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Thread: My T3-injured father in China

  1. #1

    My T3-injured father in China

    Dear everyone,


    I am a student coming to the States this September from Shanghai of China. My father, who is now 61-years old, was suddenly paralyzed last October, and was diagnosed as SCI T3 caused by Spontaneous Spine Hemorrhage. Although my mom and I put him into the best local rehab in Shanghai soon after his surgery, the staffs there were just too inexperienced to offer a good rehabilitation program.


    I am so happy to have found this community this morning – thanks Dr. Young, all the moderators, and everyone for sharing your information and in-depth advice. – Many of them are of great use to me.


    I have two questions on my father:


    1. What shall he use to keep him dry? My father has been suffering from Urinary Incontinence ever since he sustained SCI. He used a temporary indwelling catheter for 3 months and then switched to padding. He also tried external condom cath but it doesn’t seem to fit him well. The weather is getting cold in China and it is really inconvenient to change pads all the time.

    2. Could you recommend some good rehab institutes around Stanford which I can visit and talk with some staff/patient there? I am curious to know the difference between the SCI rehab program here and what my father is doing in China. (I may have some difficulty in understanding the rehabilitation ‘terms’ but I will bring a dictionaryJ)


    Thanks very much to all, and have a great thanksgiving!


    Steve

  2. #2
    Welcome to CareCure! We are glad that you found us.

    Your father should not be using an indwelling catheter, nor an external condom catheter (ECC), nor padding (diapers). He should be doing self intermittent catheterization where he passes a catheter through his urethra every 4-6 hours during the day to drain his bladder. This will also require the use of anticholenergic medications such as oxybutinin to keep his bladder pressure low and also to prevent leakage between catheterizations.

    High pressure voiding with padding or ECCs can damage his bladder and kidneys, and also increase his risks for autonomic dysreflexia. You can find information on how to do intermittent catheterization in the clinical practice guideline on bladder management from the Consortium for Spinal Cord Medicine, which you can download here:

    http://www.pva.org/site/PageServer?p...alpubs#Bladder

    If you will be attending Stanford, you can visit both the SCI Center at the Palo Alto Veterans Affairs Medical Center (right next door) and Santa Clara Valley Medical Center's Rehabilitation Center in San Jose. Both are considered leading SCI rehabilitation centers. I know people at both centers so if you need an individual contact, please send me a private message here.

    (KLD)

  3. #3
    Thanks SO MUCH Nurse KLD!

    From my research on this forum and the Paralysis Community, I noticed that quite many SCI people are using external condom catheter. Therefore I wonder:

    1. Under what condition would you recommend people to use ECC, and when to use Intermittent cath?
    2. Does my father need to take a Urodynamics Test? It seems that this is the base for the US doctors to decide the Rx for SCI patients. However the hospital in China said they could not do this test to patients with urinary incontinence..

    Again, thanks very much!

    -Steve

  4. #4
    Back in the days before we knew about high pressure bladders and the ill-effects that reflex voiding could cause to the kidneys and bladder, reflex voiding and ECCs were commonly recommended for those men with new SCI. Now days we rarely if ever recommend this for men who have the hand function to cath themselves (such as your father). For those who do it, invariably they must have their external urinary sphincter cut to try to reduce pressures (which can ONLY be determined by doing urodynamics). It is also more difficult to keep older men dry with ECCs due to problems with penile retraction that are more common in older men. Stones and UTIs are common in those with incomplete and high pressure emptying using this method.

    I would recommend talking with your father about his willingness to do intermittent cath, and print out and share the clinical practice guidelines I sited above and share it with his physicians. Urodynamics is specifically recommended for all people with SCI. Incontinence is NOT a contraindication, but indeed an indication for doing urodynamics to determine bladder capacity, the type of neurogenic bladder, and the bladder pressures. The test should include a cystometrogram, flowgram (if he voids) and external urinary sphincter EMG. Ideally it should be done with fluoroscopy at the same time (videourodynamics).

    (KLD)

  5. #5
    Steve,

    I think it is tremendous that you have come from China to care for your father. I know exactly how hard it may be (to put your own life on hold) as I returned from my 'life' in New York to become the primary caregiver for my 47 year old father- who has t5 complete injury since sept 9th of this year. And no matter how hard it may be at times, you are not alone. In addition, I have faith that the new techniques/advances that are rapidly developing may help you and your dad in the near future...so this, in combination with your help, will make a more than everlasting and positive effect on your fathers life. Good for you,

    Megan

  6. #6
    Steve is in the USA going to school. His father is in Shanghai. He is not currently or planning to be his father's caregiver. He is trying to find information and resources though.

    (KLD)

  7. #7
    Thanks Megan so much for your encouraging words..

    As Nurse mentioned, I came to the US two months ago for study. My mom is now taking care of my father back in Shanghai. My Mom and I have consulted many major hospitals in China, in a hope to help my dad recover over the past year. I am trying to find more information from the abundant info resources - and if possible, i would like to bring my dad to the States for rehab treatment.

    Having helped my Mom taking care of my dad, I completely understand how much effort you have made on your father - i think that's why we all are on this forum seeking help as well as chances to help others.

    You will never be alone.

    -Steve

  8. #8
    Hello Steve,
    My brother also got injured in China. I was wondering if you could help me with hospitals and your experience. Hope your father is doing well.
    -Bahar

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