SCI & Wintertime Body Temperature Regulation

SCI & Wintertime Body Temperature Regulation

Posted by AskNurseLinda on Dec 15, 2014 3:38 pm

One of the phenomena of SCI is a decrease in the internal ability to adjust your body temperature. This is because messages from the body to enlarge blood vessels to cool you or constrict blood vessels to keep warm cannot get back and forth to the brain. The brain being the control center of the body, directs changes to automatically adjust ourselves for different temperatures. When we become too hot, the brain will direct our bodies to sweat which puts fluid on the skin to cool the surface of the body. When we become too cold, the brain will direct our body to shiver which will create heat. It is a marvelous system but SCI can interrupt the process because these messages cannot get to the body lower than the level of injury in the spinal cord. However, individuals can protect themselves from over cooling or overheating in cold weather.

I see many individuals with SCI in cold weather without a coat, shoes and socks. The response is, ‘I don’t feel it so it is ok.’ Not so. Your body will react to cold, paralysis or not. Shivering does not typically occur below the level of spinal cord injury. The body will not start to compensate for cold temperatures.  Hypothermia is when body temperature becomes too cold.

The further away an arm or a leg is from the core of your body, the easier it is for it to develop  a complication of coldness such as turning white or blue, even leading to frostbite. Whether you have a spinal cord injury or not, you need to bundle up when going outside in the cold especially if for long periods of time and more so if you will be outside at an event, not actively moving your body around. For individuals that have arm function, moving your arms does not mean you lower body will afford the same internal heat production.

Dress for the weather. Layers of clothes are best for everyone. Wheelchairs conduct cold because they are made of metal and vinyl. They won’t contain your body heat but will adjust to the outside temperature quickly so you soon are sitting on a very cold surface. Often people put blankets on top of them and perhaps a coat on backwards because that is easier to manipulate. This is great warmth for the front of your body but don’t forget to cover the backside of your body which is next to the cold wheelchair. There is a lot of surface to lose your body warmth from the back side, too.  Hats and mittens are also important.

Breathing cold air directly into your lungs will further drop your core temperature because the cold air is going directly into the core of your body. This is why mechanical ventilation is always warmed. Try to limit time outside when it is very cold. Covering your mouth and nose with a loose scarf increases the risk of breathing in fibers if you have respiratory issues. Warm your internal body by drinking warm liquids like hot chocolate, coffee or hot tea. Alcohol decreases your body temperature making the drinker more susceptible to cold if you have a spinal cord injury or not. Come inside to a warm area when it is very cold.

If you want to warm by a fire or heater, be sure you are not so close that you over heat or burn yourself. You could be sitting outside in the cold but still get a burn from the fire or heater. For some individuals, once the body temperature falls, the only way to raise it is to sleep so the brain can reset itself.

When the body temperature becomes higher than normal. This can occur with fever but being unable to regulate your temperature when exposed to heat is also dangerous as hypothermia.  You can become hyperthermic or too hot, in cold weather by sitting too close to a heat source.  The wheelchair conducts heat, too, so you could end up sitting on a very hot surface if too close to a heat source. In the summer, you can become overheated, leading to sunburn or even heatstroke.

Avoid electrical devices and heating blankets as you won’t know when it becomes too hot even to the point of burning you or conducting heat against the metal of the wheelchair which can then burn you. I have a friend who came to clinic with a second degree burn. He was at a tailgating and told his group that the barbeque was burning. In fact, it was not the food but it was him slowly cooking on an electric blanket! This is an extreme story but a good lesson.

Not being able to identify your body temperature can lead to this situation. The best protection against the cold is wearing extra layers of clothing when it is cold. Layers are best for maintaining heat insulation. If you are in a normal temperature room, you need to dress appropriately. Being outside in the cold requires extra insulation for your body both front and back. However, in the winter, maintain a normal body temperature in the cold by preparing for falling temperatures and dressing appropriately especially when outside. Follow common sense and don’t overdo it being outside too long or not providing enough insulation for the temperature.

I'm online in this community every Wednesday from 8-9 PM ET to answer your SCI and paralysis related questions.

Leave a comment any time by clicking the reply button. Let's get the discussion going!

Re: Wintertime Body Temperature Regulation

Posted by Jean5 on Dec 17, 2014 8:11 pm

My son who has an incomplete SCI has a hard time balancing the right clothes in winter: warmth without restricting already difficult movement.

And then there are socks that wrinkle. Argh!
mom of a Brown-Sequard C4-5

Re: Wintertime Body Temperature Regulation

Posted by AskNurseLinda on Dec 17, 2014 9:01 pm

Jean, you are right, trying to find the balance is difficult. Layers work best but can be difficult in putting on clothes over clothes. Being able to take off a sweater or jacket when coming inside might just be the answer. It can be difficult to adjust especially when unable to tell you are too cold until you are shivering. Some of the outdoor clothing have temperature ranges on the labels which can help you match to your climate. Long underware can also add a layer. Many of the newer types are thin and don't wrinkle. They are a big improvement over the bulky, old fashioned kind.
Thick warm socks can be warmer than athletic socks. I have found a terrific kind that are thick at stores like Target, Costco, Sam's and Walmart. I don't endorse any store or brand but the very heavily woven socks can help.We are always advised to use natural fibers like cotton and wool but I find these bunch too much in your shoes, especially with a little dampness from sweating. A little man made stretch fiber will help. Good luck. Let me know if these suggestions help or if you come across something that works really well.

Re: Wintertime Body Temperature Regulation

Posted by AskNurseLinda on Dec 17, 2014 10:01 pm

Jean, also, when the body temperature is not the same on each side as in Brown-Sequard Syndrome, the body will still respond to cold. It may feel warmer on one side or without sensation to temperature but the effects of cold weather will be the same. The body will respond to cold as well as pain differently on each side but the internal reactions are the same, it is the messages sent to the brain that are misinterpreting. Even when it is cold, you may feel warm on just one side of your body but your body will have the same consequences when exposed to the cold. Instead of feeling cold, sometimes the body's interpretation is that of pain. Because the body is constricting blood vessels to conserve heat, the message to the brain is only that something is wrong. The cold message is not getting through the level of the spinal cord injury. This misinterpretation by the brain is then read as pain rather than cold. Maintaining your body temperature in the cold can help relieve your pain as well.

Subscribe to Topic

Would you like to be notified of updates to this Discussion Topic? Subscribe and you'll receive email updates of new posts.