Blood clots

Blood clots are prevalent in the initial few months following a spinal cord injury, especially later in the course of sickness. Walking and leg mobility improve blood circulation and help avoid the formation of blood clots. However, when legs are immobile or incapable of walking, the danger of blood clots increases. Additionally, extended bed rest may increase your risk.

Using a particular type of support hose that maintains pressure on the leg is one technique to prevent clots. Additionally, mechanical chest compression devices are employed. These devices provide pressure on the legs using airbags. In some instances, blood thinners may be utilized.

Filters may be implanted in the femoral artery of certain persons. These filters block the passage of blood clots to the lungs, heart, and brain.

Swelling, bluish, redness,

or pale discoloration of the skin, warmth to the touch, as well as discomfort are all warning symptoms of blood clots in the legs.
Be proactive and do regular examinations of your extremities for symptoms of a potential clot.

The Reeve Foundation developed a wallet card that summarizes DVT & your medical history in order to accelerate care in the event of a medical emergency.

Autonomic dysreflexia

Autonomic dysreflexia (AD) is a life-threatening medical issue that requires immediate treatment.

It is most frequently associated with T6-level injuries and higher as an overactive autonomic nervous system resulting in a rapid and hazardous increase in blood pressure. It is elicited by irritating, painful, or unpleasant stimuli located below the level of damage.

Symptoms may include the following:

• Goosebumps
• Headache that is severe
• Pulse rate is slow
• Sweating in excess of the degree of harm
• Face flushed and skin clammy
• Congestion of the nasal passages
• Hypertension (a blood pressure reading that is much higher than the patient’s normal blood pressure)

It is crucial for persons who have sustained a spinal cord injury to start recognizing their symptoms in order to initiate therapy.

• Examine the skin for irregularities such as bruises, burns, ingrown toenails, pressure sores, and fractured bones.
• Examine the bowel for obstruction.
• Treatment for AD entails identifying and eliminating the source of suffering.
• Examine the bladder or catheter for obstructions or kinks in the tubing.

Check the fit of your clothing and be mindful of excessively hot and cold conditions.
Menstrual cramps and ovarian cysts may potentially be the reason in women.
Prescription medications are available to assist in decreasing blood pressure during an AD incident.
Consult your physician to ascertain your symptoms and arrange a treatment strategy.

Certain healthcare providers may be ignorant of autonomic dysreflexia.

Individuals at risk must carry information or a wallet card, such as the Reeve Institute AD wallet card, that describes the illness and offers emergency medical information. This is to guarantee that AD is treated promptly and appropriately.

Skin care & pressure sores

Pressure sores (also known as decubitus ulcers and pressure ulcers) are referred to by a variety of different names but all allude to a severe and possibly dangerous ailment.

Pressure sores form when particular parts of the body are compressed for an extended period of time, resulting in a reduction in blood flow.

Skin can improve when pressure is eased. If the pressure continues, it may develop into a pressure sore.

Any bony part of the body is a typical site for pressure sores to form.

Skin ulcers can be avoided by changing positions every two hours, wearing loose, appropriate clothing, keeping the skin dry, and sitting and situating properly.

Occasionally, skin ulcers develop as a result of small trauma, such as a scratch sustained during a move or a tiny cut sustained while not wearing shoes. However, in the presence of paralysis, no skin damage should be overlooked.

Pressure sores progress via four stages:

1. Although the sore is superficial, it is open and may have drainage. Maintain a safe distance from the afflicted region and thoroughly clean the wound with water and saline solution. Apply a translucent or hydrocolloid dressing to the wound location.
2. Although the skin is not damaged, it is red and retains its color thirty min after pressure is withdrawn. Remain away from the afflicted region and practice adequate hygiene.
3. The skin has deteriorated to the point of bone and muscle, necessitating rapid medical treatment and surgery, as this disease is potentially fatal.
4. The skin has been further degraded into a second layer (the dermis) plus subcutaneous fat tissue. Consult your physician for treatment.

Please download this fact sheet on pressure sores and browse our collection of fact sheets on hundreds of subjects ranging from aging with such a spinal cord injury to secondary effects of paralysis for further information on skincare and related resources from reputable Reeve Foundation sources.

Spasticity

Neurological illness or injury can impair a variety of bodily activities, including muscular contraction. Individuals with spinal cord injury (SCI), brain damage, cerebral palsy, stroke, or multiple sclerosis are most frequently afflicted by spasticity (tone). Others with neurologic problems may also acquire spasticity (tone).

A rapid rise in spasticity (tone) or a change in the pattern of your spasticity may indicate the development of a new problem. Spasticity might worsen as a result of a urinary infection, a pressure injury, or other underlying problems. Increased spasticity could be one of the initial indications of a spinal cord injury in patients who have had a spinal cord injury.

Pneumonia

Pneumonia is a probable consequence of cervical & mid-thoracic level injuries owing to secretions accumulating in the lungs. Certain persons who have had a spinal cord injury are unable to breathe or exhale strongly and have difficulty coughing properly.
Individuals injured when participating in water sports may get pneumonia, lung damage, or other respiratory disorders as a result of water reaching their lungs during the accident.

Shortness of breath, fever, pale skin, and increasing chest congestion are all indications of pneumonia.

It is critical to be proactive and receive medical care for lung infections. The most effective strategy to avoid pneumonia is to be constant with secretion clearance.

Pain

Pain is frequently a normal component of the body’s healing process and maybe managed with a variety of drugs. Pain, on the other hand, may linger and develop into chronic pain and nerve pain (also called neuropathic pain). This form of pain is not induced by a direct painful stimulation but by the “jumbled” passage of sensory signals from beneath the damage level thru the injured cord.

Neuropathic pain may manifest as a sense of burning, stinging, or tingling. These feelings may be occasional or persistent.

Antidepressants and antiepileptic medications, as well as non-steroidal anti-inflammatory medicines and narcotic painkillers, are used as treatments. Nerve blocks, biofeedback, acupuncture, and psychological techniques have all been utilized to assist with pain management.

Additional secondary paralysis problems, including spasticity & autonomic dysreflexia, may be induced by pain.

Blood pressure is too low (hypotension)

After an injury, blood pressure may decrease abruptly while shifting from a flat to an upright position. Wrap your legs in support bandages and elastic stockings to keep your blood pressure from lowering, or wear an elastic belt across your midsection. Additionally, steadily reverting to an upright position can aid.

Low blood pressure symptoms include lightheadedness, dizziness, and/or fainting.
Low blood pressure is most frequently seen by those who are quadriplegic.
Medications may be recommended to maintain a steady blood pressure level.

Increase your knowledge of pain

Infections of the bladder & urinary tract (UTIs)

Following paralysis, the bladder’s usual control mechanism may be compromised. The bladder is frequently impacted post-injury in one of two ways: spastic bladder (high tone) and flaccid bladder (low tone). Spastic bladder develops when the bladder expands as well as a reflex forces the bladder to empty spontaneously. This is a regular occurrence in injuries above the level of the twelfth vertebra. When the bladder’s reflexes are slow or nonexistent, the bladder becomes flaccid.

Intermittent catheterization, indwelling catheterization (via the urethra), suprapubic catheterization (catheter surgically implanted through the belly into the bladder), & an external condom catheter is the most often used bladder management technique.

When the bladder is not fully emptied, or when germs from the catheter enter the bladder, urinary infections (UTIs) can result. Spasms, headache, fever, nausea, chills & autonomic dysreflexia are among symptoms of urinary tract infections.

The most effective strategy to prevent UTIs is to follow a regular bladder management regimen, drink the recommended quantity of fluids, and use sterile equipment.

Normally, oral drugs are used to treat a urinary tract infection (UTI).

In severe instances accompanied by a fever, the infection might spread to the kidneys, necessitating the use of injectable antibiotics.

Acquaint yourself with bladder control.

Management of the bowels

The spinal cord injury has a similar effect on the intestines as it does on the bladder. If the damage occurs above T12, spastic bowel occurs as a result. Additionally, the capacity to perceive a full rectum may be lost. Flaccid intestine is a typical complication of below T12 injury and leads to an inability to urinate.

Flaccid bowel indicates that the defecation reflex has been compromised, leading its anal sphincter to relax.

The easiest approach to avoid gastrointestinal problems is to adhere to a routine, as bowel problems can result in other problems, including autonomic dysreflexia.

Bowel programs normally last 30-60 minutes and, therefore should be performed on a biweekly basis.

There are several bowel control techniques available, including digital stimulation, pills, laxatives, and enemas. If less forceful approaches do not work, surgical procedures might be performed to promote bowel evacuation