University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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Sometimes, life is so hectic that there doesn't seem to be time to just sit quietly and think about things. Sometimes, life is so stressful that people don't want to think deeply about what is going on. For people with challenges to their health, it is probably a good idea to spend at least some time thinking about what has happened, what you would like to have happen, and how to get there. This kind of deep thinking, or reflecting, does not have to take a lot of time or to be done every day, but taking at least some time for self-reflection can be the key to making a successful plan for staying healthy and avoiding pressure ulcers (which means the same thing as "pressure sores" or "bedsores").

Of course, the real irony about self-reflection is that it usually takes place after something goes wrong. That's human nature; when things don't turn out the way we hoped or expected, we'll ask, "What happened?" There's a lot more motivation to do that than there is to look around when everything is going great and asking, "What might go wrong? How can I improve my situation?" Part of the reason for this is probably that experiencing a situation makes it seem so much more "real" than just talking about it or imagining what it would be like; for example, one of our study participants, Brenda, told us that when she was in the hospital with her second pressure ulcer, "the gravity of the situation really made me reflect, made me reassess myself. I am just determined to not let it happen anymore." In her hospital bed, Brenda reflected on the question, "How am I a different person today than when I first came into the hospital, with respect to pressure ulcer management?" Another of our study participants, Dave, said that when he looked back on what he did prior to getting pressure ulcers that eventually required surgery, he realized that he had not taken proper care of his body. After reflecting, Dave realized that he would have gotten more bedrest when he saw early signs of pressure ulcers, exercised, and eaten a more nutritious diet if he had "known then what he knows now." Both of these people were able to make changes for the better after reflecting back on what had gone wrong.

So, the advantage of doing your reflecting in advance is that it will probably allow you to avoid a lot of trouble - avoid the physical pain of having a pressure ulcer, avoid the expense of getting the treatments, avoid losing the weeks or months it would take to heal an advanced stage pressure ulcer, avoid the lasting damage to your body that a pressure ulcer, or the surgery it takes to treat it, could do. Check the other pages we have available to give yourself ideas about pressure ulcer prevention techniques, balancing activities with taking care of your health, equipment for health care (including wheelchairs, cushions and beds), care attendants, listening to your body, nutrition and weight, risk-taking, or any other topics that might help you to reflect on what you're doing now to take care of yourself, and where there might be room for improvement. Some of our topics might be areas that you would like to learn more about; we hope that the information we provide, along with some of the stories our study participants share from their own lives, will help you to find something useful for your own life!

If you like using a computer, it might be a good tool for helping you reflect on your health. You could start a journal as a way to collect your thoughts about your health, or any other topic. If you're really up on the latest technology, you might even be interested in launching your own blog on the Internet, to share your thoughts with others. Whether you want a private or public journal, or prefer to use a keyboard, an assistive device for using the computer, or speaking or dictating your messages into the computer, creating a journal is a way to express your thoughts, and then to look back later at how your thinking might have changed since the time you started the journal. You might even discover a something you weren't aware of when you read through the pages of your journal!

Of course, you can also use your computer to search for more resources to guide you in self-reflection. Not only can you use other pages in this website, but you can also go to other websites with thoughtful advice for thinking about your health. Some suggestions include a page of Educational Brochures on the website of Craig Hospital in Denver, Colorado, listing the many articles that Craig has on topics related to the health of people with spinal cord injuries. Three articles that this page can link you to talk about how to think about your health: "Optimal Health" (that is, the best health possible) explains that everyone has five "areas" of health, like physical health, spiritual health, emotional health, and so on, and gives tips for supporting each of those areas; "Quality of Life: What's Important?" shares ideas for identifying the parts of your life that are the most meaningful to you, and how to set priorities (that is, deciding what to do based on what you feel is most important); and "You Are How You Feel," which explains the connection between attitudes and beliefs about your health and the actions you take to improve your health.

There are many people with disabilities of all kinds who have created websites where they share their thoughts. You can also find many websites where newspaper or magazine interviews with people with spinal cord injuries who talk about their lives. For example, The SCI Zone, a non-profit news and discussion forum website maintained since 2003 by Michael Feger, a person with a spinal cord injury at C-3/C-4/C-5, has a number of articles where people reflect on their physical and emotional health. Among these pages is Disabled Quincy man puts past behind him, focuses on the future, about Greg Starman, a veteran with disabilities who competes in wheelchair sports. Travis Roy is a former college athlete with a spinal cord injury at C-4 who is an author, motivational speaker and political activist in his adopted hometown of Boston. He founded The Travis Roy Foundation, which gives financial support to individuals who need to "modify vans and to purchase wheelchairs, computers, ramps, shower chairs, and other adaptive equipment to help quadriplegics and paraplegics live their lives." And Monday, Monday, on New Mobility magazine online, has a question-and-answer interview with Rex Monday, a singer-songwriter with a spinal cord injury at C-7 who says that he has become a much more reflective and thoughtful person since his spinal cord injury.