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Thread: New C-4 Compete (Brother)

  1. #11
    I think the sores (because there were two), was from him pooping his pants and not being cleaned soon enough. His bowel issues were from diarrhea, that they were attributing to a stomach virus. My brother didn't want to go into the gym because of embarrassment.
    I will be flying to Atlanta to meet my brother next week. My sister actually changed her life around to be with my brother.
    My mom got an apartment five minutes from Shepherd one week before his injury. Can you believe that??

    Thank You everbody....and I will ask those questions betheny

  2. #12
    Quote Originally Posted by betheny
    Ask them if they still label him complete, given that bicep twitch. Ask if they've tested his anal reflexes, the definitive test for "complete" and "incomplete".
    Actually, Betheny, this is not correct. You can have an intact anal wink or bulbocavernosus (BC) reflex and be totally complete. It can also be seen in many people who are incomplete, and it will not show at all during spinal shock.

    The test to determine if the injury is an ASIA B (incomplete) injury is if there is SENSATION (not reflexes or movement) at the anal sphincter. If he is still in spinal shock, this may not be detectable either.

    Thad, ask the following questions at the conference:
    • How long will he be able to stay at Shephard (per his insurance and the team's best guess)?
    • Will he be able to stay in the Atlanta area and continue with an outpatient program?
    • Do you think he will ultimately wean completely from the vent?
    • Do we have problems we know about now regarding what his insurance will cover for equipment, home modifications, and attendant care? If so, what, and what other strategies do we have to get this set up?
    • Does he have c. diff (causing the diarrhea)? If so, how is it being treated?
    • How deep is the pressure ulcer (stage)? What is being done for treatment? Will this hold back his rehab?
    • How much therapy is he getting now? Even without starting the formal rehab program, he should be getting daily PT and OT for range of motion and to work on any possible strengthening. He should also be working with rehab nurses, a rehab psychologist and social worker, and getting education about his injury and how to get and stay healthy.
    Is the apt. your mother apt. wheelchair accessible? Could your brother live there initially when he gets out of rehab?

    (KLD)

  3. #13
    He is fortunate to have family that care so much. As far as the bowels are concerned, the body can also still be in shock from the spinal cord injury and it takes time to readjust. Make him go to the gym! It's your duty as his brother

    Bethany asked some good questions but don't hesitate to ask questions about her questions if you don't completely understand the terminology.
    C5 injury with partial C6 function on left.

  4. #14
    Good one KLD, I often forget about insurance since it's not fun to deal with. Shepherd is pretty good about keeping their patients busy, at least they were when I was there. When he's allowed, make sure you schedule as many activities outside of the hospital as possible (i.e. going to the mall, going to the movies etc.).
    C5 injury with partial C6 function on left.

  5. #15
    Quote Originally Posted by SCI-Nurse
    Actually, Betheny, this is not correct. You can have an intact anal wink or bulbocavernosus (BC) reflex and be totally complete. It can also be seen in many people who are incomplete, and it will not show at all during spinal shock.

    The test to determine if the injury is an ASIA B (incomplete) injury is if there is SENSATION (not reflexes or movement) at the anal sphincter. If he is still in spinal shock, this may not be detectable either.

    Thad, ask the following questions at the conference:
    • How long will he be able to stay at Shephard (per his insurance and the team's best guess)?
    • Will he be able to stay in the Atlanta area and continue with an outpatient program?
    • Do you think he will ultimately wean completely from the vent?
    • Do we have problems we know about now regarding what his insurance will cover for equipment, home modifications, and attendant care? If so, what, and what other strategies do we have to get this set up?
    • Does he have c. diff (causing the diarrhea)? If so, how is it being treated?
    • How deep is the pressure ulcer (stage)? What is being done for treatment? Will this hold back his rehab?
    • How much therapy is he getting now? Even without starting the formal rehab program, he should be getting daily PT and OT for range of motion and to work on any possible strengthening. He should also be working with rehab nurses, a rehab psychologist and social worker, and getting education about his injury and how to get and stay healthy.
    Is the apt. your mother apt. wheelchair accessible? Could your brother live there initially when he gets out of rehab?

    (KLD)
    Just to clarify... According to Dr. Young, the definition of complete is sensation at the anal sphincter and/OR voluntary anal contraction (not reflex).

  6. #16
    Thanks, KLD. I was trying to convey info w/out going into too much detail. Glad you clarified. What I remember is being bent over and poked with a toothpick, the first day of rehab. I was thinking, what the HELLL kind of place is this??!! In my case, I could feel it despite spinal shock. I bet he poked the side w/ the sensation.

  7. #17
    Senior Member
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    Jun 2005
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    Capt:

    I just read this thread.... Our prayers are with you and your brother. My husband also fell from a tree and sustained a complete thoracic SCI. It's been just a little over 3 years.
    The Shepherd center is wonderful. I hope your bro gets off the vent soon. Please keep us posted.

    Sieg

  8. #18

    Thanks

    My brother did have a bad day monday. That was the first time that a doctor showed him his x-rays and explained what was done.....and what wasn't done. When my brother arrived at Shepherd, there was no reflex of the sphincter muscles, but now there is. His is still complete and the doctor said that "spinal shock" is now over. It's been 28 days post injury. The doctor expects to get my brother off the vent and should get bicep control before leaving Shepherd.

  9. #19
    Here we go, with the misunderstandings. Perhaps in the sense of some medical professional's technicality, spinal shock is over. In the sense of spinal shock as we who have lived it understand it, it is NOT.

    I swear to you on the life of my son, spinal shock lasted close to 9 months for me. I have no doubt many others here will testify the same.

    At 28 days, they were still arguing, trying to convince me that the muscle twitches in my quadriceps I was feeling, when I strained so hard that I groaned, were imaginary. That I was in denial.

    At 9 months I could stand. At 2 years I could walk.

    Not everybody had that kind of return, obvs. But many many many of us were still dealing w/ swollen, shocked spinal cords at 28 days.

    Please tell him-grain of salt. Those medical guys know everything except how it is to be paralyzed. That part is what we're here for. We may not always be right, we've all had different experiences, but we won't lie to you. You know the old saying "I heard it straight from the horse's mouth"?

    We're the horse's mouth!

    I hope tomorrow will be better.

  10. #20

    That is good.

    Something strange that happened last night was the fact that my brother said he felt pressure....like in his stomach. He said he felt it....and right after he said that he had a bowel movement. Not sure if this means anything....but how can he "FEEL" that??

    ....plus, he went back on CPAP breathing during rehab today.

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