Health Care and Spinal Cord Injuries

Your spine allows you to help stand up straight and do some pretty amazing movements. It also aids in the control of your ability to feel pain. The “cord” is that nerve that runs from top to bottom through the middle of your vertebrae and connects with the nerves in your body. If the spinal cord is injured, the affects can be debilitating not only physically but also psychologically to the individual, and often to the family. Your world instantly changes.

Learning that you, a family member or friend has gotten a spinal cord injury is devastating and overwhelming news, according to the Christopher & Dana Reeve Foundation. The best way to combat your feelings of helplessness and confusion is to arm yourself with information on what a spinal cord injury is, and what it means in terms of short-term planning and long-range goals.

According to this website, http://www.apparelyzed.com/spinal_cord_injury.html , the spinal cord is about 18 inches in length and extends from the base of the brain, surrounded by the vertebral bodies, down the middle of the back, to about the waist. The nerves that are situated within the spinal cord are called 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 carry messages about sensation from the skin such as pain and temperature, and other body parts and organs to the brain. The motor portions of the LMN send messages from the brain to the various body parts to initiate actions such as muscle movement, per the info on the Apparelyzed site.

The spinal cord is the major bundle of nerves that carry nerve impulses to and from the brain to the rest of the body. The brain and the spinal cord constitute the Central Nervous System. Motor and sensory nerves outside the central nervous system constitute the Peripheral Nervous System, and another diffuse system of nerves that control involuntary functions such as blood pressure and temperature regulation are the Sympathetic and Parasympathetic Nervous Systems. Much more detail about spinal cord injuries can be found at the Apparelyzed website.

According to the National Spinal Cord Injury Association (NSCIA), any damage to the spinal cord is a very complex injury. People who are injured are often confused when trying to understand what it means to be a person with a spinal cord injury (SCI). Will I be able to move my hands? Will I walk again? What can I do? Each injury is different and can affect the body in many different ways.

Damage to the spinal cord can occur from either a traumatic injury or from a disease to the vertebral column. In most spinal cord injuries, the backbone pinches the spinal cord, causing it to become bruised or swollen. Sometimes the injury may tear the spinal cord and/or its nerve fibers. An infection or a disease can result in similar damage. After a spinal cord injury, all the nerves above the level of injury keep working like they always have. From the point of injury and below, the spinal cord nerves cannot send messages between the brain and parts of the body like they did before the injury.

The doctor or specialist examines the individual to understand what damage has been done to the spinal cord. An X-ray shows where the damage occurred to the vertebrae. The doctor does a "pin prick" test to see what feeling the person has all over his body (sensory level). The doctor also asks, "what parts of the body can you move?" and tests the strength of key muscle groups (motor level). These exams are important because they tell what nerves and muscles are working.

A person's injury is described by its level and type. The level of injury for a person with SCI is the lowest point on the spinal cord below which there is a decrease or absence of feeling (the sensory level) and/or movement (the motor level), according to NSCIA. A significant amount of information about SCI can be located on this site: http://www.spinalcord.org/resource-center/askus/index.php?pg=kb.book&id=56 .

According to the Paralyzed Veterans of America, Immediately after a spinal cord injury, the spinal cord stops doing its job for a period of time called “spinal shock.” The return of reflexes below the level of injury marks the end of spinal shock. At this time, a doctor can determine if the injury is complete or incomplete. If the injury is incomplete, some feelings and movement may come back. Rehabilitation usually begins immediately.

The individual will be instructed in strengthening exercises, new styles of movement, and the use of special equipment. If additional recovery of feeling or movement does not occur, a rehabilitation team will help the individual to develop new goals. More material on this subject can be found at their website: http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6344373/k.4182/Spinal_Cord_Injury_Information.htm .

Traumatic injury to the spinal cord, according to the Centers for Disease Control (CDC), can result in neurologic impairments in any body system controlled by the affected nerves, including musculoskeletal (resulting in incomplete or complete paraplegia or tetraplegia), respiratory, urinary, or gastrointestinal. Long-term complications from SCI also include any psychological side effects, such as depression and anxiety. The CDC has statistics about SCI that are very interesting:

Occurrence:

·         About 200,000 people are currently living with SCI in the United States.

·         Annually, 15 to 40 new cases per million people—or 12,000 to 20,000 new patients—are estimated to occur.

·         Alcohol has been found to play a major factor in 25% of spinal cord injuries.

Cost:

·         Average annual medical cost: $15,000–$30,000 per year

·         Estimated lifetime cost: $500,000–more than $3 million, depending on injury severity

Causes:

·         Motor vehicle accidents: 46%

o    Use of a seatbelt can reduce the odds of a spinal cord injury by 60%

o    Use of a seatbelt and airbag combined can reduce the odds of injury by 80%

·         Falls: 22%

·         Violence: 16%

·         Sports: 12%

Demographics:

·         Males account for 80% of spinal cord injury patients.

o    Most new SCI cases occur in persons younger than 30 years old; an estimated 50%–70% occur in those aged 15–35 years.

·         Estimated racial/ethnic distribution:

o    White: 65%

o    African American: 25%

o    Hispanic: 8%

o    Other: 2%

Spinal cord injury (SCI) is an important contributing factor to morbidity and mortality in the United States. More info can be found at this site: http://www.cdc.gov/traumaticbraininjury/scifacts.html .

Adjustment to paralysis is a process of changing one's thoughts and feelings and is something that takes time. The goal of adjusting is to rebuild one's identity and to find a new balance in relationships. The stages of adjustment can include grieving, taking control, talking about your disability, taking care of yourself, and looking ahead, according to the Christopher & Dana Reeve Foundation.

Depression is a serious medical disorder that affects your thoughts, feelings, physical health and behaviors as well as other aspects of your life. Depression can cause physical and psychological symptoms. It can worsen pain, make sleep difficult, cause loss of energy, take away your enjoyment of life and make it difficult for you to take good care of your health.

Other symptoms include oversleeping, change in weight, loss of interest or pleasure, and/or negative thoughts. Depression is common in the spinal cord injury population--affecting about 1 in 5 people. If you are concerned that you may be suffering from depression, please speak with your physician. A lot of information about SCI can be found at this website: http://www.christopherreeve.org/site/c.ddJFKRNoFiG/b.4409743/k.C825/About_Us.htm .

Spinal Cord Injuries happen frequently every year, and they are dangerous. If you or a loved one has suffered an SCI, see your doctor regularly to monitor your treatment and ongoing rehabilitation. You also may need to secure mental or spiritual counseling on occasion if you suffer from any emotional trauma from time to time. This health care situation is serious, and it should be handled by trained professionals who can help you deal with the affects long term if your recovery is not immediate or within a short period of time.

Until next time.