A big problem post SCI is blood circulation. The body is designed to be mobile. Not to sit around in a chair all the time. Laying down at night isn't good enough either. Legs are meant to be moved often, arms and shoulders aren't, and our skin tends to like not being pressed on all day every day.
Because of these facts there are a few ailments that can tend to befall a para or quad if they're not careful. Firstly, are blood clots. These like to form in the legs; though they can form anywhere. I, myself, got one in my left lung towards the end of my stay at Craig. But a blood clot in the leg is much more common.
Early in my stay at Craig I had to wear these really tight socks that were supposed to help with blood circulation in the legs. All I knew at the time is that they seemed very difficult to get on and off and I am glad I don't have to wear them anymore.
We were taught to look for symptoms though. For... possibly the entire time I was there, maybe only the beginning (I can't recall,) they would measure the circumference of my legs every morning and evening to make sure that they were not swollen or, more importantly that they were approximately the same size. When one leg has a blood clot it swells, significantly. It also tends to be warmer due tot he excess blood and be reddish in color.
Secondly, there is a side effect of paralysis that is tied to blood pressure and is potentially life threatening, more so than a blood clot. Autonomic Hyperreflexia, or AH, is caused by a sudden spike in blood pressure. It is most common in those with spinal cord injuries T6 or higher. If you recall from one of my early posts I am well above that. The fact that one's blood pressure is spiking means that if the cause is not seen to, it could be life threatening.
When AH kicks in the symptoms are immediate and obvious: a throbbing headache, sweating, redness of the skin, nasal stuffiness, and intense anxiety. The way I had it described to me is that there is something wrong below the level of injury and the body is trying everything it can to tell your brain what it is. So you get all of these signals going off and immediate action needs to be taken.
Most of the time it's simple: I need to pee. Bladder infections and bowel obstruction are common causes of AH and urinating may relieve the pressure causing the reaction.
The point is, I spent a long time reminding myself of these symptoms and what they could mean. I carry a laminated card in my wallet (Craig's idea) to give to paramedics who might be attending to me to let them know to be on the look out for those symptoms. I am not as constantly vigilant any more because it is automatic now. I have felt the sensations once, and hope never to again.
Lastly, pressure sores. I think everyone has heard of bed sores. We tend to warn lazy people who sleep in a lot that they'll get them if they're not careful. Well for paras and quads they are a very real and constant concern.
I sit. All day. On my butt. And due to a VERY active nerve at the top of my left leg, I can only sleep comfortably on my back or right side. So my back side doesn't get a lot of relief. If you have spent much time around me at all you have probably noticed that I shift around a lot, lift myself up for a second or two every few minutes, and maybe squirm a bit. I'm not doing it because I'm being impatient or ADHD or anything. I am doing it out of habit.
Very early on at Craig none of us could sit upright for more than a few minutes at a time. We just weren't used to it. But we had to push ourselves to get stronger. Not only that, but we couldn't just lie in bed. So in our primitive wheelchairs we would be tilted backward into a reclining position every 20 minutes. We even wore little timers that would go off to remind us. Why? Because pressure sores are so incredibly difficult to heal. Especially when you sit on them all the time.
Gradually, as we got stronger and the habit of shifting every 20 minutes became automatic, we lost the timers. It really is habit for me now to move around every few minutes to prevent pressure sores. But hey, it works. I haven't gotten a sore yet. I check most every night to make sure.... /knock on wood...
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