PRESS NOTE ON WORLD SPINAL DAY:

Let me first ask you a question:  Can a SCI patient who is paralysed below his waist, who has no sensation or motor power in her / his legs, walk?
The answer may surprise you. The answer is a definite “Yes”!  Indeed we train many such SCI patients to walk – after training and with appropriate orthosis –
for half a kilometer,
climb up and down stairs,
climb onto a community or self-owned vehicle and
don and doff the appliance independently

I have the privilege to have got my post-graduate training in a Rehabilitation centre which was started by a person with a spinal cord injury. She used to operate from a wheelchair, and won the Padma Shri for the incredible work she did. This person was Dr Mary Verghese, and the institute is Christian Medical College, Vellore.
Because she herself was a spinal cord injured patient, she was thronged by patients with SCI. What makes SCI patients different from other patients is that they have problems that span many traditional specialties:
The medical and social problems that SCI patients who have paraplegia face :   1.  Motor weakness, paralysis, contractures  2.  Sensory loss, pressure sores  3.  Bladder incontinence, infections, stones, kidney damage  4.  Bowel incontinence, constipation, spurious diarrhoea  5.  Sexual dysfunction  6.  Dependence in activities of daily living  7.  Vocation / Education issues  8.  Psychological issues, mainly depression, sometimes anger or anxiety    As you can see in the traditional model one SCI patient would need the medical management of an orthopaedician, a plastic surgeon, a  urologist, a neurologist, a clinical pyschologist, plus others.

In this model – followed in many centres – what happens sadly is that it
fragments the care,
quadruples the cost,
confuses the patient, and
frustrates the doctors

However, thanks largely thanks to one man, it doesn’t have to be so:   After Dr Mary Varghese’s demise, the person who followed her saw the large number of SCI patients that were admitted, and decided  to help them in all their needs.
So he specialized in Orthopaedics, trained for 2 years in Plastic Surgery, and another 2 years in Urology, and then specialized in Physical Medicine & Rehabilitation. Thus he brought under one umbrella all the training required to holistically treat SCI patients.  All the residents who work at CMC Vellore are taught all the relevant aspects of the above mentioned specialities – and many more -  in the 3 years of their training.
The person who made this possible is Dr Suranjan Bhatacharji, who later went on to become Director of CMC Vellore. This kind of comprehensive, cohesive, cost-effective care is available in very few centres.  The PMR dept of St John’s Hospital, Bangalore is one them.  2 of our faculty have trained in CMC Vellore and all our post-graduates train their too. Thus our expertise and philosophy is very similar.
We are in a privileged position to help SCI patients, and they form the bulk of our in-patients. SCI rehabilitation includes all the 8 areas that I had mentioned before. SCI management is our core competency. Apart from training in CMC Vellore, I have also trained in a SCI centre at UK for 2 years. Our association with the Association of People with Disability which does amazing work goes back 20 years. I am here on this panel because I am on their Advisory Panel.

The aim of rehabilitating SCI patients is to enable a person to do the best that he or she is capable of doing. 
 Successful rehabilitation of SCI patients depends less on how much the treating professionals know about the patient’s condition, and more on how much the SCI patient and his family know about it at the time of discharge. 

In my mind, a successfully rehabilitated SCI patient is one who pays tax! Though this bar has been set very high, we do have many patients who are “Successful”.  However this largely depends on the status – socio-economic status, educational qualifications – of the person before he became a SCI patient.

In our dept of Physical Medicine & Rehabilitation at St John’s Hospital, we have a full fledged team which includes doctors, physiotherapists, occupational therapists, speech therapists, nurses, orthotists and prosthetists.

The central pivot around which rehabilitation revolves is in the belief that each life is worthwhile, and that everyone should try as far as possible to contribute to the family, the community and to the nation.
Our job is to try and get them jobs, and experience with them, joy