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New to Forum, L1 Burst Fracture, Incomplete, Asking Questions

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  • New to Forum, L1 Burst Fracture, Incomplete, Asking Questions

    Hi! My name is Nick. I sustained a SCI from a nasty fall. I had a L1 burst fracture and I am fused with instrumentation from T11 to L3. I was out of ICU for 2 days and developed a horrible ileus and went back to ICU for 3 days. Two days later I had tightening in my chest and they for a PE in the right lower lobe and scans reveled a spinal epidural hematoma. Today is 3 weeks since the accident. I have walked with a walker since day 11. I have been working on using a cane and standing balance. At first I was worried about stairs but found out with a cane they are no problem. I can fully eliminate bladder with great effort but it's better than a UTI. My backside has no feeling and I can not control my bowels. I have developed the sensation of constipation. Uggg. I can sometimes clear my bowels when bearing down to void bladder. Obtained erection on day 17. Hamstrings feel like rubber. Calves have very little movement and I worry about atropy. At first my bum felt like I was sitting on a 5 gallon bucket with no lid but now I feel more and my bum just hurts. My feet feel like they have seran wrap around them. I have pretty good dorsal flexation and a very small amount of plantar flexation. I can curl all toes on my left foot pretty well but I can barely move a toe on the other. Anyone similar with advice on prognosis. I am cherishing every little advance. It's a huge victory!

  • #2
    Welcome to our forums. You will find many others with cauda equina injuries like yours here.

    Are you in a SCI specialty rehabilitation center? As an inpatient or outpatient? Straining to void your bladder (as it appears you are doing) can be dangerous long term. You need to get on a proper bowel and bladder management program in addition to getting physical and occupational therapy. Are your erections functional? Are you getting proper medication for the neuropathic pain (usually Neurontin is used first)?

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


    • #3
      Nick, you are still in the very early days of your recovery. I agree with KLD that you need a better way to manage your bladder elimination. That does not mean that the measures you need today will be needed in the future. As an incomplete injury, your long term recovery is unknown. Therapy with real SCI specialists (PT and OT) will be critical to your long term recovery.

      You need to be working with real SCI specialists to determine the best care for your body at this time and then be willing to make adjustments based on your recovery. To have made the progress that you have in only three weeks is amazing. You should not have to strain in order to eliminate your bladder. That may or may not get better in time. Usually, bladder and bowel control are linked. That control is considered the "Holy Grail" of SCI. With that ability, all things are possible. They may or may not happen, but are possible. The control you seek may develop as time goes on.

      Be thankful that the doctors gave you a chance to eliminate you bladder on your own. I have a son that is an Incomplete C-2 and it took months for the doctors to let him try and the dropped jaws when he could. His injury is so high that even the SCI specialists thought it would never happen. Call Ryan Mr. Never. --eak
      Elizabeth A. Kephart, PHR
      mom/caregiver to Ryan-age 21
      Incomplete C-2 with TBI since 3/09


      • #4
        Hi there congrats on doing so well! I'm so happy for you! I agree with everyone, straining as much as you are with your bladder can't possibly be good for it. I get wanting to do it yourself, but a little assistance for now seems like it would go a long way and veyr well may not be long term. A lot of us catheterize, it's an easy thing to do and certrainly much easier and less time consuming than straining. I'm sure there are many other options out there for bowel and bladder management. i hope they find one for you that works, but please ask them to help you figure it out adn dont' keep straining becuase you want to void like you used to simply because you can (albeit with effort and difficulty) the goal is to get better, not damage your bladder/bowels further. I'm sure you're going to be just fine no matter what you seem very dedicated to getting yourself as healthy and mobile and functional as possible. Your awesome...congrats
        Liza R. McCollum


        • #5
          You really are doing great from your injury. bowel problems are normal, but straining is hard and I know how frustrating it is. I used milk of magnesia at first and it works pretty quickly, than I tried murilax and that took a couple days to work, now I am taking a stool stimulant called LLS from the health food store along with a metamusil tablet and that seems to be the trick for me. Sometimes I do not always know when I have to go, but I can deal with that.

          I too had injury to L1 and had cage and fushion between L1- L2, but also am dealing with the nerve roots with equine area. I am 7 mo post and used the walker alot, but now I am using just a cane. I am doing water therapy and it is so good because you can do more things in the water than land it's so much easier. Pain is the same though afterwards, but at least I can handle the pain with small amount of percacet. I also have feet and toe issues, at first I could only move my big toe and I had the pins and needle pain. Now I can move all my toes, but they feel like they are broken. I do have fire and ice feeling in my feet. I take neurotin for that and it has helped me. My feet feel real heavy and I am having trouble with shoes due to swelling thank God for flip flops!!

          I think your prognosis sounds good. I will tell you this is the hardest job you will ever do rehabing is gruiling, but the outcome is so worth the hard work. Remember the nerves in your back grow very slowly and neurons are trying to fire up. Keep a journal of your progress it is so rewarding for me to go back to when I came home from the hospital with a walker and a wheelchair to where I am yet. I still have healing to do, my incision was done going thru my left side and I have total numbness there, but I am so grateful I am able to walk even though I look like a penquin wobbling yet!!

          Just keep up the faith you will get better and keep us posted on your progress. The best of luck to you and your recovery.

          There are quite a few of us on here with that injury site maybe some will chime in.
          JeAnNE L1Burst Fracture inc. 11/5/10

          Live Well--Laugh often


          • #6
            Yep, I totally agree with Jeapow. I have an L1 and L5 and your descriptions of how you're feeling are very familiar. You have gotten a lot of function in a very short span of time. I can walk with a cane, but it took me 10 months to get there. So, you're off to a very good start. The numbness, weird saran wrap feeling, bladder and bowel problems are typical in the portion of the spine that you injured. I would imagine that recovery will continue for you but realize that it can take a very long time for nerves to come back. You may see a lot of little improvements before they become one giant step forward.

            The back of the calf, hamstrings and back of legs, bum, have all recovered more slowly for me than the front of my legs. Since you are able to walk, one of the best exercises you can do is walking. If you can get in water, it would be ideal for you because you won't have to worry about balance. I've also been able to get on a treadmill, recently. If you do this, make sure that any treadmill you use is capable of very slow speeds, like .5 mph, because that's where you're likely to start. You can work up from there. Your hamstrings, calves, and all portions of your legs will benefit from walking exercise and it's very beneficial to your bones to put weight on them.

            Get a physical therapist, if you can, to help you along.

            I think you're doing great for being so recently injured and I hope your recovery continues and gets you back to your normal function and health.
            Last edited by truly; 06-13-2011, 03:49 PM.


            • #7
              I'm CES also, still making progress twelve months in. Sounds like your doing great.


              • #8
                Thank you all for your support. It feels so good to have people that can better understand the sensations I am going through. I am in a rehabilitation center and working on my strength and stamina every day. I wish they had a pool. That sounds like a great way to excercise. I have found that it has become much easier to void my bladder today. My balance with no aide is better as well. I have been eliminating my bowels during urination but I cannot feel anything. Your posts are very encouraging for me. Thank you for welcoming me.


                • #9
                  Does sound like your doing great!! Keep up the good work and WELCOME!


                  • #10
                    Hi Nick,

                    I'm an L1 burst with a fair amount of hardware. I'm truly sorry you've entered the world of SCI. Took me a quite awhile before I got a handle on the bowel problem and I am resigned to intermittent cathing for, well, forever, even though I can void some by exerting pressure. Cathing is the least of my worries.

                    I do walk now without any assistive devices and can easily do a mile, but 2 miles leaves me a little used up. I ride a bike with a "powergrip" strap to keep my left foot from falling off the pedal and 15-20 mile rides are routine.

                    I am one on the lucky ones around here and I don't take that for granted.

                    You are going to have to work your ass off to maximize your recovery but you need to know that much lies out of your contro,l in the hands of fate. If hard work was all it took you wouldn't see so many people in wheelchairs.

                    There is much wisdom to be found here. Stick around even if you mostly lurk (like I do)



                    • #11
                      It's been quite some time since my last post. I hope all of you in the sci world are working on getting the most out of your life. Some days you may feel like you can not handle your new life but don't give up. I'm doing quite well after 8 months. I can walk unassisted and my stamina will allow me to do so for over a mile. I still have LOTS of pain but I am very thankful for my progress. I will probably have a spinal stimulator trial in the next week or so. If anyone has gone through this please give some advice or your personal experience. I believe things will continue to improve. I wish the sexual part would return but I'm coping. Thank you guys for your incouragement. Live life to the fullest!!!