Managing and Preventing Health Problems
Lifetime health and wellness are important components to management of your spinal cord injury (SCI). After SCI, there are often a number of medical problems affecting your body. Over time, many of the initial problems may improve. Staying as healthy as possible can prevent further medical decline and worsening of disability.
There are multiple risk factors for development of cardiovascular disease. These risk factors are generally the same for people with SCI as for people without SCI.
Some risk factors for cardiovascular disease are out of your control, including:
- Family history
There are other risk factors for cardiovascular disease which you do have control over, including:
- High cholesterol
- High blood pressure
- Diabetes management
- Physical inactivity
Reducing your controllable risk factors helps to reduce your risk for cardiovascular disease.
Additional Risk Factors for People With SCI
People with SCI may have additional risk factors for the development of cardiovascular disease. After SCI, there are often lower levels of good cholesterol, a higher percentage of body fat, and a higher level of glucose intolerance. In combination, these changes can increase risk for cardiovascular disease.
In order to prevent cardiovascular disease after SCI, you can:
- Attempt to control high blood pressure, high cholesterol, diabetes, and stress.
- Quit smoking.
- Lose weight.
- Eat a healthy diet.
- Increase physical activity.
Persons with SCI may be at risk for development of diabetes. Although healthy weight and food choices help to prevent diabetes, genetics also may play a role.
Diabetes mellitus is a common disease in which the body has high blood glucose (or sugar) levels that result from the body’s inability to make or use insulin. The most common type of diabetes in the United States is type 2 diabetes.
In type 2 diabetes, the body either makes too little insulin, or does not respond well to the insulin that is available. Insulin is important to move sugar from digested food into cells for energy. When glucose builds up in the blood stream, it can result in a number of complications, including changes to vision, sensation, and kidney function. Some of the complications from diabetes may be permanent.
Certain risk factors increase the chances that someone will get diabetes. Risk factors include:
- Family history
- High blood pressure
- Race or ethnicity
Unfortunately, having SCI also may increase the risk for diabetes, due to the changes in the body’s response to insulin. Steps to help reduce risk of diabetes include:
- Maintaining a healthy weight.
- Eating the right foods.
- Exercising if possible.
- Keeping blood pressure under control.
After SCI, a person may develop swelling in the legs. This swelling, called edema, may progress over time. In some cases it can increase the weight of the legs and lead to a bothersome appearance of the limbs. In extreme cases, edema can cause chronic skin changes, including sores and infections.
It is important to control edema in its early stages. Often, elevation of the legs and compression with stockings is all that is needed to manage edema. However, additional medical management or medical therapies may be indicated if edema continues to worsen.
Depending on the level of the injury, the lungs may be affected. Persons with high SCI may have difficulty with breathing or coughing. This can increase risk for pneumonia.
Often, assisted cough can help to clear the lungs of secretions. Assisted cough can be performed manually or with a "coughalator" machine. In some cases, additional pulmonary medications or treatments are indicated.
Persons with known pulmonary disease are often followed by a pulmonologist in order to maximize their pulmonary health.
Weight Management and Nutrition
Maintaining optimal weight after SCI can be challenging because there are many changes to the body’s metabolism. People with SCI may have issues with being underweight or overweight.
- Being underweight can increase the risk for more health problems, and can inhibit healing. Increasing calories from healthy foods is often needed to maximize weight. Sometimes, supplemental shakes or drinks may be needed in order to promote health weight gain.
- Some people have problems with weight gain after SCI. In addition to changes in metabolism, it is also more difficult to perform physical exercise. Both proper diet and exercise are traditionally utilized to help control weight. Because it may be more difficult to exercise after SCI, weight control may be more heavily dependent on changes to diet.
A dietitian or nutrition specialist may be helpful when planning dieting strategies in order to maintain a healthy weight. Some options for exercise include pushing a manual wheelchair for exercise, or using a hand cycle. The UPMC Body Changers program is also an option for patients with SCI.
Self-Management of Health
It is important to realize that many medical complications related to SCI can be prevented. Follow-up with your primary care physician and SCI doctor can help to identify and treat many medical problems. Although your caregivers, doctors, nurses, and therapists can help you with your medical problems, it is up to you to make the changes needed to keep yourself healthy.
Often, a person must make lifestyle changes in order to treat medical problems and prevent more problems from developing. It is important for you to take control of your own health. Being proactive about following up with your medical team and following recommendations for treatment are important to maintaining your health.
UPMC HealthTrak offers patients secure online access to portions of their outpatient/clinic medical records. It enables you to manage your health — online and on your schedule. With UPMC HealthTrak, you can:
- Get advice securely from your doctor's office.
- Review your medical history and test results.
- Renew prescriptions.
- Spot problems early by tracking glucose and blood pressure at home.
- Request appointments.
- Ask billing questions.
- Have an online doctor visit using eVisit.
You can sign up for HealthTrak at your next outpatient physician appointment.