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Thread: more bad A/D problems

  1. #1
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    more bad A/D problems

    At 4 this afternoon, i went to check on my b/f in his lab. he was sweating all over, had goodbumps, and his hands and arms were really cold. more A/D. it was strange b/c he peed three times during the day, all were normal and then started to have problems. also strange b/c he said that the headache just kind of came and went in waves, would come for a few minutes and then nothing else until another 1/2 hour or so. took his blood pressure, 150 over..cant remember. his brother came over, he is a second year med student. we gave him nitro and got him into bed, and he peed about 600 cc. i thought we should just cath him, but the brother along with his parents (doctors, involved over the phone) decided that it was best not to do that unless necessary. but i think it was pretty necessary. so he has no cath in him and i for one am very very worried about tonight. the problem is that i cant put a cath inside of him--he has only had to do this twice, and so i have no experience doing this. i also dont think that his parents (an obgyn and a gen surgeon) really necessarily know what to do for this. my b/f has a doctor's appt. tomorrow with a SCI nurse pract. so hopefully he can talk about this tomorrow. but meanwhile, i am worried about now. I have a feeling i am just going to be staying up and watching him. he has since peed again and had a really bad headache. does not have a UTI, so prob other problems with the bladder? i am pretty scared. and of course he seems really depressed, has been crying, and feels horrible in general. all of this was fine until 3 weeks ago, and now it has been nothing but problems.

  2. #2
    Senior Member Jeff's Avatar
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    Misa - How does he pee? I reflex void and it always raises my BP by 40mm. If he has impacted bowels or any other problem then his normal voiding could be pushing him into AD territory.

    ~See you at the SCIWire-used-to-be-paralyzed Reunion ~

  3. #3
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    Misa1,
    A steady diet of AD with the freezing sweating and headaches would make me cry too. I suggest some light reading on the PVA website. Go to the health link and you'll find a manual or publicattion on Acute Management of Autonomic Dysreflexia. It might help you him and his Non SCI knowledgeable Drs.WR

  4. #4
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    One more thung-Y ou said he's in bed,If he's lying down the headaches will be worse so sit him up if Possible.

  5. #5
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    jeff, he pees by...i dont know what it is really called but it is the kind of catheter that looks like a condom, just goes over him and he pees on his own.
    he is lying down now, just took blood pressure and was normal but had more problems before when he peed. nitro nice stuff though. i am sleeping on two chairs right next to the bed (now is not the night to squish him like a sardine), and i hope he sleeps through the night. he still has a dull headache. i am just really worried. every time he pees he has a horrible headache. i feel like i have no control over anything and i am sure he feels that too.

  6. #6
    Member Cory's Avatar
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    I think you have already figured this out, but it is probably his bladder that is causing his AD. He should probably see a urologist familiar with sci stuff to get one of those urodynamics tests done to check his bladder pressures and all that. He maybe needs to switch to another way of managing his bladder like cathing every few hours or having one in all the time because even though he is able to go on his own it is building up too much pressure and causing the discomfort that is giving him the AD, or just the reflex voiding itself that causes it. I saw in another post you said he had a catheter in for a while, was the problem completely gone during that time? Going to cathing has its own problems, he might be able to keep what he's got but take something or have something done that makes it work better without the pressure or discomfort thats giving him the AD.

    [This message was edited by Cory on 08-14-03 at 01:59 AM.]

  7. #7
    Misa 1 - You have gotten a lot of good advice and I hope by now your b/f has been seen by a doctor who understands SCI. For some people, increased urine in the bladder and the inability or difficult ability to urinate (such as when a condom catheter is used) can cause AD. This needs to be determined by urodynamic studies; these are best done by a urologist who understands SCI. I am wondering, since I have not been covering the Care forum for a while, if your b/f is a recent SCI. If so, there can be changes going on during this early period that may alter his bladder management needs. This can only be determined by testing and SCI medical management.

    The advice to obtain the PVA booklet on AD is excellent. It is a great resource; it is downloadable from the website: http://www.pva.org/NEWPVASITE/public...bs/AutoDys.htm however this is a lengthy document. You can also order it for about $10 from their publications office: 888-860-7244. The publication also includes a wallet card about the symptoms and emergency treatment for AD as well as a page to keep track of onset of AD symptoms, etc.

    AD is the body's was of alerting the person that there is a problem present in the paralyzed body. Most often the cause is bladder or bowel related and can be treated rather quickly. However, when these are not the cause it takes an astute physician and the patient's awarenesses to search to find the cause. Some of the causative problems can be a pressure sore, fracture, appendicitis, bunion, blood clot. CRF

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