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Thread: Question for Dr Wise Young or SCI nurses

  1. #1

    Question for Dr Wise Young or SCI nurses

    I have a question about my teenage son who has a T4 injury after surgery on 12/10/09. Injury most likely caused by a cavernous hemangioma. I hope you can help with my confusion.

    The week after surgery I was told his injury was "incomplete" after a sphinkter exam. Also, he had occasional feeling lower than the injury site. From time to time he could feel someone touching his stomach. He does not have that feeling anymore and has been called "complete" at the rehab hospital we are now at.

    Also, today when he received a needle in his foot he felt pain, this was a new sensation and we are hopeful this will continue.

    Should I request another evaluation? I understand the spinal swelling may have gotten worse before it got better, this could explain the change in sensation.

    I also read the following that was written by Dr Young, does this apply to the situation I have described here?

    "A person who has preservation of function below the injury level during the first days after spinal cord injury, is likely to recover substantial motor and sensory function after injury"

    Thank you for any help you can provide!

  2. #2
    Sharon, so sorry about your son. I realize sometimes those of us with SCI are called complete right after the injury when we are incomplete. It takes time for swelling and also time to see what level of functioning will happen over time. I know as an incomplete quad, my function has increased a lot over a few years time. Good luck to him!

  3. #3
    Quote Originally Posted by SharonD View Post
    I have a question about my teenage son who has a T4 injury after surgery on 12/10/09. Injury most likely caused by a cavernous hemangioma. I hope you can help with my confusion.

    The week after surgery I was told his injury was "incomplete" after a sphinkter exam. Also, he had occasional feeling lower than the injury site. From time to time he could feel someone touching his stomach. He does not have that feeling anymore and has been called "complete" at the rehab hospital we are now at.

    Also, today when he received a needle in his foot he felt pain, this was a new sensation and we are hopeful this will continue.

    Should I request another evaluation? I understand the spinal swelling may have gotten worse before it got better, this could explain the change in sensation.

    I also read the following that was written by Dr Young, does this apply to the situation I have described here?

    "A person who has preservation of function below the injury level during the first days after spinal cord injury, is likely to recover substantial motor and sensory function after injury"

    Thank you for any help you can provide!
    Sharon,

    Yes. Your son appears to have an incomplete spinal cord injury. While I cannot predict how much he will recover, the likelihood is that he will recover significantly more function in the coming year. From your description, I don't know how much motor function your son has below T4. If he has some motor function (i.e. is an ASIA C), some studies suggest that his chances of recovering unassisted locomotion with a year is over 90%. However, if he has just sensation, the probability of recovering unassisted walking drops to 30-40%.

    But, as you know, all rules have exceptions and statistics apply to populations and not to individuals. Even in people who are so-called "complete" spinal cord injuries, my experience is that 17% of such patients will recover walking if they received a drug called methylprednisolone within 8 hours after injury. On the other hand, I have known many people who have not recovered walking after spinal cord injury, even though they were incomplete after injury. That can be embittering to a person who is told that he is supposed to walk but doesn't. It is not a good feeling to think that you are unlucky and have been dealt bad cards.

    In my opinion, whether they have complete or incomplete spinal cord injury, everybody should be trying to walk after their injury because everybody has some chance of recovering walking. Besides, weight-bearing is good for the muscles, bone, and health. It matters not that your chances are 90%, 40%, of 17%. It is worth the effort and it is good for your health. Therefore, they should do it.

    Recovering function should be regarded in the same way as achieving goals in sports are regarded. For example, I don't know whether your son is into sports but there are many things that he could not do in the beginning. For example, he probably could not jump 5 feet, run 100 yards in 10 seconds, shoot a 3-point basket 90% of the time, or swim 100 yards in a minute when he first tried. As he practices, he will approach that goals but may not make them. He will be disappointed but no embittered or think himself unlucky if he doesn't meet the challenge.

    How much should your son work for recovery? If and while he is highly motivated to do so, during the first year, I would encourage him to do it full time for several months for as long as he can tolerate it. Spinal cord injury has already taken so much, why give it more by not trying. Finally, it is important that he does not neglect his education and go back to school as soon as feasible.

    Wise.

  4. #4
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    Quote Originally Posted by Wise Young View Post

    ...

    Recovering function should be regarded in the same way as achieving goals in sports are regarded. For example, I don't know whether your son is into sports but there are many things that he could not do in the beginning. For example, he probably could not jump 5 feet, run 100 yards in 10 seconds, shoot a 3-point basket 90% of the time, or swim 100 yards in a minute when he first tried. As he practices, he will approach that goals but may not make them. He will be disappointed but no embittered or think himself unlucky if he doesn't meet the challenge.

    ...

    Wise.

    i like that. i should take that into my own account. i am able to walk with a single crutch (free when inside the house) slowly.. i was hurt 6 months ago (c4 asia d) but hey, wise is right..

    - stan
    c4 incomplete
    brown sequard syndrome

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