Transverse MyelitisAdapting to Change

Joy Sinclair

Professional Background

Post Graduate Certificate in Spinal Injuries at Stoke Mandeville

Marketing – large international pharmaceutical company- animal health division

Primary Health Care

Private Health Care

People living with TM experience the same later life issues as the general population but are also susceptible to a variety of health issues specific

to their condition

Physical changes

• Wear and tear on shoulders, wrists, hands- use right walking aids, splints, crutches - physio for exercises to stay flexible and avoid stiffness

• Change in bowel function- avoid constipation

- eat high fibre diet

• Change in bladder- Continence support; Continence Specialist Nurse- Bladder and Bowel Foundation Helpline: 0845 345 0165- Urodynamic tests e.g. bladder emptying- Urinary Tract Infections

Physical changes

• Fatigue- What is the underlying cause- Exercise – the right type and quantity e.g. Yoga, Pilates

• Pain- Pain management clinics- Conventional medicine- Alternative therapies

- NB always check for compatibility when using alternative therapies - Other options such as transendental meditation, acupuncture

Physical changes

• Spasms- Physio, exercises, night splints

- Passive movements- Medication; Baclofen

• Skin management- Prevention of pressure ulcers- Pressure relieving equipment, mattress, cushions- Tissue Viability Nurse

Psychological changes

• Mood changes - hormonal changes• Depression – family support, obtain appropriate treatment

Other factors• Disturbed sleep patterns

- establish cause• Intolerance to medications - long term use of analgesics• Memory loss

Wellness in late life

• The length of time a person has spent since onset of TM has a impact on increasing care needs for daily tasks

• Managing relapses, recurrence / fluctuations of old symptoms e.g. infections, temperature control, heightened sensitivity

• Maintaining friendships, hobbies, trying new activities

• Having the right equipment to ease daily activities

Wellness in later life

• Important to focus on nutritional needs and exercise both active and passive

• Annual MOT at a specialist centre / Spinal Cord Injury Centre

Social changes

• Difficulty with transferring• Maintaining independence • Managing adjustment to later life• Difficulty accessing SCI services• Failing health of partner / carer• Loss of a parent • Loss of partner / main carer• Abandonment

Mobility• Examine what methods of mobility have been used and consider how these can be adapted to changing functionality

• An Occupational Therapist could carry out an assessment and advise on any equipment changes

• Try aids for transferring – sliding boards, hoists, swivel seats

• If a wheelchair user, wear good quality gloves for propelling, to protect skin and help prevent carpal tunnel syndrome

• Explore add-on power pack for wheelchair propulsion

• Adaptations to your vehicle e.g. minor or major

Social Changes

Accessing care for the first timeDo you know who to contact when assistance is needed?

Professionals who can help:- Social Services, GPs, District Nurses, Occupational Therapist

Accessing increased levels of care

• Adult Care – Social Services• Needs assessment• May need ‘critical’ or ‘substantial’ need in a crisis• Benefits – carer’s allowance

Social Impacts

Adapting to Change

General Health

Weight

Later Life

Existing Co-Morbidities

Psychological Status

Upper LimbFunction

Length of time injured

Any Questions