Quadriplegia for Dummies

It took me a little while after my accident to fully comprehend what it means to be a quadriplegic. Most people cannot begin to imagine what it’s like to live life, paralysed from the neck down. I’m assuming that some would like to try to understand my condition because I’m asked about it repeatedly.

So I’ve put together a simple, easy-to-understand piece explaining everything to you. Please don’t be offended by my tongue-in-cheek humour. I must just emphasise, though, we are all individuals thus we experience our abilities, and disabilities, very differently. This is written from my personal perspective and own unique circumstances.

Each of us has a spinal column, made up of vertebrae, discs and a spinal cord which is a communication channel for the brain. It’s also referred to as a backbone – except, of course, if you are weak in character.
Vertebrae – 33 funny-little-roundish-bones with holes in the middle which are attached to one another to make a tunnel; the last four are fused, making up the tailbone. Whether you believe in Evolution or not, it doesn’t matter, wag it, Baby!

Discs – each vertebra is separated by this soft cushion enabling movement. Bend it, Baby!

Spinal cord – a bundle of nerve cells and fibers wrapped together like electrical-scooby-doo-wire going all the way from the brain, through the tunnel to the lower back.

The spinal cord enables your brain to communicate with your body. The brain sends and receives electrical signals via the spinal cord, every second of your life, giving instructions to your arms, legs and other body parts to keep you on the move. Electrify me, Baby!

When there is an injury to the spinal cord, the flow of information from that point, downwards, is stopped. Permanent damage to the spinal cord will prevent individuals from moving, leaving them paralysed.

Paralysis is the loss of control over voluntary movement and muscles of the body. It is also the loss of sensation and reflex function below the point of injury, including autonomic activity such as breathing and other activities such as bowel and bladder control. Other symptoms such as pain or sensitivity to stimuli, muscle spasms and sexual dysfunction may develop over time. SCI patients are also prone to develop secondary medical problems such as bladder infections, lung infections and bed sores.

Disability is any restriction or lack of ability to perform an activity in a manner considered normal for a human being. But, Baby, what is normal?

I had a car accident and broke my neck at the 4th Cervical vertebra. My spinal cord was stretched, pulling many of those scooby-doo-wires apart, but not all.

At this stage, God is the only electrician who knows how to put those wires back together again – and even He is obviously struggling or He would have done it by now. Surely? However, new research proves that spinal cord repair and regeneration is possible. But, for now it’s: We are aware of the problem. We are working on it. Please be patient.

So, for now, I am a C4 quadriplegic (incomplete). People often confuse paraplegic with quadriplegic. There is a huge difference.
Paraplegia – loss of sensation and movement in the legs and in part, or all, of the trunk usually resulting from an injury to the spinal cord below the neck (thoracic or lumbar area). Basically, you are screwed!
Quadriplegia (or Tetraplegic) – total or partial paralysis in all four limbs, including the trunk, usually resulting from an injury to the spinal cord in the neck (cervical area). Basically, you are double screwed!

Complete – means total loss of function and sensation below the affected vertebrae.

Incomplete – means only partial loss of function or sensation below the affected vertebrae. I can feel you in some places, Baby!
I use a wheelchair to get around. It’s my source of freedom. It gives me independence and power. I’m most certainly not confined to it like a prisoner with handcuffs. I’ll leave those for the bedroom, Baby!
I am also not wheelchair-bound because I’m not stuck to it permanently with some sort of super glue. I’m definitely not tied to it like a mad-rabid-woman-on-a-leash. Besides, I sleep in a bed – just like you do, Baby! The only difference is that I have a special-egg-shell-type mattress on my double-bed to help prevent pressure sores.
Pressure Sore (or Bed Sore) – a potentially dangerous breakdown of the skin due to pressure on an area of the skin resulting in infection and tissue death. It can get really ugly, Baby!

Many quadriplegics die as a direct result of complications related to pressure sores. Scary! I have to practice a strict routine of pressure release which is relieving pressure from the buttocks every 15 minutes in order to prevent pressure sores. Baby, bounce my butt!

I shower every day on a commode which is like a waterproof toilet on wheels. My bowel and bladder have to be manually emptied, everyday at a specific time to encourage a habit program so that regularity can be achieved. Let’s keep it regular, Baby!

I don’t wear nappies. I’m not incontinent. My bladder has to be emptied intermittently, usually 4 hourly, using a female catheter. It is a short, flexible, plastic tube resembling a thin straw which is placed in the urethra, extending into the bladder in order to empty the urine into a clear urinal bottle. It is important for me to see the colour of my urine for early detection of a urinary tract infection (UTI). No more moaning about leaving the seat up, Baby!

By choice, I use an indwelling, Foley catheter, at nighttime, which is a long, thin, flexible, silicon tube inserted through the urethra into the bladder and held in place with a small, fluid-filled balloon, draining continuously into a plastic urine bag on a special stand. No wetting the bed, Baby!

There are lots of other things I can’t do like coughing, blowing my nose, spitting and sneezing which puts me at risk of getting pneumonia. But, if my carer applies external pressure on my diaphragm it helps to increase the force of air in order to clear the respiratory tract. Oh, Baby, squeeze me tight!

Twice a week I am exercised, passively, by a physiotherapist while being strapped to a tilt table and elevated into a standing position. Yeah, Baby we can do it standing!

The weight-bearing and prolonged stretch is important to delay the onset of osteoporosis (loss of bone density) which is common after a spinal cord injury. Each of my joints is taken through its full range of motion. These exercises are designed to maintain this range and prevent contractures and spasticity.

Although it’s embarrassing, spasticity is not always a bad thing because it acts as a warning mechanism to identify pain or problems in areas with no sensation. It also helps me spot bladder and bowel problems, maintain some circulation and work my muscles. If my foot dances, turn up the music, Baby!

I’ve learned to listen to my body. It has an amazing way of telling me things, especially when something is not right. I usually know when something feels painful, uncomfortable or physically irritating by the signals my body gives me. I get goosebumps, Baby, and hot and sweaty!
Jokes aside – this is serious!

Autonomic Dysreflexia (Hyperreflexia) causes the blood pressure to rise to potentially dangerous levels. It can develop suddenly. I usually get a pounding headache, a sweaty upper lip and I’m extremely restless until I have identified the problem and sorted it out. It’s most often my bladder which is too full or my bowel needs to be emptied. Sometimes, it’s as a result of pain caused by an ingrown toenail or something similar. If not treated promptly and correctly, it may lead to seizures, strokes and even death.

There is a constant pins-and-needles-burning-type-of-pain over most my body which I have just learned to live with. I’m not numb, Baby!
In reality, all of us are facing our own unique challenges every day – we all have our issues. Baby, I have a whole magazine stand!

If there is anything else you would like to know, please feel free to ask me. Come on, Baby, ask me – you know you want to!