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Thread: Life outside of the hospital..

  1. #11
    you should have some antibiotic for uti's and some nephedipine for dysreflexia.

    the best thing you can do after going home is: realize that it's going to feel really strange for awhile because you no longer fit there anymore.

    and to get out and go do as much as you can. sitting at home is a recipe for depression & self loathing. that's no good for you.

  2. #12
    Quote Originally Posted by wheelz99 View Post
    you should have some antibiotic for uti's and some nephedipine for dysreflexia.
    I think the OP's level of injury is low para, so the AD drug is not needed, and it would not be appropriate to send someone home with an antibiotic as antibiotics should ONLY be taken for true UTIs that have been diagnosed by the physician and when a C&S specimen has been collected, and the antibiotic based on the sensitivity test. It would be irresponsible and bad practice for your provider to prescribe it otherwise.

    Oops...I see that she is indeed a mid-level para, so yes, she should have supplies (a blood pressure cuff, irrigation supplies) and meds (nifedipine, lidocaine gel 2% in a urethral applicator), etc. for AD management prior to going home, as well as a plan for management.

    (KLD)
    Last edited by SCI-Nurse; 08-30-2011 at 02:13 AM.

  3. #13
    Junior Member
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    Smile Pressure sores and sleep..

    T5/T6 SCI..this may go along with what i wrote earlier about life outside of the hospital..situations at home..im fearful of getting pressure sores while i am asleep..not being able to turn myself every so often for pressure relief..i am still in the hospital where i can be awakened by loud nurses and lights being turned on..but i dont have that at home..would i need an alarm clock to wake up and turn myself??..i also cath every 5 to 6 hours..an alarm clock would be helpful with that as well..i understand 2 hours would be an appropriate amount of time to stay in one position..any suggestions on the firmness of a bed??..brand??..size??..should i have any bars on the walls around my bed??..im usually good about sleeping and staying in one position all night..is it better to sleep on my stomach??..suggestions and experiences will surely be appreciated..thank you..

  4. #14
    Why can you not turn yourself? This is something your PT and nurses should have taught you how to do prior to discharge. Please ask them to work on this with you.

    It appears you do not plan to have a hospital bed when you go home, is that correct? What are you sleeping on now?? Have you practiced doing your care such as dressing, cathing, etc. on a bed without putting the head of the bed up? Turning without side rails? Some people at your level decide to use a hospital bed initially (rental) but rarely long term. You should discuss this with your team members.

    What mattress you use also depends on your insurance and if they will cover a pressure reducing replacement mattress and in what size. For example, I work in the VA, and we do not cover any specialty mattress size except hospital bed/twin. If one of our SCI veterans wants a full/queen/king, they must purchase it themselves. We can then only provide them a pressure reducing overlay (in a twin size).

    Some like memory foam. I would recommend trying this before you purchase. Some complain about it being too hot, and it can be difficult to turn on yourself. A good quality foam pressure reducing mattress may be the best option for you if your skin is good. You do need to turn at least every 3 hours. Try turning every 3 hours now to be sure that your skin will tolerate this.

    Get an alarm clock that will wake you and that you can easily operate. If you are concerned about awaking other family members with this, get a vibrating alarm clock you keep under your pillow (designed for the blind or hard of hearing primarily). "Shake-Awake" is one brand. Most people eventually learn to awaken automatically for caths and turns, but using the alarm clock now and when you first go home will help you to learn this habit. Some will tell you that they never turn, but this is not a good practice and can quickly lead to pressure ulcers, esp. as you get older. Get into the habit now.

    You can sleep on your stomach not turn at all between cath times, but you must learn how to "bridge" your boney areas on the front of your body (toes, tops of feet, knees, pelvis) and breasts to prevent skin breakdown in these areas when sleeping "prone". Work on learning to do this yourself, and building up time sleeping on your stomach gradually. Properly done, you can lay in this position 8-10 hours without turning (except to do your caths).

    I am very concerned that your rehab team members are not addressing these topics with you. Please insist on getting some answers and proper advice from them...that is what they are being paid to do for you right now. Hold them to their responsibilities.

    (KLD)

  5. #15
    I'm t6/7, 38 years post injury. I sleep all night on one side. I don't wake up to turn, ever. I may lay on my back as I wake up to straighten out the legs, but that's about it. I alternate sides every other night. Never had a pressure sore from sleeping. The only ps I've had was due to my own fault of having my footrests up too high. It healed very quickly. I do check my skin regularly.

    Never had any sign or symptom of AD. I am completley independent and did bowel and bladder til 2 years ago when I had to have a colostomy. But that's 36 years post so can't complain.

    My best advice to you, is to concentrate on getting as strong as you can, stand as much as you can and if you can find a fes bike to ride, ride it.

    I'm 63 years old, I stand at least 4 hours a week, go to the gym twice a week, ride the fes at the local hosp. two times (14miles) a week, workout at home and ride my handcycle at least 35 miles a week. Also get a massage and chiropractory 2x's a week; who said life had to be tough.

    Best way to get back into life and the social scene is to get as active as you can. Join a wheelchair sports team to learn from the guys who have gone thru what you are now. Get back to school or job.

    I know you'll be searching for the cure etc. , I have that in the back of my mind still; it helps motivates me. If there is a cure, you have to be as strong and as healthy as you can be; if the cure doesn't come along, you have to be as strong and healthy as you can be to push your sorry(lol) self thru life. It will get better, I can assure you that. How you live your life is your choice, it's not easy at first, but again, it will get better.

    YOu came to the right place. We are here to help each other and nudge the rookies to maximize their abiiities with what they have left. T4/5; you have plenty left.

  6. #16
    Memory foam mattresses have evolved and there are now options with cool technology. When you are shopping for a mattress or topper and you are interested in memory foam as an option, look for Cool Sensation, CoolMax, Cool-Tek, Iso Cool Memory Foam, Polar Foam, Cool Action by Serta, etc. Many of the major companies offer these cool mattresses as an option.

    Another option for a "regular bed" is Sleep Comfort Sleep Number beds. We purchased adjustable Sleep Comfort beds. When you go to a Sleep Comfort store, they have a pressure mapping system that gives you an idea what your sleep number should be. I sleep on a Sleep Comfort bed topped with a medical sheepskin all night without turning and haven't had skin problems (just my story, may not be right for you).

    If you are considering a "regular bed" (not a hospital or air exchange bed) think about getting an adjustable frame to allow you to raise and low the head and foot of the bed to help with dressing and draining swollen feet.

    All the best,
    GJ

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