Life on Wheels (25 page)

Worrying how others see you, particularly at stages of disability when you are adapting to your new identity as a chair rider, can by psychologically stressful.

You might experience discrimination, such as being denied access to jobs or transportation.

Stresses with bureaucracies such as Social Security, Vocational Rehabilitation, Medicaid, Medicare, or other systems that you must rely on for support.

The simple act of breathing is an extremely valuable stress manager. When you take a couple of deep breaths and close your eyes, you can discover where you are holding physical tension in your muscles. Breathing allows you to notice that your belly is tight or your shoulders are slightly raised or that you are holding your head in a limited range. If you don’t have the use of your trunk muscles, keeping the area around the lungs relaxed is all the more important.

You already know how to breathe, of course, but you might be in the habit of breathing only in your chest. Even if your disability precludes the use of your abdominal muscles, you can imagine your breath starting from that part of your body. Imagine that the air you are breathing first goes all the way down to the very bottom of your lungs and out to the farthest small branches of the bronchial “trees” that make up your lungs. As you practice this method, you will find that you are able to comfortably take in more air. This ability to breathe deeply will help you counteract the stress response.

Another important technique for stress management is your own thinking. When there are parts of your life that are upsetting, staying focused on those problems increases the negative impact of the resulting stress. In time, you lose perspective and the ability to think objectively. Certainly it is healthy to experience emotions about events and challenges in your life, but it is not healthy to be continually overwhelmed by them. You can minimize the effect of stress by doing your best to relax, giving your attention to other activities and allowing your mind to have a rest from what is troubling you. When you come back to thinking about a problem, you will likely have a fresh perspective, and your body will not suffer so much from the tension, loss of nutrients, and other detrimental effects of excessive stress.

Meditation might sound like something that only Buddhist monks or Californians do, but it is a simple and powerful tool available to anyone, anywhere. Meditation is not about going into a trance, nor is it about superhuman concentration. To meditate, all you do is sit comfortably and pay attention to your breathing. That’s all. Your thoughts will continue but, each time you notice getting caught up in a certain thought, just put your attention back to your breathing. Decide that for the 15 minutes you will spend in meditation—or longer, if you choose—that any thought that comes to you will still be around later, and you don’t have to stop and explore it. The simple act of observing your breathing will allow you to gain a fresh perspective and help to moderate physical tension and emotions. Try it once a day for a week, without judgment, and see what happens.

Urinary tract infections or bladder infections are a constant risk for those with a neurogenic bladder. If not cared for promptly, a UTI can make you severely ill with high fever, spread to the kidneys, and ultimately kill you. However, the only reason an infection would reach these proportions is if you don’t take care of yourself.

Multiple sclerosis is often treated with immunosuppressive drugs that increase the risk of infection. Urinary complications are common with MS. Women more frequently have neurogenic bladders with MS than do men, and so they have more UTIs. When men with MS get infections, however, they tend to be more severe.

Some people with disabilities experience low-grade bladder infections two or three times a year without the infections being a major problem. Many other people find they constantly struggle with more severe UTIs. They find it difficult to hold a job or make social commitments because of the frequency of occurrence.

Despite a good bladder program, some people continue to struggle with UTIs. It has been a chronic problem for this 35-year-old woman with L5 paraplegia from an SCI:

The most common contributors to UTI are:

Failing to drink enough and empty the bladder often

Excessive intake of dehydrating drinks—caffeine or alcohol—and salty foods

Picking up infection from a sexual partner

Bacteria carried into the bladder on a catheter

The answer to the first is obvious—drink enough appropriate liquids and commit to a regular bladder program appropriate to your needs and minimize dehydrating foods. The third is solved by using condoms, urinating after sex, and paying attention to signs of infection, which indicate that you should employ sexual options other than intercourse until the condition clears. People who use catheters have a harder time preventing infections completely because they are regularly inserting a foreign object into their body. No matter how well you clean the catheter, some bacteria are going to get in. Nonetheless, practice the cleanest habits you can. Signs of a urinary infection include:

Fever

Sweating and chills