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    #16
    i was wondering

    my brother is a c1 injury, and he moves his shoulders... the neurology practitioner says that this doesnt make a difference. He says that his ability to shrug his shoulders is all cerebral. my brother can nod and shake his head, i understand this is cerebral too, but i just wasnt sure if the shoulder shrugs were. some good news though, he is able to vocalize a few words sometimes, even with his same trach tube in.

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      #17
      Some shoulder shrug is C4...it is not all cranial nerves. Where is his sensory level? Does he have sensation at the tops of his shoulders or top of his chest (collar bone)??

      (KLD)
      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.

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        #18
        Oh yay, I didn't want to say but that's what I was hoping!
        Blog:
        Does This Wheelchair Make My Ass Look Fat?

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          #19
          spasms pain and fear

          I had a question about muscle spasms...
          my brother has a fairly new sci about 1 and a half months, due to a gun shot injury to his c-1 vertibrae.
          my question is: when there is some painful stimuli administred, he does not feel it, but he has muscle spasms... i was wondering is this due to reflexes, and the other night he had a dream that he was running and got kicked in the face and when he woke up his body spasmed... and when my mom asked if he had a nightmare he said yeah. is this jus another muscle spasm?

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            #20
            Spasticity and spasms are due to the loss of inhibitory innervation from the brain down the spinal cord. Spasticity, with increase muscle tone that makes it hard to move limbs or joints passively, and spasms (involuntary muscle movements) are common after a spinal cord injury, once spinal shock starts to subside. Spasms can occur with even very small amounts of sensory stimulation....a touch, a cold breeze blowing across the skin, a full bowel or bladder, even waking up suddenly, etc. etc. They are usually just reflex activity and don't indicate return of normal motor function. There is no known relationship between dreams and spasticity.

            If spasms or spasticity are interfering with safety, comfort, hygiene, range of motion or function, then treatment with medications may be indicated. The medications help more with spasticity than with spasms. Regular (at least daily) range of motion exercises and stretching, proper positioning and wheelchair fit, and standing (when allowed) will also help to reduce spasticity. Has this been discussed with his physician? Does he have a physiatrist now?

            What is happening about getting your brother moved to a good SCI rehab center? Is Rancho still in the picture?

            (KLD)
            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.

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              #21
              on the way maybe

              right now we are waiting for a bed at rancho... but he is currently still at harbor ucla hospital. but they are saying he cannot stay in the hopital too much longer and say that they have to transfer him to a convalescent home while he waits, because there is no way to tell how long that wait will be. so currently we are trying to find out what we can do while we wait for his bed. i work as an emt, so im constantly visiting nursing homes, ive only seen 2 or three out of probably hundreds that i even consider close to adequate.

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                #22
                If he cannot get into Rancho right now, other options might include the following, although not all will take ventilators:

                Long Beach Memorial Hospital Rehab Center
                Casa Colina Rehabilitation Center (Pomona)
                Northridge Hospital Rehab Center
                UC Irvine Rehab Center

                Also, you may want to see if you could convince your insurance to send him to Craig Hospital in Denver. It is one of the world's leading centers for SCI rehab. Santa Clara Valley Medical Center in San Jose would also be an option.

                Any of these would be better than a nursing home, even if it means him being far from home. Those nursing homes that take ventilators (very few) are generally storehouses for people in persistant vegatative states (long term coma), know little or nothing about SCI, and have minimal staff with nurses aides (few RNs). Pressure ulcers, contractures and pulmonary infections (often with MRSA or VRE) are rampant, and severe depression is often the result.

                Have you spoken to Rancho people yourself? Don't just depend on the discharge coordinator or SW at Harbor General.

                (KLD)
                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.

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                  #23
                  He is FINALLY in rancho!!! he is in the icu right now over there. so far he has been there 4 days, they really havent done anything there yet. but im glad he is finally there. anything i should ask of them or anything?

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                    #24
                    Great!

                    1. Ask them how soon you can have a family/team conference. This is a critical meeting for asking questions, meeting all key team members, setting goals, and talking timelines.

                    2. Ask to meeting Marilyn Pires, RN, MSN, the clinical nurse specialist for SCI there, and ask that she be your friend, confidant and advocate. She is an internationally known expert on SCI care.

                    3. Get a home evaluation done ASAP so you have time to get home modifications done before discharge.

                    (KLD)
                    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.

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                      #25
                      I had a question... my brother says he feels stomach pains sometimes. ive witnessed it twice. once was last week when they just had finished tube feeding him with that syringe looking thing that they use for the Gtube (he was asleep when that happened, so he didnt know he had just been fed), he woke up and was like "my stomach hurts". the second time was today, he said he felt like he had to have a bowel movement and it hurt a lil like he really had to use it bad, (he said he tried to push but didnt have the bowel control), but a minute later he had bad diarrieah, and that was the first time he had a loose bowel movement like that in weeks!

                      my mom told me that he was feeling pain in his stomach a few weeks ago when he had a GI tube infection. he said it had felt like burning or something. what do you think this is? do you think this is sensation he is feeling, because he doesnt say he feels his stomach much, and those are the only three times he said he felt it; and it seems like there were issues those three times.

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                        #26
                        It sounds like he may have some sparing of visceral (organ) sensation, which is good. Have he had any other return? Is he still ASIA A? Does he have any position sense (proprioception)???

                        Have you had your initial team meeting with his team at Rancho? Have you asked his SCI physician about this?

                        (KLD)
                        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.

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                          #27
                          No, I havent, but we are having the meeting this week. He is being transfered to the icu this week, probably today actually. I asked about, Marylin Pires, but she is currently on vacation. but im gonna ask all this at the meeting this week. they got him on a portable vent, he is sating at 100%, they think that is good.
                          they were able to put him on a ventilator the otherday with pressure control, (i think thats what they said) and he was able to stay on it for about 5 minutes. i guess he could breath with its assistance. they thought he would go longer because he is able to do so well with the portable respirator.

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