Diabetes care in patients with spinal cord damage

Article by Dr. Le Thu Huong – High-Technical Unit for Treatment of Cerebral Palsy and Autism – Share99 Times City International Health Hub

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Urinary disorders are a great part of the quality of life of the sick and their families. Therefore, urinary control and diabetes care are an important part of caring for spinal cord injury patients.

1. Where's the spinal cord injury?

The spinal cord located in the spinal canal is part of the central nervous system. Normally the spinal cord is very well protected in the spinal system. However, the pulp can be damaged due to the following causes: Trauma, pulpitis, myeloid vascular accidents, congenital diseases (hernia of the meninges, low adhesion), infectious diseases, tumors, cancer, pinching due to herniated discs … Depending on the location of the pulp lesion, there are different manifestations, the general characteristics are below-the-lesion motor defects, urinary disorders and other acute injuries (muscle atrophy, stiffness of the joints, embolism, ulcers caused by bleeding, pneumonia, urinary infections …).

Among the above problems, urination disorders are a great part of the quality of life of the sick and their families. Urinary disorders also lead to urinary infections, kidney failure, and may cause bouts of reflexive sympathetic disorder (AD) that increase blood pressure, reduce heart rate, headache, can lead to cerebral vascular accidents in people with damage of D6 or more. Therefore, urinary control and diabetes care are an important part of caring for spinal cord injury patients.

2. Common urinary disorders

Urinary nights in men

Night urination, repeated urination are 2 of the many common urination disorders

In the stage of myeloid shock immediately after the injury, the bladder is deactivation (loss of reflexes), after exiting shock, depending on the location of the lesion, the degree of damage, the bladder will have different manifestations of the disorder:

1.1. Symptoms associated with urine storage (filling phase)

  • Urinary fold
  • Rusty
  • Night urination
  • Urinate multiple times
  • Sensory disorders: Decreased sensation, loss of sensation, increased sensation, urgent sadness, bladder pain

1.2. Symptoms of urination (extortion phase)

  • Little hesitate
  • Sub-weak current
  • Intermittent minor
  • Sub-ridge
  • Urinary difficulty, urinary secret
  • Xiao long

1.3. Symptoms after urination

  • The feeling of urinating does not run out
  • Drip urination after urination

In these manifestations, urinary secretes and urination, urination does not run out of paddocks are the most common symptoms

3. Causes of urinary disorders

Normally, urine is produced from the kidneys, through the ureter 2 ureter to get down, stored in the bladder. 1 normal person has a bladder capacity of 400-600ml. When the bladder is full, it stimulates the end of the sensation of transmits sensory information along the S3 cord to the spinal cord and s lateral muscles in the bladder neck are opened. At the same time, from the spinal cord broadcasts signals to the cerebral bridge, then to the cerebral cortex. If the environment is suitable (at the subjective will of the individual), the cerebral bridge sends a signal that allows the sysular muscles beyond the urethra to open and urination will be taken place smoothly.

In patients with spinal cord injury, due to loss of neuro-signaling between the spinal cord and the brain, or in some cases damage under the cone of the pulp (ponytail), signals between the bladder and the spinal cord are also affected, resulting in 8 forms of bladder and post-bladder sedular disorders :

Bladder disorders

Picture of bladder and sedd muscle disorders

3. Diabetes care in patients with spinal cord damage

3.1. Set urination

After damage to the spinal cord, most patients cannot urinate completely on their own, most have urinary insy, urinate, urinate. And these patients usually have a urinary in dinh.

Common types of urination and pros and cons:

  • Urinary circulation

This usually is inlet in the post-traumatic stage and should be drawn as soon as possible as soon as the patient stabilizes. In addition, urinary circulation is also used in the exacerbation of urinary infections for continuous drainage of urine during this time. Urinary circulation cannot be set for long due to the risks of urinary infections, pain, bladder bleeding when moving, bladder stones, and inconvenience in daily life

  • Clean Intermittent Urination (CIC)

It's an hourly type of urination to get urine with a clean cathe tube (usually Nelaton's).

Advantages: Compared to urinary circulation, intermittent urination shows superiority in independence in daily life. Instead of regularly wearing urinary cathees and urine-containing bags such as urine types, patients will use intermittent urination at certain hours, just like an average person goes to the toilet by the hour. Intermittent urination helps to obtain the entire urine in the bladder in the most physical way like the average person, limiting urination, being active in daily life, not causing the bladder to shrink as small as urinary circulation, limiting bladder stones, limiting the possibility of urinary infections. Depending on the patient's ability to urinate, the volume of urine residual, the patient has in order to place intermittent urination with different times

  • Ordinary people: V sub-residual <50ml
  • if <70ml – Không đặt thông tiểu
  • 70-100ml: consider ordering urination once a day
  • 100-200ml: Once a day: Priority booked in the evening before bedtime for better night sleep.
  • 200-300ml: twice daily in the morning when waking up and in the evening before bedtime
  • 300-400ml: 3 times daily
  • >400: 4-6 times/day

Disadvantages: Like other types of urination, intermittent urination can cause urinary infections, damage to the urethra, very rarely the possibility of perforation of the bladder. To avoid these disadvantages, patients need to comply with the regulation of esthema, apply gel (water-soluble gel – KY)

  • Urination on the pubic bone

As an option for patients with spinal injury urination disorders that can not be placed intermittent urination, for example patients with urethral lesions, 2 difficult motor hands (patients with CS neck injuries). Advantages: longer circulation time than urination, less bleeding when moving, can change the information itself

Cons: There is a risk of urinary infections, shrinkage bladder, bladder stones

Patients with cathethe tube

After damage to the spinal cord, the majority of patients are unable to urinate on their own and will often have a urinary in dinh

3.2. Rehabilitation

For neurological disorders of urination, settings is the most optimal measure to protect diabetes. In addition, at the rehabilitation center, patients can participate in a number of treatments and interventions to improve the problem of urination disorders. These measures improve the functioning of the bladder and urethral sysic muscles, improve the ability to urinate, alleviate disorders, for example, bladder sensation disorders, bladder pain, urinary insuria, which in early words can improve the quality of life:

  • Strong perineal muscle exercises for patients with urinary leakage due to weak urethra sysing muscles, weak pelvic floor muscles
  • Bio-feedback exercises improve motor function of sysy muscles and perineum muscles
  • Neuro-stimulation exercises improve the functioning of the muscles of the bladder, urethra sysing muscles and the conditioning of bladder activity – s lateral muscles, improve sensory disorders, relieve bladder pain

3.3. Nutrition and other care

  • Drink plenty of water: Should drink about 2l of water / day, do not use water with gas, should use more orange juice, lemon
  • Increased use of foods rich in Vitamin C
  • Use the drug prescribed by the doctor, do not voluntarily stop the drug, stop the urination if it has not been agreed by the doctor.
  • Record urination, check urine and urinary system regularly as in dinhed, measure uroly uroly regularly with patients with in dinh

Share99 International Health Hub with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in neurological examination and treatment, patients can be assured of examination and treatment at the Health Hub.

To register for examination and treatment at Share99 International Health Hub, you can contact Share99 Health System nationwide, or register for an online examination HERE.

SEE MORE:

  • Cure urinary disorders with physical therapy
  • First cure for urinary disorders caused by meningeal hernia with stem cells
  • What is urinary ina autonomy?

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SEE MORE:

  • Learn about urination disorders
  • What is urogenital measurement?
  • Causes and signs of urinary tract inflammation

About: John Smith

b1ffdb54307529964874ff53a5c5de33?s=90&r=gI am the author of Share99.net. I had been working in Vinmec International General Hospital for over 10 years. I dedicate my passion on every post in this site.

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