The CatWalk Spinal Cord Injury (SCI) Research Trust was founded in 2005 by Catriona Williams MNZM, formerly one of New Zealand’s leading international equestrian riders. Following a riding accident in 2002, she is now C6/C7 tetraplegic and confined to a wheelchair. Initially, a group of friends planned to fundraise for Williams herself – but a bigger picture quickly became clear. A cure for paralysis was Williams’ dream – and so CatWalk was born. We believe in supporting researchers in the very realistic bid for a cure for spinal cord injuries.
Catrionas’ illustrious equestrian career saw her reach the pinnacle of the show jumping and three-day event world. She represented New Zealand on the international stage at Badminton and the Open European Championships with the key target being the 2004 Athens Olympics.
Since that life changing moment in 2002, Catriona has completed the New York City Marathon and climbed to Everest Base Camp on a handcycle, was a finalist in the 2014 KiwiBank New Zealander of the Year, recognised in the 2014 Queen’s Birthday Honours list as a Member of the New Zealand order of Merit and most recently was the Community and Not for Profit sector winner at the NZ Women of Influence Awards.
Our key objectives are:
- Support the scientific opinion that a cure for SCI can be found.
- Promote and generate funding for research into a cure for paralysis.
- Identify and assist in medical research and development into techniques designed for the
- regeneration of the effects of spinal cord injuries.
- Monitor the research progress of all scientists funded by the Trust.
- Provide targeted assistance to organisations working on projects that promote the purpose of the Trust.
- Foster cooperation between all disciplines engaged in central nervous system research, regeneration and direct relief.
- Disseminate information about research into SCI.
- Cooperate with international efforts in this field.
The CatWalk Spinal Cord Injury Research Trust is registered as a Charitable Trust under the Charities Act 2005.
Charities Commission Registration No. CC27170
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Dr. Leanne McAlister, an expert in the field of Spinal Cord Injuries, answers the most common questions that arise when a loved one is injured. Dr. McAlister works at the Burwood Hospital in Christchurch, NZ.
What are the options for bladder management?
For a male the options are Self Intermittent Catheterisation (SIC), a Suprapubic Catheter (SPC) or an External Collecting Device (ECD/Uridome/Uritip). For women options include SIC or SPC. In very basic and general terms if there is adequate hand function and trunk control, SIC would be the usual option. If there is not adequate hand function and/or trunk control, or if there are other reasons why SIC is not appropriate, a SPC or ECD (in men only) is considered. An ECD can only be used if there is automatic emptying of the bladder when full (like a newborn baby) which is usually possible if the spinal cord injury (SCI) is above about T12/L1.
If with any of the above management options there is significant problems, then surgical procedures and various implants may be helpful, but require careful assessment, planning and thought before embarked upon.
Why do I get Spasm?
Before SCI, a normal function of the spinal cord is reflex activity. Usually however this reflex activity is only obvious when your body needs to instantly react without you thinking – for example when your hand draws back without conscious thought if you place it in hot water. For those with SCI above about T12/L1 these reflexes still occur – but now the messages from the brain that modulates these reflexes don’t get through the damaged part of the spinal cord well, causing spasticity – or over exaggeration of these reflexes. If the SCI is below about L1, spasticity is very unlikely.
Will I be able to get an erection/ejaculate/orgasm?
Most men and women with SCI experience changes in sexual function after injury. For men there can be problems gaining and/or maintaining erections, lost or decreased sensation and inability to ejaculate. For women, changes include less vaginal lubrication and decreased sensation. For men, paraplegics are more at risk of erectile dysfunction than tetraplegics. However the good news for men is that Viagra and other medications for erectile dysfunction, vacuum pumps and penile rings can help most men achieve and maintain erections for intercourse.
If these don’t work, there a whole range of other approaches to sex and intimacy that those with SCI and their partners can find very satisfying. It can be relatively easy for women with SCI’s to maintain normal sexual activities. However, there are often changes to the way women feel or respond to stimulation. Many can still achieve orgasm. Often areas of the body that still have sensation become more sensitive and new erogenous zones are found. Communication with partners and their lovers is the key to enable those with SCI and their partners to explore different ideas and approaches to sex and intimacy.
Are there any treatments that can fix a damaged spinal cord?
At the moment – unfortunately there isn’t. However there is a lot of research interest being shown in regard to the possibilities of medications given at the time of spinal cord injury to limit the damage, and the use of stem cell implants to repair damaged spinal cord some time after the injury has occurred. The research is certainly still in its infancy, but it is progressing.
What are the options for bowel management?
For those with injuries above T12/L1, bowel management usually relies on the preservation of the ‘evacuation reflex’. A suppository, or digital stimulation can help trigger the reflex to empty the rectum. Laxatives may or may not be required to aid the passage of bowel material through the bowel to the rectum. Those with injuries below L1 are usually unable to utilise this reflex and the bowel needs to be emptied manually. Usually fibre is required to aid stool passage to the rectum. There may be overlap around injury levels of T12/L1 where the picture can be one or the other, or a combination of both. For some, a colostomy – where a section of the bowel is brought to the abdomen wall and the stool matter collected in a bag – is becoming a increasingly utilised option.
Why do I suffer from pain?
For many people with a SCI chronic pain can be a major issue. The source of pain can be many. Aches and pains particularly in shoulders and upper back due to wheelchair use are common and may respond to local therapy such as physiotherapy and massage. Spasticity can also lead to pain and anti spasticity medications may be useful. Often the most troublesome pain is due to pain generated in the damaged part of the spinal cord. This ‘neuropathic’ pain is mediated by the damaged spinal cord. It is often described as ‘electric shock like’ or a ‘hot burning poker’.
There are various modalities for treatment of this type of pain including medications, TENS machines (electrical stimulation) and as a last resort surgical procedures. If useful, these treatments usually only dampen the pain and are unlikely to eliminate it completely. An important part of treatment involves diversion tactics such as keeping active and relaxation techniques.
How will I be able to return to the work force?
Getting back to work is proven to be good for people with SCI. Those with SCI who work have fewer health problems, better physical and mental health, a wider social group and generally better quality of life. For some, their old job may not be suitable to do with SCI, but this is just an opportunity to consider something different. There are many different vocational rehabilitation organisations which can aid return to work and retraining if needed.
Questions on Stem Cells
CatWalks goal is to support research that will lead to a cure for Spinal Cord Injury. Internationally, there are many areas of investigation. One promising area is the cell-based approach in which damaged spinal cord cells are replaced.
There are many potential candidates for these cells. Currently, the use of cells derived from the patients themselves are thought to be the most promising candidates, such as those derived from nerve tissue at the back of the nose.
Other cells from the patient, such as from the bone marrow, hold possibilities and need further investigation. These are known as adult stem cells. Cells derived from the discarded umbilical cord and placenta without any harm to the newborn baby may also be of value. These are known as foetal stem cells.
Other sources of cells, such as embryonic stem cells, are possibilities for the future, but a number of issues must be addressed before these become a real option.