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COMMON COMPLICATIONS OF SPINAL CORD INJURY: LOW BLOOD PRESSURE AND DECUBITUS ULCERS
Low blood pressure
Normal methods of maintaining blood pressure are sometimes damaged by spinal cord injury. Blood pressure may drop suddenly when moving from a lying to a sitting position, especially during the first few weeks after the injury. This phenomenon, called orthostatic hypotension, is what Franklin experienced when he got dizzy the first few times he tried to sit up.
To prevent a substantial drop in blood pressure when sitting up, you may need to wrap your legs or use an elastic belt around your abdomen in order to eliminate pooling of blood. Rising slowly also helps. At first you may feel faint and may even pass out, but this will improve with practice. Often, as in Franklin’s case, the problem is eliminated spontaneously with regular sitting and activity. For those with severe problems sitting up, a tilt table is sometimes useful. Faintness and dizziness on sitting up can recur whenever you’ve had prolonged bed rest.
Decubitus Ulcers
Pressure sores, or decubitus ulcers (also known as bed sores), develop on the skin in areas subjected to prolonged pressure that temporarily decreases the blood flow to that area. The skin can easily recover if the pressure is relieved, but when pressure persists, pain and eventually irreversible damage can result.
Decubitus ulcers are a potential problem in the absence of normal sensation in the skin, because the individual does not feel discomfort after putting pressure on one area for too long. The first approach to preventing decubitus ulcers when you are confined to bed is to change position every two hours, turning onto the side or onto your back. Once you begin sitting up in a chair, regular pressure releases will get pressure off the sensitive areas. These will become part of your daily routine for the rest of your life. The several kinds of pressure releases relieve the pressure of body weight from particular areas of skin.
A common type of pressure release for those who can use their arms is a wheelchair pushup, using both arms to lift your body above the seat for about a minute to relieve pressure on the buttocks. If you cannot use your arms, pressure can be relieved by using an electric wheelchair that automatically tilts back your upper body and thus shifts your weight. To prevent decubitus ulcers from forming while you sleep, you may need to change position every few hours. This may require assistance from another person.
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