Q: What are the most common results of a spinal cord injury?

A: Depending on the particular injury sustained, there are a wide variety of primary and secondary complications that can result from a spinal cord injury.

Damage to the nerve fibers that carry motor signals to the brain through severing or compression can lead to muscle paralysis and loss of sensations such as those experienced through touch or pressure. Other potential effects are loss of bladder control, muscle contractions, decreased breathing capacity, exaggerated reflexes, over or under sensitivity to temperature changes, lasting pain, impaired sexual functioning and issues with bowel control.

Some of the most common secondary effects are increased blood pressure, sweating, pressure sores and an increased susceptibility to respiratory ailments.

Typically any of these functions that are lost will be regained within six months, if they are to return at all. After that point your chances of recuperation decreases greatly. This is why it is so important to make sure you receive proper care immediately after sustaining a spinal cord injury.

We mentioned last week the Christopher and Dana Reeve Paralysis Act (H.R. 1727) and there was a bit of confusion. To clear things up, here is a direct description from the Christopher Reeve Foundation Website, should you wish to assist in passing this bill:

“In an attempt to move legislation before the August recess, Senate Majority Leader Harry Reid (D-NV) introduced S. 3297, Advancing America’s Priorities Act, a legislative package which contains approximately three dozen bipartisan, non-controversial bills that have been passed by the U.S. House of Representatives, the respective Senate Committees and have been awaiting Senate action. The Christopher and Dana Reeve Paralysis Act (CDRPA), S.1183, has been included in this package which is expected to be debated in the Senate later this week.

NOW is the time to act to help pass legislation that will encourage multi-disciplinary consortia style research to enhance understanding and speed discovery of better treatments and cures; support rehabilitation research; and, build quality of life programs to promote independent living, self-sufficiency and equality of opportunity for individuals with paralysis and mobility impairments.

STATUS: The Senate is expected to debate S. 3297 later this week and into early next week. Your help is urgently needed to pass the Christopher and Dana Reeve Paralysis Act.

ACTION: Contact both of your US Senators NOW and urge them to support Advancing America’s Priorities Act, S. 3297, which includes the Christopher and Dana Reeve Paralysis Act, S.1183.

CALL: Click here to identify your federal legislators and find their contact information. The most effective way is to call or write them directly. If you know your Senators, call the Capitol Switchboard at 202-224-3121 right now! Here is the message you should convey:

Please ask Senator _____________ to support Advancing America’s Priorities Act, S.3297, which includes the Christopher and Dana Reeve Paralysis Act, S.1183. The Reeve Paralysis Act encourages collaborative research in paralysis, will hasten the discovery of treatments and potential cures and will improve the quality of life for millions of Americans living with paralysis. Please ask the Senator to vote for passage of S. 3297, Advancing America’s Priorities Act.

WRITE: A fax or an email from you is very impactful, but time is of the essence. For a sample letter click here.”

Finally, a benefit from those love handles, pot bellies and beer stomachs! Scientists found that fat taken from the inner thigh and lower abdomen was rich in stem cells. This study, reported in August’s Plastic and Reconstructive Surgery journal, is the first of its kind to pinpoint a variation between stem cell concentrations in different portions of the body’s fat stores.

We already know that stem cells have huge potential for repairing injuries, but we also know that there is a great deal of controversy surrounding the use of embryo stem cells, the ones with the most plasticity. With the discovery of a plentiful source of adult stem cells, there is an increased potential for studying how these valuable resources can be applied to healing spine injuries, repairing bones, eradicating diseases such as cancer…all without the censor of those against embryonic stem cell research.

Of course, this journal is more concerned with the ways in which these cells can be used to benefit the plastic surgery industry. They would like to find ways to erase wrinkles and generate new tissue for their procedures, and who are we to argue? If the search for eternal youth unearths valuable resources that will help those who are trying to recover from a spinal cord injury, then we are all for it!

Scientists are exploring the ways in which your body’s sugars can be used to “create stem cell treatments for heart disease and nerve damage” according to a recent University of Manchester study.

As those with a spinal cord injury know well, nerve damage is hard if not impossible to completely recover from. This avenue of exploration may come up with some beneficial applications, making it easier for the body to repair that damage.

The sugars that our bodies produce instruct cells on “who” and what they are - what their function is in relation to the cells around them. Dr. Catherine Merry from The School of Materials in Manchester has been given a grant to figure out how cells make sugar and how that sugar influences cell behavior.

If Merry can determine how to make certain cells produce specific sugars, she can then train them to mend nerve damage along with other helpful applications. Keep an eye out for more research from the Materials Science Centre at the University of Manchester. With a major laboratory upgrade, this center is prepared to lead the way in cutting edge research covering everything from stem cells to molecular biology.

Q: Since my spinal cord injury, I have been living with chronic pain and my doctors have been unable to figure out what’s causing it. Why is it so hard to pinpoint?

A: Chronic pain is often difficult to find one specific cause for due to a combination of factors. First, patients who suffer from chronic pain, no matter what the initial injury was, often also experience anxiety and depression. These two strong emotions not only interfere with a proper diagnosis, but contribute to the pain.

One theory is that an injury causes increased nervous activity that transmits pain from the spinal cord to the brain, damaging the nerve circuits it passes through. These circuits amplify the pain beyond what the physical injury would seem to suggest.

The idea being considered by researchers is that these “pain amplifying circuits” have become self-sustaining. If this is the case, the next step is to figure out if they can be turned off or at least dialed down. We don’t have the answers yet, but at least there is some comfort in the knowledge that scientists are working on a solution.

The time following a brain or spinal cord injury can be confusing, overwhelming, and extremely difficult to navigate. Quite commonly, a patient and his or her family are uncertain when it comes to what to expect or how to move forward. However, taking three simple steps will ensure that the patient and his or her friend and family deal with the situation as effectively as possible.

Step 1: Educate Yourself

Whether you are the patient or the friends and family of the patient, it’s extremely important to learn as much as possible about the injury, as well as potential treatment options and long-term outcomes. The medical team that is overseeing the patient’s care is an ideal resource, and should be able to give you the answers you need. They will also be able to steer you toward additional resources and support groups that will have all the information you need pertaining to the injury.

Step 2: Focus on the Present

While it’s tempting to think about the future, focusing on the present is very important during the initial time following the injury. It’s not uncommon for a patient to take one step back for every step her or she takes forward. It’s important, during this time, to understand that recovery will take place at its own pace. Patience and support are two things the survivor will need much of at this time. While the survivor should try to be as independent as possible, he or she should not be afraid to ask for help when it’s needed.

Step 3: Prepare for the Future

Life following a brain or spinal cord injury will be significantly different than life before the injury. Focusing on the future and what it holds is a very important part of the healing process. This stage should include goal setting, determining long-term care needs, researching treatment and clinical trials, and finding support groups.

Q: What can you do immediately after an accident to minimize the long-term effects from a spinal cord injury (SCI)?

A: While there is still no way to completely reverse the damage done by a SCI, there are certain steps you can take to prevent further damage and to minimize the long-term effects.

After someone is discharged from the treatment facility, medical staff will focus on treating the initial injury, making sure it doesn’t develop into a worsening condition. Medications, immobilization and surgery will address the initial issues that arise from the accident, be it paraplegia or quadriplegia.

Once the patient is on his or her own, it becomes important to focus on the issues that can develop from being immobilized. Muscles will need to be stretched and maintained, bedsores watched for and treated and the urinary tract will have to be closely monitored to prevent infections. Paying attention to these aspects of care early on will help to prevent them from creating irreversible damage.

Rehabilitation therapy will be structured around the particular injuries each patient has suffered, and will attempt to help with the family and patient’s adjustment to their new situation. Sticking with the suggested program, exercises and all, is very important to the patient’s overall chance of recovery and regaining any degree of functioning.

During the difficult period after an injury is sustained, it is typically hard for people to maintain a positive and gung-ho attitude, but that the best chance to regain the ability to participate actively in life is to dive right into their rehabilitation program can’t be stressed enough.

The Importance of Exercise After a Paralyzing Spinal Cord Injury

While it may not be the first thing you think about when recovering from a spinal cord injury, exercise has many beneficial functions to help with healing and quickened recovery. It prevents some of the potential secondary conditions related to SCI such as cardiovascular disease, diabetes, carpal tunnel syndrome, pressure sores, urinary tract infection and respiratory disease. It also helps prevent obesity while reducing stress.

SCI does make certain motions difficult and others impossible to do, but there are versions of both aerobic and strength training workouts that can be tailored to your disability.

It’s recommended that strength training be performed three times a week, with exercises such as pull-ups and push-ups in your wheelchair. There are stabilizing straps that can be purchased to assist with balance and coordination. Another useful exercise includes the use of free weights or a machine such as the Bowflex. With a spotter, these can be useful to your training program and doable with partial paralysis.

Some suggested cardiovascular exercises for someone in a wheelchair include upper-body calisthenics, the use of a rowing machine, sports such as basketball, and wheelchair ergometry.

With all of these exercises, keep in mind that you should rest between training muscle groups and always have a partner or straps to help with balance and safety!

A study by BrainStorm Cell Therapeutics, Inc. performed in the W.M. Keck Center for Collaborative Neuroscience at Rutgers, The State University of New Jersey, found a positive correlation in spinal cord injury recovery and the use of NTF cells. According to the company’s Website, they are “focused on developing NTF cells from the patient’s own bone marrow in order to treat Parkinson, ALS and Spinal Cord Injury.”

This study used rats in which a spinal injury was created, meant to mimic that of paraplegia in humans, and then had Brainstorm’s nuerotrophic factor (NTF) human cells implanted. Scientists found that the addition of the NTF cells in the male rats inspired better recovery.

Their next step will be to use rat cells, instead of human stem cells, to limit rejection by the rat’s body. If this procedure continues to show improvement, then we can expect eventual human trials. For now, this is just another promising study, but as with many things, the knowledge that there is continuous movement forward in spinal injury recovery procedures brings hope to many.

Read the original article here.

Q: What should you look for when considering a SCI Rehabilitation Program?

A: There are a wide variety of rehabilitation programs, so finding the right one for your situation requires a comparison of your specific needs and what the center can offer you. Here are some useful questions to ask during your search:

Are the beds for people with SCI in the same area of the facility? Are there people in the SCI program of the same age and sex as the person considering admission?

Do the people in the SCI program have similar levels and kinds of spinal cord injury e.g., quadriplegia, paraplegia, incomplete and complete?

What is the average number of people admitted annually to the SCI program? (program staff should treat people with SCI on a regular basis to acquire and maintain expertise.)

Is the SCI program accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) or theJoint Commission on Accreditation of Healthcare Organizations (JCAHO)? Has it been designated as a Model Spinal Cord Injury Center by the National

Institute of Disability Research and Rehabilitation (NIDRR)? Click here for a current list of Model spinal cord injury centers)
Is the SCI program part of a SCI rehabilitation system operated by the state?

Are there treatment specialists in the SCI program who speak the primary language of the individual seeking treatment?

Will the treatment team develop a rehabilitation plan with both short and long term goals?

Will an experienced case manager be assigned to help family members obtain medical payments and other benefits from public and private insurance? Will a team member be assigned to coordinate treatment and act as a contact for staff and family members?

Staffing/Rehabilitation Program Elements

Is the physician in charge a Physiatrist? If not, what credentials does he/she have? How long has the physician in charge been directing programs specializing in SCI? Is there physician coverage seven days a week? Twenty-four hours a day?

Do the regular nursing staff and other specialists responsible for providing treatment in the SCI program have specific training in treating SCI? Is the nursing staff employed by the hospital or employed through an outside agency?

Does the program ensure the availability of rehabilitation nursing and respiratory care on a twenty-four hour basis?

Are there consultants available at the facility or nearby medical centers? These should include neurosurgery, neurology, urology, orthopedics, plastic surgery, neuropsychology, internal medicine, gynecology, speech pathology, pulmonary medicine, general surgery and psychiatry.

How often and for how long each day will participants get treatment by specialists such as occupational and physical therapists? Treatment should be no less then three hours per day.

Are other specialties such as driver education, rehabilitation engineering, chaplaincy, and therapeutic recreation available if needed?

Are activities planned for SCI program participants on weekends and evenings?

How much time is spent teaching SCI program participants and their families about sexuality, bowel and bladder care, skin care and other essential self-care activities?

Does the SCI program offer training in the management and hiring of personal care assistants? If so, how much time is spent by staff on this topic?

Questions have been taken from Spinal Cord Injury Resource Center, a site created and maintained by a SCI patient who has drawn the previous questions from his own experience.