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Patient and Family Spinal Cord Medicine Handbook Page 2 Patient and Family Spinal Cord Medicine Handbook Page 2 Table of Contents Table of Contents 2 Introduction: The Patient & Family Handbook 6 Handbook Contributors ................................................................................................. 6 A Brief Note About the Founder of Frazier Rehab Institute .......................................... 6 Getting Started ............................................................................................................. 7 Chapter 1: Comprehensive Rehab Goes Far Beyond the Rehab Center 9 Your Spinal Cord Medicine Team at Frazier Rehab Institute ....................................... 9 After Discharge from the Rehab Hospital ................................................................... 10 You and Your Family are Team Members .................................................................. 11 Chapter 2: Anatomy of Spinal Cord, Facts and Figures 12 Key Points .................................................................................................................. 12 The Spinal Cord .......................................................................................................... 12 The Spinal Column and Injury .................................................................................... 12 Who Gets Injured and How ........................................................................................ 14 References and Resources ........................................................................................ 15 Glossary ...................................................................................................................... 16 Chapter 3: Bowel Care 18 Bowel Movement After Spinal Cord Injury .................................................................. 18 Conclusion .................................................................................................................. 22 References and Resources ........................................................................................ 22 Glossary ...................................................................................................................... 23 Chapter 4: Bladder Care 24 The Urinary System .................................................................................................... 24 Conclusion .................................................................................................................. 32 References and Resources ........................................................................................ 32 Glossary ...................................................................................................................... 32 Chapter 5: Skin Care 34 Risk Factors for Developing a Decubitus Ulcer .......................................................... 34 Stages of a Pressure Sore ......................................................................................... 34 Care and Treatment of Pressure Sores ...................................................................... 36 Prevention of Skin Breakdown ................................................................................... 37 References and Resources ........................................................................................ 38 Glossary ...................................................................................................................... 38 Chapter 6: Medical Concerns 39 Autonomic Dysreflexia ................................................................................................ 39 Deep Vein Thrombus .................................................................................................. 41 Heterotopic Ossification (HO) ..................................................................................... 42 Orthostatic Hypotension ............................................................................................. 43 Spasticity .................................................................................................................... 44 References and Resources ........................................................................................ 45 Glossary ...................................................................................................................... 45 Chapter 7: Lung Care 47 Normal Anatomy and Physiology ............................................................................... 47 Patient & Family Handbook 3nd Edition – Spinal Cord Medicine Program UofL Health - Frazier Rehabilitation Institute - Louisville, Kentucky Copyright 2019 Page 3 Pathology .................................................................................................................... 48 Level of Injury and Respiratory Function .................................................................... 49 Oxygen Delivery Systems........................................................................................... 50 Diagnostic Testing ...................................................................................................... 50 Breathing Retraining ................................................................................................... 50 Pulmonary Hygiene .................................................................................................... 51 Respiratory Care......................................................................................................... 53 Warning Signs of Respiratory Problems – Call Your Doctor ...................................... 54 References and Resources ........................................................................................ 54 Glossary ...................................................................................................................... 54 Chapter 8: Cognition, Communication, and Swallowing 56 Cognition and Communication ................................................................................... 56 Swallowing .................................................................................................................. 56 Quality of Life .............................................................................................................. 58 References and Resources ........................................................................................ 58 Glossary ...................................................................................................................... 58 Chapter 9: Nutrition 59 Soon After Injury ......................................................................................................... 59 Once Medically Stable ................................................................................................ 59 Ideal Body Weight After Injury .................................................................................... 59 Health Issues and Nutrition: Food for Thought ........................................................... 60 Healthful Meal Planning – So Many Pastabilities ....................................................... 65 A Primer for Nutrients ................................................................................................. 66 Recapping the Role of Nutrition – In A Nutshell ......................................................... 69 References and Resources ........................................................................................ 69 Glossary ...................................................................................................................... 69 Chapter 10: Self Care & Activities of Daily Living 72 Dressing ...................................................................................................................... 72 Bathing ....................................................................................................................... 73 Toileting ...................................................................................................................... 74 Grooming and Hygiene ............................................................................................... 74 Feeding ....................................................................................................................... 74 References and Resources ........................................................................................ 75 Glossary ...................................................................................................................... 75 Chapter 11: Mobility & Range of Motion 78 Range of Motion ......................................................................................................... 78 Pressure Relief ........................................................................................................... 80 Transfers ..................................................................................................................... 84 References and Resources ........................................................................................ 85 Glossary ...................................................................................................................... 85 Chapter 12: Equipment 88 Wheelchairs and Cushions ......................................................................................... 88 Power Wheelchairs ..................................................................................................... 92 Power Assist Wheelchairs .......................................................................................... 95
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