Life on Wheels (15 page)

Educate yourself about insurance options and your coverage.

Know your medical history.

Know your medications. Be familiar with all types of medications you are taking and which ones you’re allergic to. Before you accept a prescription from your doctor, let her know what medications you are presently taking, and ask her to check her

for any possible conflicts. Establish a good relationship with your physician.

Tell others about particular health risks. Inform those closest to you and most likely to be present should an emergency arise about particular health risks. For example, if autonomic dysreflexia is a possible complication for you, give close family and friends enough information so they know how to recognize it and how to respond.

Become a MedicAlert member. Consider getting a MedicAlert bracelet or necklace to help alert emergency medical services personnel and others in case of an emergency, particularly if you have difficulty communicating or have a nonobvious medical condition. The initial membership fee for MedicAlert is a minimum of $35, depending on the style, metal, and size of the bracelet or necklace you order. After that, the annual renewal fee is $15.

Execute a durable power of attorney document. A durable power of attorney for health care (DPAHC) is a legal document that must be signed by a competent adult. It allows you to transfer medical decisionmaking authority from yourself to a person you designate as your agent. Obviously, the person you select to be the agent of your DPAHC should be someone you know and trust and someone you feel is capable of making decisions based on your wishes. The DPAHC guarantees that your healthcare choices will be carried out according to your wishes, values, and beliefs. Once signed and witnessed by either a lawyer or a notary public, the DPAHC can only be executed if you are unable to make the decisions yourself, for example, if you are unconscious, comatose or cannot speak for yourself.

Autonomic dysreflexia (AD) is also called autonomic hyperreflexia or paroxysmal hypertension (among other names). Autonomic dysreflexia is particular to people with spinal cord lesions at or above the sixth thoracic vertebra, although it has been reported with injuries as low as T8. It is marked by an increase in blood pressure and should be taken very seriously. AD can cause stroke or seizures and can be life threatening.

The nervous system tries to send a message to the brain when it perceives an irritant to the body, such as a full bladder or a wound. Since the message can’t get past the spinal cord lesion to the brain, and since the brain can’t respond by sending inhibitory agents down the cord past the injury, a “hyper reflex” occurs. The body keeps trying to send the messages, and blood vessels tighten below the injury level. Above the injury level, vessels open, which causes the typical red, blotchy skin seen with AD.

Stimulations that can produce this response include:

Urinary tract infections

Impacted bowel

A full bladder

Pressure sores

Bladder, kidney, or gall stones