GETTING INTO REHAB
In the beginning the challenges ahead look daunting. The questions keep you up at night and evade you when the whitecoats suddenly appear only to disappear again. Intensive Care Unit staff and skilled nursing facility CNA's don't have answers for you. A good inpatient rehabilitation program does.
Individuals with spinal cord injury who go through an inpatient rehab program have much better outcomes.
You must be your own advocate. Your health providers or insurance may not want to send you to rehab. They may say your injury is so severe, rehab isn't possible. This is NOT true.
Rehab isn't going to work miracles or have you walking again, but every level of injury, even a complete high level one, can benefit greatly from the services of a good rehab. You will learn how to live outside a facility, with the help of physical therapy (PT) and occupational therapy (OT).
Rehab helps quadriplegics to increase independence. A rehab team includes doctors, nurses and physical, occupational, and speech therapists. At the rehab you'll receive around the clock nursing care and intensive therapy with the goal of regaining as much independence as possible.
What can rehab do for me if my injury is "complete"?
Your therapists at rehab are your ticket back into the world as a quadriplegic. Your physical therapist will help you to properly stretch and strengthen any muscles you have control of. They will teach you and your loved ones how to perform the critical range of motion exercises to avoid contracture in the body. They will teach you how to perform transfers from chair to bed and bed to chair.
Higher level quads will try out power wheelchairs that can be operated by head, mouth or even eyes, and a good rehab will give the opportunity to check out assistive technology using voice only, or mouth devices. They may even make custom adaptation equipment. Lower level quads will check out manual chairs and power chairs according to their motor function.
Your rehab may also have a psychologist to keep an eye on your mental health. Many quadriplegics agree that it's helpful to talk to someone right away- someone other than loved ones who are emotionally connected to your situation. They are also educated on dealing with PTSD.
Each of these therapists are our lifelines. Let them encourage you and push you. Communicate. What do you absolutely need to find a way to do again for the sake of your sanity? (a beloved hobby, a career, parenting) Your therapists should be there to help you work toward realizing that goal.
Of course some beloved pastimes cannot be recreated in any form, and your grief over your loss is understandably heavy! You may not be ready to hear it yet but you would be surprised to learn how many people with quadriplegia adapt and adopt new methods for achieving goals old and new. Remember to work on your mind as well as your body. See Chapter 10: Mental Health Matters.
What will you learn in inpatient rehab?
Acute Care
Tracheostomy care
Ventilator care
Incontinence Care
Therapists will show you and/or a family member/caregiver how to empty a catheter bag, and check it for flow and kinks.
C6-7 quadriplegics may learn intermittent straight catheterization
Therapists will explain and demonstrate how to perform bowel care, a process of using suppositories and digital stimulation to empty the bowels regularly, avoiding accidents and constipation.
Skin Integrity
How to turn the body to avoid shearing and pressure
How to keep pressure off heels at night
How to rotate body at night (you can also use air mattresses)
How to offload pressure in wheelchair
Body Maintenance
How to do passive and active range of motion exercises to avoid spasticity and contracture
Recommend boots/splints for night wear
Safe Transfers
Using sling and Hoyer lift
Proper placement
Slide board use
Transferring to shower chair
Wheelchair Tryouts
Try different wheelchairs from vendors
Learn driving skills