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Thread: Complete/ Incomplete ? Wise?

  1. #1
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    Complete/ Incomplete ? Wise?

    Hello. My husband has a C6/7 injury (27 days post). I have been educating myself since, and have been through and through the ASIA charts and many other sites. I recently read a post by Wise describing that Incomplete was the presence of anal sensation AND voluntary anal contraction. It was my understanding that a person could be classified as incomplete with only light touch sensation at S4/5 - and this I concluded after a careful study of the official ASIA Charts and descriptions.
    Could someone please clear this up for me? I looked in his chart at the hospital and read "incomplete". Yesterday his physical therapist saw on her paper that he was "complete". He has only light touch sensation in the anal area (no contraction, no pinprick) Help??

  2. #2
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    Hi JacksonsGirl, so sorry for you and your husband problems. I'm far from being an expert but, complete means no sensation or movement below injury site. If your husband has any of these, below injury, that's mean he is incomplete.

  3. #3
    Quote Originally Posted by Cielo View Post
    I'm far from being an expert but, complete means no sensation or movement below injury site. If your husband has any of these, below injury, that's mean he is incomplete.
    That is NOT correct. According to the International Standards for Classification of Spinal Cord Injury (ISCSCI, formerly the ASIA standards), in order to be considered ASIA (AIS) B, the person must have preservation of sensation at the peri-anal (area within 1 cm. of the anus) area or deep anal pressure. Sensation elsewhere does not count. The person does not need to have all types of sensation intact there though. See the description in the standards below.

    http://www.asia-spinalinjury.org/pub...m_Sheet_r4.pdf

    (KLD)

  4. #4
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    That is good news for Jacksonsgirl and her husband, right SCI-Nurse? Somewhere Dr Young has written a good description of the recovery chacnces of a newly injured person who is incomplete.
    2012 SCINetUSA Clinical Trial Support Squad Member
    Please join me and donate a dollar a day at http://justadollarplease.org and copy and paste this message to the bottom of your signature.

  5. #5
    When I was injured I too was very curious about my ASIS level as if that would somehow make a difference. I too had inconsistent chart classifications which caused some confusion for me. I still don't fully understand the clasification as I have no sensation to speak off in S4-5 yet have preserved motor function and sensory below my injury.

    I am much lower, T-12 but my experience would indicate that if your have anything spared below the injury level it is very good news as it was for me.

    At 27 days I could not move anything without removing gravity and need to manually manipulate my legs in bed and transfers. Now at 7 1/2 months I am walking with a cane. It may be too early to tell what his return may be but now is the time to work with whatever comes back and take advantage in anyway you can.

    Make sure that you are preparing for B&B issues and keeping an eye on his skin as complications resulting from these issues can become very serious. These may prove to be the most challenging parts of recovery. My motor function has returned but I still have B&B problems and will likely for some time to come.

    Find a good SCI threapy gym that espouses to activity based therapy and settle in for a long fight. Be thankful for everything you get back and keep building. Don't worry about the labels. The truth is, it is hard if not impossible to tell the severity of SCI. These are all labels to use to classify him by some standard of consistenciy. Your huusband has been injured uniquely and will recover at whatever pace his body allows whether he is classified as complete or incomplete.

  6. #6
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    MFloumlacker is right, therapy is the key. Ryan is legally a C-2 (site of injury). He functions at anything but. Then again, he has bladder and bowel control.

    With that said, he did not demonstrate bowel control until months after his injury. He had bladder control but no communication ability in the trauma hospital and in rehab (Atlanta) he was told not to expect bladder or bowel control. Two weeks later, he told his nurse one morning that he had to go (off schedule as they tried to make hm a night person). He has used a urinal since we conned the doctor into removing the foley cath.

    The road of an incomplete is long and VERY individual. His long term prognosis is dependent on too many things. All SCI injuries are unique. They all take an incredible amount of work from everyone. He will work hard and so will you. Determination is key but it will not get back what will not come. At the same time, lack of push CAN limit recovery in an incomplete.

    I have travelled this road as a mom, not a wife, and my heart goes out to you. It is the hardest thing either of you will ever do, but also the most rewarding.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

  7. #7
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    Thanks all. I am so thankful to have stumbled upon the site, and truly appreciate everyone taking the time to reply. Its awesome to have somewhere to go to share experiences and ask questions..

  8. #8
    Jacksongirl- Makke use of Care forum. It is a great resource for honest info from those who have experienced first hand what we go through. But always remember that recovery is unique. No two injuries are the same.


    I wish you and your husband luck and hope that you will find peace with all of this. I am so thankful to have my wife by my side. God Bless!

  9. #9
    They tweak the ais score and just did an update last year. it is now "Voluntary" contraction of anal as the score sheet and instructions say- not as before - that we got a reflex or something.
    Outcomes are based on the ais score and that is why you must be really interested in it. ZPP- zone of partial preservation or area that has something.
    But time will tell! so do what you have to do and see what develops!!!
    CWO

  10. #10
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    Yes, SCI Nurse, that is the chart I was studying , and concluded that the presence of light touch anal sensation alone would classify someone as being incomplete. The post from Wise must have been older then, when the standards were different, is that what you're saying ?
    I know what you all mean about the labels and all. I've been telling him to pay no mind to any of it, and to just build on what he's got and we'll end up wherever we end up, together.

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