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Thread: Autonomic dsyreflexia

  1. #1

    Question Autonomic dsyreflexia

    T-4 complete, 35 years post-injury.

    I was never bothered with AD until this year. Then, boom, I started getting it. I've had a cystoscopy and urodynamics study done in August which found nothing. During the course of the past year it has struck at seemingly random times. On bowel care days, off them, full bladder, nearly empty bladder, naked, clothed, after meals, before meals, morning, noon and night. I had a colonoscopy and AD wasn't triggered (and it indicated I'm in fine shape).

    I went to the Dallas VAMC SCI Clinic just nine days ago. I was given a KUB, EKG, blood and urine workups. The doctor called back that afternoon to tell me they found no stones and things looked "fine." My "unconfirmed copy" of my EKG says "Sinus tachycardia, Left posterior fasicular block, Abnormal ECG." I requested the EKG after complaining about an irregular heartbeat: When using my Ozeri CardioTech Digital Blood Pressure Monitor w/Arm Cuff it would skip one or two beeps when reflecting my heart rate. While I understand that the Ozeri is not medical-grade equipment, it does indicate that periodically my heart rate seems a bit irregular. When I was first injured I was diagnosed with a BPVC, but that spontaneously resolved.

    I have gone through three months this year with no AD; I've gone though a couple of months with only a single episode. Then there are months where I hit the jackpot and have several episodes, typically spaced days apart. On only two occasions have I been able to determine a probable cause; once removed, the BP lowered to my normal value.

    I am a vegetarian, drink distilled water (with a dollop of lemon juice and D-Mannose) and exercise regularly. I don't smoke, don't drink and I get a good night's sleep. I use no prescription medication apart from nitro ointment.

    Earlier this year my doctor prescribed nitrogylcerin ointment for treating the elevated BP and that has kept me out of the ER (and Baylor Grapevine does not know how serious AD is, despite patient explanations). That ointment just knocked down my 161/110 to a more reasonable 118/75 in a little over 30 minutes.

    I have tried hard to determine the cause of my AD but I am completely baffled.

  2. #2
    So if you are having heart or chest palpitations regularly, you could request a cardiology consult if the heart palpitations are new and it corresponds to the elevated BP you have.Cardiologists want to know what your symptoms are when it comes to heart issues. You could get a holter monitor to check your heart and BP for 24 hours. You document in a diary what your symptoms are during the 24 hours period. Theyn the cardiologist will compare the findings with the symptoms.

    The other thing is what is your BP running most of the time? if it is elevated anyway you could be placed on a anti-hypertensive by your provider. and see if it helps

    pbr
    Last edited by SCI-Nurse; 11-18-2015 at 11:09 PM.

  3. #3
    Quote Originally Posted by SCI-Nurse View Post
    So if you are having heart or chest palpitations regularly, you could request a cardiology consult if the heart palpitations are new and it corresponds to the elevated BP you have.Cardiologists want to know what your symptoms are when it comes to heart issues. You could get a holter monitor to check your heart and BP for 24 hours. You document in a diary what your symptoms are during the 24 hours period. Theyn the cardiologist will compare the findings with the symptoms.
    Thanks for that information. I'll discuss that with my doctor. The VAMC has a process and that generally entails working up each level and scheduling tests in the future. Naturally I'd like for this to be done immediately, however the VAMC doesn't operate at my frequency.

    Quote Originally Posted by SCI-Nurse View Post
    The other thing is what is your BP running most of the time? if it is elevated anyway you could be placed on a anti-hypertensive by your provider. and see if it helps

    pbr
    I maintain a running log of my BP, taken in the morning, evening and at various times throughout the day. When I feel a change in my BP, I take a measurement. I always take care to position the cuff correctly, calm myself, and remain quiet and still during the measurement for the greatest accuracy. My doctor has instructed me to apply nitro paste if my systolic pressure reaches 150. For example, here are my BP and BPM readings since November 11. The asterisk denotes indication of irregular heart rate. This month my bowel program falls on even-numbered (italicized) days. As you can see, that does not seem to matter.

    BP Log - Newest to earliest

    145/85 72 9:25a 11/19
    146/81 76 8:53a
    137/84 70 8:13a
    145/84 71 7:50a
    140/88 81 7:13a
    123/77 71 10:28p 11/18
    119/70 72 10:10p
    118/67 80 6:32p
    124/72 82 6:27p
    130/81 81 6:16p
    151/87 81 6:04p
    142/85 73 5:36p
    118/75 86 3:22p
    133/76 89 3:08p
    145/87 90 3:00p*
    161/11082 2:47p
    156/87 74 2:30p
    156/94 74 2:16p*
    153/78 69 1:54p
    142/85 84 10:31a*
    140/85 65 7:50a
    140/84 79 6:04a
    128/73 79 10:30p 11/17*
    134/75 66 10:26p*
    138/87 88 6:08p
    145/90 73 5:46p*
    156/85 73 5:37p
    161/85 87 5:32p
    104/60 78 10:25p 11/16
    120/79 97 6:08a*
    128/74 70 7:49a
    95/58 75 10:29p 11/15
    124/79 81 4:16p
    105/65 77 10:25p 11/14*
    133/80 70 8:00a
    106/66 75 10:45p 11/13
    126/81 83 6:16p
    122/77 74 7:16a
    105/65 80 11:05p 11/12
    123/74 72 7:55a*
    106/60 75 10:38p 11/11
    126/82 87 5:42p
    123/75 73 12:31p
    95/75 66 10:28p 11/10*
    126/76 104 6:14p
    142/83 82 8:19a
    137/85 81 6:58a*
    109/67 85 10:58p 11/9
    125/72 69 8:25p
    115/67 114 8:18p
    124/74 77 4:35p
    117/67 105 4:00p
    161/87 86 3:12p*
    148/81 72 1:17p
    148/82 70 12:46p
    137/76 104 8:36a
    136/87 77 6:58a
    142/83 71 6:49a
    115/68 71 10:49p 11/8
    135/76 75 2:17p
    137/77 85 10:15a
    142/84 67 8:26a
    136/85 66 6:23a
    109/66 64 10:50p 11/7
    118/71 75 1:29p
    137/75 57 12:19p
    142/81 60 12:02p
    144/84 66 11:46a
    147/86 66 11:36a
    128/82 70 7:20a
    123/76 74 10:34p 11/6

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