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Get to Know the Disablities and Glossary of Terms

Learn about Amputations
Learn about the Challenges of Living with an Amputation
Learn about Paralysis
Learn about Paraplegia
Learn about Tetraplegia (Quadriplegia)
Learn about the Challenges of Living with Paralysis
Learn about Service-Connected Disability
Learn about Combat-Related Disability
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Challenges Amputees Face

An amputation, especially a major amputation, can affect all aspects of an individual's life. The most obvious is their physical life, but psychological, emotional, and social problems are also common.

The first tasks are adapting to simple mobility and self-care without the amputated extremity or extremities. This can range in difficulty depending on the number of amputations and their locations, as well as the overall health of the individual before and after the amputation(s). Physical Therapy is big part of helping the individual achieve these tasks, though the physical adujustment to losing a limb can be a difficult and long process.

There can be psychological and emotional difficulties with adjusting to life as an amputee. Some may go through a grieving period for their lost limb similar to a grieving period for a deceased loved one. There may be "phantom pain" where the individual feels pain where the limb would be. Amputees may experience difficulites with body image and depression. Counseling and support groups are a good way to tackle some of these issues.

Social isolation can be a problem that amputees face. Sometimes it is the fear of what other people will think about them, other times it's concerns over not being mobile or independent enough, which can lead to concerns that they will just be a hinderance in a social setting. There are many organizations that specialize in amputee sports and recreation as well as support groups and social groups to help with the above mentioned concerns.

There are additional medical concerns to be considered when dealing with an amputation. There can be concerns of heart complications because of a difficulty of the heart to effectively pump blood through the body. There are always concerns of infection at the amputation site which could also result in Sepsis.

Amputees face many challenges after the initial amputation(s), but they are not all just physical challenges and some of them last a lifetime. There are, however, people with amputations in every walk of life. Life is not over because of an amputation.

About Paralysis

Paralysis is the loss of muscle function in part of the body. It most often occurs because of damage to the nervous system, specifically the spinal cord. Major causes of paralyis come from stroke, trauma to the spinal column, and disease, though there are other causes. With a Spinal Cord Injury (SCI), the amount of ability is determined by the location of the injury. See the image below for a comparison of the areas of the body affected relating to the areas of the spinal column damaged. The regions above the injury should function as normal. Anything below the injury will have some level of, if not complete, disability.

Paralysis can be described as complete or incomplete. A complete injury means that the injury results in a complete loss of function below the point of injury. An incomplete injury means that there is some feeling or mobility below the point of injury. The American Spinal Injury Association (ASIA) Impariment Scale is often used to determine the level of injury:

  • A = Complete: No motor function (no voluntary control) or sensory function is preserved in the Sacral Segments, S4-S5.
  • B = Incomplete: Sensory, but not motor, function is preserved below the neurological level and includes the Sacral Segments, S4-S5.
  • C = Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade of less than 3.
  • D = Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade of 3 or more.
  • E = Incomplete: Motor and sensory function are normal.

Challenges Paralyzed Individuals Face

Living with paralysis has many challenges other than the lack of motor and sensory function that corresponds to the injury incurred.

The first tasks are adapting to simple mobility and self-care without the use of, or limited use of, the paralyzed limbs. This can range in difficulty depending on the level of the injury and resulting paralysis, as well as the overall health of the individual before and after the spinal cord injury. Physical Therapy is big part of helping the individual achieve these tasks, though the physical adujustment to loss of motor and sensory control can be a difficult and long proccess.

There can be psychological and emotional difficulties with adjusting to life as a paraplegic or tetraplegic. Some may go through a grieving period, especially if the paralysis occured quickly or unexpectedly. Depression is a common concern with individuals living with paralysis. Paraplegics and Tetraplegics may experience difficulites with body image. Counseling and support groups are a good way to tackle some of these issues.

Social isolation can be a problem that Paraplegics and Tetraplegics face. Sometimes it is the fear of what other people will think about them, other times it's concerns over not being mobile orindependent enough, which can lead to concerns that they will just be a hinderance in a social setting. There are many organizations that specialize in paraplegic and tetreaplegic sports and recreation as well as support groups and social groups to help with the above mentioned concerns.

There are many medical and physical concerns and possibly complications to living with paralysis. In most cases, as long as the symptoms are known and the paralyzed individuals are monitored, these complications can be avoided or treated.

  • Blood clots or Deep Vein Thrombosis is a common issue with paralysis. Walking and moving the legs promotes blood circulation, which prevents blood clots from forming. The risk of blood clots increases when the legs lack the ability to have movement or when excessive bed rest occurs.
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  • Autonomic Dysreflexia (AD) usually occurs with injuries to the T6 level and above as an over-activity of the autonomic nervous system causing an abrupt and dangerous rise in blood pressure. It is usually triggered by an irritating, painful, or uncomfortable stimuli below the level of the injury. This is a medical emergency and must be treated immediately.
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  • Pneumonia can be a problem with any injury from the Cervical to mid-Thoracic range. Since the ability to inhale, exhale, or cough effectively is diminished, secretions and fluid can build up in the lungs. This allows for bacteria growth and lung infections.
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  • Pressure Sores (bed sores or pressure ulcers) are caused by prolonged pressure to a specific area of the body. This creates decreased blood flow to the area. As a result the skin in that area starts to break down. They are most common in the bony areas of the body, such as the heel, ankles, or hips. Complications from pressure sores can result in Sepsis, Cellulitis, Bone and Joint infections and other problems. They can be life threatening.
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    Paraplegics and Tetraplegics face many challenges after their injury and paralysis, but they are not all just physical challenges and some of them last a lifetime. There are, however, people with paralysis in every walk of life. Life is not over because of paralysis.

    Combat-Related Injury

    As defined by U.S. Army Human Resources, combat-related injuries are injuries incurred in the performance of Military Duties including:

    Simulating War (exercises, field training)

    In general, this covers disabilities resulting from military training, such as war games, practice alerts, tactical exercises, airborne operations, leadership reaction courses, grenade and live fire weapons practice, bayonet training, hand-to-hand combat training, rappelling and negotiation of combat confidence and obstacle courses. It does not include physical training activities such as calisthenics and jogging or formation running and supervised sport activities.

    While engaged in Hazardous Service(e.g., flight, diving, parachute duty)

    Such service includes, but is not limited to, aerial flight, parachute duty, demolition duty, experimental stress duty, and diving duty. A finding that a disability is the result of such hazardous service requires that the injury or disease be the direct result of actions taken in the performance of such service. Travel to and from such service, or actions incidental to a normal duty status not considered hazardous and are not included.

    Through an Instrumentality of War (combat vehicles, weapons, Agent Orange, etc.)

    Incurrence during actual period of war is not required. A determination that a disability is the result of an instrumentality of war may be made if the disability was incurred in any period of service as a result of such diverse causes as wounds caused by a military weapon, accidents involving military combat vehicle, injury or sickness caused by fumes, gases, or explosion or military ordinance, vehicles, or material.

    As direct result of Armed Conflict

    The disability is a disease or injury incurred in the line of duty as a direct result of armed conflict. Armed Conflict includes war, expedition, occupation of an area or territory, battle, skirmish, raid, invasion, rebellion, insurrection, guerilla action, riot or any other action in which service members are engaged with a hostile or belligerent nation, faction, force, or terrorists.

    Armed Conflict may also include such situations as incidents involving a member while interned as a prisoner of war, or while detained against his or her will in custody of a hostile or belligerent force, or while escaping or attempting to escape from such confinement, prisoner of war, or detained status.

    U.S. Army Human Resources