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Autonomic dsyreflexia

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    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
    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; 18 Nov 2015, 11:09 PM.
    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.

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      #3
      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.

      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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