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  1. #1

    any help/suggestions/ideas

    Hi I am a c7 quad incomplete since a diving accident in dec.1980 things had been going along pretty smoothly up until about 1997 when things started to change i no longer was able to free flow urine and had to do intermittent catheters and put on ditropan initially once daily then twice now three times it was discovered i had developed a syrinx at the levels c2-t2 a shunt was put in to stop the pressure that was about 3 years ago now since about january 2003 i have been getting really bad sweats not at any particular time of day but really bad at night it was then discovered i had an infection in my spine at t9/t10 level and have been on antibiotics for 4 months the disc in between t9/t10 was detroyed by the infection what i am asking is this .
    are the sweats i am getting anything in your opinion to do with the infection (which by the way has nearlly gone) or do you think it is my bodies way of telling me there is pain. no one i ask seems to be able to say definately. or is it autonomic dysreflexia which is why i was put on ditropan .
    i also get hot flushes and goose bumps with the sweats
    any advice would be great
    thanks

  2. #2
    Hi Pcamore,
    I'm sorry I can't help much, but I believe that Ditropan has to do with urine, not A.D.
    Remember, one way to see if something IS A.D., is to take your BP, and check your heart rate.
    God Bless,
    Cathy

  3. #3
    Do you cath when you are feeling heated, flushed and having sweats? Some thoughts I had which may be related to increased sweats at night:

    1) Your bladder retaining more urine in bladder due to not cathing throughout night(when asleep?). What is your Urine output in A.M. your first cath?

    2) Are you laying in a single position ALL night, without turning, etc? This can place added pressure to certain areas of your body, esp. bonier prominences-hips, back, feet, etc.
    Also, I'm 15 yrs post and i have noticed increased sweats in recent years, perhaps due to decreased tolerance of skin over time(?).

    Your body will experience A.D. symptoms when your body is feeling some discomfort- increased sweats, flushing, hot/cold, pressure in head and chest, headaches, heart palpatations, dizziness, etc. You can try cathing when these or other symptoms occur to see if there is any relief of symptoms. If you experience this at night, perhaps try turning if you can, to see if it is related to positioning/pressure. If not related to either, you can also check bowels. You mentioned infection clearing up, but this should be continually monitored since you may still experience some AD if infection still present. If you have noticed increased symptoms after your ditropan was increased, it may be related to bladder and urine retention, or some other bladder related issue, which your doctor/urologist should be made aware of, especially so your medication effects can be monitored/adjusted if necessary.

    Anyway, these are just some initial thoughts I had. SCI Nurse can assist you more and your doctor should me informed as well. Take care.

  4. #4
    pcamore,

    Your problems sound like it may be from a recurring syrinx. If you have not done so, I would suggest that you get an MRI to find out how it has been doing since the shunt three years ago. I agree with you that another possibility is that you are having autonomic dysreflexia relating to your disc infection and the "pain" that it is causing. You may not be able to feel the pain because your spinal cord is not passing the messages up to your brain but the pain messages are getting to your lower spinal cord and that is creating the sympathetic reflexes that cause autonomic dysreflexia. I am concerned by the fact that you got a disc infection. A disc infection is an unusual occurrence and I hope that the cause of the disc infection was identified and eliminated.

    Ditropan is an anticholinergic drug that suppresses bladder spasticity. Bladder spasticity is when your bladder is overactive and contracts when it is partly filled. If the bladder and sphincter are not coordinated, i.e. the sphincter does not relax when the bladder contracts, this causes the pressure in the bladder to go up. High pressures in the bladder can cause urinary reflux (return flow) into the ureters (the tubes that go from your kidney to your bladder) and consequent kidney infections. So, the ditropan relaxes your bladder and reduces the pressure in the bladder. Bladder spasticity and increased pressure itself causes autonomic dysreflexia As you know, in a person with feeling, increased bladder pressure causes intense discomfort.

    Your description of hot flushes, as well as goose bumps with sweats, are consistent with autonomic dysreflexia that may be resulting from bladder spasticity, and possibly from back "pain" resulting from the infected disc. The quesstion is how to distinguish between these two potential causes of autonomic dysreflexia. One way that you should be able to tell is to drain the bladder with a catheter and see if it eliminates the sweats and hot flushes. If it does, this would strongly suggest that it is from the bladder. If it does not, it would suggest that the autonomic dysreflexia is due to your back, or perhaps the syrinx expanding again.

    I am sorry and hope that that above message is clear.

    Wise.

  5. #5
    Thankyou very much for replying to my query you have given me something to work on i have printed your replys off and will show them to the doctor.
    thanks again

  6. #6
    hi to those who replied
    i thought you might like to know that i have tried some of your thoughts
    chick
    yes i have tried cathing when i get the flushes and sweats even getting up at night makes no difference that i can see.
    even when i do at night the volumes are only like 100/200 mls.

    as for moving around to different positions during the night yes i have tried that also i have found that the only position i can lie is on my back when i turn on my sides i sweat something terrible. on my stomach i wind up with a stiff neck.
    i have tried a sheepskin this may stop me from getting an area on my butt.

    the infection in my spine is called "discitis" and yes it is being monitered with weekly bloods and the crp and esr have just last week returned to the normal ranges.

    bowels are a bit of a nightmare at present i think with the increased ditropan and and the antibiotics.

    wise young

    i have had about 10 mri's now about seven of those have been for the discitis the syrinx hasn't been checked for awile i was looking back through some of my stuff and found that the syrinx was drained back in 2000 but it instantly sealed and started to refill that is why in march of 2001 they put a shunt in i will mention a redo on the mri for the syrinx and see what they say.

    as i said to chick above i have checked my bladder volumes and even got up in the night to drain but this dosn't seen to help so you may well be right with the pain setting off AD

    thankyou for your concern about my back infection and yes the dr's are onto it (infectous diseases)on my dicharge summary it says " spine xrays demonstrated a soft tissue swelling t9/t10 mri demonstrated complete loss of t9/t10 disc space with destruction of adjacent end plates in keeping with chronic infection ct guided biopsy of spine grew s.aureus".( this was after 3 biopsys first was to get fluid this grew nothing 2nd was to get tissue this they thought was contaminated with my own skin cells 3rd was confirmation with bone biopsy that was the same bug as the 2nd then they put in a picc line and sent me home on iv clindamycin but after 10 days i had to have it removed as my blood pressure was dropping to much and i was nearlly passing out since then have been on oral clindamycin and this seems to be working thank god
    anyway dont want to waffle on to much just to say thanks for the advice and concern it has eased my mind being able to get some positive remarks.

    cathy
    thanks for your input as well
    god bless you to

    pcamore

  7. #7
    Hi pcamore. Thanks for your update. I wish you improved health soon and hope your doctor can help relieve your discomfort from the AD you've been experiencing.

    Regarding the sleeping positions. I have been sleeping more on my stomach lately since this seems best for decreasing pressure on back and hips, as well as stretching out back after sitting all day. I do get neck cramps as well but have mostly adjusted to that. Im sure you are already aware of this, but placing pillow between legs to help support opposite leg from forcing too much pressure on your hip, helps to reduce AD sweats. If your back is causing pain to trigger AD, would laying on your back be contributing to this , especially considering you stated that your AD symptoms appear mostly at night and not during the day?

    I do wish you well. Take care

    ______________________________
    "There is no fate that cannot be surmounted by scorn. This hell of the present is his kingdom at last" ~Camus

  8. #8
    hi guys
    just thought you might be interested in a follow up re my sweats
    it looks as though i will be having an operation this friday if all goes well as it turns out the AD was being brought on by pain in my back where the infection is.
    so they are going to do an operation called
    "t8/t9 corpectomy with posterior thoractic instrumentation"
    big name it means they will rip out the 2 affected vertebrae replace it with a cage filled with bone from someone else "hip replacement bone" then stick one or two metal rods on either side for support 7-10 days in hospital not to bad may even wind up in the spinal unit for a bit of rehab who knows
    anyway wish me luck will let you know how it goes

  9. #9
    pcamore - Glad that they have determined the cause of your AD; I do hope that all goes well with your surgery. Best wishes and keep us posted about your progress as you can.

    Prior to or at the time of admission to the hospital be sure that the staff is familiar with AD (you my need to provide this information), has the type of bed/mattress that will reduce your risk of pressure sore formation, will check your skin at least twice daily, turns you regularly, has a call light with a push pad on it that you can use, understands your bowel and bladder program routine. If you work to get this information in place, prior to or upon initial admission, it will help facilitate a good hospital experience. I don't know what your resources are in NZ, but many persons with chronic SCI who are admitted, in the U.S., for elective or emergency health care find themselves in a hospital with the general population and staff unfamiliar with the unique needs of the person with SCI. CRF

  10. #10
    good luck

    i take chlonidine hydrochloide 0.1 mg when the sweats get bad, it helps

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