What is the spinal cord?
The spinal cord is the main connection between the brain and the rest of the body. It is also referred to as the central nervous system (CNS). It is a collection of nerve fibers which transmits messages from the brain to the other parts of the body, such as commanding the arm, hand and fingers to turn the page of a book. It also serves as the pathway for sending critical information, gathered from sensory receptors located throughout the body, back to the brain for an appropriate reaction, such as pain warning that an affected body part needs to be protected. The spinal cord also sends sensory feedback to the brain for processing in order to formulate the appropriate response to activity or movement.
What is a spinal cord injury?
Any damage to the spinal cord, whether temporary or permanent, is a spinal cord injury. The injury to the cord may be complete or incomplete. A complete injury often causes a complete loss of feeling and control over the body parts below the level of the injury. A partial injury allows for some feeling and motor control but can result in altered sensation, such as burning, sharp or dull pain or slow or impaired movement.
How does a spinal cord injury occur?
Most spinal cord injuries result from trauma suffered in automobile accidents, work-related injuries, falls from heights, gunshot wounds or sports-related injuries. Spinal cord injuries may also be caused by an infection of the membrane surrounding the spinal cord (meningitis) or of the spinal cord itself (spinal abscess).
When should treatment be sought?
It is essential to receive emergency medical treatment, not only to prevent death, but to reduce the extent of permanent injury and disability that follows a serious injury. A study sponsored by the National Institute of Health has shown that much of the damage and paralysis that follows spinal cord injuries is caused by the degeneration of the cells and tissues in the spine, not from the initial injury itself. This is why patients who are given high doses of the steroid methylprednisolone within eight hours of the injury achieve a higher level of recovery.
Spinal surgery is often necessary to stabilize the spine and to reduce swelling and inflammation of the tissues caused by bleeding, bone fragments and the accumulation of fluid, all of which can result in further damage to the nervous system.
When does the rehabilitation process begin?
As soon as the patient is medically stable, rehabilitation (rehab) will begin. Traditionally, the main goal of rehabilitation has been to prepare the patient for the life-altering changes that must be made and to provide the skills necessary to cope with these changes. Rehabilitation programs may be hospital-based on an inpatient or outpatient basis; may be provided through a rehabilitation facility after discharge from a hospital; or may be conducted at home by professionals or family members or the patient him/herself, after proper training. Each program is individualized based upon the extent of the injury.
Education is also an important part of the rehab process. Understanding how and why pressure sores (bed sores) occur, practicing proper bladder and bowel management, learning to maintain a good diet and appreciating why exercise of the affected and non-affected muscles is necessary in order to safely function and stay healthy, are all parts of the rehabilitation process.
How long will rehabilitation take?
That will depend upon several factors, such as the level at which the spinal injury occurred, the extent to which the spinal cord was injured and the age and physical condition of the patient.
Generally, an evaluation of the patient will be conducted during the initial hospital stay. This is necessary in order to determine the most appropriate place for the patient to continue the recovery process upon discharge from the hospital. In severe injury cases, the patient may need to spend up to several months in a specialized rehabilitation facility.
Upon completion of the formal rehab program, patients are often encouraged to continue some form of ongoing exercise program so as to preserve and strengthen the non-affected muscles that are most heavily relied upon.
Is there an emotional component to life after a spinal cord injury?
During the hospital phase of recovery, the patient is often surrounded by family, friends and dedicated professionals, all of whom provide encouragement and support. Patients often respond positively to this and push themselves to achieve goals greater than expected, and at a faster pace that predicted. Unfortunately, the patient's progress, and often the emotional support that was being offered, begins to slow down or stop, which may lead to feelings of hopelessness, denial, anger, confusion, fear and defeatism. Any one of these emotions, while normal and part of the recovery process, may interfere with achieving maximum recovery. It is important for the patient to know s/he is not alone on the way to recovery.
These feelings are normal and have been experienced by the estimated 10,000 Americans who suffer, and survive, acute spinal cord injuries and paralysis each year. Learn from their experiences by seeking help from the hundreds of spinal cord injury groups and associations that exist to educate and support those in recovery.
How to carry on life after a serious spinal cord injury?
Certainly, a permanent spinal cord injury will result in dramatic changes. The sooner one learns the limitations that accompany complete or partial paralysis, and how to adapt to the changes they require, the quicker the patient can return to a meaningful, productive and happy life.
There are hundreds of websites, articles, blogs, books and resources available that help to identify the barriers and difficulties that will be encountered, as well as how to successfully overcome them. Another way to obtain help and guidance is to simply reach out to anyone who has suffered such an injury. You will find a friend and mentor for life.
Do people who have spinal cord injuries have special civil rights?
"Disability is a natural part of the human experience and in no way diminishes the right of individuals to live independently; enjoy self-determination; make choices; contribute to society; pursue meaningful careers; and enjoy full inclusion and integration in the economic, political, social, cultural and educational mainstream of American society." This quotation from The Rehabilitation Act of 1973, as amended in 1992, expresses the clear intent that Congress will no longer tolerate actions or barriers to exist that will result in the exclusion of persons with disabilities from participating in the American way of life open to the non-disabled. Through the Americans with Disabilities Act of 1990, Congress provided persons with disabilities comprehensive civil rights. These civil rights provide individuals the right to have reasonable accommodations in the pursuit of employment, education, access to hotels, restaurants, public and private transportation systems, telecommunications, car rentals suitable for persons with disabilities to operate, and access to government services.
Persons with disabilities have always been a productive part of society and with our understanding and accommodations, they will continue to be a valuable part of our lives.
