My Experience with the Mitrofanoff Procedure – Or Something Like It!

By Roberta Palmer, RN

I have a spinal cord injury due to an ATV accident on 5/24/14.  My level of injury is T3 Complete.  I am a paraplegic with full use of my hands and arms and I get around in a manual wheelchair. Over time, I have become fairly independent. I am able to do most everything on my own although it just takes a lot more time, as we all know. 

The one big bother in my day was intermittent catheterizations (IC).  It was such a production.  Due to the level of my SCI, I am not able to feel when my bladder is full nor can I control my bladder to void when I want.  So I must use a catheter to empty my bladder 4 to 6 times a day.  Many paraplegics can cath from their wheelchair but I was never able to master it.  Being paralyzed from the chest down, I didn’t have the core strength to be able to get to the edge of my chair, get my pants down and manage to cath without falling over or seriously contaminating the catheter in the process.  So my method was to transfer into my bed to cath each time. The process took about 20 minutes and I always had to plan my day around being home at certain times to do this.  I felt like a slave to my IC routine.  Not only was it such a production, I still managed to get Urinary Track Infections (UTI's), regardless of how careful I was cathing.  It's just part of the female anatomy that lends itself to increased risks of UTIs when performing IC.  All that said, my Physical Therapist told me about a surgical procedure where you could cath from a very small stoma (an opening in the abdominal wall).  By doing this, you could cath in the chair and not have to deal with getting pants up and down or transferring to bed.  And there is less risk of contamination during IC due to location of the stoma.The surgery called Mitrofanoff procedure uses the appendix to create a pathway between the bladder and the stoma.

The Crucial Rotator Cuff

By Kate Helfrich, PTA, Certified Exercise Physiologist, ACSM

Rotor cuffs, rotary cups, “my rotator” - you name it, I’ve pretty much heard all the misnomers for the group of muscles and tendons surrounding your shoulder joint called the Rotator Cuff. Most people have either heard of it or think they know something about it. Since it’s a pretty crucial area for people of all ability levels, especially those who push themselves in wheelchairs, I thought it might be helpful to clear the air about the Rotator Cuff.

WHAT IT IS: The Rotator Cuff (also commonly designated RTC) is a group of 4 muscles and their respective tendons encapsulating the shoulder joint. 

WHAT IT DOES: Holds and helps stabilize the upper arm bone (the humerus) in the shallow socket of the shoulder bone (the scapula or shoulder blade). Secondarily, it also helps lift and rotate your arm (think of holding your arm out to your side and turning it palm up to palm down...that’s using your RTC!)

WHY IT’S IMPORTANT: We utilize the RTC all throughout our day when we use our arms for activities like propelling, styling our hair, getting dressed, putting a seatbelt on, or hooking an arm around the armrest to weight shift, etc. Since we utilize the RTC so frequently, it is prone to injuries such as tendonitis, bursitis and muscular tears. Making every effort to keeping this group of muscles strong and mobile is key to reducing or preventing risk for injury.

Paralyzed and Pregnant…Rolling with Baby on Board

By Patty Kunze, RNC, BSN, The Rollin RN ™ 
Patty Kunze, "The Rollin RN" & her family
What a “labor of love” in creating this article. The women seated in wheelchairs have rolled to the top of their highest mountains. They are some of the strongest women on this earth and NOTHING stops them. Next time you encounter a woman in a wheelchair think, “What is she all about and how has her life impacted others in a positive way?” Never underestimate a woman in a wheelchair because you will be astonished by what that woman has done since her life-changing incident.They are major go-getters, major winners, and major champions in their lives.   I have found lawyers, nurses, writers, artists, students, engineers, models, mentors, bloggers, volunteers, designers, you name it and I found it……all while sitting in a wheelchair.  That chair is only our mode of transportation but the true individual and talent is the one sitting in the chair. The chair doesn’t define us; it only made us 110% stronger as women. We all started out the same but some catastrophic event placed us in a chair but that was only the start of the climb. Once we started up the mountain there was no stopping us.  These women are the strongest women on the face of the earth.  Don’t let the wheelchair fool you.  Fact is only 18% of spinal cord injuries are women but there is a lot of FEMALE FORTITUDE sitting in that chair.

Researching the material on becoming a parent while spinal cord injured and being spinal cord injured (SCI) myself, I wanted to include every bit of information I could find. 
I have had children, two sons, and I went through pregnancy and delivery b.a. (before accident). Being a previous Labor and Delivery nurse, I knew the pertinent medical content that I wanted to include but after some thought, found it necessary to organize and funnel my knowledge to this particular subject, and compare and contrast it to spinal cord injured women. By revisiting this subject from a new perspective, I have had a total BLAST with this topic.  It was so much fun posing questions to my friends and sifting through the responses.