Individuals with SCI should also have an ongoing, life-long plan to help prevent respiratory complications. Maintain proper posture and mobility and sit up in your wheelchair everyday and turn regularly in bed to prevent buildup of congestion. Coughing regularly is a useful technique in avoiding respiratory complications; individuals can use machines to help them cough, have someone perform manual assist coughs, or perform self-assist coughs. Individuals should wear an abdominal binder to help assist the intercostal and abdominal muscles.
Individuals with SCI should attempt to follow a healthy diet and manage their weight. Weight management is important because respiratory problems are more likely to occur if an individual is too underweight or too overweight. Drinking plenty of water is important because doing so helps the body in many ways, and water helps to keep congestion from becoming thick and difficult to cough up.
Do not smoke under any circumstances! Smoking not only causes cancer, but other harmful effects include a decrease of oxygen in the blood, an increase in congestion in the chest and windpipe, a reduction in the ability to clear secretions from your lungs, a destruction of lung tissue, and an increase in the risk for respiratory infections such as pneumonia and bronchitis.
Live sensibly by avoiding close contact with people who may have a cold or flu and avoid areas with dust, smog and other air pollutants. See a doctor at least once per year. The doctor may recommend that the individual receive a chest x-ray or a flu shot.
Exercise is another critical element to avoiding respiratory complications. Every individual with SCI can benefit from some type of exercise. However, it is important to first talk to your doctor to find the right exercise program. Participation in athletics and other cardiovascular activities can improve strength and endurance while helping to keep the pulmonary system strong. If an individual suffers from a high level of injury or does not like strenuous exercise, it may be helpful to do breathing exercises.
Here are five breathing exercises that you can do at least two times a day to help your pulmonary system.
- Take a deep breath and hold it for a few seconds before slowly breathing out.
- Take a deep breath bringing in as much air as you can and as fast as you can before pushing the air out as fast as you can.
- Take a deep breath and hold it, take another breath and hold it, and take one more before slowly breathing out.
- Take a deep breath in then breathe out counting as long and as fast as you can.
- If you have a spirometer, use it to both exercise and keep a measurement of your progress.
BLOOD CLOTS AND CIRCULATION
With a spinal cord injury, being immobile for long periods of time slows blood circulation and can cause clots to form. Blood-thinning medications, leg pumps, and special stockings, can help improve circulation and prevent fluid build up.
An individual living with a spinal-cord injury may experience muscles spasms which cause their limbs to twitch or “jump”; this is relatively rare and unfortunately it is not an indication that the person is regaining sensation or movement in those areas. These involuntary movements occur because some nerves have become more sensitive, yet the damaged spinal cord will not allow the brain to interpret and regulate these nerves’ signals.
PERSONAL CARE ATTENDANT
Between 40 and 45 percent of individuals with spinal cord injuries (SCI) need personal assistance with some daily activities. It is understandable that the majority of persons needing assistance have higher levels of injury. They may need personal care assistance with getting in or out of bed, managing bowel and bladder issues, bathing and dressing. Some individuals may need someone to drive, shop and clean for them too. However, there is also a growing percentage of persons with lower levels of injury needing assistance as they get older. They may need assistance with household activities as they grow older and experience increased pain or fatigue.
Most Personal Care Attendants (PCAs) need education and training on general issues associated with SCI. Even if you find a PCA with a lot of experience, you yourself have unique needs. Although all issues are important, your bowel, bladder, skin, and respiratory care must be understood by your PCA. Communicate your bowel and bladder needs clearly. Make sure you stress the importance of daily skin care, and your PCA should know how to conduct daily skin checks and spot problems.
PCAs need to know about respiratory sickness too. Flu and pneumonia can be life-threatening for most people with SCI. This fact makes it important to have PCAs understand these dangers and work to prevent spreading these conditions. Washing hands should always be done often to help prevent the spread of germs. PCAs who are sick with a cold or flu should avoid contact when possible. If contact is unavoidable, PCAs should wear a mask and wash hands more often. For individuals on a ventilator, PCA training on all the mechanical works of a ventilator can mean life or death. There should also be an emergency plan for ventilator problems and failures.
Individuals who have recently suffered a spinal cord injury (SCI) may experience many emotions, such as fear or anxiety. Many individuals may require spinal cord injury rehabilitation to adapt to a new way of life after the injury.
How Does Rehabilitation Help People Recover From Spinal Cord Injuries?
No two individuals will experience the same emotions after surviving a spinal cord injury, but almost everyone will feel frightened, anxious, or confused about what has happened. Individuals commonly have very mixed feelings after suffering an SCI: relief that they are still alive, but disbelief at the nature of their disabilities.
Rehabilitation programs combine physical therapies with skill-building activities and counseling to provide social and emotional support. The education and active involvement of the injured individual and his or her family and friends is critical.
A rehabilitation team is usually led by a doctor specializing in physical medicine and rehabilitation (called a physiatrist), and often includes social workers, physical and occupational therapists, recreational therapists, rehabilitation nurses, rehabilitation psychologists, vocational counselors, nutritionists, and other specialists. A case-worker or program manager coordinates care for the injured individual.
In the initial phase of rehabilitation, therapists emphasize regaining leg and arm strength since mobility and communication are the two most important areas of function. For some, mobility will only be possible with the assistance of devices such as a walker, leg braces, or a wheelchair. Communication skills, such as writing, typing and using the telephone may also require adaptive devices.
Physical therapy includes exercise programs geared toward muscle strengthening. Occupational therapy helps redevelop fine motor skills. Bladder and bowel management programs teach basic toileting routines, and patients also learn techniques for self-grooming. People acquire coping strategies for recurring episodes of spasticity, autonomic dysreflexia, and neurogenic pain.
Vocational rehabilitation begins with an assessment of basic work skills, current dexterity, and physical and cognitive capabilities to determine the likelihood for employment. A vocational rehabilitation specialist then identifies potential work places, determines the type of assistive equipment that will be needed, and helps to arrange for a user-friendly workplace. For those individuals whose disabilities prevent them from returning to the workplace, therapists focus on encouraging productivity through participation in activities that provide a sense of satisfaction and self-esteem. This could include educational classes, hobbies, memberships in special interest groups, and participation in family and community events.
Recreation therapy encourages patients to build on their abilities so that they can participate in recreational or athletic activities at their level of mobility. Engaging in recreational outlets and athletics helps those with spinal cord injuries achieve a more balanced and normal lifestyle and also provides opportunities for socialization and self-expression.
