Q: What factors need to be considered with an acute spinal cord injury (SCI)?

A: For acute spinal cord trauma, stabilization is the first priority. After an injury, according to Jack de la Torre MD PhD, there are biochemical, metabolic and physiological issues that arise such as reduced blood flow to the spinal column, the formation of free radicals, sodium channel activation, inflammation and energy substrate depletion.

To address these issues de la Torre suggests the use of fructose 1,6-diphosphate combined with dimethyl sulfoxide (DMSO) as when combined, the two stabilize the SCI and provide a high-energy substrate to the damaged tissue. Dr. de la Torre is a professor of neurosurgery and physiology at the University of New Mexico Medical School in Albuquerque who has been one of the main advocates for the use of DMSO, a controversial drug that has many healing properties.

Anders Holtz with the Department of Neurosurgery, University Hospital in Uppsala, Sweden emphasizes the need to consider secondary injuries that can result from surgery. He believes that the aim of surgery is to minimize neurological deterioration, stabilize and align the spinal cord, reduce pain and prevent secondary complications.

Immediately after a trauma to the spine, Holtz stresses the importance of monitoring the respiration system in order to time drug treatment so that the chosen medication is given at the most optimal time. In addition to the respiratory system playing an important role in medication administration, it also accounts for a high percentage of illnesses in SCI patients.

According to the Journal of Neuroscience Nursing in an article by Kathleen T. Lucke, “lung diseases and breathing complications cause significant illness in patients following spinal cord injuries. The mortality rate from pulmonary complications, such as pneumonia, lung collapse, respiratory failure, and infections, can be 40-80% in the first year after injury.”

As you can see, there are a variety of important factors that need to be addressed and closely monitored immediately and soon after a SCI. Awareness of the areas of special concern will help you to better understand what your doctor is focused on and why - not to mention that this knowledge will help you to determine if your doctor is competently approaching the treatment of the injury.

The majority of people who sustain SCIs will not have the medical knowledge to determine the best course of treatment, but even some awareness of the problems that can arise can add to you overall security that you are getting the best treatment available.

For further reading:
Essentials of Physical Medicine and Rehabilitation, Review and Self-assessment, Julie K. Silver & Walter R. Frontera, pp. 346, 2003. Price £28.99. ISBN: 1-56053-563-6. Hanley & Belfus, Philadelphia

Pulmonary management following acute SCI. (spinal cord injury) Journal of Neuroscience Nursing; Apr 1, 1998; Lucke, Kathleen T.

The time following a spinal cord injury can be a confusing and difficult time, both physically and emotionally. This is the time during which the patient and his or her family will come to terms with what has happened, and will plan for the future. That’s why it’s helpful if both the survivor and his or her family have some general information about spinal cord injury.

Number of Americans With Spinal Cord Injury

About 11,000 Americans sustain a spinal cord injury each year, and nearly 200,000 Americans live with a long-term disability as a result of a spinal cord injury. About 52 percent of spinal cord injury survivors are considered paraplegic, while 47 percent are considered quadriplegic.

Males are more likely than females to experience spinal cord injury, and African Americans pose a higher risk than whites. According to the Center for Disease Control, more than half of the people who sustain spinal cord injuries are between the ages of 15 and 29.

Cost of Spinal Cord Injury

Only 52 percent of spinal cord injury survivors are covered by private health insurance at the time of injury. The first year expenses for a paraplegic are, on average, $152,000, while the first year expenses for a quadriplegic are $428,000. A paraplegic who is injured at the age of 25 can expect to spend $428,000 on care throughout the course of his or her lifetime, while a quadriplegic who is injured at the same age can expect to spend $1.35 million.

Life Expectancy of People with Spinal Cord Injury

Life expectancy of spinal cord injury survivors remains slightly below that of people without spinal cord injury. Mortality rates are highest the first year following the injury, and then decrease. Common secondary complications that cause death include renal failure, pneumonia, pulmonary emboli, and septicemia.

Many find themselves caught up in a Monday afternoon daydream where they get to wake late and spend their afternoons with nothing better to do than watch their favorite TV program…and then the phone rings or the boss looks their way and they snap back into the reality of work.

What if this wasn’t your daydream? What if you were stuck at home, not because of some windfall of luck, but because employer after employer refused to hire you? For many disabled people, this is an all-too-real scenario.

The Americans with Disabilities Act (ADA) of 1990 found that society has had a tendency to isolate and discriminate against those with disabilities by refusing them work, housing, education, health care and other vital services. Add to this physical barriers such as inaccessible workstations and unmodified entryways and the need for the ADA becomes apparent.

To prevent these discriminatory acts from continuing to happen, the ADA has set up certain provisions that protect qualified people against discrimination related to hiring, job advancement, discharge, compensation, training and other such employment rights and opportunities. This includes providing “reasonable” (meaning that the size of the company and its financial resources are taken into consideration) modifications to the workplace such as ramps, workstations and the location of necessary work tools.

Companies who fail to meet the ADA standards can be required to pay a fine, go to court or both. This process begins with a person who has experienced discrimination filing a claim to any United States Equal Employment Opportunity Commission (EEOC) office within 180 days of the incident. If a reasonable settlement isn’t reached, then it is possible to file a lawsuit with the Federal court after receiving a “right-to-sue” letter from the EEOC.

While the ADA enforcement has helped to prevent and curtail workplace discrimination, there are still countless cases of disabled persons being turned down for work who believe it is due to their particular disability.

If you or anyone you know has questions regarding their own situation, here are some good resources:

EEOC field office locater: (800) 669-4000 (voice) & (800) 800-3302 (TTY)

ADA Accessibility Guidlines

This week’s technology report is on wheelchair seating products. For those who spend large periods of time in a wheelchair, finding the right seating enhancements that provide both comfort and support is of high importance.

There are a wide selection of seat cushions that take into account everything from moisture resistance to pressure relief. Some products include materials that are lightweight and contoured to fit your body, while others emphasize your degree of activity and how likely your lifestyle is to cause skin breakdown.

Other options to look for are whether or not the manufacturer provides a solid cushion such as those made with gels or foam or a liquid one that prevents bottoming out - a situation that can lead to skin sores. Most companies will take into account your size and shape, fitting you with the best seat for your situation.

Backrests are another important item to consider when shopping for optimal comfort and health. There are an assortment of wheelchair backs that are suited to a variety of lifestyles. For the active person, there are specifications such as flexible positioning systems, removable hardware and lightweight structure. For those with a more sedentary or indoor lifestyle, you can find backs that will align your posture, provide maximal support and easy release.

Backs come in as many different materials as seats do and can be found in either hard shelled form or with an upholstered structure. Some are created for a greater weight bearing ability and others specifically for those who want to travel quick and light.

Consider what sort of life you lead and under what conditions before buying a wheelchair and seating products. These run in a wide price range and it will pay off later to research first!

While we don’t endorse any specific manufacturer, Sunrise Medical may be a good place to start looking as they have over 30 years of experience providing assistive products to those with disabilities.

Anyone who experiences a traumatic brain or spinal cord injury is aware of how significantly his or her life can change within a matter of seconds. The two populations most at risk to sustain brain or spinal cord injuries are drivers and athletes. By being aware of certain information, both these groups can minimize their risk for brain and spinal cord injuries.

How Drivers Can Minimize Risk

There are several ways that drivers can minimize their risk of brain and spinal cord injury:
• Don’t multitask—turn off cell phones and put away anything that may distract you from the task at hand.
• Wear your safety belt.
• Drive defensively.
• Don’t drive under the influence of drugs or alcohol.
• Do not drive when you are fatigued.

How Athletes Can Minimize Risk

There are several ways that athletes can minimize their risk of brain and spinal cord injury:
• Always protective gear that is appropriate to your sport, such as a helmet or padding.
• Be safety conscious, and don’t attempt high-risk stunts or tricks.
• Prepare yourself by knowing what to do should a brain or spinal cord injury occur.

Seek Medical Attention

All the care in the world can’t prevent every brain and spinal cord injury. If you suspect that you or someone you know has sustained a brain or spinal cord injury, seek medical attention immediately. Remember, brain and spinal cord injuries can be caused without any direct impact to the area of injury, and sometimes do not show symptoms for several days or weeks.

Rich Newsome with the Newsome Law Firm, along with Tom Harmon, Pete Newsome and Clancey Bounds will be participating in the Nov. 2nd 2008 Florida Ironman on behalf of the Christopher and Dana Reeve Foundation as “Team Reeve Ironman.” Team Reeve Ironman is raising money for the Reeve Foundation.

The Florida Ironman race will take place in Panama City, Fla. and is one of only seven official Ironman races held annually in the United States. Ironman Florida is also a qualifying event for the Ironman world championship in Kona, Hawaii. The Florida Ironman race includes a 2.4 mile swim, 110 mile bike race and a 26 mile run.

The athletes who are part of Team Reeve Florida hope to raise not just money, but also awareness about the Reeve Foundation and the vital work they are doing for the SCI community. The Reeve Foundation is focused on finding a cure for paralysis as well as giving spinal cord injury (SCI) survivors much needed direct aid.

Please help support this worthy cause.

For more information on how to support the Team Reeve Ironman, please visit their Web page.

California based Van Duerr Industries, Inc. is doing its part to create a greener world.

Over the last 20 years, California’s publicly accessible buildings have been modernizing their facilities to comply with the American Disability Association’s (ADA) regulations. According to a Market Wire report, until recently the necessary ramps and door transitions have been made of materials that are not environmentally friendly. Van Duerr carries the only 100 percent recycled ADA compliant products in the construction industry.

This is not to say that there are not other companies who provide recycled and environmentally friendly accessibility products. Marmax, for example, creates seating, fencing and other outdoor wheelchair accessible items. Van Duerr stands apart in that it is helping tax funded institutions such as schools save money while helping them to meet ADA’s standards while also creating a minimal impact on the environment.

The Van Duerr SafePath(TM) Products are easily installed and touted as being durable in types of weather. They are made from recycled tires and can be used both indoors and out.

For more information on this company and how they are helping to lighten their environmental footprint, please visit their Website.

This week’s resource is the Assistive Technology Industry Association’s (ATIA) list of upcoming events that focus on new developments and accessibility in the area of assistive technology.

Some of the upcoming events include the ATIA 2009 Orlando celebration that will showcase new and innovative technology for both adults and children, the ATIA Leadership Forum on Accessibility that is designed to “help large corporations, government agencies and educational institutions derive business value through accessibility,” and the ATIA 2009 Chicago technology celebration.

ATIA has been focused for the past ten years on providing education and a forum for communication between those with disabilities, who work with the disabled and who provide assistive technology. They are a non-profit membership organization of manufacturers of assistive devices and services.

If you are interested in any of these or future events, please visit their Website here.

With all of the recent breakthroughs in stem cell research, next month’s World Stem Cell Summit is bound to be an interesting event.

The gathering will be held on September 22 through 23 in Madison, Wisconsin and is expected to have scientists, ethicists, investors and corporate heads from around the world in attendance…”the event brings together the founding visionary researchers, clinicians, business pathfinders, key policy-makers, regulators, advocates, experts in law and ethics to present compelling presentations, share information, and together chart the future of regenerative medicine.”

Participants will be able to hear the full details of the latest research and development in stem cell studies and applications. Not only that, but government funding and company financial backing will be disclosed in an effort to work with those who have ethical objections to this area of research.

For more information, visit the World Stem Cell Summit’s Website.

According to a Washington Post article, scientists have figured out how to turn one type of adult stem cell into another. What makes this development even more interesting is that it wasn’t done in a petri dish - this change was created inside of a living animal.

This breakthrough will potentially lead to cures for currently un-fixable illnesses and injuries such as spinal cord injuries (SCI) while bypassing the ethical objections that are now hindering stem cell research.

Research on mice by Harvard Stem Cell Institute (HSCI) co-director Douglas A. Melton, and colleagues, found three molecular switches that were able to turn a common cell in the pancreas into one that can produce insulin. This has the potential to benefit people suffering from diabetes, heart disease and other illnesses.

Imagine being able to cure your illness or heal your body through the flip of a cell switch - a process that would save both time and money that is currently spent on drugs and other ongoing therapies.

“I see no moral problem in this basic technique,” said Richard Doerflinger of the U.S. Conference of Catholic Bishops, a leading opponent of embryonic stems cell research. “This is a ‘win-win’ situation for medicine and ethics.”

While researchers warn that “many years of research lay ahead” before they will be able to prove that this innovation will be of use for curing disease and injuries, it is another big step made by science towards creating health and longevity.

As of today this study hasn’t been posted on the HSCI Website, but for those interested, here is the HSCI list of research projects.

Click here for the original article.