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WORLD SPINAL CORD INJURY DAY- 05 SEPTEMBER 2024


 

Spinal Cord Injury (SCI) is a tumultuous event in the life of a victim. Being paralyzed from the neck down or waist down is bad as it is. To this is added the problems of managing urine and bowel incontinence, urinary tract infections, chest infections, bedsores, and so many other complications. Medical problems apart, the incapacitated breadwinner is without any income, faces mounting medical bills and is ostracized by society. Spinal Cord Injury is more than a simple paralysis - it is the death knell of even the wealthy, as the family slips into poverty. There is no state security and insurance companies balk at paying bills. 

So what can be done? Broadly there are two issues - Medical and Social.

Lots can be done medically for the victim. There are two components to the injury - a fracture of the spine and an injury to the nerves in the spinal canal. Which of the two is more important? 

It is the Spinal Cord Injury. The fracture is the appendage of the neurological collapse. The spinal cord goes into shock and all functions supplied by the cord are suppressed. When the spinal shock wears off, the returned functions constitute the survivors and the rest are irretrievably lost. 

What are the treatments available? 

Secure the spine at the site of injury and prevent further damage. Carefully transport on a stretcher to the hospital. Careful clinical examination, a search for other life-threatening injuries, and a catheter to drain the bladder are the basic steps. Available facilities, the experience of the surgeon decides if surgery or non-operative care is the way forward. Preventing complications is easier than treating them.  Perhaps the trickiest and complex part is managing the bladder and bowel. 

A change in attitude is the first step, with the change beginning in each of us. A simple way to look at the problem is what if that is me in that wheelchair?

Compassion, empathy and a helping hand can soothe tons of distress.  Children of the victim must not be allowed to drop out of school. This means support not just in school fees, (many schools will waive their tuition fees!), but also things like school uniforms, shoes, sporting events, a nutritious diet (the family of the victim cuts back on food) and so many other proceedings that happen in school. 

Charity apart, a job has to be found for the healthy members of the family, so they are psychologically improved. Nothing is more demeaning than being given charity and handouts. 

Changes need to be made in the home for wheelchair accessibility, self-opening doors, and changes in the washrooms. One could go on.

Patients, understandably, find it hard to accept the sudden, catastrophic, and dramatic transformation in their life. A lot of counseling and support is needed, along with exercises and certain supportive gadgets.

Society and Government have to do their bit in the care of these patients. Dedicated wards, and trained medical personnel are needed. Many medical colleges have dedicated Paraplegic/ SCI Wards. This is because many eminent teachers recognized the need for these facilities and fought to establish them. Many have emerged as centers of excellence. Empathy, skill and facilities in every district can help in integrating the SCI victim back as a productive member of society.

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