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Thread: Life expectancy?

  1. #1

    Life expectancy?

    Does SCI reduce a person's years of living? I am thinking about a future with my man with a SCI. Although it won't change my feelings any (I love him so much), I am still curious about the years down the road.

  2. #2
    Personally, I don't believe in all that SCI life expectancy stuff. I think it depends on the person. I am 26 and have lived 20 years healthy as an SCI. I think it's possible to live to an old age as long as you take care of yourself

  3. #3
    Senior Member MikeC's Avatar
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    Here is a link of some stats on shortened life expectancy from SCI (this link was in this post: Do we live longer?)

    Spinal Cord Facts and Figures

    In other posts people have argued that our life expectancy is shorter because we don't work out and do all of the things to maintain good health.

    T12 Incomplete - Walking with Walker, Oct 2003

  4. #4
    We don't work out or won't work out? Big difference.

  5. #5
    Many people CAN'T work out, or maybe those high quads are just lazy, huh?

  6. #6
    Originally posted by alissa:

    Many people CAN'T work out, or maybe those high quads are just lazy, huh?
    That's not what I said.

  7. #7
    lovnlife,

    Spinal cord injury does impose several additional risks that can shorten the life of people. Care taken to avoid these problems will improve the likelihood that a person will live a nearly normal life span. Let me discuss some fo these.

    1. Urinary tract infections and kidney damage. Before World War II, over 50% of people who get spinal cord injury died from urinary tract infections due to lack of technology to prevent contamination of the bladder, urinary reflux into the kidney as a result of bladder spasticity, increased incidence of urinary tract and kidney infections, along with the occurrence of kidney stones. In the last decade or so, urinary tract infections and renal failure surrendered its first place as the cause of death to pneumonia. Many urinary tract infections result from use of indwelling foley catheters, inability of many people with spinal cord injury to do sterile intermittent cathetherization, and overuse of antibiotics. In my opinion, although I have not seen a rigorous study of this issue, the increasing use of suprapubic catheterization, mitrafanoff with bladder augmentation, and other approaches may have significantly reduced urinary tract and renal infection. The other major change has been more judicious use of antibiotics. Until the early 1990's, clinicians often prescribed antibiotics for bacteruria (the presence of bacteria in the urine) without evidence of systemic infection. Overuse of antibiotics resulted in a higher incidence of antibiotic resistant infections.

    2. Pneumonia has become the main cause of death in people with spinal cord injury, particularly those with cervical spinal cord injury. For people with impaired cough, pneumonia is a frequent complication of colds and other pulmonary problems that all of use suffer from. The advent of better respirators, phrenic nerve, or diaphragm stimulators has significant reduced the likelihood of fatal pneumonia.

    3. Decubiti. This continues to be a major but preventable problem. Better cushions and more attention paid to treating decubiti earlier and avoiding progression of decubiti has reduced the number of severe skin wounds that require surgery.

    4. Over-medication. Many people with severe spasticity, neuropathic pain, autonomic dysreflexia, and other neurological complications of spinal cord injury take a large number of drugs. Clinicians use to throw drugs at this problem. Some people with spinal cord injury take as many as 10-15 drugs every day. This tendency fortunately has been reversed and there is a more cautious approach to give only drugs and doses that are necessary and sufficient to treate the complications. The availability of the baclofen pump for people with severe spasticity, neurontin or gabapentin for neuropathic pain, and more experience in treating pain has reduced the number of overdoses and overtreatment.

    5. Osteoporosis. Loss of bone occurs in almost everybody with spinal cord injury. Lack of use causes bone atrophy and loss of calcium. Fortunately, there are now a variety of drugs that may reduce the loss of bones. When combined, with standing and functional electrical stimulation, anti-osteoporosis drugs can prevent bony atrophy. This reduces fractures and other problems associated with bone atrophy.

    6. Autonomic dysreflexia (AD). Most people do take AD for granted. Whe AD occurs, blood pressure can increase to very high levels, along with stress to the cardiovascular, renal, and other systems. Care taken to address causes of AD and to treat AD has reduced the consequences of AD.

    7. Endocrinological disorders. Many people with spinal cord injury suffer from hormonal problems, including hypothyroidism, hypoparathyroidism, diabetes, low testosterone/estrogen/progesterone, low growth hormone, and other hormonal problems. More aggressive treatment of these problems has probably contributed to the reduction of morbidity and mortality associated with endocrinological problems.

    8. Exercise and diet. Paralysis encourages a sedentary lifestyle with all the problems that is associated with such lifestyles, including obesity, high cholesterol/fat levels, diabetes, constipation, and atherosclerosis, and other problems. Although it is harder for people with spinal cord injury to participate in exercise program and it takes discipline, effort, and time, people can now undertake exercise programs with functional electrical stimulation, and other programs to stimulate the cardiobascular system.

    9. Gallbladder stones. Several studies has suggested that over half of people with spinal cord injury will get gallstones sometime in their lives. Recognition of this problem and appropriate corrective actions (e.g. diet) may help reduce this risk.

    10. Depression and drug use. The incidence of psychological problems is higher in people with spinal cord injury. Inadequately treated neuropathic pain, social isolation, economic problems, and delays in addressing depression, anxiety, and other problems contribute to poor health of people with spinal cord injury. A person who is depressed does not take as good care of his/her body and this aggravates the other problems. Likewise, people may treat themselves with alcohol, smoke, and other drugs to counter the depression.

    Of course, many of the risk factors the general population also affects people with spinal cord injury. The reduction in smoking, aggressive treatment of cholesterol and lipid levels, better diet, and better medical treatments have remarkably increase the lifespan of the general population over the past few decades. There was a time when 65 years old was considered to be very old (in the 1970's) but it is possible to be a young 65-year old today. People with spinal cord injury must take advantage of these advances as they age.

    There are of course other reasons for shorted lifespan. However, many of the causes of shortened lifespan can be effectively addressed in people with spinal cord injury.

    Wise.

  8. #8
    I would just add to Dr. Young's list the following:

    We know that people with SCI are 3X more likely to have type II Diabetes than the AB population. We don't know why.

    We also know that hyperlipidemia is common in both diabetes and in people with SCI.

    These two problems are the top two risk factors for heart disease and cardiac related death in people in the USA.

    Because of this, many SCI centers are now getting more aggressively involved in both diagnosing and treating diabetes and hyperlipidemia in people with SCI. In the VA system, this is a nation-wide initiative, and many VA SCI Centers are setting up model SCI diabetes/lipid clinics within their SCI clinics.

    We hope that early education of patients about risk factors and how to try to prevent these two problems with help them maintain their health for longer, and push those longevity numbers up.

    Keep in mind that all these life-expectancy numbers (below) are AVERAGES only. Some will exceed them (about half) and some will not reach them (about half).

    (KLD)

  9. #9
    This post is valuable. Thank you Wise/Sci Nurse.

    TAKE YOUR HANDS OFF MY MOJO


  10. #10
    Senior Member lynnifer's Avatar
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    Three out of six of my family members has/had diabetes (one's gone already, one's on the way out and another probably has less than twenty years). It's truly a horrible disease and afflicts so many.

    Why are SCI so prone to this?

    Aren't they really close to a cure for this as well? Gawd I hope so ...

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