Understanding Your AD

Reprinted from PN February 2009

No matter how frequently you encounter this potentially life-threatening medical condition, there is no denying it brings on intense anxiety—and needs immediate attention.

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Maybe you have been through it: the unexplained sweating, the goose bumps, and the headache that tells you something isn't right. Autonomic dysreflexia (AD) can be a daily disturbance for some people with spinal-cord injury (SCI), while for others it happens rarely. Or perhaps you are one of the 12,000 new SCI cases that occur each year and you haven't yet had AD.As the wife of a C4 quad for more than 14 years, I have seen my husband endure countless episodes.

Know your baseline blood pressure so you can communicate effectively with healthcare professionals.
New and long-standing quadriplegics should understand that their own AD symptoms are unique in their onset and intensity.Because your friend Fred is a C4 quad like you doesn't mean his dysreflexia will behave the same way, or for the same reasons, as your own episodes.Just as people without SCI experience pain in their own unique ways—your Uncle Mel requires bed rest and plenty of painkillers for a sprained wrist, while Aunt Fran just grins and silently bears the pain—quads also have unique experiences with dysreflexia.

AD (hyperreflexia) is an exaggerated response by the autonomic nervous system, and it typically occurs in people with spinal injuries above T5-6. This response is triggered by something your body would normally find painful or otherwise disturbing. The autonomic nervous system is a part of your peripheral nervous system, that wide network of nerves connecting your limbs and organs to the spinal cord.

The goal of the autonomic nervous system is to maintain stability by regulating the involuntary activities that go on in the body. Your mouth maintains a relatively constant state of moisture because the autonomic nervous system controls salivation. You don't have to think about taking a breath because this part of your nervous system ensures your breathing is constant. And your heart rate and blood pressure will go down when you are digesting a meal, thanks to your autonomic nervous system.

Normally this process is quite streamlined. When was the last time you remember having to control the diameter of your pupils to respond to a change in light? Most likely, you haven't had to worry about any of these internally controlled bodily processes. But there are times when the system goes absolutely haywire. Your blood pressure spikes, you get a strong headache, and you may start to sweat. Or maybe you just get a stuffy nose, some goose bumps, and your skin gets patchy red spots. It may seem like there is no reason for these strange bodily responses, but something in, or on, your body is causing irritation or pain.

Symptoms vary for people with AD. The important thing to remember is that if the progression of the symptoms remains the same, there is no reason for alarm. AD resources are also given in the February PN.


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