Living with Brown-Séquard

The initial diagnosis of a traumatic spinal cord injury can be an extremely difficult time for patients and their families and friends.  A spinal cord injury, even a less severe one like a Brown-Séquard injury, is a devastating life event.  The initial period of evaluation of the injury may be especially stressful, when it may not yet be clear that the injury to the spinal cord is partial, and indeed, a type of injury with better prognosis than other partial cord syndromes.  During this early period it is almost impossible to say how severely an individual will be affected, as the initial constellation of symptoms is the most dramatic.  This initial period also requires the most medical intervention to sustain an individual’s vital signs, which can be frightening to family members and patients.  In the initial period patients may not realize how much capacity they will have to improve.   Thus it is important for individuals to receive extensive education about their injury and about how the body functions.  Individuals also need to receive education and support about the social and psychological effects of their conditions.

Patients with this type of injury experience a deep kind of grief, similar to that experienced with the loss of a loved one.  In this case, the patient mourns the loss of his motor skills and sensory perceptions, as well as the loss of his independence and normal life.  This grief may wax and wane in intensity.  Individuals may experience a period of denial or disbelief in which they are unable to accept the significance of their injuries.  An individual may only come to accept his condition in small steps.  He may feel angry about the injury, at himself, at others, at God.  A patient may feel all of these things at different times.  There is no single pattern.  It takes time to process and adjust to these events, and that time is different for everyone.

Sometimes a normal period of grief can turn into a deep depression.  Depression is a medical condition characterized by extreme sadness, disruption of eating and sleeping patterns, feelings of hopelessness or worthlessness, and sometimes suicidal thoughts.  It is extremely important to get help for depression.  Even if a full depression is not present, psychological support can be useful to all individuals with Brown-Séquard.  Individuals with religious or spiritual beliefs may find support from their communities as well.

Eventually individuals come to accept their condition, at least to some degree, and they begin to move forward with their lives.  Many individuals with Brown-Séquard syndrome go on to lead very healthy, active, and fulfilling lives.  They continue to encounter new challenges as the rehabilitation process continues.  It may be difficult for some individuals to accept how much help they need, at first in the hospital, but also later as they try to return to the everyday activities of life.  Though the situation is challenging, it is helpful to maintain a proactive and positive point of view; we all have the power to change how we think about the events in our lives.  Appropriate self-care is extremely important in functional recovery, as well as in maintaining a healthy emotional life.  It’s best to maintain an attitude of helpful optimism without holding on to unrealistic expectations.

Family and friends may also experience grief and other emotions about the injury.  A spinal cord injury changes the lives of everyone who is close to that person. The family dynamic may change, and families may find themselves under financial pressures.  It is important for friends and family members to acknowledge and deal with their own emotions, even as they try to support the injured individual.  It is important for these individuals to take care of themselves as well.

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