Pay Attention SCI-ers and families of individuals with spinal cord injuries T5 and above: AD is a real thing.
Many of us who have had our injuries for a while are no stranger to the affects of a stubbed toe or blocked catheter but if you ask any of us if we have ever had a scary moment involving autonomic dysreflexia, you’ll likely get a resounding “yes.” That is because AD can happen fast, very fast, and if you have impaired sensation or don’t quite know how to recognize the symptoms of AD, you could be covered in sweat with a pounding headache before you know it! But calm down, I am not trying to make you paranoid, there are signs you can look for. This article is designed to help you notice the signs and symptoms so you don’t get caught in a moment of panic. However, please take this article seriously because AD is a potentially life-threatening condition and people have suffered from stroke or death because of an attack.
What happens? In a nutshell any number of these things can happen (it may be different between people)…
- Your blood pressure raises quickly resulting in a pounding headache, throbbing neck arteries, flushed skin, and flashes or spots in your vision
- Sweating above your level of injury, even if you’re freezing
- You get goosebumps, even if you’re not cold
- Irritability and anxiety
- Stuffy nose
Why does this happen? Many people with spinal cord injuries above the T-5 level have experienced the affects of AD. Basically, AD is the result of the brain’s inability to regulate the body’s response to intense stimulation, with pain being the primary culprit. Here are the most common triggers of AD in SCI-ers:
- An unknown injury such as a cut, burn, stubbed toe, or broken bone (I’ve burned myself with a coffee cup once…okay, twice, only to have a bout of AD inform me that I had done so)
- A blocked catheter or UTI
- A full bowel or bladder
- A deflated cushion or developing pressure sore (shoes being too tight counts)
- A sunburn
- Sexual activity (it’s ironic that one of the most pleasurable experiences could also trigger AD)
- Basically anything else that could cause pain or discomfort
How do you deal with it? It’s very simple- find out what’s hurting, and relieve it quickly! But don’t be stubborn about it or afraid to speak up. If you feel your blood pressure spiking and you’ve done every logical thing and checked everything you could think of, GO TO THE EMERGENCY ROOM! Get someone to take you and have them call ahead. Also, bring an AD card with you- you can print one out here: Printable Autonomic Dysreflexia Card. But if your blood pressure is just elevated, and the goosebumps have just started, start looking for the cause and follow these steps:
- Stay elevated always! Do not lay down flat- this will allow your blood pressure to raise higher.
- Bladder fullness is the most common cause so check there first.
- Check the bowels for impaction by digital stimulation. Try to stay as elevated as possible.
- Check your skin, nails, toes (poor toes and backsides bear the brunt of the abuse)
- If all else fails, go to the emergency room. Don’t fool around with blood pressure!
In all, autonomic dysreflexia is one of those things that is likely to happen if your injury fits the category, its more a matter of when, but if you are educated and prepared for when it does happen and the people in your immediate circle understand it, too, then the dangers will be significantly reduced.
You can read more about AD by visiting the SCI Info Pages or by doing an online search. There are many great articles related to AD- some more technical than others but all helpful.