New sci C5-C6, pls help with questions

[SCI-Nurse]

Most people with a SCI at that level will have problems sitting up...most at first, some long-term. It is because his blood pressure drops when he sits up due to inability of his body to vasoconstrict his leg and abdominal arteries (through the spinal cord from the brain) when he comes upright. The bluish legs are also normal.

He should be wearing a very snug, low fitting abdominal binder before and while sitting, as well as compression hose (sometimes with elastic bandaged or Ace wraps over the top) to help this. It is also important that he not be dehydrated when trying to sit up. He should start by sitting up with head of bed elevation for 10-15 minutes first, then transfer to a reclining back wheelchair. The back can be gradually raises as he tolerates this. Using a tilt table in therapy will also help.

Some will need to take medication but this must be carefully used as it can sometimes trigger autonomic dysreflexia. He also needs to work on trying to tolerate being a little dizzy...not passing out, but a little dizzy. If they put him back to bed every time he is dizzy, he will never progress.

(KLD)

[BillMiller823]

Hi Adema,

What SCI nurse KLD said regarding the abdominal binder, leg compression hose and additional ACE bandage wraps -- all that was necessary to try to stabilize my blood pressure so that I could sit upright in my chair. And even then, it wasn't until just before I was discharged from Rehab (almost exactly 3 months post injury, with the last two in Rehab) before I finally sat as vertical as my chair would go. After being discharged from Rehab, we still used the binder, hose & wraps for another couple months until my blood pressure stabilized more easily on its own.

Earlier in Rehab, when being transferred to my chair, my chair would have to be completely tilted back, because my blood pressure was that unstable. Then I would literally inch up slowly, like a couple inches every 10-15 minutes. Now, when placed on a tilt table, I can go from completely horizontal to as vertical as it goes (roughly 80-85 degrees) in three big jumps, with about 5 minutes to stabilize after each jump. So I've come a long way, and your brother should too -- in time.

God bless!

- Bill :-)

[BillMiller823]

Ok, I had previously only read part of SCI nurse KLD's above post (I realized I could chime in after reading her suggestion of the binder, hose & wraps, and I stopped reading to write). But what she described is exactly how they proceeded with me, except I didn't use a tilt table in Rehab. It wasn't until probably a year post-injury before I got the opportunity to use a tilt table.

[Adema]

Thanks Rick and SCI Nurse. He is getting a little better now at sitting up - he says he feels like everything inside his body is floating...but he can manage through blood pressure drops now... although doctors say sitting in the wheelchair might be too early.