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Neurologic Changes After Injury

"It is devastating and it's a whole new world. Everything is doable, you just have to figure it out." Hear from individuals with SCI and their loves ones how this is a change but that with patience and new strategies, there is no challenge that can't be overcome.

The Living With a Spinal Cord Injury series is made possible by a gift from David and Barbara Loeb.  

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Ed S.: It is devastating, I mean it's a whole new world. You got to figure things out. Everything's doable. It's just a matter of figuring out how to do it.

Ed H.: You have to think your next move every time. You just can't get up and do something.

Bernadette: Because he is frustrated, and he does feel at times, like this is something I used to be able to do. So, if he learns his own way of doing it, then he feels better about himself.

Brad: As soon as I realized the severity of it. I just focused on the stuff I could do. Focused on the music. Figured I could still make beats. Figured out how to do that. Did that. Figured I could still rap and write songs, so I did that. And I'll just continue trying to do whatever I still did. Did art.

Tyra: Learning how to be social again. Battling depression, and anxiety, those were big.

Narrator: To understand your spinal cord injury, you need to first learn a bit about how your spinal cord works. The largest nerve in your body the spinal cord carries critical messages for movement feeling and organ function from the brain downward. Messages for feelings like touch pain and temperature travel up your spinal cord and back to your brain. Your spinal cord is protected by vertebrae that surround the cord. This is called your vertebral column or spinal column. The vertebrae are grouped in four sections. Seven in your neck or cervical area. 12 in your chest or thoracic region. five in your lower back or lumbar. And three to five vertebrae that are fused together in the tailbone or sacral coccidia. There are 31 pairs of spinal nerves branching from the left and right sides of the spinal cord. Any traumatic or non-traumatic injury that causes bruising, swelling, pinching, or tearing can prevent messages from traveling along these nerve fibers. If you have a diagnosis of paraplegia, this means you've sustained an injury below the level of your neck or within the thoracic lumbar or sacral region of the spinal cord. Someone who has damage to their neck or cervical spine will be diagnosed as having tetraplegia.

Long: Someone with paraplegia will have some weakness in their trunk. They may lose some feeling in their legs, may also lose some movement in their legs, and this may cause it then they may have problems walking or may have problems sitting upright. Tetraplegia, which in the past has been called, “Quadriplegia” is someone who had an injury to their neck. This injury to the neck causes them to lose strength or sensation in both their arms their trunk and their legs. So, someone with tetraplegia may have trouble sitting up. You may have trouble breathing. You may have trouble moving your arms, legs, in your trunk, and you may lose feeling in those areas too.

Rajnarine: A complete injury describes a patient who has no neurological function at the lowest portion of the spinal cord injury S4 and S5 (Sacral Roots 4 & 5) and also describes no motor or sensory preservation below your neurological level of injury. Complete injury would be classified if we have a rectal exam performed and a patient would not be able to sense that finger or have any type of contraction of the anal sphincter. Clinicians, doctors, therapists, we all use what we call the “International Standards for Neurological Classifications for Spinal Cord Injuries.” This allows us to just communicate with each other, divided into different ASIA Impairment Scales, also known as, “AIS.” AIS A is a complete injury. AIS B is a sensory incomplete. AIS C is a motor incomplete. AIS D is also a motor incomplete injury as well. D vs C would have more strength.

Allison: After my accident, I was told that my diagnosis was a T10 complete AIS A. T10 complete basically means from right about my bellybutton down, I have no feeling or sensation.

Ed S.: So, it was a diving accident. I was playing with my niece’s dog, so I guess I was distracted. I'm an AIS A T3, which means nipple line down. Which means no movement. No sensation.  I don't have very many spasms, I do have tone, full hand functions.

Narrator: Your recovery after a spinal cord injury depends on the severity of your injury, how quickly you receive medical treatment, and your overall health before your injury. Sometimes swelling may decrease and allow nerve fibers to relay messages again or some nerves may regenerate.  Most recovery of nerve function occurs within a year after injury. But no matter how much or how little movement or sensation returns, your rehab team can help you adapt and regain the ability to live your life.

Rajnarine: No, two spinal cord patients are the same. You might have a patient who might have the same neurological level, same ASI impairment scale, but completely different because their experiences are different. How their bowel and bladder react will be different. It's all, everything is patient specific. So, it's kind of hard sometimes to use one approach for every single patient.

Long: After your injury, below the level of your injury, you'll notice some changes. They may occur that involves your motor strengths, so, your muscles. It may change in your sensation. You may have bowel and bladder problems. You may have changes in your sexual function. And another big thing that a lot of people with spinal cord injury have is problems with their temperature regulation, or their body's ability to maintain a stable temperature. So, for example, when it's a cold day and a person with a spinal cord injury goes outside, they may have trouble staying warm, as compared to somebody without a spinal cord injury.

ED S.: If you can learn some patience, that will help a lot. Keep up your strength, keep up your stretching, and keep moving.

ED H.: We had all the kids around and my nieces and nephews and their kids. And like having everybody around makes me even more happier.

Bernadette: After a while it got easier. And now I don't hesitate to call him when I need help and I know it's something he can do.

Brad: I lived in Hawaii for two years and that was only a taste of what I want to do. I really want to go everywhere, and I want to try to food from all over the place. Sort of experience everything.

Narrator: Your rehab team will help you manage your symptoms and it's important that you share all the changes you notice. Listening, learning, asking questions, and following up with your rehabilitation doctor and the rehab team will provide you with the best education and recommendations to assure you recover from a spinal cord injury as fully as possible.

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