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Thread: Merciless Sweating

  1. #1

    Merciless Sweating

    I am a C5/6 quad who was injured in early 1982. Throughout most of the years since I've suffered from periodic bouts of sweating which causes me to remain home seated in front of a heater fan to keep the front of my head and shoulders dry and warm. While it may be a result of autonomic dysreflexia I am skeptical because my blood pressure is only sometimes elevated above 150 and regardless of how high it becomes I can stop the sweating by lying down and, as I learned only six years ago when getting my first tilting wheelchair, by tilting it nearly fully.

    However, because I become even more depressed when having to lie down before 10 or 11 PM or remaining fully tilted, as I can barely engage in any activity other than listening to the radio or watching television, I endure the misery of sweating in front of a table mounted heater fan. This month I've been doing so virtually every day from late morning until getting into bed at 10 or 11 PM. I have mentioned the problem in years past to two physiatrists but not received a helpful response. Any thoughts?

  2. #2
    It might sound stupid but I sweated like a pig when I had high-protein intake. Protein shakes made me sweat.
    C5/C6 Complete since 08/22/09

  3. #3
    When I was in the hospital I was sweating so bad I could not slide on a slide board had to use a beze board, not sure on the spelling, but doesn't matter. I was changing pants 2 and 3 times a day. Tried doing a diaper, but that just helped keep the butt from sticking . My doctor put me on Gabapentin and for me it worked very well. He had said it is not what it was intended for, but had read it had worked sometime for women in menopause. Saved my butt.:-)

  4. #4
    my doctor gave me oxybutnin
    for the bladder--completely stopped the sweating. i was just like you in front of a fan all day--it was sweet relief!!

  5. #5
    Quote Originally Posted by Mac85 View Post
    It might sound stupid but I sweated like a pig when I had high-protein intake. Protein shakes made me sweat.
    All the time, or only during bowel routine?

  6. #6
    I practice family medicine and can give you a frame work that can lead you on a path of better management and hopefully significant relief. As you come to understand your hyperhidrosis (excessive sweating) better, you will need to make a specific physician appointment to go though what may be triggering it and how your case might be best evaluated and treated. The more you know the better a partnership can be formed to address this debilitating problem. I understand your skepticism of autonomic dysreflexia being the cause. Think of the sweating as the first sign and lowest level of autonomic dysreflexia. Blood pressure elevations only occur once critical and dangerous levels of autonomic dysreflexia are triggered.
    Most individuals with your level of injury will have one degree or another of autonomic dysreflexia because the sympathetic nervous system which causes adrenalin surges, sweating, increased heart rate and blood pressure is not adequately connected to the parasympathetic system which would otherwise keep that sympathetic system under reasonable control.
    There is an occasional individual who after a very thorough search and best management of all aggravating factors will still have the problem. There are reasonable and good medications for it, and as a last resort a surgical procedure that can bring it under control. That being said...start with a very thorough search and manage all aggravating factors.

    In short, any thing that is a problem or causes pain signals to be sent to the spinal cord below the level of your injury can be causing your sympathetic system to be excessively excited and trigger your sweating. If you have two or three problems, that adds up. All aggravating factors have to be brought under control and stay that way for a month or two to get the relief you are looking for. the degree that you are experiencing for the length of time suggests that you will need a medication to help manage it, atleast for a few month to a year.. So here's a list to start thinking about:
    Conditions that can exacerbate it:(Most via sympathetic system)
    Bladder distention more than about 500 cc
    Fecal impaction
    Bowel distension/constipation (even if your bowel regimen seems to be going well, over the years the colon can become slowly enlarged and distended which is very often a major cause of your condition. Ask your physician about a plain x-ray to evaluate for this)
    Noxious stimulus with or without perceived pain-pressure sores, ingrown nails, musclespasms, injuries,burns, cold exposure, hemorrhoids, stomach ulcer, gall bladder, fractures, food intolerances, intestinal cramping, too much pressure on a boney, pressure sore prone area when you are sitting.
    Increased ureteral pressure (worsened by full bladder/ distended bowels)
    Erections
    Infections-bladder/wounds/bones/flu/appendicitis, ect
    Thermoregulation issues
    Bladder andkidney stones
    Endocrine-thyroid dysfunction, low testosterone levels, diabetes (ask for blood work)

    Management of hyperhidrosis:

    1. Identify and manage all aggravating factors.
    2.Medications: Robinul and similar meds directly interfere with a signals which are generated in the sympathetic system by blocking acetycholine muscarinic receptors in sweat glands.Acetylcholine is otherwise a parasympathetic neurotransmitter, so side effects include constipation, difficulty emptying bladder, and dry mouth.
    3. Surgery-Last Resort, requires a referral to a tertiary specialty center

    Hopes this helps get you going in the right direction. It can be a lot of work figuring this out, but it's worth it.
    Last edited by rplute; 03-01-2017 at 12:08 AM. Reason: incomplete

  7. #7
    Quote Originally Posted by Scaper1 View Post
    All the time, or only during bowel routine?
    All the time around my neck
    C5/C6 Complete since 08/22/09

  8. #8
    Why would your blood pressure have to be elevated above 150?? AD and symptoms of AD ( but may not have symptoms- called silent AD ) is 20 mm HG above your baseline- and when sitting up I would bet yours is about 90/50. Therefore at 110 you could be having the initial AD. We don't treat till above 150 with medicine but.... the earlier that you recognize it the better.
    And the Evidence based medicine(EBM) literature it is no longer described as a "noxious" stimuli because of the misconceptions- #1 you can't "feel" the noxious stimuli. It is a what can be a "normal stimuli- (i.e. a bladder- full or with a low amount is not noxious stimuli )- it is a stimulus ( sometimes normal ) with an overexaggerated response- the autonomic component.

    What is your blood pressure when the sweating starts? Is your bladder is recently emptied of catheter draining, daily bowel program, clothing not too tight- I had a patient once who had bad stimulus- figured out it was his tennis shoes tied "too tight". It can be any stimulus but most commonly bladder, bowel, skin. I also had a patient with AD who died- we did everything right but on autopsy he was found to have a bad gallbladder. Also some we would give them Tyelenol or Ibuprofen when sitting up because of some pain somewhere below their injury that caused it- helped for 4 to 6 hours.
    In addition, repeated bouts of AD or chronic AD even if below 150 can be bad on your cardiovascular system so if possible, figure this out.

    The best "wallet card" is from the Christopher Reeves foundation and has your baseline blood pressure- lying and sitting. Ask for a couple.
    And other misperception - the headache- which may never happen, and the bradycardia- slow pulse. Typically the blood pressure goes up, the pulse may stay the same of even go up a little and the slow pulse is a late sign.
    But there is silent AD- really no symptoms at all. Not even if I am asking. It can be a slow upward course or a very fast course upward.
    Over 150/ is it is there or higher and we can't find the source within a couple of minutes.
    Use Nitropaste only.
    When it starts to drop, wipe it off -or then your blood pressure will be very, very low and then here comes the trendelenburg and starting of the IV's. If at home, wipe it off, start drinking water if dropping lower than usual.
    Another reason- people describe feeling "Yucky" after a bout of AD so the more you manage at the earliest sign, the better you feel all around.
    Look at the newest publications on AD and silent AD.
    At least your are monitoring your blood pressure.
    Whenever someone comes up with vague symptoms- possibly AD- I ask what was/is your blood pressure, what is/was your pulse? What is/was your symptoms?
    And when I get the response" I didn't check it" or I can't check it- I have no blood pressure monitor! ". Bad discharge planning and bag SCI care is my thought. But, will your health insurance pay for it! Nope! But Walmart ( or their competitors )have the wrist blood/pressure/pulse monitor for $15.99 or $29.99 normally. Buy one or borrow one( forever!).
    The best thing I can tell you then or now- is get a wrist monitor! keep a record.
    There are also those of you who never/ or it has been years then you start having some new symptoms- same thing- check your blood pressure.
    Vets used to get free but that was stopped many years ago. Everyone at risk for AD - that $30 or so will be the best money you spent.

    CWO

  9. #9
    Senior Member darty's Avatar
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    Last time I had sweats it was a bad uti.
    ^^(A)^^

  10. #10
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    I'm a C7 complete injured in 1994. I've also had bouts of intense sweating for various reasons. Some of the possible reasons could be:

    1. Over-extended bladder. The oxybutinin might help in this case if you're not voiding properly.

    2. A UTI or other type of infection.

    3. A reaction to pain. This was my major problem for years. If you have a sore of any type that is being aggravated, it could cause sweating. My problem was that I was developing contractures and when I would lie down I had so much pressure on certain parts of my body that it was causing severe pain and would induce severe sweating until I got up and moved around. Based on the fact that you say it is alleviated when you recline or change positions, I'm guessing the sweats might be a reflection of some pain you are experiencing. More frequent weight shifts and moving around might help your cause. I'm assuming your chair and cushion has been properly fitted and mapped to provide the best pressure distribution while sitting.

    4. I took Robinl to help with my sweats. It worked to reduce them in certain instances but never completely eliminated them until I solved the root problem.

    That's about all I can offer based on my experiences.

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