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Thread: Husband's Recent L5-S1 Disc Rupture causing Cauda Equinas Syndrome

  1. #11
    Hi Tiffany, it sounds like he's making good progress. I was injured at L1 and L5 and do not have CES. However, against all odds, I regained b&b function and am about 90% normal. It's been a journey, though. Your husband's description of feeling need of a bm all the time is familiar. So is going in small pieces. That's what happened to me at first, too. With time, things changed and things began to normalize. In the four years that I've been injured, I've had phases of constipation. And diarreah. Then it's a matter of eating habits, medication and working back to equilibrium.

    I encourage your husband to make use of his PT and any exercises or therapies that could help strengthen his inner workings. My SCI rehab doctor pretty much wrote me off when I asked if there was anything I could do to encourage those muscle groups along. It was my primary physician that recommended PT. It did wonders, but not without a lot of work and diligence with exercises. I live pretty normally as far as b&b is concerned. I hope the same happens for your husband.

    It is true that when you have an SCI, you are never the same as you were...to different degrees. He should do his best, take good care of himself, let time do its healing work...and remain positive.

    I wish you the best!

  2. #12
    Ket,

    Thank you for all of your advice. He takes Metamucil 3x a day and eats an extremely high fiber diet. He doesn't take any pain medicine of any form. He is on Lyrica but has never really had any nerve pain that he is aware of. The spine surgeon didn't want him doing laxatives as he at one point had hemorrhoids so bad that he was in extreme pain (one week post-op from straining to urinate/defecate they believe). They think he blew approximately 60-75% of his disc and he was starting to lose internal muscle tone and they said that he would have become paralyzed next had they not done the surgery.

    Again, thank you for your advice. I talk to him about everything I read on here.

  3. #13
    Quote Originally Posted by truly View Post
    I encourage your husband to make use of his PT and any exercises or therapies that could help strengthen his inner workings. My SCI rehab doctor pretty much wrote me off when I asked if there was anything I could do to encourage those muscle groups along. It was my primary physician that recommended PT. It did wonders, but not without a lot of work and diligence with exercises. I live pretty normally as far as b&b is concerned. I hope the same happens for your husband.

    If you don't mind sharing, what type of exercises did you do or still do to encourage rehabilitation? I have a couple of friends who are PTs, I need to get into contact with them to see about setting something up for him. His spine surgeon keeps telling us that him using our elliptical is the best thing for him as he has minimal disc left and this is a good way to get a full body exercise without the damage that you would get from running. He also wants him walking a mile a day. Other than that though, he doesn't think he needs to do PT but I don't see where it would hurt to have him evaluated. Thanks in advance if you are comfortable sharing.
    Last edited by SCI-Nurse; 09-07-2014 at 11:29 PM.

  4. #14
    Typically walking or eliptical for legs is best. He needs clearance for ortho doctor. But a true complete cauda equina will have flaccide or areflexic bowel and bladder- and wouldn't need to relax anything. But it seems he is incomplete CES.
    And good he doesn't have pain which would be more post op. We don't put people on Lyrica until we know they have neuropathic -nerve pain but good that he doesn't.
    It sounds like he is recovering well & recovery does take a while. Checking the consistency of bowels- should be firm but no lumps or hardness- will help the bowel to empty easier. Stool softeners recommended only if needed.
    CWO

  5. #15
    He saw a GI specialist on Tuesday about his bowel problems. He isn't constipated but just isn't able to go often enough and is ultimately getting backed up. He determined that his anal sphincter isn't working at all. He is having him go to a Pelvic Floor & Core Rehabilitation Center in Cincinnati tomorrow to start physical therapy. Apparently, they will try to retrain the muscles and use electrical stimulation to attempt to get his nerves working again. He seems to think that since the bladder came back that there is plenty of reason to believe that the bowels can/will too and that it is more of a neurological issue of just getting the brain and muscles to communicate properly again. Hopefully, we see progress as he will now go to this once a week for an hour.

  6. #16
    Also, he has in about the last two to three weeks started to have an electrical shock type of sensation in various areas--his left heal, his lower back, and most recently his left testicle. He compares it to being mildly electrocuted (like what you would feel if you touched a low voltage electric fence). He says that it doesn't hurt but it is slightly uncomfortable and he generally stops whatever it is that he is doing. Is this the nerve pain that most CES patients experience or is that a constant sensation? Could this be his nerves attempting to regenerate/reconnect? Most of his numbness is to the left side as his original herniation caused sciatica on the left side before the rupture.

  7. #17
    Senior Member ~Lin's Avatar
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    Yes, an electrocution type sensation/pain is classic of neuro pain.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  8. #18
    Thanks, Lin. That is what I figured and so did he but his doctor started him on Lyrica a few weeks post-surgery and he was never really given an opportunity to feel nerve pain without medication as he didn't have much at that point.

    He had his first PT appointment and he feels optimistic that it will help. The therapist worked on trying to get him to use the proper muscles when trying to go to the bathroom and he quickly realized after biofeedback therapy that he wasn't using the right ones at all--mainly because he can't feel like he used to be able to down/inside there. He was starting to get depressed as he had gained 10 lbs and felt frustrated. This has given him his drive back that he can get better. I am excited for him and hope he sees improvements.

  9. #19
    If he truely has CES, electrical stimulation will not help with a flaccid (paralyzed) anal sphincter. He really needs to learn how to manage a neurogenic, lower motor neuron (LMN) bowel.

    Here is a good booklet for you both to read. Most likely he needs to keep his stool very firm (avoiding too many laxatives or stool softeners) and then manually evacuate his stool at least once daily. Many people find the they will be better able to prevent bowel accidents when straining (valsalva) during exercise or mobility activities if they do bowel care after each meal.

    http://www.pva.org/atf/cf/%7BCA2A0FF...ic%20bowel.pdf

    (KLD)

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