Personal Health Safety

Posted by Nurse Linda in Life After Paralysis on December 23, 2020 # COVID-19, Health, Safety

This month, we have been discussing safety issues. Today, we will continue this topic with a look at how to provide personal safety within our own bodies. There are simple activities that can be accomplished to keep our minds and bodies healthy and safe.

Every day look at your fluid and food intake to ensure you have a healthy diet and hydrate your body. Your body requires maintenance to keep it running smoothly. Fluid and food are the fuel to keep your body in good shape.

We are in the middle of the holiday season. This year is looking much different. Typically, there are opportunities for overextending with activities and eating. Much of that type of celebration has been reduced due to COVID-19 restrictions, but there are still pressures to find gifts, to be present on zoom calls, and overeating from gifts of food or just boredom.

There are many wonderful things to do right from our homes, but there is also a loss of seeing people. The world has stepped up with programming that you can watch from your home. These activities are all great, but they still need to be crammed into your regular routines. Monitor yourself for overtiredness. Be sure you are getting healthy food, fluid, and sleep that you need to be at your best.man wearing mask

If you find you are being overwhelmed by the holidays, become lonely, or sad, contact your health professional. You do not have to deal with this time of challenges alone. Getting some help or direction will benefit your mental health. You can get information about how to strengthen yourself mentally.

If you become overwhelmed, you can always call the hotline. You do not have to be at the end of your rope. They can intervene with strategies to help you through. 1-800-273-TALK (8255), or visit https://suicidepreventionlifeline.org

COVID-19 has already been going on for a long time but keep up your vigilance. The end is on the horizon even though the pandemic is raging. It is important to keep up cautions, especially now. Remember the 3 W’s. Wear a mask when with others unless you have breathing difficulty or issues with hand function. Wash your hands frequently or after touching anything, someone else has touched. Hand sanitizer is a good substitute. Watch your social distance. Stay six feet apart from others or more if you can.

The COVID-19 vaccine is being distributed. By the time this blog entry is published, it probably will already be given to some. If you have questions about the vaccine, talk with your healthcare provider about it. This vaccine could save your life. But understand the risks and benefits for you as an individual with your unique healthcare issues. More will be learned about the virus and the vaccine as time passes.

Another personal consideration for your health maintenance is to keep your respiratory system healthy. This can be accomplished by breathing in as deeply as you can three times and exhaling slowly after each breath. Then cough as strongly as you can. The breathing process puts more air into your lungs, so when you cough, you can move around mucous, particles, and secretions in your lungs. This process helps to keep pathogens from building up. The three deep breaths inflate small alveoli in your lungs, where oxygen enters the body, and carbon dioxide is expelled. Coughing will move secretions to higher levels of the lungs so they can be pushed out. Try to do this a minimum of four times a day.

If you have an incentive spirometer, use it. The incentive spirometer was probably issued to you in the hospital. You may not have used it, but if you still have it, the time is now to begin. Incentive spirometers are different depending on the manufacturer, but they consist of one to three chambers, each containing a plastic ball. A mouthpiece is attached for you to inhale to force the balls up in the chamber. It does not matter which type of spirometer you have.

Your instinct will be to blow air out of your lungs, but the goal of the device is a strong inhale. It does not matter how high you can elevate the balls in each chamber the first time you use it. You might not be able to raise the balls. But keep at it, you will see that you can raise the balls more and more. You should even attempt to hold the balls up in the chamber for a matter of seconds for more lung exercise. Be sure to wash and dry the mouthpiece and connector after each use so you are not inhaling bacteria that collects from your breath moisture.

These photos are what incentive spirometers looks like. The images are randomly selected; your device may look slightly different. Any brand works well. Incentive spirometers are available online at a variety of prices if you do not have one. Try to use the incentive spirometer a minimum of four times a day.





If you use mechanical ventilation, the device can be set, so you have deep breaths incorporated into your ventilation programming. Some have a ‘sigh’ button so you can take a deep breath at your desire, but most often, the deep breath is programmed in. Suctioning or use of an insufflator / or cough assist device will help with secretion removal. With all breathing devices, keeping the mouthpiece and tubing clean is essential for avoiding respiratory infection.

Everyone should keep their mouth clean to avoid respiratory infection. If there is food in your mouth from eating, not swallowing effectively, pocketing of food, or food stuck in your teeth, bacteria are forming on it. If you should happen to inhale that food rather than swallowing it, the bacteria has now entered your lungs, creating the opportunity for infection. After eating, rinse, or brush your teeth to ensure food particles are not available to enter your lungs. Good oral hygiene has been demonstrated by research as one of the best and easiest ways to reduce your chance of lung infection or pneumonia as well as heart disease.

Oral hygiene is often overlooked by individuals especially if someone else provides it for you. A toothbrush with a suction attachment can be essential in making oral hygiene an easier task. Also, be sure to keep up with dental appointments to ensure your teeth and mouth are in excellent shape. If you do not have a dentist, you can locate one by using the ‘Near Me’ app on the Christopher and Dana Reeve Paralysis Foundation website or contact the Reeve Foundation Peer Mentor group for suggestions.

Vaccinations will help with your respiratory health. The pneumonia vaccine is given every ten years. The flu vaccination should be taken every year. Ask your health professional if the ‘senior’ dose flu vaccination is right for you. It is four times as strong as the regular flu vaccine. It is often provided to younger individuals who have immunosuppression issues, as is often found in those with SCI and other neurological diseases. The COVID-19 vaccination should be discussed with your health professional to make sure it is right for your individual health needs.

Another yearly testing to ensure your health include urodynamic and bone density testing. Urodynamic testing is a procedure that assesses the function of your urinary system. It is a good idea to get a urodynamic test before issues arise. Once a baseline is established, changes in your urinary system are much easier to detect. In the urodynamic test, sterile fluid is slowly dripped into your bladder through a sterile system. A special catheter is placed just for the duration of the test. This catheter has sensors, so pressures in your bladder and urinary sphincters are measured. A sensor is also placed in the rectum and sometimes on the abdomen to pressure in those sites.

For the urinary system to be effective, the bladder muscle must contract while the urinary sphincter opens. Incoordination of these pressures or extra pressure from the abdomen can upset this delicate balance. Individuals often are unable to detect changes in the pressures as there is no outward indication of this occurring. Aging can affect the urinary process. No one knows when aging or the length of time of injury will make this effect. Pressure build-up can lead to kidney damage, which is not correctable. A yearly urodynamic test will keep your entire urinary system working effectively and healthfully.

Bone density testing is also important as individuals with mobility issues tend to lose minerals in the bones from lack of standing. The bone density test is one of the easiest to do because you just need to lay on an exam table for a short period of time. A wand travels above your body, which will measure the density of your bones in predetermined places, usually the wrist, lumbar spine, and hip. This is another test where you need to have a baseline and continue to be tested annually to detect changes. Lower minerals in your bones that are detected early can be treated quickly. Bones with low mineral density are more prone to fracture, and sometimes they can be so frail, just gentle movements can lead to harm.

One other health habit is adding movement into your life. That will be discussed next week as the importance is critical. Nurse Linda

Pediatric Consideration:

The COVID-19 vaccine in children’s doses is not yet available but, as indicated in current information, could possibly be ready in about a year. Following the CDC guidelines should continue to be maintained even when adults have the vaccine. Children with breathing, neurological, and immunosuppression issues are, particularly at risk. The full list of children’s risk factors, precautions, treatments, and school issues can be found on the CDC website.

Children and teens should follow the same healthy habits, as indicated above. Sometimes adults think, my child is doing well. I don’t think we need these tests. However, after spinal cord injury or other neurological diseases, it is just as important to have these tests and treatments to avoid the early onset of issues. Discuss with your child’s healthcare provider if these same opportunities have not been suggested for your child. They are keys to maintaining health. Nurse Linda

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in our Heath & Wellness discussion.