Frequently Asked Questions
Frequently Asked Questions
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What is the Urinary Tract?
Who does the urinary system be affected by SCI ?
How does the bladder function ?
How does level of inquiry affect your Bladder Management Programme ?
What is a Bladder Management Programme ?
What is a spinal Cord ?
What happens when you get a Spinal Cord Injury ?
What are the main cause of a SCI ?
What do the terms paraplegic and tetraplegic and mean ?
When would be the doctor able to give me prognosis ?
My limbs jerk and and moves sometimes does this means I would soon walk ?
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What is the Urinary Tract ?
Urinary tract refers to the system that is concerned with formation storage and excretion of urine. It consists of two kidneys that lie at the back of upper part of abdomen, one on each side. Urine formed in the kidneys is drained by two hollow tubular structures, called the uterus into the bladder.
Bladder is a hollow muscular bag that lies in the lower part of abdomen. Bladder serves to hold urine till it is full and then contracts to empty itself through another hollow tube called urethra, to the outside. A muscular valve, called the sphincter, located in the urethra, keeps the urethra closed & opens when a person wishes to pass urine.
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Who does the urinary system be affected by SCI ?
Depending upon the type and level of your injury, some functions of the bladder will be affected either temporarily or permanently. Some of the common changes that you may observe are,
Lack of sensation of
bladder fullness and/or
bladder fullness recognized by excessive sweating, flushing, tremors, headache.
Inability to judge urine leakage that occurs without one's knowledge
Inability to control passage of urine
Inability to pass urine at all or fully.
Depending upon neurological status, each person will observe either. One or various combinations of above mentioned symptoms. Neurological recovery takes a long time and this period may vary from few weeks to months to years. Therefore, the final behavior pattern of bladder function will also take time to emerge.
Immediately after SCI, the spinal is in a shock phase. During this phase, there is complete inactivity of the bladder and its muscles are not capable of contraction. Therefore, the bladder will continue to store large volumes of urine, becoming over distended. This state of over distention is detrimental for eventual bladder muscle recovery and imparts over stretching and thinning of its muscle. Over destination is prevented by an indwelling catheter placed in the bladder to keep it empty. This catheter is passed via the urethra and connected to a collection bag. Between 2-4 weeks when the spinal shock begins to wear, the indwelling catheter is removed and you will start doing intermittent catheterisation scheduled every 4-6 hours.
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How does the bladder function ?
Urine is stored in the bladder. As the bladder becomes full this information is passed via your spinal cord centres to your brain. If you wish to empty your bladder, then the bladder muscle contracts to empty the bladder.
Normally the desire can be modified. One can suppress the desire to pass urine until an appropriate time or, place is available. Usually, the bladder empties completely leaving behind insignificant residue. Presence of large volume of urine at the end of voiding happens either because of weak muscles or some obstruction along the outlet.
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How does level of inquiry affect your Bladder Management Programme ?
Generally there are two ways the bladder works after a spinal cord injury.
Spastic or Reflex Bladder means that when your bladder fills with urine , a reflex automatically triggers the bladder to empty. The problem in a reflex bladder is you do not know when the bladder will empty. Reflex or spastic bladder usually occurs when the injury is above the T12 level. The choice of bladder management methods for an individual with a spastic/reflex bladder include intermittent catheterisation, indwelling catheter and condon drainage.
Flaccid or non-reflex bladder means ones reflexes may be sluggish or absent. You may not feet when the bladder is full. It then becomes over distended arid stretched. This can cause the urine to back-up through the ureters to the kidneys. It individuals with injuries below Tl 2/Ll usually have a flaccid bladder. The bladder management system most commonly used is intermittent catheterisation. To avoid problem do not, allow more than 400 cc of urine to fill in your bladder.
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What is a Bladder Management Programme ?
A bladder management programme allows you to plan for bladder emptying in an acceptable manner when it is convenient for you. This helps you to avoid accidents and prevent infections. Your level and type of injury will affect the choice you and your. Doctor make for your bladder programme. Because each person's injury is different, your doctor vvill probably conduct some tests to see how your bladder functions. You also need to consider your hand function. How easy is it for you to do your own bladder programme ? Can you manage alone or will you need help? During your rehabilitation you learn different ways to empty your bladder. The methods most frequently used are intermittent catheterisation; indwelling catheter; and the condon external catheter for male. You may use just one programme or a combination of methods. You will decide the method that works best for you.
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What is a spinal Cord ?
The backbone is the number one support for your body. The bones stacked on top of each other are called vertebrae and the spinal cord runs through them. The bones help pro tect the spinal cord. The vertebral column is made up of 33 bones called vertebrae. Seven vertebrae are in the neck region called Cervical Vertebrae denoted as Cl, C2 --- C7, twelve in the thorax also called thoracic vertebrae and denoted as Tl- T12 or D 1 --D 1 2 and five in the lumbar region, Ll -L5. There are five vertebrae in the sacral region (Sl--S5) and remaining four are fused together as a vestigial organ, to remind us that our ancestors had tails. The spinal cord is a part of your nervous system. It is like a Telephone wire that goes from your brain to to the middle of your back.
It divides into many nerves as it move down, like a wire of a telephone cable and carries message from the brain to the various parts of the body and back.
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What happens when you get a Spinal Cord Injury ?
With a spinal cord injury (SCI) your spinal cord can be hurt ar,iy place from neck to the hips. Just like a telephone wire will stop relaying messages beyond the point it is damaged, in the same way rriessacies from the brain stop passing beyond the injured part.
The area below the injured part of the spinal cord becomes paralysed witti probable loss of sensation and movements. Depending upon the level of injury you could be either a paraplegic or a tetraplegic.
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What are the main cause of a SCI ?
The main cause of a spinal injury in our country is fall from height. May it be from a tree, scaffolding, top of a building, into a well etc.
Fall of weight over you
Road traffic accidents
lnjuries due to violence
Sports injuries
Tuberculosis of the spine
Medical and surgical accidents
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What do the terms paraplegic and tetraplegic and mean ?
If you cannot move your legs but came move your arms like before, your spinal cord is hurt in your back (Tl and below) and you would be termed in medical language as a paraplegic. if you cannot move your legs and arms both then your spinal cord is injured in your neck area (Cl to C8) and you would be termed as a tetraplegic. The closer the injury of the spinal cord to the brain fewer parts and systems of the body work normally.
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Will you be able to move again like you used to?
This would depend entirely on how hurt or damaged the nerves of your spinal cord are. The prognosis differs from patient to patient. Depending upon the extent of injury, some people are able to walk normally, some use calipers to get about and some also would have to use a wheelchair. The progress is extremely slow, therefore, you need to be patient and have a tot of hope. Ask your doctor to give you a clearer picture . in your case.
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When would be the doctor able to give me prognosis?
The doctors,would be able to give you the prognosis only after weeks. It is difficult to be sure of anyything before that as your spine is in a spinal shock. Only after the spinal shock out can a more appropriate judgement be made.
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My limbs jerk and and moves sometimes does this means I would soon walk?
This movemment is called spasms. This is an unexplainable symptom normally seen in the case of incomplete spinal cord injury. This is an involuntary movement so let it not you. It need not mean that you would soon be walking, though it is a good sign.
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