Hello..

[Springroll]

Hello everyone. I am a 29 year old female and I have a few questions that I hope can be answered in here. I am from the US but I am living in Peru with my husband and children( 8,3,2,) .....I need some advice, and I have no where to turn really.

In 2006 I was approx 7 weeks into a pregnancy and I began bleeding. I went to the hospital and I was told that I was miscarrying(after hCg tests, untrasound, etc) I was given a RHogam shot..but the nurse sneezed as she was injecting me and instead of giving it to me in the hip, she nailed it into my lower back. i got dizzy and i just figured it weas the trauma of everything and i also threw up in the hospital. i left. we returned to peru and i slowlu, over a weeks time had prickly sensations creeping down my lower back, buttox and legs. doen to my toes. i seen several specialists, and they told me that it was a nerve that was damaged. i was unstable and completely numb from my waist down for about 6 weeks, give or take. my husband had to rent a wheelchair, and i seriously couldnt feel when i had to urinate or other. i went about a day without peeing and he took me to a hospital here in peru and they cathed me and showed my husband how to do it. they also showed my husband how to remove my feces with me on the bed....sorry to be gross....it was terrible...i did feel pressure, though when i had to defecate, however everything was too embarassing and i had no idea what was happening....i slowly got better, and i thought everything was alright...i still had some problems with not realizing that my bladder was full enough to drip out, and that was about it. i used a pad. i was, for the most part alright.

then i got pregnant with the 2nd child..and from 4 months of pregnancy, i was back in the same situation. i recovered when my second child was about 2 months old...and when she was 4 months old, i was pregnant AGAIN...seriously....the whole thing all over again...only in the area where i was injected, i had this terrible burning sensation...this began again, around 4 months of pregnancy....my last child is about to be 2, and i am really afraid because i am getting hte tingling and numb sensation and the terrible urgency to urinate. i was intimate with my husband and i urinated everywhere...my legs are heavy and i just have no idea what or why this is happening. i cant live my life like this. the drs here in peru are crap. again, my husband had to get the wheelchair(which we purchased during hte 2nd pregnancy) for me to be reliant on. i have practically no feeling in my toes and my legs feel weird..numb and really heavy. the need to urinate and defecate is barely existant as well...i am thinking that i will have to have my husband help me AGAIN with cathing and what not...i am too afraid to do it myself, and after months and months of helping me, hes an expert.

i dont know. any suggestions? thanks in advance.

[SCI-Nurse]

I am going to ask Dr. Young to weigh in here, but it sounds like you have some damage to either the cord or the peripheral nerves, probably with some compression from your lumbar or sacral spine. The pregnancy issue may be related as the ligaments that hold the bones in place soften somewhat during pregnancy to allow passage of the baby through the pelvis, and this may be making any lower vertebral or sacral instability and compression you have much worse at those times.

Do you recover bowel and bladder function and walking between pregnancies? Do you have loss of sensation in your genitals?

Have you had an MRI of your lower back recently? You need this, if not. You also need to see a good neurosurgeon who really knows spinal cord and spinal problems. A trauma center is a good place to find one. You should be able to find someone in Peru, but if not, Chile or Argentina may be an option.

Meanwhile you need to get together with a physiatrist (a physician specialist in physical medicine and rehabilitation) and a good SCI clinic. You need to learn to do your own bowel and bladder care. It is not hard, and your husband should not be doing this for you. You also need to see a good neurologic urologist. If you don't take proper care of your bladder you could run into some long term kidney problems. You need regular evaluations of your kidney function and tests to determine how best to manage your bladder. You should have gone to an inpatient SCI rehab program when this first occurred, and that would still be ideal.

(KLD)

[gjnl]

Hi Springroll,
Welcome to Care Cure Community. Glad you found this site.

It must be a bit scary trying to negotiate the medical system in Peru. Where are you located? I did a search on Google for Lima, Peru +physiatrist (the rehabilitation specialist that the SCI nurse mentioned). I discovered the name of a doctor, who has reviewed several books on Rehabilitation Medicine for Amazon.com. He has a website you might like to go to and maybe you could get an appointment with him or have his office recommend someone for you to see.

His name is Tomas Nakazato. His office is called Clinica Especializada en Dolor Muscular y del Hueso. Along with his reviews, he wrote the following:
I am a Physiatrist (Physician specialized in Physical Medicine and Rehabilitation). My office is located in Lima, Peru (South America). The address is: Jr. Manuel Del Pino Nº 110, Esquina 14 Av. Arenales, Urb. Santa Beatriz, Lima 01, Peru. Telephone number: 265-1890 or 586-4015 Web page: www.cedomuh.org

Hope this works out for you. Keep in touch with us through this thread and let us know how you are doing.

All the best,
GJ

[Springroll]

thanks so much for the info, i made an appointment with him for today at 1215. you will never believe how much it costs for an appointment with him....40 soles or about 14 USD.....i hope for this cheap price he knows what hes talking about i really need some answers and some closure to this whole situation...i just cannot imagine my life being like this forever. i am sorry to offend anyone...its just that my kids really need me, and me not being able to care for them or chase them etc. is really eating at me.

sci nurse...this problem has been on and off for years...since that day at the hospital when the rhogam shot was jabbed into my back....it would worsen during pregnancy where i was completely unaware of anything. i seriously had lost all feeling and movement from basically the bottom of my stomach/hips down. i had no epidural for either of the previous 2 children...i had contractions(i felt them) with fever and i had to have a nurse and my husband hold my legs for the 2nd, and the dr kind of slung my legs in a stirrup type thing for the 3rd baby. i was delivering a baby and my legs were shaking and i had no awareness what so ever. what a terrible way to deliver.

the thing that frightens me the most, is that i recovered pretty well after the pregnancies. i have only had trouble with urinating as it is hard to gauge when my bladder is full until the last minute. i had limited sensation when being intimate although my legs always felt as though something was draped over them..i was walking..i would certainly not say 100 normal, but pretty close too it. NOW i am NOT pregnant, and i am having major issues again. i cant do the cathing. i am afraid. i dont want to do it. its hard enough to have to go through this for the 4th time. the past 3 times i got semi better, and this time i just woke up feeling as though i had burning all down my back and legs and prickly adn then over a few days, completely unaware...again. here i sit. just hoping that this time wont be prolonged over months. i also have a slight fever and i am wondering if that has anything to do with this or if i am just coming down with a cold.

i guess ill find out something more concrete today. ill post and let you know waht he said. thanks for the support.

[gjnl]

Hi Springroll,
I hope this physiatrist can help you too. Remember, I know nothing about him other than reading the reviews he has written on several rehabilitation textbooks. I Googled several searches regarding spinal cord injury, rehabilitation in Peru. There was very little information, and even fewer references to spinal cord injury centers and doctors.
Take care and keep us up to date on the progress.

All the best,
GJ

[Springroll]

hi, and thanks again. i went yesterday to see the dr. he was nice and he spoke english. he ordered some tests, one being an mri with contrast,a nd another, an emg. i had the emg at an outpatient center, and almost everything came up ok and within normal limitsthere were 2 periphreal something that showed non reactive and ...i had a non reactive f wave in both legs(although the test was done in my foot) this was done by a neuro. he also checked the same nerve in my arm and htat came back reactive and just fine... i also got started in therapy and i am setting up home visits today. i was anally checked to check for some reflex and it laxed my bowels and i had a bowel movement as the neuro was diagnosing me. i am being seen by a neuro at la clinica javier prado. it was disgusting and embarassing to say the least. i was put on 2 meds, and my mri is scheduled for thursday. still no changes in movement bladder, etc. i guess we will ahve to see waht happens. the neuro said something about cauda equina syndrome, but i just got online and it says if not treated asap, it can be dangerous and permanent? i dont think so since this is not the 1st episode and i have recovered a few times before. any other advice? isnt there a dr that can respond??

thanks so much

[gjnl]

Hi Springroll,
I am so pleased that you had a good experience with the physiatrist and that you are getting what appears to be appropriate testing and treatment. Sorry about your "accident" while at the neuro. Don't worry or be embarrassed. Doctors and nurses are very used to these kinds of things. They understand. There have been a couple of threads posted here on cauda equina syndrome. Here is one: /forum/showthread.php?t=20145
For other references on this forum, enter cauda equina syndrome in the box at the top right corner of this page under Google. Make sure that CareCure Forums is checked and search.

Take care and keep your updates coming!!!
GJ

[Wise Young]

Hello everyone. I am a 29 year old female and I have a few questions that I hope can be answered in here. I am from the US but I am living in Peru with my husband and children( 8,3,2,) .....I need some advice, and I have no where to turn really.

In 2006 I was approx 7 weeks into a pregnancy and I began bleeding. I went to the hospital and I was told that I was miscarrying(after hCg tests, untrasound, etc) I was given a RHogam shot..but the nurse sneezed as she was injecting me and instead of giving it to me in the hip, she nailed it into my lower back. i got dizzy and i just figured it weas the trauma of everything and i also threw up in the hospital. i left. we returned to peru and i slowlu, over a weeks time had prickly sensations creeping down my lower back, buttox and legs. doen to my toes. i seen several specialists, and they told me that it was a nerve that was damaged. i was unstable and completely numb from my waist down for about 6 weeks, give or take. my husband had to rent a wheelchair, and i seriously couldnt feel when i had to urinate or other. i went about a day without peeing and he took me to a hospital here in peru and they cathed me and showed my husband how to do it. they also showed my husband how to remove my feces with me on the bed....sorry to be gross....it was terrible...i did feel pressure, though when i had to defecate, however everything was too embarassing and i had no idea what was happening....i slowly got better, and i thought everything was alright...i still had some problems with not realizing that my bladder was full enough to drip out, and that was about it. i used a pad. i was, for the most part alright.

then i got pregnant with the 2nd child..and from 4 months of pregnancy, i was back in the same situation. i recovered when my second child was about 2 months old...and when she was 4 months old, i was pregnant AGAIN...seriously....the whole thing all over again...only in the area where i was injected, i had this terrible burning sensation...this began again, around 4 months of pregnancy....my last child is about to be 2, and i am really afraid because i am getting hte tingling and numb sensation and the terrible urgency to urinate. i was intimate with my husband and i urinated everywhere...my legs are heavy and i just have no idea what or why this is happening. i cant live my life like this. the drs here in peru are crap. again, my husband had to get the wheelchair(which we purchased during hte 2nd pregnancy) for me to be reliant on. i have practically no feeling in my toes and my legs feel weird..numb and really heavy. the need to urinate and defecate is barely existant as well...i am thinking that i will have to have my husband help me AGAIN with cathing and what not...i am too afraid to do it myself, and after months and months of helping me, hes an expert.

i dont know. any suggestions? thanks in advance.

springroll,

I am sorry to hear that you are having these problems. From your description, it doesn't seem that the shot that you received in your hip in 2006 was responsible for several reasons. First, in order to damage the spinal cord or cauda equina (the nerve roots in the lower spinal cord), the needle would have to go considerably higher than the hips. The needle would have to enter the spinal canal around L1, which is would be close to the level of the ribs. Second, any damage to the peripheral nerves going through the hip area would produce unilateral (one-sided) loss of sensation and paralysis. You seemed to be having problems on both sides. Third, you recovered and then had the problem again, associated with pregnancy.

It would be hard to tell based on just a description but one possibility is that your uterus is in a position such that it is pressing on your lumbosacral plexus when you are pregnant. Such compression has been reported [source]http://www.ejog.org/article/S0301-2115(97)02730-9/abstract[/source] and is sometimes called "nerve entrapment syndrome" [source]http://emedicine.medscape.com/article/1234809-overview[/source]. That is the best guess that I have. You need to be carefully examined by a doctor. Do you find that the symptoms depend on position, i.e. they go away when you are lying down on your side, for example?

I am sorry that I can't be more helpful.

Wise.

[SCI-Nurse]

Thanks, Dr. Young. I would hope that MS has also been ruled out, although its relationship with pregnancy is usually IMPROVEMENT of symptoms during pregnancy and then often an exacerbation after delivery, not the pattern that the OP has described here.

(KLD)

[gjnl]

SCI Nurse: It isn't easy to search for abbreviations used on this site. Please define "OP."
Thanks,
GJ

[Springroll]

hi everyone. dr young....the injection was into my back. seriously jammed into my back. i seen another neuro yesterday and i had an MRI.....wahtever it means in english, i dont know...it was LUMBAR and DORSAL. there was a lesion in teh d3 area. they are requesting that i go inpatient to recieve somethig called corticoide (sp) on monday. there seems to be no rush, but hten in peru, if you have no money to pay, they will let you die...wonderful third world. i have the money to do it, however they wont let me in there until monday. i am almost hoping for a weekend recovery although that dosent seem likely. another diagnosis was called mielitis transversa..again, no idea....this was given by the dr who put me on the list for monday to recieve this corticoide treatment.

i have been with dr N since the referral from G although only using his aggressive physical therapist group. he only works a few hours a week, and i needed more immediate answers, so i continue with my neuro. lazar treatment and range of motion down with me for an hour, and then my husband continues at home in the middle of the night. he shifts me and watches for my feet to not fall out to the side. why is that? he also wakes me up to cath every 6 hours and does the therapy in the interium. any other thoughts here??? know what this means in english??? i find it in spanish and i cant read it.....

thanks

[SCI-Nurse]

OP = original poster. Widely used abbreviation throughout the entire internet.

mielitis transversa = transverse myelitis. Here is some more information on this spinal cord disease:

http://transversemyelitis.net/index.php

http://www.myelitis.org/index.html

http://www.ninds.nih.gov/disorders/t...semyelitis.htm

corticoide sounds like a steroid, which would be appropriate for an autoimmune disease or acute spinal cord damage, but has little or no benefit for a chronic traumatic injury.

You should be cathing every 4-6 hours, and really need to learn to do this yourself. Many thousands of women with SCI around the world learn how to do this. It is not that difficult...if you can put in a tampon, you can do a cath. No one WANTS to do intermittent cath, but it is necessary, and at your level, should not be something your husband should be doing for you. The same goes for bowel care, turning yourself, checking your skin (with mirrors), and other aspects of your disability management.

(KLD)

[gjnl]

Thanks SCI nurse for the definition of "OP". I don't participate in other forums and this is the first time I have seen it here.

Springroll,
I'm very glad you continue to get treatment, and hope that you get some relief with Monday's injection. Hopefully, you can discuss learning bowel and bladder management with Dr. Nakazato or his therapy staff. He should be able to direct you to an occupational or physical therapist who can coach you in the techniques and set you up with the appropriate supplies. Try to have a restful weekend. Take care.

All the best,
GJ

[jody]

ummm, Dr wise, I had problems in late pregnancy with emptying my bladder. I had gotten a broken tail bone and pelvic hairline fractures when I was 12. pregnant at age 20. the second was not to term, third I lost bladder control between 6-8 months and did not regain until 1-3 months post for both full term pregnancies. I used a Foley. the accident then caused two more fractures to the pelvis, and coccyx, and l5s1 incomplete cord injury.
My first fractures were caused by being kicked in the butt with steel toed boots, second from landing on pavement after being airborne, However my pregnancy bladder problems I figured were caused by the coccyx and pelvic fractures, but orthopedic says birth defect or the L5s1.

To springroll, Cathing is no big deal if that is how you are needing to pee. I always do before sex, and usually that prevents peeing myself. I am not sure why your husband woud need to help with cathing and bowel program. once you learn how, its a one person job, and there is nothing at all to be afraid of. do you think you may have a urinary tract infection? that is always possible with having to cath, and makes the urgent feeling. no matter the reason for needing to cath, I think it would be better, if you learned to do that for yourself. what if he needs to be somewhere else? or you have to go somewhere without him? even people with limited hand use can do their own bathroom needs by themselves, so I hope that you make extra effort to learn how to care properly for your yourself, so that you can get on to being a busy mom.
I hope that your situation improves, and welcome to care cure.

[jody]

Kld mentioned that if you can put in a tampon you can cath yourself. true.
if you put in a tampon, while learning to cath, you know the catheter does not go there, so makes it easier to find the right place. you must go above where the tampon is, though below the good spot. wash hands well before you touch your clean catheters. wipe your area from front to back with a diaper wipe, and if you can do it on the toilet.