Autonomic Dysreflexia and Living with a Spinal Cord Injury
By: Brian Elliott
How well do you know yourself? Inside and out. As a person with a disability, there are many things that are important to know. An article from New Mobility Magazine about a condition called Autonomic Dysreflexia (AD), a potentially life threatening situation that had me thinking about how truly important it is to know your body along with a level of comfort around your disability. Each disability comes with its unique characteristics, and just like snowflakes, no two people with disabilities are exactly the same. At the risk of over generalizing across disabilities, I am going to stay with spinal cord injury (SCI) for this posting.
Obtaining a SCI is like getting a new body. You need to learn how it operates and what function it has. For starters, people with SCI no longer have full control over bowel and bladder function. Meaning they can no longer hold a full bladder as before the SCI. When it’s time to go; it’s time to find somewhere to go. Knowing yourself and establishing those baselines are a way to gauge severity. Is something not quite right? Or, is something wrong? Similar to the old adage “are you hurt or injured”, there is a difference.
Knowing your body and what “normal” feels like is an important part to living with a SCI. Which is weird to say in regards to someone with a SCI that may have decreased or no sensation in parts of their body. Yet, it truly is important to identify that “normal” feeling; how you generally feel throughout a majority of days. It’s when that “normal” feeling is gone that it is time to start going through a mental checklist of common issues for feeling “off”. Even though the spinal cord is no longer fully functioning to send signals down to the nerves below the level of injury, the body finds a way to bypass those normal routes for warnings and sends other signals like increased blood pressure, blotchy skin, headaches, sweating (people with SCI do not sweat below their level of injury normally) as some examples that a person with a SCI may experience when something is not right. These are also the early warnings signs of AD. For myself as an example, the most common culprit is a full bladder. If after using the facilities to empty out the bladder but still not feeling “right”, it is time to go through other potential common causes. How does a person without sensation go through the options and determine what’s wrong? It starts with the normal culprit checklist that was mentioned earlier.
- Look over yourself for anything out of place. Maybe a foot is turned or you acquired an injury you weren’t aware of at the time like a cut.
- Use the restroom to empty your bladder.
- Remove shoes to check for a toe facing the wrong direction or sock bunched and pinching skin. Maybe the heel of the shoe rolled down when putting it on and is pushing into an Achilles tendon. Those are common sources that can lead to a pressure sore. You do not want any pressure sores!
- Make sure other clothing is not bunched on your back, sides, under your butt and thighs. Also leading causes to get a pressure sore.
- Find a way to lean back and elevate your legs above your heart. Many power chairs come with a tilt feature or have someone tilt a regular wheelchair back and rest that way for a few minutes.
- If you are still having issues, it’s time to start taking the clothes off. Ideally at home in your bed if possible. Give your entire body a check looking for redness or other abnormalities.
- Try for a bowel movement.
Best case scenario, one of those quick and easy checks or the little self-exploration combined with laying down or bowel movement found the cause and you begin feeling better. If not, time to get on the phone with a medical professional. No matter how long a person has had a SCI, these are concerns and checks to use and always have in the back of your mind. #Awareness