Not being a quadriplegic, I can’t honestly say, but I would assume the worst part of a spinal cord injury would be the lack of bowel and bladder control.

I feel that if these two functions could be returned to those with a SCI, their quality of life would increase dramatically.

Without going into too many details, for Tom’s privacy, I will say that these two functions basically control his life.

Lets touch on bladder issues today. (Not that we’ve had any major bladder issues recently, mind you.)

We’ve been through multiple catheter issues, some that actually involve having to make a trip to the ER.  I don’t blame those in the medical community for thinking that we’re crazy when we call an ambulance if Tom’s catheter isn’t working correctly.  Very few people realize that, although the catheter issue itself isn’t life threatening, the reactions that Tom’s body has to the catheter not functioning could be very harmful.

Autonomic Dysreflexia, or AD, is something that most quadriplegics hope they never encounter.  The quick and simple analogy I use to explain AD is something like this:

Ya know when ya stub your toe, and it hurts?  When stubbing your toe, a signal goes up your leg, through the spinal cord, to your brain.  Your brain says, ‘way to go, slick, and cuz you’re stupid enough to stub your toe, I’m gunna send this signal back down there to make you realize you’re an idiot’.  When the signal goes back down to your toe, it quickly stops off at the heart and tells it to pump harder to get blood down to the stubbed toe – cuz as far as it knows, the toe has been cut off and it needs to heal pronto.  The signal finishes its trip down to the toe and you holler out in pain.  The blood makes it down to the toe, realizes it doesn’t really need to get there so quickly, and slows back down to normal.

Tom’s spinal cord is damaged, remember?  So, if Tom stubs his toe, the message makes it to his brain, but the message is in German and Tom’s brain doesn’t understand German.  Tom’s brain kinda freaks out.  It knows from the urgency of the German speak that there is a problem, but the brain isn’t quite sure where its at… or how bad it is.  So, the brain sends out messages to several areas below Tom’s injury level, hoping that it finds the spot that the German toe was trying to address.  The signal stops at the heart also, and tells the heart to get beating cuz there’s a problem somewhere.  Heart rate goes up.  Blood pressure goes up.  As soon as the signal finally gets to the toe, the brain reacts and slows down the heart again – since the toe isn’t missing or anything. Problem eventually solved.

Now, imagine your full bladder. You know, the one where you dance around until you get to the bathroom? Now, imagine the line to the bathroom is soooo long that you’re just not gunna be able to make it there. But, there is no other option available to relieve yourself. You’re miserable, right? If you hold it in too long, your blood pressure will actually rise because its trying to clue your body in, telling it that there’s a biiiig problem and you need to fix it now.

If Tom’s biiiiig problem doesn’t get fixed promptly, his blood pressure rises too. But, Tom’s blood pressure doesn’t have the same ‘mellow out’ switch that our bodies have – its been damaged from the SCI. Until whatever the situation is that made Tom’s blood pressure rise is resolved, his BP can continue to rise.

It is plausible to have a heart attack or stroke from high blood pressure.

Do you see the crazy issue here?

If Tom’s catheter is messed up so badly that we have to go to the ER, we are going because the situation needs to be resolved as quickly as possible so Tom’s blood pressure doesn’t start shooting through the roof, putting him at risk for a stroke or heart attack. All this could happen just because he couldn’t tinkle… strange, huh?

Tomorrow – we’ll attempt a socially acceptable post regarding bowels…