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Ten frequently asked questions concerning cure of spinal cord injury

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    Originally posted by Wise Young
    A disk herniation is a compression injury of the spinal cord. In my opinion, the spinal cord should be decompressed. There is probably no other part of the body or central nervous system where we would allow compression to continue as it has been for the spinal cord. For example, if something is pressing on the eyeball, a peripheral nerve, the heart, or any organ, the first thing that the doctor does is to decompress.

    Decompression surgery is not very risky. Of course, appropriate care should be taken to ensure that the spinal column is stable and the spinal cord is minimally disturbed during the decompression. And yes, there is some risk, as there is always with any surgery. However, the risk of leaving something compressed is far greater than doing surgery to decompress.

    If you have something that is compressing your spinal cord and it is causing neurological deficit, it should be removed. I have written several articles summarizing the literature on this subject. One of them is linked in a post below.

    If you have something that is compressing your spinal root and it is causing neurological deficit, it should be removed as soon as possible. There is some data suggesting that leaving the spinal root compressed for more than 3 months will significantly reduce the probability of recovery associated with decompression.

    The first criterion is of course the presence of cord compression. It there is no compression, there is no decompression. The question is what is compression. Some people say 10% of the diameter of the cord while others say 25%. The second criterion is presence of neurological deficits. If there is no neurological deficit, then you can afford to wait. However, if there is neurological deficit and you have cord compression, it should be operated relatively soon. Many neurosurgeons and orthopedic surgeon, however, will not decompress just because of pain alone. This is because decompressive surgery often will not eliminate pain. Third, while pain alone is not sufficient to warrant surgery, it should b considered if it is combined with neurological deficits (such as motor and sensory loss).

    If you are incomplete, that is good news because decompression helps people with their neurological deficits much than that it would help somebody with a sefere injury.

    Wise.
    Dear Dr Young,
    Thank you for this info, which already clarifies a lot.
    You mention a post with a link ?
    By the way, just for the sake of clarity, this concerns a friend of mine who has a hernia. This info above, though, is also interesting to me, since my own spinal cord remained compressed for 4 months [the time for me to arrange a second opinion and to convince doctors to go for a second [decompression] surgery ! ].
    Kind regards. Corinne
    www.endparalysis.org!

    Comment


      cure?

      " preparing for the cure"? Am I missing something here? The list Dr. Young just gave me shows no remote signal of a cure. Why hasn't Korea started with their spinal injured patients to therapuetic clone? In reality, they already accomplished the hard part, disproving the truckload of naysayers. After long term SCI doesn't all the tissue become necrotic, rotted, and narrowed? How in the hell can this lifeless tissue become re-activated into the super computer it once was, restoring electricity from the injury level down. This electricity hasn't been successfully restored up to now, and what ever happened to embryonic stem cells internationally?

      Comment


        Originally posted by damagedgoods
        " preparing for the cure"? Am I missing something here? The list Dr. Young just gave me shows no remote signal of a cure. Why hasn't Korea started with their spinal injured patients to therapuetic clone? In reality, they already accomplished the hard part, disproving the truckload of naysayers. After long term SCI doesn't all the tissue become necrotic, rotted, and narrowed? How in the hell can this lifeless tissue become re-activated into the super computer it once was, restoring electricity from the injury level down. This electricity hasn't been successfully restored up to now, and what ever happened to embryonic stem cells internationally?
        Your spinal cord is not lifeless. What level is your injury and do you have spasticity?

        Wise.

        Comment


          Originally posted by Cherrylips
          Dr Young,

          Was wondering if you could comment - I read somewhere that a Cervical injury will be enevitably easier to 'cure' / 'regenerate' than that of the same lesion but at T, L OR S level. Is this simply because of the smaller surface area, for example

          thanks in advance

          Dr young i wonder if you noticed my last post and could comment

          thanks

          Comment


            cervical sci for cure

            The top part of the cervical spinal cord is actually enlarged if I'm not mistaken, similar to the lumbar spinal cord. Pretty much the bottom and the top are the thick parts of the cord, since I assume they access and store information to be sent through the rest of the spinal cord.
            As cure is concerned, I don't think any part of the spinal cord is easier to cure than the other, and a cure, 100% cure, is most likely at least 40+ years away. What we can only hope for are tiny little improvements with quality of life issues in the next several decades. Hey, it's great to be optimistic, but I don't see where everyone is getting this cure idea from.

            Comment


              Originally posted by Cherrylips
              Dr young i wonder if you noticed my last post and could comment

              thanks
              Cherrylips,

              While what you say does seem to be true, i.e. there are more severe or "complete" injuries in the thoracic and lumbar cord, I don't think that the problem is in the thickness of the spinal cord but rather the forces that are necessary to injure the spinal cord. The neck is the most vulnerable part of the spinal cord and less acceleration (force) is necessary to damage it than the other parts of the cord. The thoracic spinal cord is very well protected by the ribs and the chest. The lumbar cord is also very well cushioned by the abdomen. It therefore takes a lot of force to damage the thoracic spinal cord and most injuries of the thoracic and lumbar cord involve high-speed injuries that subject the the spinal cord high accelerations. Probably over 70% of cervical spinal cord injuries are "incomplete" while most thoracic and lumbar injuries are "complete". That may be why it seems that many people with cervical spinal cord injuries recover more.

              Wise.

              Comment


                Originally posted by damagedgoods
                The top part of the cervical spinal cord is actually enlarged if I'm not mistaken, similar to the lumbar spinal cord. Pretty much the bottom and the top are the thick parts of the cord, since I assume they access and store information to be sent through the rest of the spinal cord.
                As cure is concerned, I don't think any part of the spinal cord is easier to cure than the other, and a cure, 100% cure, is most likely at least 40+ years away. What we can only hope for are tiny little improvements with quality of life issues in the next several decades. Hey, it's great to be optimistic, but I don't see where everyone is getting this cure idea from.
                Damaged, you may be right that no part of the spinal cord is easier to "cure". But I suspect that we are thinking of different reasons. You seem to think that the whole spinal cord has been damaged whereas I look at spinal cord injury as interrupting the connections between the brain and the spinal cord below the injury site. I don't know how to explain it in words and thus decided to draw a picture.

                In the picture below, sensory systems are in blue and motor is in red. If you had cervical spinal cord injury, it interrupts both motor and sensory connections in the neck. If you had thoracic spinal cord injury, it interrupts the motor and sensory connections in the thoracic spinal cord. The part of the axons (nerve fibers) that are disconnected by the injury will die. Regeneration means to regrow the nerve fibers. However, the targets of the motor axons or motoneurons should remain alive. Likewise, the targets of the sensory axons remain alive. Likewise, the neurons from which the motor and sensory fibers come from are also alive. So, the goal of regeneration is to regrow the axons from the injury site to their original targets. Many studies have shown that regeneration can occur in animals, that the obstacles to regeneration are threefold:
                1. The injury site itself is bereft of signals and cues for axonal growth. To solve that problem, we need to put cells that are attractive to axons at the injury site.
                2. Regeneration is very slow and the axons have to grow for many months. Therefore, we need to have a source of growth factors to stimulate the regeneration for long periods.
                3. The spinal cord contain several factors that seem to block regeneration. These include a protein called Nogo located on myelin (the membrane that normally wraps around and insulates axons) and an extracellular matrix protein called chondroitin-6-sulfate proteoglycan (CSPG). Nogo can be blocked, the nogo receptors on axons can be blocked, and CSPG can be degraded by an enzyme called chondroitinase.

                That is why there is hope that combination therapy with a cell transplant that is secreting growth factors, combined with Nogo blockers or chondroitinase will be effective in stimulating regeneration in the spinal cord. Animal studies suggest that these combination therapies will stimulate regeneration that restores function to animals. Nogo blockers are starting clinical trials. Many cell transplants are being tried. Many stem cells and olfactory ensheathing glia secrete growth factors. Finally, chondroitinase has been shown to stimulate regeneration in rat spinal cords.

                Wise.

                Comment


                  ok..what about this-

                  What if a spinal cord injury was located on the tip of the Conus medullris, where there was no more of the cord beneath the injury, just the cauda equina. Am I correct in assuming that sensation could possibly be restored by trhese therapies, but motor could not? The brain tells this person to walk forward, but the messages are stopped in their tracks at the Conus injury, and their is no spinal cord left beneath, since it terminates, to make reconnections with cellular therapies. Am I making any sense here?
                  how does the spinal cord surface at the injury site differ between let's say a laceration injury due to a vertebra slashing the cord, but not compressing it for a long period of time, due to the obviousness of the cause of injury and the doctors removing the verterbra, as opposed to a injury due to long periods of compression, with interupption of blood flow, from something like a vascular spinal cord malformation, AVM, not putting pressure on the nerve roots, but actually a intermedullary AVM, located right on the spinal cord's surface?

                  Comment


                    dear dr young,
                    i'm a c-6 complete, 9 months post. i'm curious about how one would go about getting the special treatments, theprocedures to help prevent secondary conditions, such as [osteopouritis, cysts, more muscle wasting ect.
                    and the special equipment, like pools, standing frames, ect. if your pt/ot/place doesnt have them. and how could i use them everyday if i don't own them?

                    do you have to be independently wealthy or
                    have super ins. not just medicare and medicade?

                    i live in a small town 40 miles s. east of pgh.PAthere is ONE SCI DR in the pittsburgh area who accept my ins., i have lost faith and trust in him.
                    my next appt. is monday.
                    if you could please answer my 1st questions andd i'll give you a list of my symtems. please give me some idea how to talk to him, i would be ever grateful.

                    ihave terrible neurological pain from my chest down it feels as though someone is burning my flesh with a blow torch while simutaniously cutting it up with razors.
                    i always have excruciating pain in butt and back i'm assuming because i'm always on them.

                    thank you i advance for your speddy reply,
                    loori
                    sigpicPlease Visit My Blog at: http://queenquad.blogspot.com

                    But those who wait on the Lord
                    Shall renew their strength;
                    They shall mount up with wings like eagles,
                    They shall run and not be weary,
                    They shall walk and not faint
                    Isaiah 40:31

                    Comment


                      Originally posted by damagedgoods
                      What if a spinal cord injury was located on the tip of the Conus medullris, where there was no more of the cord beneath the injury, just the cauda equina. Am I correct in assuming that sensation could possibly be restored by trhese therapies, but motor could not? The brain tells this person to walk forward, but the messages are stopped in their tracks at the Conus injury, and their is no spinal cord left beneath, since it terminates, to make reconnections with cellular therapies. Am I making any sense here?
                      how does the spinal cord surface at the injury site differ between let's say a laceration injury due to a vertebra slashing the cord, but not compressing it for a long period of time, due to the obviousness of the cause of injury and the doctors removing the verterbra, as opposed to a injury due to long periods of compression, with interupption of blood flow, from something like a vascular spinal cord malformation, AVM, not putting pressure on the nerve roots, but actually a intermedullary AVM, located right on the spinal cord's surface?
                      Damaged,

                      A conus injury damages the lowest segments of the spinal cord, typically the sacral segments. Depending on the extent of damage, it may involve the lower legs, bladder, sexual function, and anal sphincter. Because the damage often includes the neurons that innervate these structures, neuronal replacement may be necessary.

                      At the present, there are only two therapeutic approaches to replace neurons in the spinal cord. One is embryonic stem cells that have been predifferentiated to produce neurons can replace neurons, and then combined with treatment with cAMP or phosphodiesterase 4 inhibitors. The other is with fetal neural stem cells obtained from aborted fetuses. While there have been some reports that bone marrow stem cells can produce neurons in culture, no credible study has yet shown that transplanted bone marrow stem cells can produce neurons when transplanted into the spinal cord. I don't know how long it will take for the solution to be available but many laboratories are working on this problem. It is the central problem in many conditions where there has been loss of motoneurons. These include polio and other viral diseases that damage motoneurons and degenerative motoneuronal diseases such as amyotrophic lateral sclerosis.

                      Laceration occurs when a sharp edge has cut into the spinal cord. This is rare. Compression is more common from bony compression of the spinal cord or disc compression of the spinal cord. Most surgeons will aggressively decompress a traumatically compressed spinal cord within several hours if it is possible to do so without surgery. However, for people who require surgery for decompression, the decompression may be delayed for 24 hours or longer. Compression of the spinal cord for prolonged periods is obviously not good for the spinal cord. Ischemia contributes to the damage, particularly gray matter (or the cells in the spinal cord), but some axons may survive the ischemia, leaving some residue sensation.

                      You are talking about a lot of different conditions. As you know, an AVM is an arteriovenous malformation that may be either on the surface of the cord or inside the cord (intramedullary). An AVM typically causes the veins on the surface of the cord to enlarge. This is because the AVM feeds arterial pressure directly into the veins. Enlargement of the veins may compress the cord. But, more frequently, the damage to the spinal cord occurs when the AVM leaks blood or ruptures. When this happens and blood gets into the spinal cord, the blood may compress the cord and damage the spinal cord directly.

                      Are these the answers that you are looking for? I am trying to guess what you want to know.

                      Wise.

                      Comment


                        Loori,

                        I am not sure how to answer your questions because this is what rehabilitation was supposed to do and teach you. Let me comment on a few things first and then try to answer your question concerning each of the secondary conditions. At 9 months after injury, you may have some more recovery in front of you. Where was your original injury level? How much have you recovered? Do you have any triceps (C7)? How much wrist function (C6) do you have?

                        • Osteoporosis. Bone loss occurs relatively quickly (within 6 months) after spinal cord injury. Although many people believe that standing an hour a day may prevent bone loss, several studies have suggested that standing alone do not reverse bone loss. However, most of these studies have involved only standing for 3 times a week for about an hour a day. On the other hand, I understand the combination of standing and functional electrical stimulation (FES) activation of the legs will restore bone to some extent in the legs. This was what Christopher Reeve did. He stood at least an hour a day and also used FES to stimulate his legs to bicycle, and this not only increased the size of his muscles in his legs but also increased his bone density.

                        • Cysts. I assume that you are talking about spinal cord cysts, something called syringomyelic cysts. These occur if there has been scarring between the spinal cord and the surrounding membranes, obstructing cerebrospinal fluid flow down the spinal cord. If a cyst occurs, removal of the scar tissues between the spinal cord and surrounding membranes, and possibly shunting the cyst, may eliminate it. I would not worry about this until it occurs. Cysts can be detected with MRI's. I recommend that people get an MRI at least every two years after spinal cord injury.

                        • Muscle atrophy. Probably the best way to prevent atrophy is to not get rid of spasticity altogether. In your case, with a C6 injury, you should have spasticity in your legs. You are probably taking a drug called baclofen to reduce spasticity in the legs. I would titrate the dose of baclofen so that you still have muscle tone but of course not so much that you have difficulty transferring, sitting, etc. But, the goal should be to reduce the amount of baclofen that you take so that your muscles have some activity. I have always joked that spasticity is free muscle exercise.

                        • Standing frames. I believe that everybody should have a standing frame if they cannot stand up on their own. There is a device called a Easyglider 6000 which costs about $6000. This allows you to stand and also do some stepping motions.

                        • Pool. I believe that swimming is a good form of exercise for people with spinal cord injury. Because the water supports your weight, you can stand in the water if you put some weights with velcro straps around your ankles. You can go to shallower water to support more weight. It will also allow you to use your arms for exercise.

                        • Pain. I am really sorry to hear that you have the burning pain in your chest and butt. This sounds like neuropathic pain. I am concerned that your doctor has not talked to you about them and what is causing them. You know what spasticity is... it is increased activity of the muscles below the injury site, resulting from the disconnection of your brain to the spinal cord below the injury site. Neuropathic pain is the flip side of the coin to spasticity. Instead of having increased muscle activity, you are feeling pain. The pain is probably coming from your spinal cord. There are several treatments that may reduce the pain but there is not adequate solution to neuropathic pain right now. You need to see a doctor who is experienced with neuropathic pain, who can try different medications to help reduce the pain. The following may help, in the following order:
                        1. Amitryptaline (Elavil) 20 mg/day. This is a drug that is sometimes given for depression but the dose of 20 mg/day is lower than that usually used for depression. Several studies have reported that this may take the edge of the neuropathic pain, particularly the burning type that you describe. However, it does not usually eliminate the pain.
                        2. Gabapentin (Neurontin). This is an anti-epileptic drug that was discovered several years ago to reduce neuropathic pain. Unfortunately, the effect wears off as you take the drug and people have to take higher and higher doses. So, typically, you may start out with 100 mg four times a day (a total of 400 mg/day) and keep going up to 1200 mg/day, 2400 mg/day, and even as high as 4800 mg/day.
                        3. Tizanidine (Zanaflex). This is an alpha adrenergic agonist that is sometimes used for spasticity but may help reduce neuropathic pain in some patients. Usually it is not that effective if taken alone but it may work in combination with some of the above treatments.
                        4. Dextromethorphan. This is the stuff that is in cough syrup for kids. I know that there is a clinical trial going on at Harvard where they are assessing the effects of gabapentin and dextromthrophan. I think that it is helping some people more than either drug alone.
                        5. From this point on, the number of drugs and treatments become fewer and less effective. For some people, ketamine or morphine may help. There is a powerful opioid drug called fentanyl that can be given via a skin patch (called Duragesic). I have heard that spinal cord stimulation may help. Acupuncture helps some people. You should go to the Pain forum here and read what people are doing. As you can see, for some people, nothing really works.

                        I am not an expert on reimbursement but many of the above treatments should be covered by Medicare/Medicaid or other insurance. It often takes a lot of work and much depends on the program in your state. I don't know the situation in Pennsylvania but you should contact others with spinal cord injury in the area and see how they go about getting coverage for the treatments.

                        I hope that this is helpful. I am sure that many other people may have other advice or disagree with some of my recommendations.

                        Wise.




                        Originally posted by weepinglamb
                        dear dr young,
                        i'm a c-6 complete, 9 months post. i'm curious about how one would go about getting the special treatments, theprocedures to help prevent secondary conditions, such as [osteopouritis, cysts, more muscle wasting ect.
                        and the special equipment, like pools, standing frames, ect. if your pt/ot/place doesnt have them. and how could i use them everyday if i don't own them?

                        do you have to be independently wealthy or
                        have super ins. not just medicare and medicade?

                        i live in a small town 40 miles s. east of pgh.PAthere is ONE SCI DR in the pittsburgh area who accept my ins., i have lost faith and trust in him.
                        my next appt. is monday.
                        if you could please answer my 1st questions andd i'll give you a list of my symtems. please give me some idea how to talk to him, i would be ever grateful.

                        ihave terrible neurological pain from my chest down it feels as though someone is burning my flesh with a blow torch while simutaniously cutting it up with razors.
                        i always have excruciating pain in butt and back i'm assuming because i'm always on them.

                        thank you i advance for your speddy reply,
                        loori

                        Comment


                          neuron damage

                          Do neurons play a big part of, let's say, when a man is sexually aroused due to direct contact with his penis? Are more scientists focused on treating higher, more manageble injuries than low, sacral insults? I mean, why would scientists bother with sacral SCI, when as of now, they are too complicated to address, and emphasis is still focused on treating Cervical injuries? I'd imagine that a spinal AVM inside the cord would cause the most considerable damage, since it's virtually inside the gray matter, causing it to infarct. How would one fix a spinal cord, when looking at a cross section of the cord, the butterfly shape of the gray matter is obliterated on one side, virtually gone? This type of injjury just seems faaar too complicated and time consuming to address in this lifetime. Am I right?

                          Comment


                            Dr Young and damagedgoods - just wanted you to know that I'm reading your posts with interest. As always, I'm learning something about lower level injuries. In another post Dr Young mentioned the work being done in peripheral nerve grafts. I assume these are for the bowel and bladder and hopefully would help those of us with lower level injuries. Mike
                            T12 Incomplete - Walking with Crutches, Injured in Oct 2003

                            Comment


                              Originally posted by damagedgoods
                              Do neurons play a big part of, let's say, when a man is sexually aroused due to direct contact with his penis? Are more scientists focused on treating higher, more manageble injuries than low, sacral insults? I mean, why would scientists bother with sacral SCI, when as of now, they are too complicated to address, and emphasis is still focused on treating Cervical injuries? I'd imagine that a spinal AVM inside the cord would cause the most considerable damage, since it's virtually inside the gray matter, causing it to infarct. How would one fix a spinal cord, when looking at a cross section of the cord, the butterfly shape of the gray matter is obliterated on one side, virtually gone? This type of injjury just seems faaar too complicated and time consuming to address in this lifetime. Am I right?
                              Damaged, at Ohio State University, Jackie Bresnahan and Michael Beattie worked on understanding the circuitry of the spinal cord that controls the bowel, bladder, and sexual function. Astonishing as it may seem, relatively little was known about the neural systems that controlled these vital organs. The reasons are as follows:
                              1. These functions are hard to observe in animals and most neurophysiological studies are done when the animal is asleep. So, much of our knowledge have come from making lesions and trying to see whether or not the function is impaired or absent. Sexual function is particularly hard to observe and study.
                              2. Unlike most other functions of our body which involve well-defined somatic sensations and motor function (to striated muscles), these three functions involve smooth muscle or vasculature. For example, although many people think of the penis as a muscle, it is a vascular organ. Erections occur when the penis become engorged with blood, and it is mediated throught sympathetic and parasympathetic nervous system. Likewise, the bladder and rectum involves a combination of all three systems: sympathetic, parasympathetic, and somatic. The neurotransmitters are different and the control systems are also different.
                              3. Most bladder, bowel, and sexual function are largely reflexive and are only under partial control by the brain.
                              4. Certain sensory phenomena, such as orgasms, are not really well-understood at all. For example, there is some evidence to suggest that during the sexual act, many of the rules of spinal reflexes are actually suspended.


                              Barry Komisaruk at Rugers Newark, for example, has been studying the neural mechanism of orgasm in animals and people with spinal cord injury. During vaginal stimulation, both animals and humans show a remarkable loss of sensitivity to pain stimuli. Barry recently compared the analgesia that occurs during vaginal stimulation to a huge dose of morphine. I must admit that I was skeptical when I first heard this and said that this must be due to "distraction" of the animal rather than true analgesia. But, Barry's laboratory showed that the both animals and humans were able to detect light touch during this period and to pay attention to such stimuli. During penile or vaginal stimulation, the pain system in the spinal cord is turned off. I thought that this is a pretty cool discovery. Barry and his students are working very hard trying to understand the neural mechanism behind this.

                              By the way, I just found a recent article about this:

                              http://www.chicagotribune.com/featur...ewomannews-hed

                              Women with spinal-cord injuries rediscover sex, orgasms

                              By Faye Flam
                              The Philadelphia Inquirer
                              Published November 23, 2005

                              Despite a glut of literature available on how to have more and better orgasms, science is only beginning to unravel the mysteries of the nervous system. The experiences of some paralyzed women prove how little we know: Though seemingly cut off from all feeling below the waist, some have found they still had orgasms when they tried sex.

                              More mysterious still, some could have orgasms when touched in a spot on the trunk or neck just above the region of injury.

                              One Philadelphia-area woman who was paralyzed from the waist down was overwhelmed to learn she would never walk again. She was 30, and single. She assumed she would never enjoy sex again either, though at the time it was a lesser concern.

                              Ten years later she fell in love. The couple tried sex. "I was fulfilled, I had orgasms," she said. "It was like I was reborn."

                              Neurologist Barry Komisaruk of Rutgers University has been studying sex in paralyzed women for 10 years. Sometimes, the loss of sex was the most devastating and irreconcilable consequence of spinal-cord injury, he says, tearing apart relationships and families.

                              "Doctors had told many of them their sex life was over because there's no pathway to the brain," Komisaruk said.

                              A behavioral neuroscientist, he started out studying the nervous systems of rats. In female rats, the vaginal stimulation from sex caused a cascade of hormonal changes and kicked in a painkilling effect more powerful than morphine. There could be a blockbuster drug in this, he reasoned, if he could decode the neurobiology of female rat sex.

                              He tried severing the three nerve pathways that connect the genitals to the brain--the pelvic, pudendal and hypogastric nerves. Oddly, the rats reacted to sexual stimulation as if their nerves were intact.

                              He discovered a new channel for sexual pleasure--the vagus nerve--which threads from the brain through the lungs, intestines and other internal organs, bypassing the spinal cord.

                              Could the vagus nerve also channel sexual sensations in humans? To find out, he decided to study women with complete spinal-cord injury.

                              He and colleague Beverly Whipple brought women into their lab and interviewed them. In their stories, recorded in a 1997 academic paper, most had shut down sexually at first.

                              "I have no feeling ... therefore I can't experience any type of sexual pleasure. ... I became I guess you'd call frigid ... ice woman ... ," one said.

                              "I went back to teaching full time ... I drove my car ... everything was in its place except for my liking myself and my sexuality, and feeling like I was a woman again," reported another.

                              In months or years, many of them began to experiment with sex, either to please a partner or because they were curious. Some discovered they could orgasm from sex, others found their nervous system had become reorganized, so they discovered new hypersensitive regions above their injury that could lead to orgasm.

                              In the lab, the researchers investigated the women's sexual potential directly by giving them a device called a stimulator, which looks a little like a tampon. It's designed to create sensation in the vagina and cervix.

                              "Some of the women who realized they still had sensation started crying," Komisaruk said. Until then, they had given up.

                              Last year, his team began using magnetic resonance imaging to look at what was happening in their brains as women were having orgasms.

                              He found in those with and without spinal injury, it lit up an area called the nucleus accumbens which is, not surprisingly, also activated by nicotine and cocaine.

                              He also scanned women who had orgasms from being touched above the injury, and found that in the brain it looked like any other orgasm.

                              Komisaruk and his colleagues are now trying to change patient care to put more emphasis on the possibility of sex after spinal-cord injury. They're also planning more brain scanning to better understand orgasm and compare the male and female versions.

                              For a phenomenon that many experience several times a week--or even every day--there's still plenty of terra incognita to be explored.
                              Last edited by Wise Young; 26 Nov 2005, 6:00 PM.

                              Comment


                                dear dr. young,
                                thanks for your quick reply. this is the 5th time i've tried to type this post, but because i havfe no use of my hands, i must use my page tuner to peck out the letters one at a time. and keep accidently hitting some damnnbutton that sends my hard earned typing somewhere into the great garbage dump in cyberspace.

                                please let me try to answer your questions and clarify some of my comments. first the questions:

                                1. i was diagnosed as a c-6 complete ASIA-A by the rehab dr. upon my arrival april 29th of this year. i was supposed to be reevaluated right before i left rehab, however tthis was never down, at least by the dr. the p/t and o/t therapists left their recommendations, they wanted me to stay an extra 2 weeks because they felt i was making extraordinary progress, but due to overwhelming homesickness and complete ignorance of how incredibly hard it would be at home, i decided against them and came home after 6 weeks.
                                2. I HAD GOOD WRIST MOVEMENT WITH MY HAND AND FINGERS pointing down.[tenadesis?spelling] grasp but not thenother way. i'm not sure which
                                is extension or flexion. right before i left r3ehab i had a flicker in my triceps.which excited me because i thought if i got them back it wouldn't be long before i got some movement in my hands.
                                3. there was an extended period of time between inpatient rehab and outpatient p/t and o/t [from june 14th until mid november] because so many state programs to get attendant help and other pprograms like centers for independant living, which i still don't know if my advocate has followed up on that. then the pain came on and i could hardly sit in my chair let alohne make all the nescessary calls. there was also trouble with my equipment which is still unresolved. anyhoo, there were NO local rehabs who could help my sort of severe condition. finally i made the decision to take the 1 1/2 hour ride in the medicade van back to
                                pittsburgh for my outpatient.
                                4. despite my at home efforts to make my triceps stronger [i may have] i scored a 1 or 2 on my right tricep and a 1 on my left. still can't lift them against gravity.
                                5..as i said earlier i was never reevaluated by my dr., who by all this time and suffering, i've lost most of my trust and faith in, on a medical basis. and my live-i n fiancee of 12 years who is responsible for at least 80 percent of my care says he CAN feel alittle movement while doing my bowel program and he asks me to push.
                                6. i learned alot in rehab, but more when i came home started reading, and got on the net.

                                i guess i clarified alot in questions seegment, so if you wouldn't mind i'd like to ask you just a few more queestions.

                                1. in your opinion, is the pittsburgh area a good place to find the drs, and treatments i need?
                                2. how accurate is the ASIAscale, i've read all about it, and is it the standard.
                                3. can a complete injury ever become incompletee?
                                4. i certainly CAN'T afford 6 thousand dollars for a standing frame, what are my options?
                                5. what is the difference between a FES and an E-STIM?
                                6. are they safe to use at home unassissted
                                7. eric and i have cut my baclofin very slowly from 120jgs a day to 70 still no leg movements.
                                8.i get terrible spasms around my chest and stomach i caall ''band'' spasms because they feel like someone is twisting a belt or something around me tigfhter and tighter.
                                9. i've had anxiety disorder for 20 years, that has gotten so bad post injury that i have more trouble breathing than just what my injury causes.
                                my pcp gave me albuteral but it makes me nervous and gives me chest pains. i also take 3mgs of klonopin a day. any suggestions?

                                sincerely and waiting anxiously for your reply,
                                lori [not loori, typo,my bad]
                                sigpicPlease Visit My Blog at: http://queenquad.blogspot.com

                                But those who wait on the Lord
                                Shall renew their strength;
                                They shall mount up with wings like eagles,
                                They shall run and not be weary,
                                They shall walk and not faint
                                Isaiah 40:31

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