Archive for the 'Healthy bones Osteoporosis Rheumatic' Category
The kidneys usually function well after spinal cord injury. However, voluntary control of the bladder is usually lost. The bladder can become overfilled, resulting in high bladder pressures, and backing-up of urine into the upper urinary tract can lead to serious complications, including kidney failure. At one time, kidney failure was a common cause of death in people with spinal cord injury, but it is now a rare complication. Modern techniques for bladder management, especially intermittent catheterization, have revolutionized the care of individuals with spinal cord injury. Some major problems with bladder care do persist, however.
Some individuals with spinal cord injury cannot retain urine in their bladder and they urinate involuntarily, even when taking medications designed to suppress bladder contraction. Scientists are working to develop better methods of preventing this involuntary bladder contraction. Some people have an incompetent or “leaky” urethral sphincter, which allows urine to leak from the bladder at inconvenient times-Urologists can sometimes inject artificial material directly into the sphincter to tighten it. Urologists and biomechanical engineers are working to develop an implantable artificial urethral sphincter, but we don’t yet know whether these efforts will be successful.
For people who retain urine in the bladder and are unable to urinate, scientists are now developing methods for computerized electrical control of the bladder. In one system, an electrical stimulator produces contraction of the bladder’s muscles, causing it to empty. This research is still at an early stage but may someday lead to an implantable, artificial system for overall bladder control. The device would keep track of the volume of urine in the bladder, signal when the bladder is full, then stimulate the bladder to empty when so instructed. For some people, electrical stimulation of the bladder may need to be combined with an artificial sphincter system to achieve full bladder control.
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Until very recently, the party line was that from the perspective of bone density, Caucasians and Asians get the short end of the stick compared to African-American, Hispanic and Polynesian people. I was taught that thanks to gene pool differences, and a greater tendency to have small frames, white and Asian people have a significantly higher risk of losing too much bone mass, developing arthritis and suffering fractures. But I recently learned from Dr. Juanita Archer, a metabolic bone specialist at Howard University, that the most recent studies indicate that African-Americans have the same risk as Caucasians. Historically, black people were presumed not to be much at risk for osteoporosis and so by and large weren’t screened for it until there was already a fracture. When doctors challenged the assumptions they’d been working under, and started looking for low bone density in black women at random, they found it was prevalent in them, too. We don’t have the data yet, but I’m guessing that when we begin to look at other ethnic groups, we’ll discover the same risks.
FAMILY HISTORY
Your grandmother probably gave you many wonderful things both tangible and intangible, but if she had osteoporosis, good bones isn’t one of them. One of the primary warnings you will have that you are at higher risk of low bone density is a history of osteoporosis in your family. If your mother, father, sibling, or grandparent suffered from it (or lost height; or had a dowager’s hump or a hunchback; or got frequent fractures or fractures from minor trauma), you’ll need to pay particular attention to your own plan to avoid a similar fate.
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