There are approximately 220,000 people with spinal cord injury in the United States and about 10,000 new injuries each year. This straightforward book is designed to help them―and their family members and friends―during the rehabilitation process and the journey that follows. Written by three professionals in rehabilitation medicine and psychology, Spinal Cord Injury is an easy to understand, comprehensive resource for everyone with SCI, containing essential information for people who are newly injured and for those who have longer experience in coping with injury.
The book thoroughly reviews the challenges that may be encountered by people with spinal cord injury throughout their lives, addressing all aspects of spinal cord injury, from psychological, sexual, and social matters to transportation, housing, and employment. The authors explain how spinal cord injury affects physical functioning and how those changes may lead to lowered self-esteem, depression, family conflicts, and social isolation―all problems that can derail the adaptation process. But they remind readers that, as with any major life crisis, spinal cord injury can be a catalyst for positive change. A spinal cord injury challenges a person to find creative channels for self-expression, personal strength, and new ways of being in the world. One of the book's most important messages is that a meaningful life is possible after spinal cord injury and that psychosocial adjustment is not necessarily linked to one's degree of physical function or disability.
Illustrating each chapter with patient histories―ranging from relatively mild to moderate to severe disability―the authors begin by demystifying what takes place during emergency treatment and hospitalization and explaining the consequences of different kinds of spinal cord injury. Later chapters describe rehabilitation, returning home, and learning to live independently. Chapters include: Part I―Trauma, Hospitalization, and RehabilitationChapter 1: Into the Wilderness: Trauma and HospitalizationChapter 2: Lost and Searching: RehabilitationChapter 3: Reading the Map: AdjustmentPart II―The Challenge of ReadjustmentChapter 4: Going Home: Old Territory in a New LightChapter 5: Focus on the FamilyChapter 6: Lovers' Lane: Dating, Coupling, and SexualityChapter 7: Life Goes On: Independent LivingPart III―Successful Living with Spinal Cord InjuryChapter 8: The Next Frontier: Spinal Cord Injury ResearchChapter 9: The Journey ContinuesChapter 10: Concluding Thoughts
Life after spinal cord injury is a progression through medical recovery, emotional adjustment, social integration, and fulfillment of personal goals. People with SCI must find the courage and persistence to redefine personal and professional relationships as well as their own relationship with a changed self. Spinal Cord Injury: A Guide for Living is a much needed resource that will help people with spinal cord injury overcome obstacles in managing the challenges of their new lives.
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About the Authors: Sara Palmer, Ph.D., is a psychologist and an assistant professor in the Department of Physical Medicine and Rehabilitation, the Johns Hopkins University School of Medicine. Kay Harris Kriegsman, Ph.D., is a psychologist in private practice in Bethesda, Maryland, author of Taking Charge: Teenagers Talk about Life and Physical Disabilities, and a consultant on disability issues. Jeffrey B. Palmer, M.D., is a professor in and director of the Department of Physical Medicine and Rehabilitation, the Johns Hopkins University School of Medicine.
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When one member of a family has a spinal cord injury, it has an impact on the life of the whole family. When a parent is injured it means that the uninjured parent, besides dealing with his or her emotional reactions, is loaded with many more responsibilities, especially during the initial hospitalization, and then during rehabilitation. So practically, the family may need to trade roles for awhile or manage basic needs differently, such as, meal preparation or house cleaning. If a child or adolescent is injured, parents may feel overwhelmed but still need to reassure and attend to their other children. Families who can share the trauma story, discuss its effects on the family, reveal their feelings, and talk about what the future may hold, seem to become even stronger, and more cohesive.
2. I know a family where a teenager with a spinal cord injury is treated like the prince of the family. He doesn't have to do household chores like the other kids. Do you think that's fair?
Sometimes families, out of a sense of guilt or sadness, put the person with the spinal cord injury on a pedestal. Family members may feel that they cannot ask for their needs to be met when their "poor" sibling or child has had to suffer. But all members of the family deserve their time in the sunlight, and it's important to ensure that everyone's needs are addressed. Also, it's not helpful for the person with spinal cord injury to avoid chores or other family responsibilities. It's better physically and psychologically to continue activities and responsibilities the teenager had before injury, to whatever extent possible. Some families have been known to assign the task of "keeping the family happy" to the teenager. This is an impossible task, as every individual is responsible for his or her own feelings.
3. What did you learn about how people get on with their lives after spinal cord injury? How do they manage to live independently?
We found that each person had his or her own puzzle to put together. Sometimes it took replacing or eliminating a piece to make life work in a satisfying, rewarding way. The various pieces included accessible housing, transportation, recreation, socialization, travel, and all the other elements they wanted in their lives. Some found this a difficult process with lots of trial and error. However, once they knew how to get what they needed, they went about their lives in normal ways--working, raising kids, going to the movies, maybe playing wheelchair basketball or tennis, flying out to see the Grand Canyon. Aside from their physical and sometimes medical needs, our interviewees' lives and aspirations were almost indistinguishable from their neighbors'.
4. Can a person with a spinal cord injury engage in sex and have children?
Yes! Interest in sex and romance continues after injury. A satisfying sex life is possible, but may require some modifications. Physical sensations during sex might be different, and you may need to try different positions due to changes in strength or mobility. A loving, accepting relationship and the ability to communicate and experiment with your partner are the most important ingredients for a good sex life. Men with spinal cord injury sometimes have reduced fertility, but there are medical procedures that can enable men to father biological children. Women remain fertile after spinal cord injury but may need special care during pregnancy and delivery due to increased risk of various medical problems.
5. I've heard a lot about wheelchair basketball. Are there other sports and recreation for people after spinal cord injury?
There are many opportunities to participate in sports and recreation after a spinal cord injury. Some include wheelchair tennis, racing, rugby ("murderball"), dancing, skiing, horseback riding, weightlifting, and sailing. Traveling, camping, fishing, and hunting are also possible. The way in which you participate in these activities will vary depending on the extent of your injury. But even people with severe spinal cord injuries can participate in many recreational activities with assistance. There are organizations that provide sport and recreation activities specifically for people with disabilities, and these include accessible facilities, adaptive equipment, and assistance as necessary.
6. There are a lot of news stories about research to help repair the spinal cord. What are the most exciting current developments?
Many scientists are working on ways to regrow and reconnect nerve cells in the spinal cord, including stem cell transplants, use of nerve growth promoters, and even intense physical exercise regimens which may help "reprogram" activities such as walking. Some are researching medications which can decrease the nerve damage that occurs immediately after injury. There are exciting advances in the use of functional electrical stimulation (FES) to improve health and fitness and prevent medical complications in people with spinal cord injury. Finally, research on assistive technology, such as improved wheelchairs, braces, and computer interfaces, has the potential to improve quality of life for people with spinal cord injury.
Author photos courtesy of James VanRensselaer and Will Kirk, Homewood Photographic Services
An easy to understand, comprehensive resource for everyone with spinal cord injury
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