04/04/12

Well today was a marking time day for Jules, after a night when sleep was more broken than usual she was very tired.  The session with the occupational therapist was difficult as a couple of new exercises for biceps and triceps required intense concentration and huge physical effort.  Her shoulders were aching after and she was exhausted.

 Jules has low blood pressure upon rising from a lying or sitting position which can cause dizziness and lethargy and is controlled with the use of a "binder" which is like a corset restraining the abdomen.  Jules felt the binder was tight yesterday and inhibiting her breathing.  This phenomen is called  is called Postural (Orthostatic) Hypotension.  Postural hypotension after a spinal cord injury (SCI) occurs since the blood vessels do not decrease in size, in response to lowered blood pressure, due to the altered function of the autonomic nervous system. Because of this, blood pools in the pelvic region or legs while she is in a sitting position. Postural hypotension usually occurs when a patient is initially placed in a wheelchair or on the tilt table.  This can be prevented by wearing elastic hose and an abdominal support (binder). Jules first had postural hypotension when they transferred her from her bed to a chair.  The nurse laid her back down and the symptoms were relieved. This action increased her blood pressure and the dizziness quickly disappeared, the binder minimises this .

Jules was off the ventilator for most of the day wearing the "swedish nose" or the speaking valve.  The speaking valve was only off when doing physio or resting.

 Kind regards Norm & Val