Aging with SCI

Aging with SCI

Posted by AskNurseLinda on Apr 27, 2015 10:36 am

Just when we get comfortable with our routine care is when things start to change for no other reason than we get older. Aging comes to us all regardless of our health conditions. Health problems resulting directly from paralysis are termed "secondary health conditions".  With paralysis, there are some extra precautions than need some attention but like all of the adaptions to life, they can be incorporated into daily routines. Research has demonstrated that being proactive at a younger age can reduce some of the complications of aging. Some issues will arise or be accelerated due to paralysis.

The following chart contains some the more common secondary health conditions of paralysis. You will note that the source of the start of these issues is aging, not paralysis. We will all be susceptible to the aging process and what is termed ‘normal aging'. If you are a caregiver, the aging process will occur so these issues are the same for everyone. Our body's responses are slightly different when paralysis is present. By educating ourselves, we can be prepared to note changes with age.
Body System Normal Aging Paralysis Effects Suggestions for Treatment
Musculoskeletal Calcium loss Calcium loss from lack of weight through long bones of the legs, fractures Keep track of bone density though regular checkups and treat as recommended by your healthcare professional.
Use of a standing frame to put weight through the legs.
  Loss of muscle tissue Replacement of muscle with fat, stomach pouch, scoliosis, skin breakdown Exercise as able.
Some drugs can increase muscle tone but have significant side effects, discuss with healthcare professional when appropriate.
  Upper extremity pain Shoulder pain from propelling wheelchair, rotator cuff injury, bursitis, capsulitis Work with therapist to learn techniques for strengthening.
Don't reach back so far to propel manual wheelchair.
  Poor muscle tone Scoliosis or curvature of the back Strengthening exercises for the back.
Sit up, use excellent posture.
Nervous Slowing rate of information processing Complicated by injury to the brain Exercise your brain as well as your body. Play word and math games.
  Decreased balance and coordination      Spasticity Stretching for all parts of your body on a regular basis.
  Pain Nerve pain from inefficient nerve transmissions Discuss option with your healthcare specialists for non-narcotic treatment options.
Exercise and stretch muscles.
  Misinterpretation of nerve impulses Increase in autonomic dysreflexia Know the warning signs and treatments.
Cardiovascular Poor return of blood through the veins Orthostatic hypotension-low blood pressure, fainting Keep up with drinking fluids.
  Decreased elasticity in the arteries Hypertension Exercise and medication when needed.
  Ineffective distribution of oxygen in the blood Exercise intolerance If unable to perform the exercise routine that you did earlier, modify but stick with a plan.
Respiratory Decreased lung capacity Restriction of breathing, poor posture Breathe in deeply and exhale completely at regular intervals throughout the day.
Gastric Slower bowel absorption Slowing bowel leading to constipation, enlarged colon, hemorrhoids, colorectal cancer Increase roughage in your diet.
  Changes in ability to control cholesterol Low HDL-good cholesterol Use medication as prescribed.
Urinary Less ability to filter urine Kidney stones Know your body so you can report a change to recognize there might be a problem so this diagnosis can be made without delay.
Endocrine Reduction in hormones Low testosterone Discuss treatment options with your healthcare provider to see if you want treatment for this condition.
  Decreased metabolism of insulin Higher incidence of Type II Diabetes Perform exercises as you are able.
Medication as necessary.
Immune Slowing of the immune system reactions Increased chance of infection Wash your hands frequently.
Use strict cleanliness with catheterizations.
Avoid individuals with respiratory infections.
Skin Decreased elasticity Increase in skin breakdown Pressure releases.
Skin checks.
Digestive Lower calorie needs Obesity, stomach pouch Follow a nutritious but portion controlled diet.
Other age related issues such as prostate problems, gall bladder attacks, bowel problems, etc. maybe disguised in individuals with paralysis. Your healthcare professional should screen you for normal aging processes even if you don't have the typical symptoms.

Overwhelmed? I sure am just by writing this. These are issues everyone has as we age, with or without paralysis. My new year's resolution is to sit up straighter and breathe deeper. It has been hard to keep up with it and sometimes, I forget but then I recall and start again. Everyone has difficulty remembering to account for issues that are only potentially going to happen.

Don't worry if you are not perfect but know that these issues can occur so when age related changes do happen, you will know what they are. If you can take action to delay onset, try to do so.

All of the information in the chart is important but let me summarize with some really critical items for those with paralysis:
  1. For everyone skin becomes less elastic as we age. Hyper vigilance is critical. Skin pressure relief is imperative as is skin checks daily to ensure the skin is intact. What was easily glossed over at a younger age is now imperative. You don't have to make this your life's work in time checking. A scan of the skin is equal to the time it takes to brush your teeth. Starting with good habits at a young age makes the task easier as you age.
  2. Urinary infections become an issue as everyone ages. The use of clean or sterile technique when catheterizing as well as maintaining personal hygiene and equipment sanitation is necessary to reduce the chance of infection. Knowing early warning signs of a UTI for your body will be useful to early intervention in older age. Checking the quality of an indwelling catheter can reduce the incidence of bladder cancer. Sometimes an indwelling catheter seems like the easier route to take to empty your bladder but it can increase the incidence of bladder cancer later so stay off the indwelling for as long as you can.
  3. Infections are cleared by taking antibiotics but every medication has risks and benefits. The body builds resistance to any antibiotic that you take so the more you take, the more resistance you have, eventually building to infections that cannot be cleared by antibiotics. When needed, definitely take them but try to maintain your health and hygiene so you will reduce your need for antibiotics. Drinking fluid will flush your system keeping your urinary tract clear.
Everyone ages at a different rate. Realizing and confronting health care issues head on is a way to slow the naturally occurring process of aging. Being proactive can assist you in living life to the fullest. There may be a time when you will require additional assistance but working ahead can prevent the complications of aging for us all.

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!

Nurse Linda

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Re: Aging with SCI

Posted by JOHN on Apr 28, 2015 4:25 pm

Nurse Linda,
Considering the consequences of an appendicitis rupture, is it recommended for Quads to have their apendics removed as a precaution?  I realize every patient is different and doctors have varring opinions but generally speaking, would this be a wise precautionary step?

Re: Aging with SCI

Posted by AskNurseLinda on Apr 28, 2015 4:39 pm

John, what a great thinking question. Appendicitis is something that your physician can rule out through testing. It is not routine for anyone to have the appendix removed just as a precaution if there is nothing wrong with it. After spinal cord injury, you want to weigh surgery carefully due to secondary complications. Typically, during bowel procedures as you have had, the appendix is viewed. You can ask the person who did your bowel procedure how the appendix looked but I would ask your current physician for their opinion about its condition currently. Have you seen a medical doctor yet? You should get a throrough work-up by a skilled physician. Nurse Linda

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