Spinal Cord Injury and It's Emotional Impact
Learning to cope with a spinal cord injury spans much further and in much more complex ways than adjusting and learning to cope with the visible physical trauma. It is a life-changing experience and the impact that this can have on emotions, lifestyle and relationships is huge. The impact of a spinal cord injury not only directly affects the individual but also their family and all those close to them and it is vitally important that this is recognised.
This article will focus on the most common shared difficulties faced by those suffering from a spinal cord injury and those closest to them. Primarily focusing on the initial psychological impact, ways to cope with a newly curbed independence, changes in sexuality and fertility and ways to cope and manage with these new adjustments. Understanding and finding ways around such complications can, in most cases, be half the battle.
Spinal Cord Injury and Initial Emotional Response
A spinal cord injury, complete or incomplete, will bring about changes and obstacles in the health, sexuality and independence of the individual. Learning to cope emotionally and to fundamentally accept these alterations can often be the hardest, yet most crucial, part of the rehabilitation of any spinal cord injury.
In the first months after the injury has occurred, it is very common that all parties involved will experience a whole spectrum of emotions relating to the spinal cord injury and the impact that it will have on everyday life. It is usual to react in a range of ways including, but not limited to, disbelief and refusal to accept, grief over the aspects of life that the injured has lost, anger that you could not prevent the accident or that you were not there and general resentment of the situation in its entirety. It is vital that these feeling are expressed. Leaving and letting them sit or stew can be extremely detrimental. Communication is key and keeping these channels open to discuss how you and your loved ones are feeling is vital.
Spinal Cord Injury and Learning to Live An Adjusted Lifestyle
It is inevitable that a spinal cord injury will ultimately result in lifestyle adjustments, for both the injured party and their family. For those loved ones, family roles will change as people will take on more responsibility for the care and support of the injured individual. You may find yourself helping them to dress, bathe, move between their bed and their wheelchair, completing everyday tasks like shopping.Whilst many people do this without a second thought, it can still take an emotional and psychological toll. In this instance, it is important to remember to take time to talk. Resentment, if allowed to take over, can be very damaging indeed. Address potential issues before they become issues at all.
If caring for a loved one it is easy to start to feel trapped and that you want to or have to stay by their side and be with them at all times.. Your free time is consumed by catering to the needs and wants of your loved one. It is important to not let this sort of situation consume you - although admittedly this is easier said than done. The injured individual, in most cases, will not want to,will be very conscious of feeling like a burden and may not want ‘special treatment’ that they consider is beyond necessary. Take time to yourself and time out together to forget about the daily struggle, away from the home. This is very important to both the injured party and the whole family to remind themselves that fun can still be had and that most importantly you are still alive and together.
Special attention needs to be paid if it is a teenager or child taking on the bulk of the caring responsibility; as it can have a negative impact on their schoolwork and social life. They need to be supported at school as well as home and know that they are not alone. There are many charities and groups that are available to help young carers.
“Regaining an assisted independence.”
After suffering a spinal cord injury it is very common for independence to be greatly reduced by a lack of functional ability and in the case of spinal cord injuries, the smallest of things can often be of great comfort. It is important to know what the options are. Currently there are a plethora of assistive technologies available that can greatly improve on what is felt to be a limited independence. Assistive devices aid in a spinal cord injury individual regaining an assisted independence.. For example, there are assistive technologies that can help you access your desktop computer, laptop or tablet through controlling mouthpieces or eye tracking devices. These can often enormously aid the individual's feelings of isolation as computers today are a hub of communication and can connect someone who feels trapped inside to the whole world outside.
in the aftermath of a spinal cord injury, it is common to think that more intensive tasks like driving and walking may never be achievable again. However, this isn’t strictly the case. Vehicles can be altered to suit paraplegic and tetraplegic cases. This is, of course, conditional and subject to assessment,but in many cases being able to drive allows a huge amount of independence to remain. There is also currently a significant amount of research being conducted into exoskeletons and, more promisingly, Nutlins, a group of drugs currently being trialled for cancer treatments that could herald very promising advances in the formation of a treatment for spinal cord injury.
Sexuality and a Spinal Cord Injury
It is likely that initially after a spinal cord injury intercourse is the last thing on your mind, as either a partner or as the injured party. However, it is important that it is not ignored. Sexuality does not simply refer to sexual acts, but is also part of our personality. “It includes one’s self-perception, self-esteem, personal history, personality and concept of love and intimacy. It makes us what we are.” Being cared for and the lack of privacy that this brings may deter any thoughts of intimacy.
However, in the long term, “the need for sexual expression is never lost as a result of an injury or illness. Every person is a sexual being. Every person has the right to sexual expression. It is up to the person to discover the kind of sexual expression that works for him or her and the best way to achieve it,” (Kroll and Klein 1992). This is not necessarily about pleasure, but about feeling like a complete person who is in charge of their life once again.
“Sexual function is highly complex, involving a continuous combination of psychological, hormonal, vascular and neurological factors,” (Frohman 2002). Individuals who suffer spinal cord injuries may experience a whole range of or just a few sexual reductions, shaped by some, or indeed by all, of the previously mentioned factors. Nevertheless, it is the neurological impacts following the injury that undoubtedly have the most enduring and problematic effect on sexual functions and ability.
Though sensation around the genital area is often absent,significantly altered or diminished, you may experience an increase in pleasurable sensations around and above the level of the lesion. It is important to remember that the brain is the primary sexual organ and as such areas such as the nipples, neck or scalp can become erogenous and it may be good to explore and capitalise on these changes.
It is important to discuss your situation with your partner and/or a member of medical staff that you feel most comfortable with, during your rehabilitation process, whether that be a urologist or occupational therapist. Today there are many options available to aid and assist the continuation of leading as normal and fulfilling an active sexual life as possible, long after the injury. What is important is to explore and identify are what alternatives work for you and that both you and your partner are comfortable.
Fertility after a Spinal Cord Injury
It is a common misconception that once you have suffered a spinal cord injury parenthood can no longer be on the cards. However, this is not conclusively the case. Although each case will need to be looked at on an individual basis, female fertility, on the whole, is not usually affected. Special care, however, and medical intervention may be required at the time of birth and throughout the pregnancy. It must be noted that females with a spinal cord injury will experience an interval of amenorrhoea (lack of menstruation) which is the body’s natural reaction following disturbances caused by such a trauma.. This pause normally lasts up to six months, if it does last longer you should discuss with your doctor, as you may need further treatment.
Male fertility following a spinal cord injury, unfortunately, is not quite so simple. More often than not a decrease is experienced due to significant problems with the ejaculation process following a spinal cord injury. However,there are treatments and medical equipment available that can help to improve the chances of conception and you should discuss your options further with your doctor.
There is life after a Spinal Cord Injury
As discussed, suffering a spinal cord injury, although bringing about many life altering changes, certainly is not the end. Communication and openness between family members, partners and those closest to us is the key. Exploring what options are available to you with your occupational therapist can more often than not offer a huge amount of encouragement and hope for both parties. It boils down to understanding and learning to cope with the changes in your body, physically and mentally, that can make all the difference.
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