Tag Archives: Spinal cord injury

SCI Health Series: SCI & Your Bladder

If you ask anyone who’s paralyzed what’s the number one thing that drives them crazy about their injury, most would say their bladder. The bladder is a muscle and when you become paralyzed, this too is affected. And it’s not easy to figure this out at first. However with practice, and trial and error, finding a happy place where you can manage your bladder and live a healthy life can be done.

The level of your injury of course has a lot of sway over what kind of cath products, and the method you end up choosing. Below we’ve outlined the most important bladder tips to know for both quadriplegics and paraplegics. Feel free to add yours in the comments below.

Quadriplegic Bladder Care

There are a lot of catheterization options for quadriplegics since their independence level can vary. For quadriplegics without arm movement, they will use an indwelling catheter – either a Foley catheter (inserted into the urethra and kept in place with an inflated saline-filled balloon) or a Super Pubic catheter (a surgically-created hole in the lower abdomen that goes to the bladder, specifically made for catheter placement), that is attached to a leg bag. Combined with an automatic leg bag opener, many high-level quads can be completely independent with their bladders by pairing these two things.

Having an indwelling catheter however lends itself to longterm bladder issues, such as an increased occurrence of UTIs and it’s also been reported to cause bladder cancer after long-term use. The main thing to remember however is that no matter the kind of catheterization method you use, drink plenty of water (up to 8 cups a day). The more water you drink, the more you will flush out your bladder.

When it comes to catheter options for quadriplegics with some arm movement, many opt to get a surgery that puts a hole into their bladder that can be accessed via their bellybutton. This is called the Mitroffanoff procedure and it allows quadriplegics to no longer use a leg bag and be free of indwelling catheters (for those who cannot undress and cath themselves the “normal” way).

Paraplegic Bladder Care

For paraplegics, male or female, most end up using a straight catheter to empty their bladder by inserting it directly into their urethra. This is an easy and no-fuss (no surgery required) option, and with minimal supplies needed.

Straight cathing, even for a female paraplegic, can be done quite easily. Many women will transfer out of their wheelchairs and onto a toilet to do it in public, but many will opt to wait to do it at home. Male paras, and many lower level male quads, straight cath themselves directly in their chairs.

Tips for All

– Flushing the bladder keeps it clear of sentiment and bad bacteria. Many will irrigate their bladder with saline on a daily basis to help completely flush it out. Saline (make sure to get a generous prescription) and a 60 cc syringe is all you’ll need to flush most catheters.

– Avoid soda and alcohol. Both of these can wreak havoc on your bladder

– Healthy eating promotes good bladder health.

– Get a Cytology test of your bladder each year to stay on top of bladder cancer (this tests the sediment?

What bladder care tips do you swear by?

Learn more

Reeve Foundation Bladder Info

Bladder Management, United Spinal Association

Bladder Management Options Following Spinal Cord Injury, SCI Model System

Pressure Sore Prevention Videos

Bladder Management After a Spinal Cord Injury

Spinal Cord Injury ~ Are Your Bladder And Bowels Paralyzed?

Bowl and bladder management

Photo courtesy of Steven Jacobo

SCI Health Series: Bone Health

After a spinal cord injury, a lot of health concerns must be looked at, but the bones are often overlooked, and this is not good since a fracture can take months to heal, putting your life on hold.

One of the biggest things to remember is that you are at a higher risk of bone loss after a SCI. Doctors still aren’t exactly sure why this is, but it most likely has to do with spinal cord dysfunction. And with bone loss comes Osteopenia, or its more severe “sibling,” Osteoporosis. We all know that this perky condition can lead to a higher risk of fractures.

Doctors do know one thing however – over 80% of people with chronic spinal cord injuries have Osteopenia, and it has been proven to begin as early as eight weeks post injury. There are however interventions you can utilize to prevent this. One of the easiest is nutrition. Increasing Vitamin D and iron in your food (greens, liver, red meat) can help your body absorb more sunlight, which helps increase bone strength.

Weight-bearing exercises are another great way to prevent bone loss, but thus can be tricky with a SCI. If you’re able to use a standing frame, this is a super easy way to do weight bearing. Otherwise, a new method is a vibration machine. Standing exercises, if you’re able to stand with an assistant, is another great way to get weight bearing into your life. E-stim can help prevent bone loss as well.

When bone loss occurs, people with spinal cord injuries tend to get fractures in their hips and legs. Unfortunately, these fractures that take the longest to heal because they’re in some of the biggest bones in the body. You can also take calcium supplements to strengthen these bones, but no more than 1000 mg a day. Some people with spinal cord injuries are also at a higher risk of having too little calcium in their blood, which also known as Hypocalcemia. Doctors will prescribe Phosomax for this condition.

To monitor bone loss, it’s recommended that people with spinal cord injuries have a Dexa scan each year, which shows the bone density of all the bones in the body. Additionally, doctors will also prescribe Vitamin D to prevent both Osteopenia and Hypocalcemia.

One last condition that people spinal cord injuries must be aware of is Heterotopic Ossification. This is a where the body will suddenly create a bony mass in soft tissue in the body, typically in the joints. It’s not life threatening, but it can greatly decrease range of motion and be painful. Surgery can sometimes remove HO and they’ll also prescribe radiation to stop it in severe cases. In most cases however, people leave the mass alone.

Remember, above all else you can win the battle against bone loss after a post-injury. The secret is staying on top of your bone health through doctor visits, eating right and getting plenty of Vitamin D.

What bone health regimen do you follow?

Learn more

Osteoporosis and Spinal Cord Injury

Bone Loss and Muscle Atrophy in Spinal Cord Injury

Paralysis & bone health

Bone-Health Videos

Bone Health following SCI

Osteoporosis and Fractures in Persons with SCI: What, Why, and How to Manage

Causes of Osteoporosis and Bone Fractures After Spinal Cord Injury

Photo courtesy of Flickr