Disability is a condition that makes people unable to carry out their normal daily activities. Disabilities manifest themselves differently in each individual and their severity varies from person to person. These disabilities can range from poor eye sight which can be considered mild to brain injury which in this case is a severe disability. (McIntosh & Philips, 2002)
This case study seeks to explore the concept of disability with reference to paraplegia, a condition I chose due to its prevalence and severity as well as the impact it has on the society. My discipline is nursing and I also wanted to show its prevalence and severity as well as its relevance to the nurses.
Paraplegia is a form of disability that involves the paralysis of the lower body out of a spinal cord injury (SCI). This paralysis can either be complete or incomplete and the major cause of this condition is a severe injury experienced in the spinal cord that impairs the nervous system making it impossible for the brain to communicate with the body’s lower part. This injury causes extensive damage to the spinal cord which in turn affects the mobility of the lower body and in this condition, both legs are affected and the trunk may also be affected. It is important to note that the extent of damage does not go to the arms of the victim (Spinal Injury Network, 2009).
Statistics show that paraplegia is recording new cases every year resulting mostly from automobile accidents on our roads. In the United Kingdom, up to 666 patients with paraplegia were admitted in the spinal injury centre in 2000. Those admitted in hospital with diseases related paraplegia totalled to 159. This brings the total to 825 and this does not include those who were admitted in general hospitals. These statistics also exclude those who died on the spot from paraplegic related injuries. In the United States for example, up to 11,000 cases are reported yearly and these are seen to be alarming figures (Apparelyzed, 2008) (a).
It is estimated that up to 250, 000 people are living with paraplegia and the yearly deaths related to paraplegia are placed at 6%. This condition is common with young men below the age of 26 and drugs and alcohol have been linked to the many accidents that lead to spinal cord injuries (Jewett, 2010).
The known causes for spinal cord injury (SCI) include trauma or disease that affects the spinal cord. Trauma encompasses those distresses got from falls, automobile or motorcycle injuries, injuries resulting from sporting activities as well as those got from gun shots among others. Jewett (2010) states “Diseases that may cause damage to the spinal cord include spinal bifida, polio, friedreichs ataxia and transverse myelitis among others” (p, 67)
Lesion is the word used to refer to the damage that is caused to the spine. “Paraplegia can therefore be adequately defined as the injuries that occur in the lumbar, the thoracic and in the sacral regions and these injuries can be referred to as complete or incomplete depending on their severity” (Riva, 2001).. Complete spinal injury implies that the victim has undergone total paralysis in their lower body and this means that they will not be able to move their lower body at all. An incomplete spinal injury means that the victim has undergone partial paralysis and thus will have sensation in the lower part of their body. “When a person undergoes incomplete paralysis, he will suffer from syndromes such as the central cord, brown sequard, posterior cord or anterior cord syndrome” (Apparelyzed, 2008) (b).
Paraplegia is accompanied by varied symptoms which amount to the impact of the condition on its sufferers according to the extent of the injury. The impact of paraplegia on a person will include limp muscles in the legs and they will be unable to move any part below the injured area. They loose their feelings and this makes it hard for them to feel anything. Victims will also loose control of their bladder and bowel and breathing becomes problematic unless aided. The patient will also experience sexual dysfunction and psychosocial problems which can lead to depression and suicide. They loose their self esteem and feel helpless since they loose their mobility and depend on others for almost everything. However, these impacts can be reduced through proper medication and therapy (Riva, 2001).
The treatment for paraplegia also depends with the extent of paralysis. The health specialist that walk the patient through this disease include neurology nurses, regular doctors, psychologists, respiratory therapists, social workers, occupational and physical therapists and speech pathologists. To establish paraplegia, the care givers always test their patients to be able to initiate the necessary form of action towards recovery. These tests include the neurological ones that seek to establish which part of the spine is injured. This session is coupled with questions as the medic explores the possibilities which would have led to the spinal cord injury. X-rays are also an effective way of examining the damaged part of the spine. To check on further injuries, the medics may use a CT scan to take pictures which will show the extent of the injury to the spine (drugs, 2010).
An MRI (magnetic resonance imaging) is another test that is administered to establish the spinal cord injury. This kind of test is administered when a person is experiencing pain or spasms in the muscles. The treatment offered for paraplegics varies according to extent of injury. This treatment involves hospitalisations which the medics recommend in an effort to monitor the patient for some days. During this time, medication and therapy is administered in an effort to restore the patient to usual health.
Paraplegia is characterised by paralysis which may cause a person to loose control of their body functions as listed in he symptoms. People loose their mobility and this makes them bed or wheel chair ridden. Due tot this condition, the medics most of the time recommend rehabilitation of the patient to guide the patient on self management (Drugs, 2010).It is important for a patient to learn how to take care of themselves after this tragic event. Rehabilitation involved has different categories according to the nature of injury and the impairment that has resulted from the injury.
The roles of the nurses and interprofessional team in a paraplegic’s recovery process are diverse. One of the treatments the nurses offer includes bladder and bowel control where the patients are taken through exercises on how to manage the movements. To support the injured ligaments in the lower back, the patient is introduced to braces which help in managing the injury and some of the braces widely used include a plastic body cast or jacket. Rehabilitation includes advice on medication, and the nurses guide and advise the patient on medicine usage and their importance on their road to recovery. They ensure that the patients take their medicines as prescribed by the doctor (Drugs, 2010).
Some of the medications used with paraplegics include steroids which ensure that the spinal cord does not swell. If the swelling has already taken place, the medication then embarks on reducing it and at the same time improves the flow of blood. Osmotic diurects is also used in the reduction of swellings on the spine. Blood pressure may be a resulting effect of spinal cord injuries and nurses help monitor it and ensuring that the patient takes the medication prescribed to curb this. This medication is important in that it ensures that other organs like the brain, heart, lungs and kidneys are not affected. It’s the role of the nurse to ensure that the patient’s skin is well cared for to reduce the occurrence of pressure sores, also known as decubitus, due to the resulting inactivity. They guide the patient through the skin care procedures and instruct them on the necessary action if the sores occur (Drugs, 2010).
The role of the psychologists (mental health therapists) in a paraplegic’s recovery is to help the patient and the family to cope with the sadness and mental stress brought about by this condition. The sudden changes maybe overwhelming and could in many cases lead to psychological disorders which could push the patient to depression. Therapists come in handy in the paraplegics’ recovery process as they offer them occupational therapy (OT). They major their therapies in helping the patient recover abilities such as dressing themselves up and feeding themselves. They basically embark on teaching the patient on how to take care of themselves, perform their daily activities and work related skills (Drugs, 2010).
Physical therapists (PT) are involved with physical exercises that involve the muscles, joints as well as general movement. They teach the patient on wheelchair usage which involves getting from the bed, chair and how to use the toilet. Social workers work towards reintroducing the patient to the community as an active member. They address their social problems in the society and provide solutions which help them regain their social status. Recreational therapists engage the paraplegics in fun activities which ensure that they do not miss out on their former activities. This helps them exercise and at the same time live their lives to the fullest while Respiratory therapists help the patients control their breathing system. Inactiveness experienced during the paraplegia phase may cause breathing problems which they seek to rectify (Drugs, 2010).
Paraplegia is with no doubt a lifechanging condition that needs to be handled by professionals to ease the effects on the patient and nurses play a great role in the recovery process as they help them manage it. Their role ranges from administrating the prescribed medications to advice on dealing with after effects that include sores and other skin problems. They aid the patient for the duration he/she is hospitalised and may also cater for them from home.
Paraplegia is a condition that affects many people as evidenced by the statistics and it requires to be taken seriously. It has adverse impact on the life of the patient and inclusion of interprofessionals and introprofessionals is of essence. They help a lot in the recovery process and work as a team to ensure that the patient recovers and takes life positively. These professionals range from psychotherapists, social workers, and therapists. With proper medication, therapy and counselling, the patients will be able to take the condition in their stride and be able to live again.
References
Apparelyzed. (2008) (a). Spinal injury statistics. Traumatic spinal cord injury Facts and figures. Web.
Apparelyzed. (2008) (b). Spinal cord injury: quadriplegic and paraplegic injuries. Web.
Drugs. (2010). Paraplegia after spinal cord injury. What happens to your Body when you have paraplegia? Web.
Jewett, S. (2010). Nursing comments. Treating and understanding a spinal cord injury. New York: AMACOM Div American Mgt
McIntosh, G., Philips, J. (2002). Disability support and services in Australia. Parliament Of Australia. Parliamentary Library. Vol (6)13-14
Riva, G. (2001). Virtual reality in paraplegia: a test bed application. The international journal of virtue reality. Vol. 5, No. 1.
Spinal injury network. (2009). Paraplegia. What is paraplegia? Web.