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    Merciless Sweating

    I am a C5/6 quad who was injured in early 1982. Throughout most of the years since I've suffered from periodic bouts of sweating which causes me to remain home seated in front of a heater fan to keep the front of my head and shoulders dry and warm. While it may be a result of autonomic dysreflexia I am skeptical because my blood pressure is only sometimes elevated above 150 and regardless of how high it becomes I can stop the sweating by lying down and, as I learned only six years ago when getting my first tilting wheelchair, by tilting it nearly fully.

    However, because I become even more depressed when having to lie down before 10 or 11 PM or remaining fully tilted, as I can barely engage in any activity other than listening to the radio or watching television, I endure the misery of sweating in front of a table mounted heater fan. This month I've been doing so virtually every day from late morning until getting into bed at 10 or 11 PM. I have mentioned the problem in years past to two physiatrists but not received a helpful response. Any thoughts?

    #2
    It might sound stupid but I sweated like a pig when I had high-protein intake. Protein shakes made me sweat.
    C5/C6 Complete since 08/22/09

    Comment


      #3
      When I was in the hospital I was sweating so bad I could not slide on a slide board had to use a beze board, not sure on the spelling, but doesn't matter. I was changing pants 2 and 3 times a day. Tried doing a diaper, but that just helped keep the butt from sticking . My doctor put me on Gabapentin and for me it worked very well. He had said it is not what it was intended for, but had read it had worked sometime for women in menopause. Saved my butt.:-)

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        #4
        my doctor gave me oxybutnin
        for the bladder--completely stopped the sweating. i was just like you in front of a fan all day--it was sweet relief!!

        Comment


          #5
          Originally posted by Mac85 View Post
          It might sound stupid but I sweated like a pig when I had high-protein intake. Protein shakes made me sweat.
          All the time, or only during bowel routine?

          Comment


            #6
            I practice family medicine and can give you a frame work that can lead you on a path of better management and hopefully significant relief. As you come to understand your hyperhidrosis (excessive sweating) better, you will need to make a specific physician appointment to go though what may be triggering it and how your case might be best evaluated and treated. The more you know the better a partnership can be formed to address this debilitating problem. I understand your skepticism of autonomic dysreflexia being the cause. Think of the sweating as the first sign and lowest level of autonomic dysreflexia. Blood pressure elevations only occur once critical and dangerous levels of autonomic dysreflexia are triggered.
            Most individuals with your level of injury will have one degree or another of autonomic dysreflexia because the sympathetic nervous system which causes adrenalin surges, sweating, increased heart rate and blood pressure is not adequately connected to the parasympathetic system which would otherwise keep that sympathetic system under reasonable control.
            There is an occasional individual who after a very thorough search and best management of all aggravating factors will still have the problem. There are reasonable and good medications for it, and as a last resort a surgical procedure that can bring it under control. That being said...start with a very thorough search and manage all aggravating factors.

            In short, any thing that is a problem or causes pain signals to be sent to the spinal cord below the level of your injury can be causing your sympathetic system to be excessively excited and trigger your sweating. If you have two or three problems, that adds up. All aggravating factors have to be brought under control and stay that way for a month or two to get the relief you are looking for. the degree that you are experiencing for the length of time suggests that you will need a medication to help manage it, atleast for a few month to a year.. So here's a list to start thinking about:
            Conditions that can exacerbate it:(Most via sympathetic system)
            Bladder distention more than about 500 cc
            Fecal impaction
            Bowel distension/constipation (even if your bowel regimen seems to be going well, over the years the colon can become slowly enlarged and distended which is very often a major cause of your condition. Ask your physician about a plain x-ray to evaluate for this)
            Noxious stimulus with or without perceived pain-pressure sores, ingrown nails, musclespasms, injuries,burns, cold exposure, hemorrhoids, stomach ulcer, gall bladder, fractures, food intolerances, intestinal cramping, too much pressure on a boney, pressure sore prone area when you are sitting.
            Increased ureteral pressure (worsened by full bladder/ distended bowels)
            Erections
            Infections-bladder/wounds/bones/flu/appendicitis, ect
            Thermoregulation issues
            Bladder andkidney stones
            Endocrine-thyroid dysfunction, low testosterone levels, diabetes (ask for blood work)

            Management of hyperhidrosis:

            1. Identify and manage all aggravating factors.
            2.Medications: Robinul and similar meds directly interfere with a signals which are generated in the sympathetic system by blocking acetycholine muscarinic receptors in sweat glands.Acetylcholine is otherwise a parasympathetic neurotransmitter, so side effects include constipation, difficulty emptying bladder, and dry mouth.
            3. Surgery-Last Resort, requires a referral to a tertiary specialty center

            Hopes this helps get you going in the right direction. It can be a lot of work figuring this out, but it's worth it.
            Last edited by rplute; 1 Mar 2017, 12:08 AM. Reason: incomplete

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              #7
              Originally posted by Scaper1 View Post
              All the time, or only during bowel routine?
              All the time around my neck
              C5/C6 Complete since 08/22/09

              Comment


                #8
                Why would your blood pressure have to be elevated above 150?? AD and symptoms of AD ( but may not have symptoms- called silent AD ) is 20 mm HG above your baseline- and when sitting up I would bet yours is about 90/50. Therefore at 110 you could be having the initial AD. We don't treat till above 150 with medicine but.... the earlier that you recognize it the better.
                And the Evidence based medicine(EBM) literature it is no longer described as a "noxious" stimuli because of the misconceptions- #1 you can't "feel" the noxious stimuli. It is a what can be a "normal stimuli- (i.e. a bladder- full or with a low amount is not noxious stimuli )- it is a stimulus ( sometimes normal ) with an overexaggerated response- the autonomic component.

                What is your blood pressure when the sweating starts? Is your bladder is recently emptied of catheter draining, daily bowel program, clothing not too tight- I had a patient once who had bad stimulus- figured out it was his tennis shoes tied "too tight". It can be any stimulus but most commonly bladder, bowel, skin. I also had a patient with AD who died- we did everything right but on autopsy he was found to have a bad gallbladder. Also some we would give them Tyelenol or Ibuprofen when sitting up because of some pain somewhere below their injury that caused it- helped for 4 to 6 hours.
                In addition, repeated bouts of AD or chronic AD even if below 150 can be bad on your cardiovascular system so if possible, figure this out.

                The best "wallet card" is from the Christopher Reeves foundation and has your baseline blood pressure- lying and sitting. Ask for a couple.
                And other misperception - the headache- which may never happen, and the bradycardia- slow pulse. Typically the blood pressure goes up, the pulse may stay the same of even go up a little and the slow pulse is a late sign.
                But there is silent AD- really no symptoms at all. Not even if I am asking. It can be a slow upward course or a very fast course upward.
                Over 150/ is it is there or higher and we can't find the source within a couple of minutes.
                Use Nitropaste only.
                When it starts to drop, wipe it off -or then your blood pressure will be very, very low and then here comes the trendelenburg and starting of the IV's. If at home, wipe it off, start drinking water if dropping lower than usual.
                Another reason- people describe feeling "Yucky" after a bout of AD so the more you manage at the earliest sign, the better you feel all around.
                Look at the newest publications on AD and silent AD.
                At least your are monitoring your blood pressure.
                Whenever someone comes up with vague symptoms- possibly AD- I ask what was/is your blood pressure, what is/was your pulse? What is/was your symptoms?
                And when I get the response" I didn't check it" or I can't check it- I have no blood pressure monitor! ". Bad discharge planning and bag SCI care is my thought. But, will your health insurance pay for it! Nope! But Walmart ( or their competitors )have the wrist blood/pressure/pulse monitor for $15.99 or $29.99 normally. Buy one or borrow one( forever!).
                The best thing I can tell you then or now- is get a wrist monitor! keep a record.
                There are also those of you who never/ or it has been years then you start having some new symptoms- same thing- check your blood pressure.
                Vets used to get free but that was stopped many years ago. Everyone at risk for AD - that $30 or so will be the best money you spent.

                CWO
                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


                  #9
                  Last time I had sweats it was a bad uti.
                  ^^(A)^^

                  Comment


                    #10
                    I'm a C7 complete injured in 1994. I've also had bouts of intense sweating for various reasons. Some of the possible reasons could be:

                    1. Over-extended bladder. The oxybutinin might help in this case if you're not voiding properly.

                    2. A UTI or other type of infection.

                    3. A reaction to pain. This was my major problem for years. If you have a sore of any type that is being aggravated, it could cause sweating. My problem was that I was developing contractures and when I would lie down I had so much pressure on certain parts of my body that it was causing severe pain and would induce severe sweating until I got up and moved around. Based on the fact that you say it is alleviated when you recline or change positions, I'm guessing the sweats might be a reflection of some pain you are experiencing. More frequent weight shifts and moving around might help your cause. I'm assuming your chair and cushion has been properly fitted and mapped to provide the best pressure distribution while sitting.

                    4. I took Robinl to help with my sweats. It worked to reduce them in certain instances but never completely eliminated them until I solved the root problem.

                    That's about all I can offer based on my experiences.

                    Comment


                      #11
                      I am a C-4/C-5. I have battle sweats throughout my time being a quadriplegia. This sweating is always because of something bothering me. Lately it's always my pressure ulcer, but it could be a UTI, the way I'm sitting, the way my catheter is positioned. But always something. They just suck. I am so sorry for your situation because it seems even worse than mine. Something is bothering you, or I should say something is bothering your body where you can't tell what it is. It just really stinks. I hope you can figure it out!
                      www.symbolofstrength.com

                      Comment


                        #12
                        Do you have hemriods?

                        Comment


                          #13
                          I feel for you!

                          I am over 30 years C5 C6 postaccident and started sweating 5 years ago. My blood pressure remains low (90/50) and can only speculate as to what the cause is. Sick to death of healthcare professionals without any experience in spinal injuries telling me that I am hot and of course we know that it’s not a sweat from heat but a sweat that is cold like that of a junkie. I apologise to all the junkies out there. Hospital is a nightmare with the cold temperatures and a constant film of moisture over your skin. I sleep on my back with my head elevated and find that I can relieve the symptoms as you do by letting the head of the bed down, but not always as it is very unpredictable. I could sleep on my side years ago but that results in sweats.

                          I’ve had a haemorrhoidectomy to try and relieve symptoms but I have never seen such good advice is that from the spinal nurse. Don’t expect it to be noxious. Just for example I had autonomic dysreflexia, headache included from ejaculation. I had no idea it was going to happen but I had previous warnings when I would start to shake during intercourse and I would tell my wife to stop but one time I thought I would just leave it go, big mistake.

                          Unfortunately I believe from my experience that I can’t find an answer and you can only try different things. It is true that some of the drugs quadriplegics take to close the sphincter muscle so there will be little to no urine coming out of your penis reduce sweating as well. I would be interested to know what your urinary method is. If you have a suprapubic catheter you can experiment with these. Unfortunately if you are using a voiding method into a leg bag some of these drugs won’t be suitable. It’s a Catch-22.

                          I can only say that mine is not as bad as yours as I have good days and good nights without sweating but they are few and far between. I suspect the issue lies with bladder, bowel, skin in the pelvic area but your guess is as good as mine, take your pick.

                          I have invested via eBay in a wrist worn blood pressure monitor so I can report back if I discover anything. If you find a solution please share it!

                          Cheers




                          This message was composed using voice recognition, there may be mistakes.
                          Last edited by takenaback; 3 Mar 2017, 4:48 AM.

                          Comment


                            #14
                            Sweating can be one of the first signs of AD.
                            Oxybutynin(Ditropan)- and other anticholinergics keep you from sweating- if high dose sometimes can't sweat at all. Botox to a certain area is also used to prevent sweating.
                            CWO
                            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


                              #15
                              Cord's response [don't know how to do reply or use tags]

                              Thank you all for your replies. It was my first and only post and this is my first reply post. Unfortunately, I don't think I got the magic elixir to my problem, although perhaps it will be one of the three suggested prescription meds (Gabapentin, Oxybutynin, Robini). I will discuss them with my physiatrist. Nevertheless, I am encouraged by your replies.


                              I doubt the cause of my sweating is Excessive Protein as I am primarily a vegetarian. I only eat fish, fowl and beef when eating out and do not take any protein supplements. As to my BP I rarely take it anymore at home because over the years I found that the sweating starts when it is anywhere from 100/80 to 180 and above. About a year ago I participated in a study (unrelated to sweating) in which I had to record my BP + pulse 3 or 4 times per day for 30 days and my diary confirmed to me the sweating is unrelated to my BP.

                              Nor do Bladder/Bowel/Skin problems seem to be a cause of my merciless sweating. Sometimes I sweat as a result of one or more of those problems but such problems do not provide me an explanation for prolonged, multi-week bouts of sweating while sitting up in my wheelchair. As to my bladder, I use a Texas cath that does not cause the problems of a Foley and I have maintained very low voiding residuals for many years. My urologist checks annually. Nor does Pain offer an explanation as fortunately I only suffer tingling in my fingers and toes, and it is constant, every waking hour regardless of whether I'm sweating or laying down.

                              Tight Clothing does not appear to be the cause of my problem either. After all, I change my clothing daily, wearing it throughout the day including those days on which the sweating comes and goes; and I do not loosen anything before fully tilting my wheelchair to stop me sweating. I wear loose slippers and my abdominal binder is in the same position each day. Today by the way, I've been in my chair since 8 AM, began sweating about 11:45 AM and have been doing so off and on since then. It's now 5 hours later, as I write this while sitting in front of one of my heater fans.



                              Originally posted by Cord View Post
                              I am a C5/6 quad who was injured in early 1982. Throughout most of the years since I've suffered from periodic bouts of sweating which causes me to remain home seated in front of a heater fan to keep the front of my head and shoulders dry and warm. While it may be a result of autonomic dysreflexia I am skeptical because my blood pressure is only sometimes elevated above 150 and regardless of how high it becomes I can stop the sweating by lying down and, as I learned only six years ago when getting my first tilting wheelchair, by tilting it nearly fully.

                              However, because I become even more depressed when having to lie down before 10 or 11 PM or remaining fully tilted, as I can barely engage in any activity other than listening to the radio or watching television, I endure the misery of sweating in front of a table mounted heater fan. This month I've been doing so virtually every day from late morning until getting into bed at 10 or 11 PM. I have mentioned the problem in years past to two physiatrists but not received a helpful response. Any thoughts?

                              Comment

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