Health and medical information

As you put the puzzle pieces of your life together, you will adjust to your new situation, adapt to changing circumstances, and reconcile with reality. Adjustment is a balancing of all areas of life so as to bring about a more satisfactory situation. It includes the element of adaptation, the process of making modifications to deal with changing circumstances. Reconciliation is the recognition of the underlying consistency or congruity in your life, even when it has been disrupted by spinal cord injury.

However, before you can adjust, adapt, and reconcile to life with spinal cord injury, you need to work through old, unresolved issues. In this way you can enjoy the present and better plan for the future. The resolution of issues and needs left festering from the past is a priority before moving on. It’s like taking a car in for periodic tune-ups to correct what’s gone wrong so that it will run smoothly in the future. Your looking-back-in-order-to-move-ahead assessment will include the following personal checkpoints:

1.   Healing old wounds

2.   Checking out coping patterns

3.   Refraining personal appearance

4.   “Owning” your spinal cord injury

5.   Integrating disability into your life

6.   Relating to others.

In each area, you need to look at the challenges ahead and the strengths you have to meet them.

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Many health professionals express concern about how a patient will react if the issue of overweight and obesity is raised. They fear that it could damage the doctor-patient relationship. This sensitivity on the part of health professionals reflects the difficulties to be found in discussing obesity not just within a clinic setting but also in society in general.

In the author’s experience the majority of patients understands the reason for raising the subject, do not take offence and are often only too pleased that the doctor or nurse has expressed an interest and understanding of the significance obesity has on their potential disease development.

In raising the issue of obesity it is important that the clinician exercises good communication skills, finds the right language to use in that particular context, avoids the use of medical jargon and puts the effects of obesity in context with the rest of the patient’s medical history. For example, a patient is unlikely to embrace the concept of weight loss as a means of dealing with their type 2 diabetes if the role of medication (which would perhaps be their first expectation) is not discussed and put into context. The clinician needs to address the patient’s concern, discuss how much support is to be offered and to establish an agreed approach towards weight loss.

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Headaches regularly accompany meningitis. Meningitis means an inflammation of the meninges, the tissue covering the brain. This inflammation usually results from infection, but other causes exist as well. This section will discuss meningitis caused by infection.

When meningitis is caused by a simple virus, the condition is not usually serious. Viral meningitis is often part of a generalized viral infection, like a cold, although most colds do not cause significant involvement of the brain or its covering. Exactly why some viral infections cause meningitis is not known.

Viral meningitis usually brings with it a severe headache and an uncomfortable sensitivity to light called photophobia. Most patients also experience a very stiff neck. The stiff neck occurs because the meninges that surround the spinal cord in the neck region are inflamed.

A headache brought on by viral meningitis usually lasts only a few days, but it can be very painful and relief may require very strong analgesics. The viral infection responsible for the meningitis does not usually require antibiotics and in most cases will improve in a week or so.

Viral infections cannot usually be treated with antibiotics. Antibiotics are used when bacteria, like streptococcus (a “strep” infection ) or staphylococcus (a “staph” infection) are the cause of the illness. For the most part, the body’s own defenses are able to fight off viral infections.

Meningitis produced by a bacterial infection also causes headache and stiff neck, but unlike its viral counterpart, bacterial meningitis is a serious and life-threatening condition that requires prompt antibiotic therapy. Bacterial meningitis, often referred to as “spinal meningitis,” is associated with many serious neurological problems. At the time the stiff neck and headache first appear, however, the victim may not seem particularly ill, but hours later coma may occur.

Stiff neck and headache do not always indicate the presence of meningitis. A strained neck, cervical arthritis, or the overall achiness and stiffness accompanying colds that do not invade the nervous system may also produce headache and stiffness of the neck. Sometimes, tumors in the neck or the back of the brain can cause similar symptoms. A prompt medical evaluation of all cases of stiff neck is obviously very important.

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