Kidney failure, according to SpinalInjury.net, used to be the leading cause of death for individuals with a spinal cord injury (SCI). Today with the improved bladder management methods, there are fewer and less severe kidney complications to be dealt with. More common these days are difficulties arising from urinary tract related issues.
The loss of normal bladder function after a SCI places a patient at an increased risk for contracting a urinary tract infection (UTI), regardless of the type of bladder management used. A UTI can occur in the bladder, the kidney, or other parts of the urinary tract. Urinary tract infection remains the most common secondary medical complication following a SCI and it is also one of the costliest.
Sci-Info-Pages, lists the common UTI symptoms as:
# Fever
# Chills
# Leakage
# Increased spasms of legs, abdomen, or bladder
# Feeling the need to catheterize more often (frequency) ( Intermittent)
# Feeling the need to catheterize immediately (urgency) ( Intermittent)
# Burning of the urethra, penis, or pubic area
# Nausea
# Headache
# Mild low back pain or other aches
# Feeling “lousy” or tired
If you experience any of these, please be sure to talk with your doctor to avoid further complications.
This week’s interesting technological development is an electronic exoskeleton - something that seems better fitted to some action-packed futuristic movie.
ReWalk is the creation of engineer Amit Goffer, founder of Argo Medical Technologies in Israel, who was paralyzed in 1997. Unable to use his creation because of limited mobility in his arms, Goffer has used this machine to give others the ability to walk on their own again - or for the first time.
It consists of a set of crutches that help the user maintain their balance, motorized leg supports, body sensors and a back pack with a computerized control box and rechargeable batteries.
This week’s resource is the Website America’s Heroes at Work.
The United States Department of Labor (DOL) created this site in order to address the “employment challenges of returning service members living with Traumatic Brain Injury (TBI) and/or Post-Traumatic Stress Disorder (PTSD).”
America’s Heroes gives employers tools that can help our military men and women affected by TBI and PTSD better succeed in the civilian workplace. To accomplish this they are collaborating with the Veterans’ Employment and Training Service (VETS) and the Office of Disability Employment Policy (ODEP).
The Federal Motor Vehicle Safety Standard (FMVSS) 207 “specifies strength requirements for automotive seats and their attachment assemblies, so as to minimize the possibility of their failure by forces acting on them as a result of vehicle impact.”
While this standard helps to regulate how well a seat structure performs in an accident, it has failed to significantly decrease injuries and fatalities due to seatback failure. Alyssa’s story is one of many such devastating tales.
The Insurance Institute for Highway Safety lists 2006 as their most recent year of fatality statistics. There were 1,327 deaths caused by rear impact motor vehicle accidents. The majority of fatalities were under the age of 25, with crashes causing one of every three injury-related deaths among children under 13.
Of these numbers, it is unclear exactly how many death were a result of seatback failures, but what is clear is that auto crashes are a significant cause of life ending or altering injuries in children. What is tragic is the lack of governmental oversight, or seemingly interest, in how often seats fail with catastrophic results.
We have numerous reports on air bag related injuries, but no hard data on seat failures and the resulting injuries. A study for The Los Angeles Times by Keith Friedman, an auto safety researcher, analyzed 72 rear-end collisions using a government database of tow-away crashes, found that from 1988 to 1997 1,800 backseat passengers were injured or killed by seat failures.
What we need are more researchers willing to invest the time into this important subject. Data on which cars have a history of seat collapse and which ones are best known to withstand a rear impact needs to be better available to the public. This topic isn’t a new one - auto safety engineers have been issuing warnings on this subject since the 1950s.
The FMVSS 207 was adopted back in 1968 and other than adding vans, trucks and buses in 1972, there hasn’t been an update in its standards since. FMVSS 207 requires that a seat back be capable of handling an impact of 270 foot/lbs. Now compare that number to the 6,000 lbs. of force that seat belts are required to withstand before failure. Why would the seat only need to be four or five percent as strong as the seat belt?
The National Highway Traffic Safety Administration (NHTSA) is well aware of the problem and in 1996 actually admitted that the current standard was inadequate…this didn’t lead to any changes, only further recognition of the problem in 1997 and 1998. One of the reasons they are dragging their heels is over the concern that stiffer seatbacks will lead to more incidents of whiplash.
Compare a whiplash injury with a traumatic brain injury (TBI) that leads to permanent disability or death - which one would you chose?
For now, research into the car you own or are looking to buy is the best offensive you can take to keep you and your passengers safe. One Website with some information, though not nearly enough regarding seat failures, is Safecar.gov. Until we see higher seatback safety standards, we will continue to hear of tragic stories such as Alyssa’s. We need to write to NHTSA, to our local government and to our automobile manufacturers. These issues need to be resolved for the safety of all vehicle occupants.
Last Friday night Houston Texas receiver Harry Williams sustained a spinal cord injury (SCI) during a game against the Dallas Cowboys leaving him temporarily paralyzed. Monday he underwent surgery to fuse two vertebrae in his spinal column, a procedure that will hopefully allow him to lead a normal life, but won’t put him back in the game.
Williams was only 26, an age that would have given him years more on the field had this accident not happened. An estimated 14 percent of SCIs are a direct result of a sports related injury. Considering that there is about ten thousand new SCIs a year, this is a fairly significant number.
Last year Kevin Everett with the Buffalo Bills football team was paralyzed during a game. He has since recovered his ability to move his arms and legs, but he will never play football again. His recovery from paralysis, along with Williams’, is a rare occurrence as most who experience paralysis stay paralyzed.
There are 31 pairs of nerves that spread out from the spinal cord into the arms, chest, legs and abdomen. The nerves that are in charge of upper body movement are in the upper portion of the spine, while the ones that control the legs are in the lower area. Not only are these nerves responsible for limb movement, they also control basic functions such as breathing and heart beat.
The National Center for Catastrophic Sport Injury Research has reported that in 2006 there were 16 indirect deaths and only one fatality in football, and the death was caused by a SCI. In 2007 there were eight cervical cord injuries with incomplete recoveries. Six of these were at the high school level. The majority of the SCIs occurred in games with only two happening during practice.
Considering that in 2007 there were 1,800,000 football players, these statistics aren’t painting too bleak of a picture. While each injury or fatality is a reason for concern, innovative safety gear has greatly decreased the chance of experiencing an unrecoverable injury. We have neurosurgeons such as Richard C. Schneider to thank for the decrease in permanent spine and head injuries. He helped to develop the football helmets our players currently use which have directly influenced this decrease as documented in the National Football Head and Neck Injury Register.
As researchers come up with better and more intuitive protective gear, we will continue to see these traumatic injuries decrease. In the meantime, those who have had their lives irrevocably changed from a brain or spinal cord injury deserve our continued support.
The importance of the vehicle seat’s role in automobile accidents shouldn’t be overlooked, yet it often is. If you run an Internet search, you will find numerous stories on collapsed seat backs, faulty restraint systems and inadequate load bearing ability - all manufacturer-related issues that have contributed to injury or death in automobile crashes.
One area of concern that is overlooked more than most is that of wheelchairs used in lieu of standard seats in vehicles. For those with disabilities, the act of transferring from a wheelchair to a car seat is often difficult and thus prohibitive. Instead, they often choose to purchase a van or other vehicle with the capacity to hold a wheelchair. Either the back seats are removed or the front passenger seat is in order to create a space for the wheelchair.
Vehicles can be modified to allow room for the wheelchair and the addition of special restraints to offer protection in an accident. While these restraints are tested for strength and comfort, they don’t give the wheelchair the same protective properties as originally equipped manufactured seats would.
Keeping in mind that a stock seat is still no guarantee that the person riding in or near it will be safe in an accident, the idea of a wheelchair providing the same degree of protection is faulty. They simply aren’t built to act as car seats. They haven’t been created to withstand the load placed on them and the occupant during a wreck nor to optimize the protective abilities of the restraints.
A common cause of injury during an accident is seat back failure - when the seat is unable to bear the increased load from the force of the impact added to the weight of the occupant, causing it to collapse. The two most common types are either a failure of the seat to maintain an upright position and the deformation of the actual structure. This usually happens after a rear impact that propels the vehicle forward the person backwards, creating strain on the back of the seat. There have been thousands of life-altering traumatic brain injury (TBI) or spinal cord injury (SCI) cases from these failures.
Properly manufactured seats should be able to bear this additional load as well as prevent the occupant from coming into contact with the vehicle’s interior, but too often they don’t measure up.
Now picture a wheelchair encountering those same circumstances. This chair is designed for comfort, ease of transportation and maneuverability - not impact resistance. The Subcommittee on Wheelchairs and Transportation (SOWHAT) has been pushing for better wheelchair standards, ones that will protect a passenger during motor vehicle transportation. They call for an emphasis on “design requirements, test procedures, and performance criteria” that will provide the necessary stability, restraint and strength.
SOWHAT’s earlier efforts in the 1990s to have ANSI, the American National Standards Institute, approve WC-19-Wheelchairs Used as Seats in Motor Vehicles has been approved, but it does not address every issue or concern posed, most notably it does not cover protection from rear impacts or rollovers.
To find out how you can better protect yourself or the wheelchair user in your life, check out the Ride Safe online brochure. They provide step by step instructions on how to best secure a wheelchair and its occupant while in a motor vehicle. They also list tips for selecting a wheelchair and tiedown equipment.
This week’s spotlight is on The Prince Synergy, a worldwide organization focused on maximizing human capitol.
In The Prince Synergy’s own words, “Traumatic Brain Injury takes away victims’ freedom and opportunities internally.” With the unique obstacles faced by traumatic brain injury (TBI) patients in mind, this business works to help companies and their employees work with the limitations created by this injury and others.
The Prince Synergy provides teaching and consulting in the areas of health and stress management, leadership and innovation at “times of unexpected change, stress, illness and injury.”
If you or someone you know has sustained a TBI that is interfering with productivity, this company may be just what you are looking for. To find out more, click here.
We are always looking for new developments that can lead to spinal cord injury (SCI) recovery and press releases like this one are a great incentive to keep looking.
The PLoS Medicine site reports that researchers studying spinal cord injuries in mice found that chondroitin sulfate proteoglycan (CSPG) is needed for the repair of the neurons that will facilitate the regaining of movement, but after time, it actually hinders a full nervous system recovery. In studies on mice, the researchers allowed CSPG to act uninhibited for two days after the injury before interfering and by doing this, created a promising response in the animals.
Heavily secreted after an injury, CSPG helps to form glial scars after a SCI. These scars protect the damaged areas, but they also release chemicals that work to prevent further regeneration in the nervous system. Because of its link to preventing axonal development, researchers were focused on eliminating CSPG from the injured area.
This compounded data suggests that eliminating CSPG may not be the best answer, and scientists are opting instead to control it. CSPG has a place in the healing process as it regulates the local immune response which is vital for proper healing.
So far studies only extend to animals, not humans, but there are similar enough correlations between spinal cord repair processes that it’s believed this research can soon be applied to human subjects.
A: There are two types of spinal cord related injuries that occur most frequently in sports. The first is called a stinger or burner and the second is transient quadreplegia. While they can happen in almost any sport, they are most commonly found in contact activities such as wresting, rugby and football.
Stingers are a painful nerve injury created by compression in the neck or shoulder area that creates a sharp stinging or burning sensation in an arm. Transient quadriplegia typically results from hyperextension of the neck coupled with cervical spinal stenosis or disc protrusion.
The aptly named stingers affect close to 50 percent of those in contact sports, while the more debilitating transient quadriplegia occurs in roughly 1.3 athletes out of 10,000. Overall, spinal cord injuries are decreasing as better equipment is created and worn.
Top Three Things to Know for New Brain Injury Patients
The time following a brain injury can be confusing, overwhelming, and emotional. There are three things that new brain injury patients should be aware of to help them through this difficult time.
1. You Are Not Alone
Every year 1.4 million people in the United States seek medical care for traumatic brain injury. Survivors should be willing to ask for—and receive—help from family, friends, and other loved ones when needed. Support groups, resources, and the survivor’s medical team are all there to help the patient navigate the time following traumatic brain injury. If the patient is not able to advocate for himself or herself, caregivers should be willing to call on the medical team, support groups, and other resources for help.
2. There are Different Types of Treatment and Rehabilitation
Survivors should be aware that there are a variety of types of treatments and rehabilitation available, depending upon individual needs, as well as where they are in the recovery process. No two treatment and rehabilitation programs are the same. Instead, they are individualized based on the location and severity of the injury. The goal of treatment and rehabilitation is to restore as much function to the survivor as possible. The plan should be to focus on the particular issues the survivor faces, and to structure therapies accordingly.
3. Recovery Will Be a Challenge
There’s nothing easy about recovery, and the new brain injury patient should realize this. As a matter of fact, without the many “challenges” that go hand-in-hand with recovery, the brain can’t rewire itself. While recovery can be extremely frustrating—with the gains offset by steps backward—perseverance, patience, and celebrating all forward progress, no matter how small, can keep the survivor in a positive frame of mind.
