Spasms and stiffness of the limbs are inevitable after spinal cord injury. While I do not remember exactly when I began to suffer from spasms, I remember that the neurosurgeon mentioning about spasticity in my legs when I was still being hospitalized. Spasticity is the term used to describe the stiffness and involuntary jerking of the muscles.

After the spinal cord is injured, the nerve impulses from below the level of trauma are unable to reach the brain. As the control of limb movements depends on a two-way communication between the brain and the muscles, this disruption will result in an involuntary exaggerated contraction and flexion of the limbs, usually triggered by stimulation. And because the limbs are not moved as often as they normally should, stiffness of the joints will also develop.

Just about any stimulation can trigger spasms. Pain, heat, cold, excitement, anxiety and prolonged periods of inactivity like sleep can all initiate spasms. It can be an awkward moment in public when my legs go into spasms. This could be due to my wheelchair running over a bump. It could even be from exertion when I push my wheelchair.

Spasms are a bane and a blessing. When they strike, it can be painful and dangerous. To some it may just be a slight discomfort. It can be painful when the leg extends and kick on something hard, rough or sharp. It can be dangerous while picking up something from the floor and spasm strikes. I could fall off my wheelchair and hurt myself.

In the other sense, spasms are a blessing as they keep the limbs toned from the contraction of muscles and movements. It also aids in blood circulation and prevents osteoporosis to some extent. In my case, I manipulate my spasms to help me stand and walk on the parallel bars.

While spasticity will always be present, it can be reduced with exercises and medication. A daily routine of moving every limb will greatly reduce spasms and stiffness to a manageable level. Medication like Baclofen can be used to treat excessive spasticity but like any medication, there are always the side effects to contend with.

I have a spastic bladder. When it is filled with urine, a reflex will trigger the bladder to empty its content. However, my bladder is not fully emptied and some of the urine is pushed back into the kidneys. This condition is called a reflux. Prolonged reflux will lead to irreparable damage to the kidneys.

I was on indwelling catheter for 1 year after the spinal cord injury. It had to be changed every 10 days as it tends to get blocked after that. Infections are prevalent when using an indwelling catheter.

The catheter was then replaced with a urinary condom. The condom is not an ideal device as it tends to leak occasionally and restricts blood flow during erections. I have some permanent tissue scarring due to that.

7 years after my spinal cord injury, the urologist ordered an IVP (intravenous pyelogram) after I complained of pain around my abdomen and back. The x-ray showed swelling in both kidneys. He recommended intermittent catheterisation.

Intermittent catheterisation is where I lubricate a foley catheter with KY Jelly and insert it into my bladder to empty the urine. The catheter is then removed and cleaned under running water for reuse later. This procedure is repeated every 3 hours. One catheter can be reused up to several weeks.

Catheterising is a routine that I try to keep to no matter where I am. That is the only way to keep my kidneys healthy. When I am out, I wear adult diapers to prevent accidents just in case a disabled toilet is not available.

Foley Catheter
A latex tube of about 18″ in length. It is inserted through the urethra into the bladder to drain urine. If indwelling, water is used to inflate a balloon inside the catheter to keep it in place. A bag is attached to the flared end to store urine. Male

External Catheter
Also called the urinary condom. It is made from latex. Worn over the penis and secured with either the catheter’s own self-adhesive band or an adhesive tape. A bag is attached to the outlet to store urine.

Disposable Adult Diaper
Made up of 3 layers: A sheet of permeable material to allow urine to flow through but not back, a layer of fluid-absorbing gel and cotton, and plastic to prevent leakage.