hello! i have a few questions about my mother's recent injury!

My mom shattered her L1 a month ago, and we're grateful that she's has made A LOT of recovery within the month. She now has sensory for about 80% of her lower body, and today she was able to walk with a walker for about 50 steps, very slowly. Her bowel is doing pretty well with the help of stool softener.

Bladder...they started intermittent cathing 10 days ago, and this week she can "squeeze" some urine out with her stomach while sitting on a toilet. Is that a good sign? coz she's pushing the urine out using her stomach muscle, so i wasn't sure if that count as a sign for bladder control recovery. especially because sometimes a little bit of urine leaks out during PT. I originally thought that if she has a flaccid bladder, at least she doesn't have wear a diaper, but it seems like that's not the case here. she doesn't really have the "urge to pee" yet, and she can't feel it when she's urinating.



I also want to know, how many hours of PT/OT did you do a day at rehab? I read somewhere that u need at least 3 hours of PT/OT per day.
my mom's getting 1.5~2 hours a day M-F, so should i push her to do more training on her own? (i know the more the better, but sometimes she's just so tired...)
I read in some of your posts that FES is really good, but i dont think they have one...=(


one last question! For her level of injury/recovery, does she still need a pressure relieving matt or mattress?
if she can flip herself, lift herself up in the wheelchair, and move her legs around, then she's not in as much risk for a pressure sore, right?
or maybe just a matt for her butt? that's the area that seems to be under pressure the most right now.

That's it for now, thanks a lot!! =)

Welcome to the site. Sorry about your mother. Your doctor or physiatrist will be best in letting you know what rehab is necessary and for how much time and what mattress lis good for her. She should have a daily exercise routine so she doesn't get bed sores. Keep her moving.
It is good she has some control with her urine. Kegels (exercise) may help in her control.
Good luck and be well

Welcome Breeze, I hope you find what you need here.

Your mother seems to be doing very well so soon after injury and thats a very good sign, as I'm sure you've been told. I can squeeze out some urine myself using what I assume to be a stomach muscle, but its far from reliable. ISC for 10 days isn't a long time, give it another couple of weeks and see if anything has changed by then. Most people will have trouble with urine leakage from PT, it'll stop eventually when the body gets used to it. The docs may also suggest meds to help if the bladder continues to leak.

At the hospital I was in, PT was an hour a day, OT another hour. Once you get stronger they advise you to do a little more, but pushing a wheelchair about is also good exercise. An hour a day of intense PT followed by OT should be okay, although the PT's may recommend something else, best bet is to ask them.

About pressure relief: You'd be better waiting for someone to answer who has experience of a similar injury but when I was in hospital even people who could walk were still required to use some sort of pressure relieving cushion in their wheelchair.

L-1, that is pretty low--I imagine herrecovery will go quite well, sounds like she is getting basics which is a real gift--if and when she does use her chair just make sure she does her pressure releases but like theothers have stated be sure to get the regimen ferom her P.T./O.T. or M.D

thanks a lot for all the advices!
I will ask her doc about pressure relieving cushion. They can be kind of pricy, and I'm not sure if she'll still need it later since it seems like she'll recover a lot more in the upcoming months. There aren't that many SCIs in the hospital (mostly stroke patients), so we haven't been able to talk to people with similar experiences.

so urine leakage is NOT a good thing then. i was hoping that being able to release any urine at all would be good. :/
but it's only been a month, so we'll just be patient and keep our fingers crossed!

First, every SCI is different, so don't take what I'm about to say as the norm (according to my wife, nothing I do is normal). I was able to void on my own for the first couple months, then I lost that ability. However, I know there are others here with similar injuries who have regained full function. I had several accidents during that time as well. Once I got my meds straightened out I was able to ditch the diapers.


Fatigue is normal and gets better with time. I wouldn't push her unless she just gives up completely. If she's working at it, just encourage her to keep up the good work. You have to keep in mind that she needs emotional support more than anything.

The reason we are prone to pressure sores is because the muscles in our butts and legs have atrophied so the bones are now pressing on the inside of the skin. Judging from the location of her injury, I'd say that she should be fine with just a seat cushion. But I would have this conversation with her PT.

Hi urine leakage is not generally a sign bladder function will return it's normally just stomach muscles extruding urine past the sphincter,i think its best if you have a really tight sphincter with hardly any leakage or the complete opposite,self cath is usually the best way to go for L2 lesions

so pushing urine out with ab doesn't really count huh...


This is kind of scary. I thought that whatever ability she regains now is hers. this is at least true for her leg muscles right? meaning she wont wake up one day and find herself unable to move her legs?

Hey,

everyone is so diffrent with SCI. after nearly 10 years of SCI I crashed into the door frame the other week and felt "something" not pain, not something i reconise but something. Was a hard crash onto unprotected toes lol.

I am T-9 "complete" but, over the years i have managed to most of the time pee with a tap/push technique, so i dont have to cath much any more, and have patches of sensation in my upper lower body(not legs). SCI doc still says complete but i dunno lol. everyone so very diffrent.

i think just see what time brings, she seems to have made alot of progress so far so sounds a good thing.

I am a very very active person, more so than alotof AB's i know, cos i also help my fiencee who has had 4 strokes, and as im the mpost able i do the most stuff, and i truley think that has helped me in more ways than anything, keeping active.

so yea in all, keep your, and her spirits up, keep pushing on, and if you need anything, just shout.


Lliam


p.s, also the chat room can be a great place, lots of great people in there, lots of info support and just general freindship.

Like I said, my experience is not the norm.

The point I'm trying to make is not to have expectations of what she should or should not be doing, or how far along she should be in her rehab. As speedywheelz said, "...just see what time brings." If there's one thing I hate it's having some AB telling me I'm not working hard enough, or I just don't want it enough.

My family and friends were really good about encouraging me, saying things like, "You seem to be getting around better." or "You look like you're feeling better." Half the time I thought they were just saying that, it still made me feel like maybe I was getting somewhere with my rehab even though I didn't see any improvement myself.

Hi Breeze i am no doctor so i don't want you to take my post as gospel,heck even docs get it wrong! it is still very early days so who knows what she might regain,i am pretty sure the leg muscles will stay the same and most likely improve with time and physio,honstly don't worry on that score

From everything I've read being able to walk AND squeeze urine! Fantastic.
"my mom's getting 1.5~2 hours a day M-F, so should i push her to do more training on her own? (i know the more the better, but sometimes she's just so tired...)" Yeah right now work her as hard as possible.

"if she can flip herself, lift herself up in the wheelchair, and move her legs around, then she's not in as much risk for a pressure sore, right?" Yeah but she HAS to do all those things.

Lastly as far as FES is concerned it should be available somewhere around. Best of Luck and congrats on everything!

Hey there, I'm L4/L5 cauda equina syndrome that I let go for far too long before seeking out the help of the emergency room. I'm 10 months post, and this is what I've learned so far:

-Unless you're on a lot of meds that constipate you, try to slowly wean yourself off the stool softener, and more towards fiberous foods, timed bowel evac, et cetera. I have the stool softeners and so forth if I get plugged up, or if I change/start meds, but I prefer trying to stick with the healthy diet, because I just plain feel better!

-The fact she's going on the walker one month afterward means awesome progress! Keep encouraging her (gently) that she's doing awesome.

-What I do when I toilet (I can sometimes feel 'something', most often not) is sit on the potty at determined times in the day, and try to go - turn on the faucet slightly, and think about rushing waterfalls and the 'relief' you felt before the injury. If it doesn't work after a few minutes, then go for the intermittent cath. I don't dare push in on my stomach, for fear of hurting my kidneys. I have an issue that my bladder won't release properly - I still leak, but I generally don't empty all the way. Also, maxi-pads work great if you're a leaker. I've gotten away from diapers for the most part, but I still wear maxi-pads for little accidents. Again, once you train your body, this get so much easier.

-I stopped doing PT/OT about 60 days after I left rehab, due to evil insurance reasons. However - we knew this in advance, so we prepared by me learning how to administer my own PT. For instance - I'll spend about 20 minutes in the morning doing my adapted ballet stretches. In the afternoon (or evening, if it's warm), I'll do my own PT. One example is getting an old pizza pan and put it under my foot, loop a jump rope around the arch. I will pull my leg flat along the bed, so it's as perpendicular to my core as possible, and then try to pull the leg back down. It doesn't ever go far, but the pizza pan helps my leg slide along the bed. Ask for fliers of exercises she can do, and get creative when doing them. Also, it doesn't hurt to have cute clothes, good music, or tasty water to make it more enticing to do it. I will do PT for about an hour or so per day. As for OT, I stopped that shortly out of rehab, because I looked at is as using my house will force me to become more independent. Do request that an OT person come by her house shortly before she's released to give ideas on adapting, moving around the house, etc.

-As for the mattress, I have an exceptionally firm mattress that I put a memory foam topper on top of. Again, check with an OT to confirm that this is necessary.

-From my understanding, lower level injuries have their own set of issues - one may be pain. Try to make sure that this is controlled as well as possible throughout her recovery; depression and apathy can set in much quicker with pain as a constant.

I was the only person in the hospital with an SCI-ish injury, (as is the case with CES) where this particular hospital specialized in stroke care. While she's in the hospital/rehab, have her converse with the stroke folks as well - I really gathered strength from these folks, and it really helped keep things in perspective for me. Try to see if there is an SCI support group of some sort in her area, or have her come online and check us out! Just being able to read experiences has really helped me out, along with finding the few folks that have the same/similar injury as I do. Also, know that my advice is my own - not from the doctor. There is so much she'll find out.

When I have a particularly crappy day, I just sing the Dori song from Finding Nemo - "Just keep swimming, just keep swimming!"