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SCI Nurse - AD symptoms with lowered BP

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    SCI Nurse - AD symptoms with lowered BP

    Hello, SCI Nurse,

    Something weird is going on here. I'm having symptoms of AD (chilled feeling, sweating), but my blood pressure is far from elevated, it's way below normal (69/42 sitting, 79/50 laying in bed w/ head elevated.) I've had all the standard AD triggers (bowel, bladder, skin, etc.) checked, and they're fine. No fever. I called urologist's office, and doc on call said it didn't sound like UTI with no fever. Any ideas on what else can be checked, or what could cause this?

    Hopefully, your answer will allow a caregiver to solve the problems here. If (heaven forbid) I have to go to the emergency room, what do I ask them to look for?



    Thank you.
    Last edited by alan; 17 Dec 2016, 7:01 PM.
    Alan

    Proofread carefully to see if you any words out.

    #2
    AD you would have an elevated BP
    your BP may be low if you are dehydrated
    what is your urine output?
    you could have a virus if not an infection

    pbr
    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.

    Comment


      #3
      If you go to the ER, tell them your symptoms. Let them figure out what to look for.
      Tom

      "Blessed are the pessimists, for they hath made backups." Exasperated 20:12

      Comment


        #4
        My BP is normally that low, even when using the standing table (not light headed). I get that tense, sweating feeling when there is pain (unfelt), usually bladder or bowels or skin pressure (butt, feet, etc). I often can't find the source, and have to wait it out, for a few hours anyway, until it goes away or the cause is discovered. Have you had these symptoms before? It sounds familiar. Depending on the severity and duration, you might have to go to an ER. You know your body better than anyone, but if it's internal, you might not figure it out.

        If you aren't getting lots of clear urine, I agree that you should drink more water. I think I drink a lot, but it's still not enough sometimes (hmm, maybe that explains my low BP too).
        "Cherish your tears. If you can cry, you still have some humanity left, and you are reclaiming more of it." -- David Kelly


        Comment


          #5
          Originally posted by SCI-Nurse View Post
          AD you would have an elevated BP
          your BP may be low if you are dehydrated
          what is your urine output?
          you could have a virus if not an infection

          pbr
          As it turns out, it was/is an infection. I went to urgent care after my last message post, they did a urine sample and found blood and leukocytes. They prescribed Macrobid, and by three days later, but this reflects the sensations and lower blood pressure were gone (in between, I had some periods of actual dysreflexia with blood pressure reflecting that, but more of the time the pressure was low. It was 66/43 sitting up at the urgent care.)

          I shouldn't have been dehydrated, as I was drinking the same 2.5 to 3.5 L of water I drink every day. My urine was darker, but that was from the blood in the urine caused by the infection. With the Macrobid doing its thing, the urine is clear, even my sediment is greatly reduced (I hope it stays that way.) Urine output generally matches liquid input, though I do put out much more urine at night than during the day, due to higher BP while laying down.
          Alan

          Proofread carefully to see if you any words out.

          Comment


            #6
            I'm resurrecting this message because strange things still go on with me. My blood pressure is take it twice a day, morning and night in bed with my head elevated. I sometimes get elevated blood pressure (145/92, 138/87, that kind of reading.) There is no sweating or chilled feeling during these times, and there are no bowel or bladder problems. For the most part in recent months, my blood pressure is at levels that would be considered normal for able-bodied people, without any dysreflexia symptoms.

            In the chair, my pressure is lower when sitting up, of course.

            I've spoken with my doctor, and he has no idea. I've asked him for a blood pressure medicine to take during those elevated times, but that request has gotten nowhere so far. I've made an appointment with him, but it's over a month away.
            Alan

            Proofread carefully to see if you any words out.

            Comment


              #7
              alan if you are having both high and low blood pressure i would hesitate to take a blood pressure med. it sounds like you may have orthostatic hypotension. i would call the doctor and see if you can get an urgent appointment with him if your worried.
              T6 Incomplete due to a Spinal cord infarction July 2009

              Comment


                #8
                Originally posted by TomRL View Post
                If you go to the ER, tell them your symptoms. Let them figure out what to look for.
                That is about the scariest thing you could possibly do. To let the emergency room try treating an SCI injury, its intricacies, interactions, AD and all the other nuances of the spinal cord injury, you need to help them out as much as you possibly can.

                Have asked every doctor that is ever treated me how much training they got About spinal cord injuries in med school . Except for my Physiatrist the answer has been a universal "Part of one chapter In one book" out of all the books you read in medical school.

                You need to rule things out to the best of your ability and make the best hypothesis, postulation, or some Rough diagnosis which you suspect so that they can rule in or out.

                While you're in the emergency room you have the diagnostic equipment you need to rule things and around, think about all the bad things that they could do if you did not tell them "no" not "let them figure out."

                E.g. they called a code on me, because my blood pressure was too high, had to stop them because my blood pressure crashed. Imagine what would happen if they put something in me to lower my blood pressure? At the very least, I would insist on a patch because you can't undo an IV or oral medication.

                No matter how lousy you feel You must pay attention to what they're trying to do.

                Comment


                  #9
                  Alan, you should check your blood pressure in bed with your head flat, and then again when it is elevated. If you don't have a BP cuff, how is this being checked? You can purchase a decent digital BP cuff for less than $40.

                  Just repeating though, that it is not AD unless your blood pressure is elevated, generally 30-40 mmHg over your baseline systolic BP (the top or first number). So if your normal laying down blood pressure is 90/50, you really cannot say you are having AD until your systolic blood pressure is at least 130-140.

                  Infections, especially gram negative bacterial infections, can cause low blood pressure. Are you on any new meds? Changes in blood pressure can result as a side effect for many medications.

                  (KLD)
                  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.

                  Comment


                    #10
                    When I went to rehab they seem only concerned with my diastolic blood pressure and told me when it went above 90 to find out what was causing it and if it went over 120 to go straight to the ER.

                    Did I remember it incorrectly or is this a different situation?

                    Comment


                      #11
                      The clinical practice guidelines and all authoritative studies done on AD indicate that the SYSTOLIC (not diastolic) blood pressure reading is the most important. If your diastolic blood pressure is 100, your systolic blood pressure must be significantly higher.

                      The systolic is the pressure of blood against the artery walls when you heart beats (which is what can cause a stroke or bleed during a severe AD episode), while the diastolic is the pressure against your arteries between heart beats. If this is too high for a long sustained time, it can cause left sided heart failure. For regular essential hypertension, then the diastolic is equally important with the systolic.

                      I think you may have misunderstood your caregivers in rehab.

                      (KLD)
                      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.

                      Comment


                        #12
                        A lot of information was thrown at me 35 years ago and I understand the difference between systolic and diastolic .

                        Quite frequently. My blood pressure will be 130/100 what does that mean?. I've also had it at 300/160. This is really extreme, systolic doesn't really do anything like the AD sweats when my systolic blood pressure goes up.

                        Looking at this site http://emedicine.medscape.com/article/322809-overview

                        Significant rise in systolic and diastolic blood pressure greater than 20 mm Hg systolic or 10 mm Hg diastolic above baseline .

                        my baseline is 70/40 and then my blood pressure goes to 130/100. That's a heck of a move according to the definition, should I just ignore this?

                        I may be that my diastolic blood pressure moves much more than my systolic pressure and it always has. Granted, medical science has changed the last 35 years from when I was trained so new information is always good. Thank you

                        Comment


                          #13
                          It is common that the diastolic blood pressure will also rise in AD, but the most important number is the systolic.

                          What is your resting blood pressure (taken when you are not having AD, and laying down flat in bed)???

                          Here is a link to the clinical practice guidelines on AD, which is the evidence-based authoritative document on both pathophysiology, causes, and treatment of AD. It is written for health care providers:

                          http://www.pva.org/CMSPages/GetFile....1-c06f50aeba65
                          (see page 9)

                          Here is a link to the patient/consumer version of the document above:

                          http://www.pva.org/CMSPages/GetFile....9-f002f88bd2c1
                          (see page 2)

                          (KLD)
                          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.

                          Comment


                            #14
                            Originally posted by SCI-Nurse View Post
                            Alan, you should check your blood pressure in bed with your head flat, and then again when it is elevated. If you don't have a BP cuff, how is this being checked? You can purchase a decent digital BP cuff for less than $40.

                            Just repeating though, that it is not AD unless your blood pressure is elevated, generally 30-40 mmHg over your baseline systolic BP (the top or first number). So if your normal laying down blood pressure is 90/50, you really cannot say you are having AD until your systolic blood pressure is at least 130-140.

                            Infections, especially gram negative bacterial infections, can cause low blood pressure. Are you on any new meds? Changes in blood pressure can result as a side effect for many medications.

                            (KLD)
                            For years, I used one of those wrist cuffs. Earlier this year, I bought an Omron upper arm cuff. My arm may be a tad below 9 inches in diameter, but it works.

                            We can try to take it flat as well.

                            I'm not on any new medications. It's the same collection I've been on for I don't know how.

                            My pressure injury is healed.

                            Thank you for the assistance.
                            Alan

                            Proofread carefully to see if you any words out.

                            Comment

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