threatening condition, as it affects blood pressure, and the blood pressure cannot be controlled.
Symptoms of hyperreflexia include:
Pounding headache (caused by the elevation in blood pressure)
Goose Pimples
Sweating above the level of injury
Nasal Congestion
Slow Pulse
Blotching of the Skin
Restlessness
Other simple things that could cause hyperreflexia are things most people do not think twice about, such as skin irritations, wounds, pressure sores, burns, pregnancy and ingrown toenails. There are also causes that are not quite as simple, such as broken bones and appendicitis.
If a patient notices symptoms of hyperreflexia, he or she should get to the hospital as soon as possible. To help prevent complications, according to calder.med.miami.edu, the patient should do the following
Remain in a sitting position, but do a pressure release immediately. You may transfer yourself to bed, but always keep your head elevated.
Since a full bladder is the most common cause, check the urinary drainage system. If you have a Foley or suprapubic catheter, check the following:
Is your drainage full?
Is there a kink in the tubing?
Is the drainage bag at a higher level than your bladder?
Is the catheter plugged?
Catheters must be changed if drainage does not start within two to three minutes. If there is no problem with the bladder or the catheter, check for pressure sores, ingrown toenails and fractured bones.
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