Spinal Cord Injury 'Fun Facts'
Ashley Treseder is an athlete who shares an informative and honest post on Facebook about his diagnosis and daily life considerations and issues as a person with spinal cord injury.
This post is a bit of a novel but if you have the time and ever curious about what myself and others like me living with a spinal cord injury deal with every day while still trying to get on with a semi-normal life, read on š
FUN FACT: Quadriplegics can't sweat anymore. This is actually just my fake sweat (water) from a spray bottle.
As part of Spinal Cord Injury Awareness Month, I thought I would put together a bit of info that may answer some questions many may be curious about or unsure if it is ok to ask.
I'll be covering the topics "Difference between Paraplegics and Quadriplegics, Temperature Regulation, Breathing, Energy, Bladder and Bowels, Balance, Skin Issues, Intimacy and Emotions", Autonomic Dysreflexia (AD), also known as hyperreflexia, (means an over-activity of the Autonomic Nervous System causing an abrupt onset of excessively high blood pressure). Symptoms of AD include:
- A pounding headache.
- A flushed face and/or red blotches on the skin above the level of spinal injury.
- Sweating above the level of spinal injury.
- Nasal stuffiness.
- Nausea.
- A slow heart rate (bradycardia).
- Goosebumps below the level of spinal injury.
- Cold, clammy skin below the level of spinal injury.
If left untreated, Autonomic Dysreflexia can cause seizures, retinal hemorrhage, pulmonary edema, renal insufficiency, myocardial infarction, cerebral hemorrhage, and, ultimately, death. Complications associated with autonomic dysreflexia result directly from sustained, severe peripheral hypertension.
Besides the obvious with my paralysis and my legs not working there are other things that don't work. These are things that may not be seen by others but things we deal with daily and can often be more frustrating than the inability to walk. I'll speak on behalf of issues regarding quadriplegia but many issues still relate to paraplegia as well.
Paraplegics vs Quadriplegics
Paraplegics (para meaning 2) are those that have damaged their spinal cord on the thoracic (back) and/or lumbar (hips) vertebrae resulting in impairment in two limbs, usually their legs. Quadriplegics (quad meaning 4) are those that have damaged their spinal cord at the higher cervical (neck) vertebrae which result in impairment in four limbs.
Despite my disbelief when I first heard what had happened to me in hospital, I am classified as a C6 Quadriplegic. I had always associated quadriplegia with the likes of Christopher Reeves. But despite my appearance and my level of function I still have a loss of some hand function and weakened triceps, therefore leaving me with impairment to four limbs, quadriplegia.
Temperature Regulation
Our bodies thermostat, to heat or cool our bodies, is located in the spinal cord. A normal, healthy human is able to maintain a constant body temperature of approximately 37 degrees despite the temperature of the environment. In a hot environment, the body sends a signal to the brain via the spinal cord to say the body is overheating. The brain then sends a signal back down the spinal cord and tells the body to cool itself by perspiring which evaporates and cools the skin preventing hyperthermia. This signal is damaged with most quadriplegics which stops the body from perspiring and makes it very difficult to cool down. A spray bottle (fake sweat) is my best friend in summer.
In cold weather, the body senses the lower temperature and our brain tells our body to constrict the blood vessels in our extremities and keep the warm blood around our vital organs preventing hypothermia. The brain also tells the body to shiver which heats the body up by involuntary shaking of the muscles. Since the muscles are paralysed below my chest the shivering in my shoulders is exaggerated and can be quite painful and feels like hyperthermia. So in short, the air conditioner is a quads best friend year-round.
Breathing
With my level of injury, my respiratory system has been weakened due to the muscles in the rib wall being paralysed. These muscles assist with expelling air by squeezing the lungs to push air out. This makes coughing, blowing your nose, speaking loudly/yelling and sneezing very difficult. Coughing is very hard because your cough reflex is affected. Coughing is very important to clear our throats and keep our lungs clear. This is why quadriplegics have a much higher risk for pneumonia and at danger if contracting COVID-19.
Energy
Anytime the central nervous system has been compromised, you tire out very quickly. That is why when you suffer from a concussion, you want to sleep. A stroke, a brain injury, a severe concussion, multiple sclerosis, spinal cord damageā¦these are all things that affect the central nervous system. If you were to hike uphill all day long, you would reach the top exhausted. The time it takes you to reach a level of exhaustion happens very quickly for us.
Bladder and Bowels
Too much info right? Our bladders do not function and neither do our bowels. Since the part of the spinal cord that controls them is at the very end, pretty much all of spinal cord injury - SCI people will have some issues in this area. We have to train our bodies and develop what we call a bowel routine for our bodies to work like they are supposed to. Although rare, the lack of muscle control can make for some embarrassing situations makes for some emotional days for us. Because we try to avoid this scenario as much as possible, we have to ātimeā things. This is a learning curve as you try to read your own body. Travelling, diet, stress, a little tummy bugā¦any of these things can wreak major havoc on our schedule.
For managing our bladders, you would find it common for SCI's to use catheters to empty our bladders. Either via intermittent catheters and most commonly in my case with quadriplegics having an SPC (suprapubic catheter) inserted below the waistline accessing the bladder directly. So keeping these issues in mind please don't use a disability bathroom, as someone with impairment may need to use it more urgently than you!
Balance
For quadriplegics and higher-level Paraplegics, muscle activation stops around the chest level. For me, this means no core muscles in the stomach or lower back. It basically feels like you are a jack in the box. This makes every day doing the smallest of tasks 10x harder as we are constantly looking to try and balance using your arms as support. Unless something is directly in front of you, bending down to the ground, reaching up high, reaching forward, twisting and turning all require using one arm for support to get yourself back into original sitting balance. For higher-level quadriplegics, this becomes near impossible as they may not have active tricep or wrist muscles like myself.
Autonomic Dysrephlexia (AD)
This is a condition people with injuries at the T6 level and above need to be constantly wary. Basically, it is when there is an over stimuli below the level of injury such as issues with bladder, bowel, skin breakdowns, sex for some, pain or overheating etc. The body sends a signal to the brain that something is wrong.
Because of the injury, the body becomes confused and raises the body's blood pressure leading to a case of Autonomic Dysrephlexia (extreme headache, clammy skin, rashes on the chest). If the stimulus is left untreated this can lead to a stroke and eventually death. So needless to say we are needing to be constantly aware of our bodies to remain healthy.
Skin Issues
Another issue we need to be constantly scanning for are evidence of any markings or pressure sores on our skin. If you could imagine sitting down at work for hours on hours. How many times do you change positions sitting down on cheek to cheek or leaning back and forth. That stinging numb feeling you get in your bum is your body telling your brain that your muscles covering your sitting bones (IT's) have been compressed for too long and need fresh blood to circulate through the muscles. Without this blood flow the skin can begin to break down leading to pressure sores and days in bed off the sore to heal. This poses as a significant risk for wheelchair users as they are sitting constantly and need to constantly be doing pressure-relieving exercises to allow fresh blood to circulate. Fortunately for me I have a lot of sensation in my butt, so know when I need to move around, change sitting positions and lift off my butt.
Intimacy
Mum and Dad, please stop here. Put down your phone. You do not need to read this š one of the most common questions people are curious about knowing but do not want to be rude by asking is "Can you still have sex?" and the answer is YES. It is commonly assumed that for males that because they are paralysed above the waist, they can no longer get an erection.
This couldn't be further from the truth š¤£. I won't go into too much detail on this topic but each person dependant on their injury will have different abilities/function but are completely able to still have a healthy and fulfilling sex life taking advantage of intimacy in all its different forms.
Side note: Amazingly women are still completely able to bare children as the female reproductive system is unaffected by spinal cord damage.
Emotions
This is also a hidden part that many forget about and misunderstand. It can be as devastating and more crippling than the physical side at times.
If you know someone in a wheelchair who might be in a bad mood, maybe canāt stay in the heat or cold too long for your activity, and is aggravated that you are in the handicap stall, then please be patient with them. They are not bitter cripples. They are just dealing with hidden things that donāt work and canāt really talk about.
Hopefully, this information has been informative and if you have got this far, well done and thank you haha. If anyone ever has any further questions feel free to ask. I'm an open book. š
ā° š ā°ļø
Besides the obvious with my paralysis and my legs not working there are other things that don't work. These are things that may not be seen by others but things we deal with daily and can often be more frustrating than the inability to walk. I'll speak on behalf of issues regarding quadriplegia but many issues still relate to paraplegia as well.
Paraplegics vs Quadriplegics
Paraplegics (para meaning 2) are those that have damaged their spinal cord on the thoracic (back) and/or lumbar (hips) vertebrae resulting in impairment in two limbs, usually their legs. Quadriplegics (quad meaning 4) are those that have damaged their spinal cord at the higher cervical (neck) vertebrae which result in impairment in four limbs.
Despite my disbelief when I first heard what had happened to me in hospital, I am classified as a C6 Quadriplegic. I had always associated quadriplegia with the likes of Christopher Reeves. But despite my appearance and my level of function I still have a loss of some hand function and weakened triceps, therefore leaving me with impairment to four limbs, quadriplegia.
Temperature Regulation
Our bodies thermostat, to heat or cool our bodies, is located in the spinal cord. A normal, healthy human is able to maintain a constant body temperature of approximately 37 degrees despite the temperature of the environment. In a hot environment, the body sends a signal to the brain via the spinal cord to say the body is overheating. The brain then sends a signal back down the spinal cord and tells the body to cool itself by perspiring which evaporates and cools the skin preventing hyperthermia. This signal is damaged with most quadriplegics which stops the body from perspiring and makes it very difficult to cool down. A spray bottle (fake sweat) is my best friend in summer.
In cold weather, the body senses the lower temperature and our brain tells our body to constrict the blood vessels in our extremities and keep the warm blood around our vital organs preventing hypothermia. The brain also tells the body to shiver which heats the body up by involuntary shaking of the muscles. Since the muscles are paralysed below my chest the shivering in my shoulders is exaggerated and can be quite painful and feels like hyperthermia. So in short, the air conditioner is a quads best friend year-round.
Breathing
With my level of injury, my respiratory system has been weakened due to the muscles in the rib wall being paralysed. These muscles assist with expelling air by squeezing the lungs to push air out. This makes coughing, blowing your nose, speaking loudly/yelling and sneezing very difficult. Coughing is very hard because your cough reflex is affected. Coughing is very important to clear our throats and keep our lungs clear. This is why quadriplegics have a much higher risk for pneumonia and at danger if contracting COVID-19.
Energy
Anytime the central nervous system has been compromised, you tire out very quickly. That is why when you suffer from a concussion, you want to sleep. A stroke, a brain injury, a severe concussion, multiple sclerosis, spinal cord damageā¦these are all things that affect the central nervous system. If you were to hike uphill all day long, you would reach the top exhausted. The time it takes you to reach a level of exhaustion happens very quickly for us.
Bladder and Bowels
Too much info right? Our bladders do not function and neither do our bowels. Since the part of the spinal cord that controls them is at the very end, pretty much all of spinal cord injury - SCI people will have some issues in this area. We have to train our bodies and develop what we call a bowel routine for our bodies to work like they are supposed to. Although rare, the lack of muscle control can make for some embarrassing situations makes for some emotional days for us. Because we try to avoid this scenario as much as possible, we have to ātimeā things. This is a learning curve as you try to read your own body. Travelling, diet, stress, a little tummy bugā¦any of these things can wreak major havoc on our schedule.
For managing our bladders, you would find it common for SCI's to use catheters to empty our bladders. Either via intermittent catheters and most commonly in my case with quadriplegics having an SPC (suprapubic catheter) inserted below the waistline accessing the bladder directly. So keeping these issues in mind please don't use a disability bathroom, as someone with impairment may need to use it more urgently than you!
Balance
For quadriplegics and higher-level Paraplegics, muscle activation stops around the chest level. For me, this means no core muscles in the stomach or lower back. It basically feels like you are a jack in the box. This makes every day doing the smallest of tasks 10x harder as we are constantly looking to try and balance using your arms as support. Unless something is directly in front of you, bending down to the ground, reaching up high, reaching forward, twisting and turning all require using one arm for support to get yourself back into original sitting balance. For higher-level quadriplegics, this becomes near impossible as they may not have active tricep or wrist muscles like myself.
Autonomic Dysrephlexia (AD)
This is a condition people with injuries at the T6 level and above need to be constantly wary. Basically, it is when there is an over stimuli below the level of injury such as issues with bladder, bowel, skin breakdowns, sex for some, pain or overheating etc. The body sends a signal to the brain that something is wrong.
Because of the injury, the body becomes confused and raises the body's blood pressure leading to a case of Autonomic Dysrephlexia (extreme headache, clammy skin, rashes on the chest). If the stimulus is left untreated this can lead to a stroke and eventually death. So needless to say we are needing to be constantly aware of our bodies to remain healthy.
Skin Issues
Another issue we need to be constantly scanning for are evidence of any markings or pressure sores on our skin. If you could imagine sitting down at work for hours on hours. How many times do you change positions sitting down on cheek to cheek or leaning back and forth. That stinging numb feeling you get in your bum is your body telling your brain that your muscles covering your sitting bones (IT's) have been compressed for too long and need fresh blood to circulate through the muscles. Without this blood flow the skin can begin to break down leading to pressure sores and days in bed off the sore to heal. This poses as a significant risk for wheelchair users as they are sitting constantly and need to constantly be doing pressure-relieving exercises to allow fresh blood to circulate. Fortunately for me I have a lot of sensation in my butt, so know when I need to move around, change sitting positions and lift off my butt.
Intimacy
Mum and Dad, please stop here. Put down your phone. You do not need to read this š one of the most common questions people are curious about knowing but do not want to be rude by asking is "Can you still have sex?" and the answer is YES. It is commonly assumed that for males that because they are paralysed above the waist, they can no longer get an erection.
This couldn't be further from the truth š¤£. I won't go into too much detail on this topic but each person dependant on their injury will have different abilities/function but are completely able to still have a healthy and fulfilling sex life taking advantage of intimacy in all its different forms.
Side note: Amazingly women are still completely able to bare children as the female reproductive system is unaffected by spinal cord damage.
Emotions
This is also a hidden part that many forget about and misunderstand. It can be as devastating and more crippling than the physical side at times.
If you know someone in a wheelchair who might be in a bad mood, maybe canāt stay in the heat or cold too long for your activity, and is aggravated that you are in the handicap stall, then please be patient with them. They are not bitter cripples. They are just dealing with hidden things that donāt work and canāt really talk about.
Hopefully, this information has been informative and if you have got this far, well done and thank you haha. If anyone ever has any further questions feel free to ask. I'm an open book. š
ā° š ā°ļø