A few FAQs based on the After & Beyond Spinal Cord Injury Resource Manual

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1. How is the urinary system affected after a SCI?

   A spinal cord injury often disrupts the delivery of messages from the brain to the bladder and/or sphincter muscles. Consequently, people who have sustained an SCI often struggle with some sort of bladder dysfunction. There are two general types of dysfunction that can occur, depending on the level at which one’s injury occurs.

2. How does spinal cord injury affect your bowel?

   Spinal cord injury changes the way your body works, especially your bowels. After a spinal cord injury, bowel movements (or stool) require more time, thought and planning. Usually, people with SCI cannot feel when stool is ready to come out; therefore, their bowels need re-training. Two types of neurogenic bowels can develop after a spinal cord injury. The type of neurogenic bowel you have depends on which area of the spinal cord was injured.

3. Can a woman become pregnant and deliver a baby after sustaining a SCI?

   In most cases women remain fertile after a SCI despite irregularities in their menstrual cycles that may occur following the injury. The spinal cord injury does not physiologically interfere with a woman’s ability to conceive a child nor does it hinder the possibility of having a normal vaginal delivery.

   For a woman with a SCI, being pregnant involves similar risks like in any other pregnancy. However, as women with spinal cord injury face a number of unique health care needs, there are some increased risks such as an increased risk of urinary track infection (UTI), pressure sores, hypertension and for women with injuries at or above T6, automatic dysreflexia. The most important concept to grasp is that all these risks are manageable under the care of a knowledgeable physician.

4. What is Autonomic Dysreflexia?

   Individuals with a SCI at the sixth thoracic level (T6) or above are more susceptible to developing autonomic dysreflexia, which results from the over activity of the autonomic portion of the nervous system. It is a serious condition that can cause blood pressure to reach dangerously high levels. An overfilled bladder or UTI infection can trigger an episode of autonomic dysreflexia.

5. How does SCI affect temperature regulation?

   After a SCI, the autonomic nervous system functions are altered and the temperature of your body has an increased tendency to fluctuate according to the temperature of the environment. The higher the level of injury, the greater the tendency is for fluctuations in your body temperature. You will not be able to sweat below the level of your injury. One of more of the following symptoms may indicate hypothermia: nausea, headache, dizziness, feeling of weakness and more.

6. What are the wheelchair sports?

   Summer Sports:
   archery, cycling, equestrian, football 5-a-side, football 7-a-side, goalball, judo, powerlifting, rowing, sailing, shooting, swimming, table tennis, volleyball, wheelchair basketball, wheelchair dance sport, wheelchair fencing, wheelchair rugby, wheelchair tennis

   Winter Sports:
   Alpine skiing, ice sledge hockey, Nordic skiing, wheelchair curling

7. What are attendant services and what do they provide?

   Attendant services involve physical assistance with routine activities of daily living due to physical limitations. This includes assistance with those activities of daily living that the consumer would do for him or herself with his or her own hands, arms and legs. The consumer takes responsibility for decisions and training involved in his or her own assistance.

   Attendant services include:

   Personal grooming and hygiene Bathing and washing Assistance with dressing and undressing Assistance with breathing Toileting Eating Essential communication

   Positioning and transferring Assistance with exercises Meal preparation Housekeeping Assistance with shopping, banking and paying bills Assistance with the care of children as instructed by the consumer

8. After sustaining a SCI should you renovate your existing home or should you move into a new home?

   In order to answer this question you must assess numerous aspects of your life. It is crucial that you consider ALL of the pertinent factors, as well as investigate the many options available prior to making a final decision. You should consider; cost, your home’s renovation potential, other members of the family, your neighbourhood, emotional attachment and long-term plans.

9. If you have suffered a SCI are you still able to drive?

   In order to drive, one must be able to handle the mental and physical stress of traffic. There is a proven process for getting back behind the wheel after a SCI- evaluating your needs, selecting the right vehicle, choosing a qualified dealer to modify your vehicle, being trained and maintaining your vehicle. You must decide if you are able to transfer efficiently into the driver’s seat, whether from a scooter or wheelchair. Are you able to enter and exit the vehicle independently? Is adaptive driving equipment going to be necessary for you to drive safely? Are your vision, reflexes, concentration and perceptual skills intact for driving in today’s complex traffic? Would it be best for you to be a passenger in your vehicle, and let someone else drive?

10. Can someone who has suffered an SCI find a job and work after their injury?

    Securing employment isn’t just about getting a job. It’s about matching abilities with opportunities, finding a flexible employer and having the latest information and assistance to compete in a changing work environment. This challenge can be divided into two components: the inside challenge, which is how you view your abilities; and the outside challenge, which is how you deal with fear, ignorance and possible discrimination. You may have to educate potential employees and fellow employees so they see you for your abilities.

    There are programs that may be able to assist you in finding a job; Ontario Disability Support Program, Canada Pension Plan, Canadian Paraplegic Association Ontario and Ontario March of Dimes.

11. After sustaining a SCI, what are the different types of pain that may be experienced?

    Not everyone that experiences pain following a spinal cord injury experiences the same kind of pain. Musculoskeletal pain comes from some sort of injury to muscles, bones or tendons and the pain generally appears in the upper body, the shoulders, neck and back and may last for days to months. Neuropathic pain is damage or dysfunction in the nervous system that can be described as sharp, shooting or burning pain.

    The five types of neuropathic pain are; nerve, spinal cord, segmental, nerve root entrapment and syringomyelia. Visceral pain can occur if you have constipation or your bladder overfills causing your internal organs to stretch. Allodynia pain is a form of pain caused by something that does not normally cause pain, such as a very light touch to the skin can result in pain. Lastly, hyperalgesia is an extremely painful response to what is normally only mildly painful.