Warm Temperature Regulation


By Patty Kunze, "The Rollin RN"

I am sitting at my desk with record setting temperatures outside, and thinking about spinal cord injury and our body’s inability to regulate temperature.  It’s just another ‘thang’ we are unable to perform.  But why does that happen to spinal cord injured individuals?  Why are we powerless to regulate our bodies in hot and/or cold?  Since its summertime, I wanted to discuss the whys and hows to normalize during balmy outside temperatures and how to provide a comfortable environment while sitting in our chairs.

A normal, healthy human is able to maintain a constant body temperature of approximately 98.6ᵒ F despite the temperature of the environment. In a hot environment, the body sends a signal to the brain via the spinal cord to say the body is overheating; the brain then sends a signal back down the spinal cord and tells the body to cool itself by perspiration which evaporates and cools the skin.  This is defined as a “normal” individual.  This definition does not apply to spinal cord injured(SCI) individuals.  The signal is halted at the level of injury.  These definitions can easily explain why I can sit in a room and suffer from heat and my poor husband is wrapped tightly as a cocoon in his blanket. When I get hot, it will take me twice as long to cool down.  Same occurs during a fever associated with illness.  If a high paraplegic or quadriplegic is in an outside temperature over 90 F, especially when the humidity is high, the body temperature will begin to rise.  The ability to sweat or to make goose bumps may be lost below the level of injury.  It will take longer to cool down after a spike in temperature.  A LOT longer!!!!
Signs that you are overheated:
·         Skin feels hot, dry and appears pink or red
·         High body temperature
·         Pulse is fast and may be weak and irregular
·         Feel dizzy
·         Feel weak
·         Headache
·         Feel sick to your stomach
·
Things you can do to help prevent getting overheated:

·         Stay out of direct sunlight, stay in the shade
·         Wear light-weight clothes
·         Wear a hat
·         Drink plenty of water
·         Place a cold wet towel around the back of your neck or purchase an advertised “cooling towel”
·         Bring a spray bottle to spray water on your body to cool off
·         Drink cool fluids and/or eat popsicles
·         Use fan or air conditioner
·         Avoid hot tubs
·         Be careful not to put your bare feet on hot pavement
·         Watch out for decreased urine output…this could signal dehydration, which can contribute to many other problems/complications!

If you get overheated:

·         Get out of the sun or hot room
·         Go to a cool place (stay under shade)
·         Drink plenty of water; do not drink fruit juices, alcohol or caffeine
·         Sponge off with cool water; shower if possible
·         Lay down until you feel better
·         Go to the hospital if you do not to feel better

·    If your overheating occurs from fever, take an antipyretic medication (Tylenol, Advil, or Motrin). Force fluids to maintain hydration.

The higher your injury level and the more complete an injury is, the greater the difficulty with temperature regulation. Avoiding extreme temperatures and a few select solutions can assist with overheating during the hot months.

Food for thought…..keep a bottle of lemon water in your hands at all times.  The water assists with hydration and the acidic lemon added will support healthy urine and aid in UTI prevention.

Remember it’s all good and let’s stay cool. 
 
References:
Health Facts for You. Retrieved July 27, 2017 from https://www.uwhealth.org/healthfacts/neuro/7578.pdf. University of Wisconsin Health.
How do spinal cord injuries affect your body?  Retrieved June 21, 2017 from  http://www.uiortho.com/index.php/how-do-spinal-cord-injuries-affect-the-body.html
SCI and body temperature regulation.  Retrieved June 23, 2017 from https://thequadfiles.wordpress.com/2011/08/02/sci-and-body-temperature-regulation/.
Spinal Cord Injury Education.  Retrieved July 21, 2017 from   https://www.wakemed.org/documents/Rehab/SpinalCordInjuryPatientEducation.pdf.
Photographs courtesy of Ramone Photography

About the Author:
Patty Kunze has been a Registered Nurse since 1983.  She holds a Bachelor’s of Science Degree in Nursing and worked several years in a Spinal Cord Injury Unit at the local Veterans Administration Medical Center as a new graduate.  She has been a flight transport nurse for Neonatal Intensive Care, an assistant manager of Labor and Delivery, and an instructor of nursing students. In 2009, she was involved in an auto accident which left her paralyzed (T3-4 complete paraplegic) from chest down.  But she continues her nursing career while sitting in her wheelchair as a nurse paralegal and writing articles for others with spinal cord injuries as The Rollin RN ™.

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