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Conversely a severe lumbar kyphosis with the patient sitting on the sacrum is often associated with the Figure 13 effective 40 mg levitra extra dosage. In adults with thoracolumbar injury bracing is often advisable even if internal fixation has been performed. High thoracic spinal deformity severe enough to require surgical correction requires careful preoperative assessment, respiratory complications being a particular hazard of the operation. After injury to the spinal cord, bones in the paralysed limbs become osteoporotic, and pathological fractures may occur with minimal or even no obvious trauma. A common injury is a supracondylar fracture of the femur caused by the patient falling out of the wheelchair on to his or her knees. Violent spasticity of the hip flexors, particularly if the leg rotates, can fracture the femoral shaft. If a circular cast is used it should be split, allowing the skin to be inspected daily for signs of pressure. Insufficient padding or failure to split a cast on a paralysed limb carries a high risk of producing pressure sores and painless ischaemia secondary to swelling. Immobilisation should not be prolonged as it is important to avoid joint stiffness, which might limit the patient’s independence. It is particularly important to maintain the range of hip and knee movements, so that the patient’s posture in the wheelchair is unaffected. Fortunately, fracture healing is usually satisfactory and callus formation good. There may, however, be an exacerbation of spasticity in the injured limb, which can complicate management of the fracture. Post-traumatic syringomyelia, an ascending myelopathy due to secondary cavitation in the spinal cord, is seen in at least 4% of patients. Symptoms may appear as early as two months after injury or in rare instances be delayed for over 30 years, the average latent period having previously been reported as eight to nine years. The commonest presenting symptom is pain in the arm, usually unilateral, described as a dull ache but occasionally as burning or stabbing.

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While Gillet (1994) asserts that the alternative model is less punitive than the biomedical model safe levitra extra dosage 60 mg, several other authors conclude that both models are equally reductionist where responsibility for sickness is concerned (Berliner and Salmon 1979a, 1979b; Coward 1989; Sharma 1992). In other words, both the biomedical and alternative models blame the victim of ill health through location of the sources and solutions to health problems solely within the individual. For example, McGuire and Kantor (1987:236) describe an episode where a woman who participated in their research explained how she was being taught by her healing circle to accept her paralysis as her chosen path. In one sense, such an alternative ideology of health is even less attentive to the social production of illness than is the biomedical model. For instance, epidemiologists, at least, recognize a relationship between the environment and disease, whereas under this alternative model, it is not the environment, but rather how one reacts to one’s environment, that is the cause of ill health. Nowhere are these forms of reductionism more apparent than in this alternative ideology’s identification of thought patterns as the aetiological starting point for illness and disease. There’s a psychological background to each of these diseases; diabetics, some of them are very similar people, so they become sour people. Finally, in contrast, and in addition to health benefits, espousing such an alternative model of health can have positive consequences for the individual’s subjective perceptions of self. For instance, self and identity may be positively affected through adoption of this alternative model of health when the ideology contained within it is used as a mechanism for constructing a healthy sense of self. See Crawford (1984) for the wider cultural implications of the belief that health is achieved through self-control. CHAPTER SIX Alternative Healing and the Self In participation in alternative health care, as well as through interaction with alternative practitioners and other lay users of these therapies, the people who took part in this research began to adopt alternative ideologies of health and healing—ideologies that can have, at times, profound implications for individuals’ subjective perceptions of self. For instance, Schneirov and Geczik (1996:638) write that the networks of alternative therapy use that these people develop are a “significant source of new meanings and identities.


The Arab-American Family Support Center is a 501(c)3 non-profit, non-sectarian organization that provides culturally and linguistically sensitive services to immigrant communities throughout New York City.  © 2017 All Rights Reserved.

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