Easy to re-injure?

kaye · 06-28-2004, 02:06 PM

Isaac and I have been swimming alot. He wants me to toss him like the other kids. We also would like to go a water park. Would it harm him to go on a water slide that dumps him into a pool at the bottom. I guess what I am asking is "if you have a sci, do you have to monitor your activities for fear of re-injuring yourself". Can you still do things like tubing, being tossed in the water, etc.? He is T6.

SCI-Nurse · 06-28-2004, 03:59 PM

Wow, great question. Have you thought about checking into someone who teaches adaptive swimming? One site that KLD mentioned in the past is http://store.accesstr.com/page.cfm/PageID/133
You might want to check this one out for ideas to make it safer for Isaac. Before having Isaac try anything on his own or tossing him into a pool get clearance from his MD first.

Someone needs to be at the bottom of the slide to help Isaac swim with his arms and/or to catch him. How does Isaac feel about it? I am sure he sees the other kids having fun too. If he feels confident to go down a water slide alone and he has good upper extremity strength and/or an adaptive device, how great for him! It's just that for us parents it is hard to let our children try this on their own, let alone those kids that have disabilities.

How far out is Isaac's SCI? As far as the chances of reinjuring the spinal cord, this would best be answered by his MD or maybe Dr. Young. One would think that if the SCI happened some time ago that the risks for injuring the spine and spinal cord during swimming activity would be the same as for other children. The biggest issue is making it as safe as possible for Isaac to do these activities without hurting himself.

Let us know what his doc has to say and I hope he gets to do this soon! It must be hot in Texas! PLG

Wise Young · 06-28-2004, 05:20 PM

Kaye,

I agree with PLG. What a dilemma. Of course Isaac wants to be tossed into the pool, go down the slide, and ride the tube. And, I, too, would be nervous for the following reasons. First, Isaac cannot feel or position his legs to avoid injury. Second, the bones in his legs are not as strong as the other kids. Third, he may not know if he has hurt himself and go on playing. He may injure his skin or even break his bones and may not realize it.

For these reasons, I would suggest that somebody be there (as surreptitiously as possible) to monitor him and make sure that he does not engage in activities that might hurt him. Many kids who have impairments or conditions understand that they must take care of themselves and that there are certain things that they should not do. At the same time, it is important that he does not think of himself as being inferior to other kids or any reason to be ashamed. It is a difficult balance to achieve but I have met kids who have achieved it and have become more mature as a result.

There are several things that I don't think that you need to worry about. In general, healed spinal fracture sites are stronger than before and should not pose a risk of refracture. You should consult with his doctor to make sure that the rest of the spinal column is not at risk. If the doctor says it is okay, I think that Isaac should encourage to swim vigorously, splash, and participate in other play activities that do not pose a risk to the parts of his body he cannot feel or move.

I actually have some questions concerning practical matters of a person with spinal cord injury going swimming. For example, what do people do to protect their skin and keep from stubbing their toes in a pool, especially as they go in and out of the pool? I know that we had a discussion before here concerning wet suits. What should be done to minimize the embarassment of incontinence in the pool (this might be a emotionally traumatic experience)? Do people have any problems with their skin or temperature control when they stay in the water too long?

Wise.

alissa · 06-29-2004, 09:18 AM

A totally unprofessional opinion, but...

As a teen, my husband spent his summers working with kids with disabilities (he's AB and I guess it was some sort of camp program). The counselors took the kids on water park slides, and went down with them - kinda like tandem sky-diving. When I went horseback riding (I'm c6 - adult) I had someone on the horse with me, holding me in the same manner. I actually enjoyed the closeness and had a great time.

Wise- I don't swim much, but when I do, water temp messes with my temp very quickly.

peace

SCI-Nurse · 06-29-2004, 09:41 AM

Wise, we recommend that swimmers wear "reef walker" or "aqua sock" type foot protection to prevent injuries to their feet. Here is an example:

We also recommend swimming in water that is between 75-80 degrees F. if possible, to prevent getting cold too soon. Water that is too warm (over 85 F as in some arthritis swim program pools) tends to sap energy too quickly. In colder water a wet suit (shortie or farmer John) may be helpful. For scuba diving we recommend full wetsuits. We also recommend cathing prior to getting into the water. Those with indwelling catheters can use a leg bag. We don't recommend, and do not allow those with uncontrolled bowel programs in our pool.

(KLD)

kaye · 06-29-2004, 09:46 AM

Thank you all (pronounced ya'll) for your input! I am relieved to know that his actual spinal cord injury is not necessarily prone to being re-injured. We have run into a few things to keep an eye on. Isaac wears water shoes in the pool. He scraped his ankles on the steps once. His bowel program is pretty much stable and we haven't had any mishaps there. He is small enough to wear a swimmy (pull up for kids in the pool). Cathing him before swimming has eliminated the need for the swimmy a couple of times. He will stay in the water for hours if I let him. I will monitor his heart rate (it sometimes feels like it is racing when he gets too wild for long) and make him sit for a few minutes. He never complains about being cold though. Again thanks so much for your answers.

kaye · 07-02-2004, 07:48 AM

Dr Young,
In your previous response you mentioned "healed spinal fracture's" are generally stronger than pre-injury. Are contusions considered spinal fracture's? Isaac didn't have any broken bones or spinal fluid leakage. Thank you.

amanda · 07-03-2004, 07:41 AM

I was curious about the fracture site being more fragile now too. But, it is stronger now? interesting.

" The best way to predict the future is to invent it."
- Alan Kay

SCI-Nurse · 07-03-2004, 09:41 AM

A contusion would be to the spinal cord, not the spine. In children, it is not uncommon to have traumatic damage to the spinal cord without a fracture due to the increased elasticity and flexibility of the spine in children.

I would be more concerned about prevention of extremity fractures in the activities you describe, esp. going down the slide feet first.

The fracture site (for those with spinal fractures) is usually stronger after healing. Unfortunately in some this can make the areas above and below the actual fracture site more mobile and easier to fracture in another accident. I have seen this a few times.

(KLD)

crags · 07-03-2004, 01:47 PM

i think it very unwise to be in any situation where you can't control the forces on the body or your body position.

it is truly not worth the risk involved for such a fleeting moment of satisfaction.

after sci you must consider the consequences of activities as relates to potential serious healing problems. if sci should teach (some) us anything, it's to consider consequences of actions more than pre sci

06-28-2004, 02:06 PM	#1
kaye Member Join Date: Sep 2003 Location: Seguin, TX, USA Posts: 53	Easy to re-injure? Isaac and I have been swimming alot. He wants me to toss him like the other kids. We also would like to go a water park. Would it harm him to go on a water slide that dumps him into a pool at the bottom. I guess what I am asking is "if you have a sci, do you have to monitor your activities for fear of re-injuring yourself". Can you still do things like tubing, being tossed in the water, etc.? He is T6.

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06-28-2004, 03:59 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,301	Wow, great question. Have you thought about checking into someone who teaches adaptive swimming? One site that KLD mentioned in the past is http://store.accesstr.com/page.cfm/PageID/133 You might want to check this one out for ideas to make it safer for Isaac. Before having Isaac try anything on his own or tossing him into a pool get clearance from his MD first. Someone needs to be at the bottom of the slide to help Isaac swim with his arms and/or to catch him. How does Isaac feel about it? I am sure he sees the other kids having fun too. If he feels confident to go down a water slide alone and he has good upper extremity strength and/or an adaptive device, how great for him! It's just that for us parents it is hard to let our children try this on their own, let alone those kids that have disabilities. How far out is Isaac's SCI? As far as the chances of reinjuring the spinal cord, this would best be answered by his MD or maybe Dr. Young. One would think that if the SCI happened some time ago that the risks for injuring the spine and spinal cord during swimming activity would be the same as for other children. The biggest issue is making it as safe as possible for Isaac to do these activities without hurting himself. Let us know what his doc has to say and I hope he gets to do this soon! It must be hot in Texas! PLG

06-28-2004, 05:20 PM	#3
Wise Young Administrator Join Date: Jul 2001 Location: New Brunswick, NJ, USA Posts: 37,972	Kaye, I agree with PLG. What a dilemma. Of course Isaac wants to be tossed into the pool, go down the slide, and ride the tube. And, I, too, would be nervous for the following reasons. First, Isaac cannot feel or position his legs to avoid injury. Second, the bones in his legs are not as strong as the other kids. Third, he may not know if he has hurt himself and go on playing. He may injure his skin or even break his bones and may not realize it. For these reasons, I would suggest that somebody be there (as surreptitiously as possible) to monitor him and make sure that he does not engage in activities that might hurt him. Many kids who have impairments or conditions understand that they must take care of themselves and that there are certain things that they should not do. At the same time, it is important that he does not think of himself as being inferior to other kids or any reason to be ashamed. It is a difficult balance to achieve but I have met kids who have achieved it and have become more mature as a result. There are several things that I don't think that you need to worry about. In general, healed spinal fracture sites are stronger than before and should not pose a risk of refracture. You should consult with his doctor to make sure that the rest of the spinal column is not at risk. If the doctor says it is okay, I think that Isaac should encourage to swim vigorously, splash, and participate in other play activities that do not pose a risk to the parts of his body he cannot feel or move. I actually have some questions concerning practical matters of a person with spinal cord injury going swimming. For example, what do people do to protect their skin and keep from stubbing their toes in a pool, especially as they go in and out of the pool? I know that we had a discussion before here concerning wet suits. What should be done to minimize the embarassment of incontinence in the pool (this might be a emotionally traumatic experience)? Do people have any problems with their skin or temperature control when they stay in the water too long? Wise.

06-29-2004, 09:18 AM	#4
alissa Senior Member Join Date: Dec 2001 Location: CA Posts: 574	A totally unprofessional opinion, but... As a teen, my husband spent his summers working with kids with disabilities (he's AB and I guess it was some sort of camp program). The counselors took the kids on water park slides, and went down with them - kinda like tandem sky-diving. When I went horseback riding (I'm c6 - adult) I had someone on the horse with me, holding me in the same manner. I actually enjoyed the closeness and had a great time. Wise- I don't swim much, but when I do, water temp messes with my temp very quickly. peace

06-29-2004, 09:41 AM	#5
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,301	Wise, we recommend that swimmers wear "reef walker" or "aqua sock" type foot protection to prevent injuries to their feet. Here is an example: We also recommend swimming in water that is between 75-80 degrees F. if possible, to prevent getting cold too soon. Water that is too warm (over 85 F as in some arthritis swim program pools) tends to sap energy too quickly. In colder water a wet suit (shortie or farmer John) may be helpful. For scuba diving we recommend full wetsuits. We also recommend cathing prior to getting into the water. Those with indwelling catheters can use a leg bag. We don't recommend, and do not allow those with uncontrolled bowel programs in our pool. (KLD)

06-29-2004, 09:46 AM	#6
kaye Member Join Date: Sep 2003 Location: Seguin, TX, USA Posts: 53	Thank you all (pronounced ya'll) for your input! I am relieved to know that his actual spinal cord injury is not necessarily prone to being re-injured. We have run into a few things to keep an eye on. Isaac wears water shoes in the pool. He scraped his ankles on the steps once. His bowel program is pretty much stable and we haven't had any mishaps there. He is small enough to wear a swimmy (pull up for kids in the pool). Cathing him before swimming has eliminated the need for the swimmy a couple of times. He will stay in the water for hours if I let him. I will monitor his heart rate (it sometimes feels like it is racing when he gets too wild for long) and make him sit for a few minutes. He never complains about being cold though. Again thanks so much for your answers.

07-02-2004, 07:48 AM	#7
kaye Member Join Date: Sep 2003 Location: Seguin, TX, USA Posts: 53	Dr Young, In your previous response you mentioned "healed spinal fracture's" are generally stronger than pre-injury. Are contusions considered spinal fracture's? Isaac didn't have any broken bones or spinal fluid leakage. Thank you.

07-03-2004, 07:41 AM	#8
amanda Senior Member Join Date: Sep 2003 Location: Arkansas, USA Posts: 959	I was curious about the fracture site being more fragile now too. But, it is stronger now? interesting. " The best way to predict the future is to invent it." - Alan Kay

07-03-2004, 09:41 AM	#9
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,301	A contusion would be to the spinal cord, not the spine. In children, it is not uncommon to have traumatic damage to the spinal cord without a fracture due to the increased elasticity and flexibility of the spine in children. I would be more concerned about prevention of extremity fractures in the activities you describe, esp. going down the slide feet first. The fracture site (for those with spinal fractures) is usually stronger after healing. Unfortunately in some this can make the areas above and below the actual fracture site more mobile and easier to fracture in another accident. I have seen this a few times. (KLD)

07-03-2004, 01:47 PM	#10
crags Senior Member Join Date: May 2002 Posts: 1,021	i think it very unwise to be in any situation where you can't control the forces on the body or your body position. it is truly not worth the risk involved for such a fleeting moment of satisfaction. after sci you must consider the consequences of activities as relates to potential serious healing problems. if sci should teach (some) us anything, it's to consider consequences of actions more than pre sci