178 chapter 23
“Can anything be done about loss of bladder and bowel control?”
Yes. Although normal control rarely returns completely, the spinal cord injured child
often can learn to be independent in his toilet, and to stay clean and dry (except for
occasional accidents). Often he will need a special urine collecting device, will learn
to use a catheter, and will learn to bring down a bowel movement with a finger or
suppository. Management of bladder and bowels is discussed in Chapter 25.
VERY IMPORTANT INFORMATION ON URINE AND BOWEL CONTROL
IS IN CHAPTER 25. BE SURE TO READ THIS CHAPTER!
“What about marriage, sex, and having children?”
Many spinal cord injured persons
marry and have loving, sexual
relationships. Women with spinal
cord injuries can become pregnant
and have normal babies. Men may
or may not be able to get a hard
penis or ejaculate (release sperm).
Paraplegic and quadriplegic men
whose injuries are incomplete are
more likely to have children. Some
couples where the husband cannot
release sperm decide to adopt
children. Whether or not they can
have children, male and female
spinal cord injured persons often
enjoy loving sexual relationships.
Especially for young men, fear of the loss of sexual ability is often one of the most
fearful and depressing aspects of spinal cord injury. Honest, open discussion about this,
and the possibilities that do exist, with a more experienced spinal cord injured person
may help greatly. There is a good discussion of this in Spinal Cord Injury Home Care
Manual. See reference, p. 639.
HELPING THE CHILD AND FAMILY ADJUST
Spinal cord injury, especially in the child, brings many of the same problems as
does spina bifida. Also many aspects of rehabilitation are similar. (We suggest you
read Chapter 22 on spina bifida to get additional ideas for the rehabilitation of young
children with spinal cord injuries.)
Perhaps the biggest difference from spina bifida is that spinal cord injury begins later.
One day the child is physically active and able, the next he is suddenly paralyzed and
(at first) unable to do much for himself. He has lost all feeling and control in part of his
body; it is like a dead weight.
This is very hard for the child—and family—to accept. Both have an enormous fear
and uncertainty about the future. The child may become deeply depressed, or angry
and uncooperative. He may refuse even to sit in a wheelchair because this means
accepting not being able to walk.
Disabled village Children