Spinal Cord Injury




Spinal cord injury (SCI) is damage to the spinal column that results in a loss of function like mobility or feeling. Together, your spinal cord (which extends from the base of your brain and goes down the center of your back) and your brain make up what’s called the Central Nervous System. Surrounding the spinal cord are protective rings of bone called vertebra, each named according to its location. For example, the eight vertebra in the neck are called Cervical Vertebra, with the individual vertebra named C-1, C-2 and so on down the back. Vertebra (T-1, T-2, etc.) and other groups are further down the cord. In general, the closer the injury is to the brain, the more dysfunction occurs. Today there is no cure for SCI and, due to the nature of this type of injury, complications are common. For more details, please visit www.paralysis.org.	Kevin Kitchnefsky: This narrative was prepared by Kevin's mother, Yvonne, to help readers better understand the daily challenges of Kevin's situation. Kevin is a quadriplegic, which means that he doesn’t have full use of either his arms or legs. In his case, his legs and hands are completely paralyzed, and he has limited use of his arms. First thing in the morning, we flush Kevin’s catheter, to help prevent him from getting bladder or kidney stones. We then transfer him to a shower-chair to do a bowel program. It takes up to an hour for it to work. Afterwards, we give him a shower and transfer him back to bed. We rub lotion into his skin to keep it soft and put Carrington cream on the parts of his body that come in contact with the wheelchair, to help prevent skin breakdown (similar to bed sores). Kevin then does a series of foot exercises and leg stretches. We dress him and transfer him to his wheelchair. When he is fully dressed, it is important that he not be sitting on any wrinkles or folds in his pants, as this can interrupt his circulation. Over the course of the day, we make sure that Kevin drinks plenty of fluids – mostly water. We also empty his urine bag (which is attached to his leg - and yes, it is visible) several times during the day. We pay close attention to his leg bag - if his catheter gets pinched or twisted so that urine can’t flow into the bag, or if the bag gets full, it can cause serious problems or even death if not taken care of right away. We watch Kevin’s body temperature carefully, as he can’t regulate the temperature in the areas of his body that have been paralyzed. If his temperature becomes too extreme, and this can be from something as simple as sitting in the sun too long or being out on a chilly day, he experiences a very severe pain in his head. If his temperature is not brought back to normal, he could suffer a heart attack or stroke because his body would begin to shut down. Sufferers of spinal cord injury generally find preparing their own meals difficult or impossible. As Kevin has limited use of his arms, he needs his meals to be prepared for him. He can feed himself only with great difficulty, and sometimes only by using special devices, such as a spoon that attaches to his wrist via an adjustable strap. As a quadriplegic, Kevin can’t feel below his chest, so the loss of muscle tone and mass can become a real problem. So every day Kevin has to exercise his muscles – even the ones he cannot normally move. This is done with a series of exercise devices. He works out with weights, a special exercise-cycle for his arms, a tilt-table so he can stand, and a special bike, called a Regis Bike. The Regis Bike comes with a special pair of exercise pants with electrodes. They electrically stimulate Kevin’s leg muscles, causing them to contract – this moves the muscles and keeps them in shape. If this isn’t done, his muscles would atrophy. All this exercise is not only good for the muscles themselves, but keep Kevin’s heart and lungs primed and efficient. It also does wonders for his self-esteem. Bedtime comes early – usually around 8:00pm. We transfer Kevin from his wheelchair to his bed. We get him undressed and check his skin for breakdown. We then rub him down with Carrington cream. His catheter needs to be flushed again, and we change him over from his leg bag to an elevated height bag. We turn him on his side to sleep. To promote circulation, Kevin needs to be turned periodically during the night. A newly injured person needs to be turned every two hours, although someone injured as long as Kevin only needs to be turned every four hours. As you can imagine, the level of constant care and supervision is incredible demanding on Kevin and his caregivers. In addition to his family, he is fortunate to always have a full-time, professional aide by his side. Rehabilitation for a person with SCI serves three primary purposes. First, it is important to maintain the health and well-being of the unaffected areas, to keep them healthy and prevent additional problems from arising in the future, and to allow those strong muscles and tissues to help compensate for the injured areas. Second, there is a need to exercise the dysfunctional areas, to prevent muscle atrophy from lack of use. And third, both physical and emotional therapy is necessary to promote a healthy outlook on life and to keep a person’s spirits and hopes as high as possible. Life with SCI is a daily challenge, but a positive focus on personal priorities can help keep depression at bay. For someone with SCI, as with all people, it is important to stay active and involved…to contribute to society, to the lives of loved ones and to the search for a cure.
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