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Thread: Am I over-hopefull?

  1. #1
    Junior Member
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    Nov 2006
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    Johannesburg South Africa
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    Am I over-hopefull?

    My brother Riaan (C6-7) complete according to the Neurologist, he is slowly improving every day. For the first time today he coped for more than an hour in a chair - over 5 hours to be exact. While we were visiting him i saw his feet move, I almost jumped throught the roof. He was very suprized to see this too, he said that he does not know that he is moving them. He also said to me that he has feeling in his legs up to his bum and then from the chest up. For me this was great news.

    The Neurologist walked in there by chance and said to us that he is improving good but the movement in the feet is spasms. i dont know what a spasm looks like but imagine it like a cramp. His feet moved very slowly up and down. He also said to me that it could be that Riaan imagines the feeling when we touch him and that he would not feel it if his eyes are closed. I did not want to put him through this excersize, if he thinks he feels us it is good enough for me.

    i asked him if he can feel temperature and he said that he can feel when they wash him, how much i don't know. i have mentioned on previous threads about his bowel feeling.

    I don't know whether the doctor just don't want to get ones hopes up or if he is just pessimistic. Please give some insight if possible, is this small miracles or are we over optimistic?

  2. #2
    Small miracles are always possible. I promise.

    Hope for the best, prepare for the worst, expect the unexpected, accept that doctors only know what they're taught and don't usually share all of that!

    5 hours in the chair is good. His endurance is increasing!

  3. #3
    everything you've seen so far is a normal part of SCI. especially the spasms. sorry to say that they have nothing to do with being able to walk again.

  4. #4
    It sounds like he had clonus (a type of spasm) in his legs. This is not the same as a leg cramp or charlie horse. It would only be considered movement/motor return if he could replicate it on command.

    http://www.medicine.tamhsc.edu/neuro/80.gif

    Hot/cold is carried in the same pathway as pain, so hot/cold is rarely tested in SCI. The test for pain is pin prick. The physician should be assessing his sensation for both pin-prick and light touch (cotton wisp) below his injury level on a regular basis. This has to be done while shielding his eyes so he cannot see where the testing is being done. Ask the physician to do the ASIA again if it has not been done recently.

    Again, he would have to have sensation right at his anus to be considered an ASIA B.

    I hope he was getting every 15 minute weight shifts if he was in a wheelchair for 5 hours. That is enough time to get a pressure ulcer without them. I also assume he was on an appropriate pressure reducing cushion (not just a pillow or the chair seat).

    Hope is never inappropriate, but it is important to make plans for rehab and discharge based on where he is today....that is worse case. If he gets return, that is frosting on the cake.

    (KLD)
    Last edited by SCI-Nurse; 12-13-2006 at 07:41 PM.

  5. #5
    Junior Member
    Join Date
    Nov 2006
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    Johannesburg South Africa
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    Eating solids for first time

    Hi there,

    Thanks for the replies. Riaan is eating solids for the first time since today. i checked about the feeling and it is definately not phantom. As you said pain he does not feel. but if you brush over his skin he fells it even with his eyes closed. About the sitting, they don't move him when he is the chair and that is a concern for me. he has full movement of the left arm and wrists but his right arm is not moving at all. The arm did definately move after injury. it is the arm where moct of the drips and stuff in on so i hope that is the reason and that the movement will come back.

    If anyone has any advise with regards to arm please reply.

    Thanks

  6. #6
    I am not a Dr. or a nurse, so I cannot give medical advice, I would like to say that I think it is wonderful that you are so devoted to your brother. Love and support will carry Riaan far.

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