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Thread: First bad case of AD

  1. #1

    First bad case of AD

    Well, had my first bad case of AD sense 35 years of sci. Waited to the last second before making up my mind to get help or let it ride. Decided at last second before explosion and blackout to get my brother to call the Fire Depo about 1/2 mile away in BFE. Told bro exactly what to tell them if I was out. Cath and let it flow.
    ER doc said another minute or so and i was stroke, seizure, or if lucky hear atache bound.
    Just 3 years ago I was at this same hospital letting the urologist play with me for some USF medical students. He'd take me to the point of no return then back off. I was past that. Kinda glad i did help the teaching doc at this small hospital. the kids really paid attention plus i'm a big bs'er so yapped with them the whole time. the only problem with the demo anesthesiologist keep telling the doc to back off but he was so into what he was doing she actually had to scream at him. So when this popped up I was ready. Needless to say but will try not to let it get that bad again but I do have a habit of I KNOW MORE THAN THEY DO and can handle it myself. Lesson learned. donnie

  2. #2
    What caused the autonomia? If it was your bladder, why didn't you cath yourself or have someone cath you?

    Generally, you can find the cause of the autonomia and take steps to relieve the stimulus, but sometimes the symptoms may persist. It is a good idea to have a rescue medication on hand at home, i.e., Nifedipine, Minipress, Apresoline, or Nitropaste and a keep a medical emergency card with information and instructions for paramedics and emergency room personnel who may not be familiar with autonomic dysreflexia.

    Here is a good source for a card you can keep in your wallet, glove box of your car and bedside table.
    http://www.christopherreeve.org/site...qKWJcO0ItI7KpI
    Another good place to keep emergency medical information for paramedics is in a plastic medicine bottle in a door shelf in your refrigerator. Mark the bottle clearly "Emergency Medical Information." Paramedics are trained to look in the refrigerator for this kind of information.

    All the best,
    GJ

  3. #3
    it was cath clogged. actually was was in bed asleep and woke up with "oh S*** something ain't right. first thought i could wiggle around and un-kink tube or something. did not work. my 1 brother lives with me and another lives across the road. it was about 9pm and they were outside working on their airboats. by the time i decided i needed help i could barely speak. my bro tried to flush the cath but it was clogged. took the cath out and tried to get it in but it was not happening. i live in a rural area but a county fire depo is 1/2 mile away. i was about to go out so told brother to have them cath me first then start asking questions.
    had prepared for this since sci but nothing ever happened over 35 years. 3 years ago helping with the college med students was a refresh course. never lose composure. you cannot control a situation if you freak. i always have taken this serious but others hear about it and it never happens so they write it off. i had it covered and now they know what i'm talking about - prepaired. donnie

  4. #4
    Super Moderator Sue Pendleton's Avatar
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    I was post 16 years when I had my first. Went down the complete list I was taught in rehab and none worked and no emergency Procardia/nifedidine. Just as I was about to have the spouse call 911 a new cath started to drain some. The head explosion slowly backed off but it was my kidneys not draining not my bladder. I have regular sensation there. After that I asked my uro for the emergency med and he didn't feel comfortable prescribimng it. Thankfully my neuro did. Still no idea why things weren't draining but feel more secure having the capsules around.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #5
    For my patients with significant AD, I provide them and their caregivers directions for using nitropaste in addition to using the AD walletcard directions. I direct to use nitropaste once the systolic BP is at 160 or above. If the BP continues to rise despite two - 1 inch applications of nitropaste then I instruct people to call 911. The walletcard is excellent as it reminds you to lie down, check for kinked catheters, constipation, tight clothing or shoes, etc.

    As always, gjnl provides great reference information as above. I am taken aback at how a physician would demonstrate AD to students with you as a subject.

    Take care and get some personal directions for using nitropaste for future. The nice part about nitropaste is that it works quickly but it can also be wiped off and the effects stop. Nifedipine is helpful but has longer lasting effects with the keeping the BP low whereas the BP can bottom out and cause more problems.

    pbr

  6. #6
    Quote Originally Posted by SCI-Nurse View Post
    The walletcard is excellent as it reminds you to lie down, check for kinked catheters, constipation, tight clothing or shoes, etc.
    pbr
    I am surprised that the wallet card advises to lie the patient down. Doesn't the blood pressure go up when you lie down. I think a better recommendation would be to sit up or, at least, keep the head and torso elevated if the patient is lying down.

    All the best,
    GJ
    Last edited by gjnl; 09-03-2012 at 03:21 PM.

  7. #7
    Quote Originally Posted by gjnl View Post
    I am surprised that the wallet card advises to lie the patient down. Doesn't the blood pressure go up when you lie down. I think a better recommendation would be to sit up or, at least, keep the head and torso elevated if the patient is lying down.

    All the best,
    GJ
    Definitely sit up and keep the head/torso elevated if you're lying down as it helps bring the pressure down. I've had about three or four bad cases of AD this past week – one in the office of the urologist. The Fellow that was working on me had big round eyes as my wife took charge taking away the stimulus.

    I definitely don't think I would let a urologist play with me for the benefit of medical students since AD isn't anything to play with. It's a life-threatening medical situation. I might let the neurologist use me as a demonstration if he demonstrated the effects of sticking a fork in his eye first. Nitropaste is my friend!

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