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Thread: How do I track down this severe AD?

  1. #1
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    How do I track down this severe AD?

    Can you picture the "wedge" you lean against when you're on your side in bed? Wednesday night ~1 AM I sat up and the sweat had pooled up on my side and then ran down the wedge in a wave.

    Had to go in the spare bedroom because the bed was soaked and slept most of Thursday. Friday morning when I tried to do my bowel program, my body locked up, BP Went up to 200/130 so I went to the ER.

    They could not find anything. Bladder, bowel, bones, skin, the usual suspects.

    Still have not resolve the broken back and wonder if when I turned at night or the way it is misplaced in a twist that causes pain or discomfort could cause that much AD?

    Lying on my left side and twisting to my right?

  2. #2
    I doubt that you "misplaced" yyour back. However, I am not sure what you mean when you say the "broken back issue".... that might help me in my answer.

    was your blood pressure still elevated when you were at the ER? If not, it may make it more difficult for them to find the cause. I would be willing to bet it was your bowel program since it started when you did your routine. Once your routine is complete, it is difficult to say what may have caused it.

    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
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    Actually call the ambulance at around 170/100, It has been floating around the last few days and when I got to the hospital it kept going up. It didn't go down until they gave me 8 mg of morphine. That's where I learned my diastolic had gone up to 130.

    That knocked down to 100/70, which is pretty good for me though I usually have to take midirone to keep my blood pressure up.

    Agree 100% about the bowel program except for the sweats on Wednesday night and the KUB saying nothing wrong. Asked for one specifically. Also waited until 4 hours after I had initially Inserted the suppository

    In March of this year I went to the ER for extreme back pain. They gave me dope and said go to pain management.

    In June I went back to the ER for incredible back pain and they wanted to do the same thing and I said no you find out what it is.

    Then they told me I broke my back at T6 and they don't know when and it is halfway between my cervical fusion and my lumbar fusion.

    http://sci.rutgers.edu/forum/showthr...81#post1832981

  4. #4
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    Another data point, my bowel program went fine this morning.

  5. #5
    At T6, you are definitely in the region for autonomic issues. Have you seen a neurosurgeon or orthopedic surgeon who specializes in spinal issues? That would be my next move on that issue.

    As to the AD, you need to see a neuro urologist (if possible) and find out what was on the KUB. In the meantime, I would keep track of the episodes and make sure that you record when they start and stop, what caused them, what helped to relieve it and anything else that you can think of that might be helpful to your health care provider. That is one way of being able to pinpoint what may be triggering it and what may help lower the BP.

    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  6. #6
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    Don't know if you're referring to T6 as my level of injury because I am a C6 quad complete 1982 and broke my back at T6 at an unknown date.

    Have cervical fusion at C6 C7 Also my lumber have fused on their own.x where I broke my back is the midpoint between these two fusions and I needed to rule out a charcoal joint.

    The KUB showed no obstruction. If I knew what caused the autonomic dysreflexia I really would not have asked how to find out what was causing it. :-)

  7. #7
    I should have said what you think triggered it.... not what caused it. Usually an activity can be pinpointed if you think about when it occurred... not always. Sorry about that. And the way I read your statement about the KUB was that something had shown on it. It clearly doesn't say that. My apologies.
    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  8. #8
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    Trying to track down the cause of the AD the MRIs show that I did not break my back at T6 as the emergency department informed me and I do not have Charcot joint of the spine.

    Have always had three different types of pain in my back and now I have a new pain in the middle or upper back which started when I "throw my arm," to roll over or even just reach for something caused pain.

    The #1 pain is neuropathic, which we called burning butt or burning foot in rehab and has pretty much gone away unless it gets triggered by #2 pain.

    This starts near my coccyx and just radiates to the side and down to my feet, never up. It will get so intense the bottom half of my body gets so numb and numbness gets so intense it is like being immersed from the waist down in boiling water. Those who know understand what I?m saying.

    This also gets triggered by pain #3 pain which is caused by spasms in my lower back, which are caused by stress. The nerves keep firing and the muscles in my lower back lockup.


    There is no narcotic, muscle relaxer or anything that relieves it except intravenous Valium. Take the diazepam to keep it under control, but once it gets past that point there is really nothing I can do. Scuba diving used to help tremendously and used to relax all my muscles and spasms for about it week or so.

    Now to the answers which need to be questioned.

    When turning during the night from my back to my left side. If the wedge is not up high enough by my shoulders, my back will get really twisted because my shoulders are no longer supported by the wedge.

    When doing my turn the during the night and don't get aligned correctly, could the pain cause that bad of autonomic dysreflexia?
    This is my abstract of the summary from the MRI report from August 1.

    Dextroscoliosis, this was caused by severe lumbar sprain shortly before my SCI which never had the time to heal correctly. This was compounded significantly by using a Roho cushion rather than a Jay cushion, which kept my ass in the center of the chair instead of my left hip resting against the left arm rest.

    Loss of height at T3 and T7 which are chronic.
    Disc bulge at T4 - T5 without narrowing.
    Disc bulge at T6.
    Disc bulge at T6 - T7.
    Bilateral facet hypertrophy at T10-T11. Also, mild central canal narrowing and mild bilateral formidable narrowing at this level.
    Bilateral facet hypertrophy noted at T11-T12.

    It appears that my vertebrae are disintegrating from osteoporosis, compounded by the scoliosis my my spinal column is just way out of alignment and there is not much I can do about it, is there?

    One of the options that was discussed (sat and talked with this doctor for an hour and 15 minutes) was a brace, and explained the logistical nightmare it would be for me.

    He then suggested a soft brace but I don't know if I could put it on and off or do my transfers by myself. He gave me a lot of information which I have not yet researched and digested. Such as a spinal cord stimulator, therapy or injections.

    Any information, guidance or insight would be greatly appreciated.

  9. #9
    Have you tried anything other than medications to control the pain (#3)? Acupuncture? TENS? Imagery?
    These may be worth looking into. They have worked for many people but not for some. Spinal Cord stimulators have had mixed results, but I would encourage you to explore this option. Have you looked into a baclofen pump to help control the spasms? injections are frequently used and often have good results - but again not for all. Unfortunately, you will probably need to try different modalities to see what works for you.

    I would also look into a seating eval. Correct positioning may help the pain- it needs to be done by a PT or OT that is experienced in the issues of Spinal Cord Injury.

    I would encourage you to look into as many of these as possible. Then go back to your physician with your questions and the way that you think you would like to proceed. You also may want to get a second opinion. It never hurts (no pun intended) and may give you some other options.

    If you have other questions, please do not hesitate to ask.

    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  10. #10
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    If the #3 pain gets bad , I lie on my back in the dark and "push the pain.". For a lack of better words it may be a form of meditation.

    When it gets so my entire lower back is on fire, in my head I go around the edges and "push the edges of the "pool of pain" to the center. Then I go, "In my head", to a different side of my back and "push the edge of pain back into the center again".

    Then I just keep doing this making the "pool of pain" smaller, it will take a while and doesn't always work, but sometimes I get relief.

    Acupuncture, tens, imagery I have never explored or been offered. Would not do a baclofen pump back in the 80's when my spasms were really bad, which this Doctor seemed to agree with, certainly will not do one now.

    I'm still digesting the information from the MRI and modifying my behavior to avoid actions which cause pain.

    Trying to track down what the causes AD, another data point: woke up with the AD headache and my blood pressure was 171/105 and was laying on my back. Then I took a hit and it dropped to 129/92, and now it's 139/96.

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