BUMPS IN THE ROAD

About 2 years ago Chris was driving his wheelchair outside and he accidentally hit the wall of one of the buildings and smashed his toe (he had sandals on).  He couldn't feel it and his foot fell off the footplate but the whole nail was bruised and the toe was bloody.  For those of us who are not paralyzed, it would hurt and be annoying but we'd heal and move on.  For Chris it meant something different......

Since he can't feel anything below his collarbones you would think that something like this would be easier for him because he doesn't "feel the pain."  Unfortunately it's not.  In his body he realizes something is wrong by a different feeling - autonomic dysreflexia.

AUTONOMIC DYSREFLEXIA - is something that happens to people who are paralyzed (have a spinal cord injury) above the 6th thoracic vertebra (about the level of the bottom of your shoulder blade).  In people without a spinal cord injury when something painful happens to our foot, a message gets sent up to our brain to tell us that our foot is injured and another message gets sent down to keep our bodies calm (like keep our blood pressure from raising too high or keep our heart rate regular).  For Chris this message doesn't get up to the brain and the "calming down" message doesn't get sent back down.  So although he doesn't feel the "normal" pain, his body isn't able to calm down either.  His blood pressure raises higher and higher and causes him to sweat, get blotchy skin, have a headache (which gets very intense when blood pressure gets very high),sometimes get congested, and his pupils dilate.  There are other symptoms that people can have but these are the ones that Chris has almost every time that something painful happens below the level that he is able to feel.  Until the pain in his foot is gone (the foot is healed) he can experience dysreflexia.

In this particular injury he felt mildly dysreflexic for a few days because of  it but then it went away.  Every now and then he would feel that way but for the most part it was ok......until the past few months.  In March, right before we were to leave for 2 1/2 weeks for speaking engagements his toe got infected.  He was sweating a lot and had mild - strong headaches off and on each day.  He was able to get some antibiotics to try on the road until he returned to Dallas.  These symptoms were hard to read though because at the same time his toe got worse, he also got a pressure sore from sitting in his wheelchair.  So he didn't know if the pain he felt was because of the pressure sore or the toe or both.....makes it hard to know how to make the symptoms go away - especially when you are on the road!!

But fortunately when we returned he saw the podiatrist who cut out the ingrown toenail that formed, the old toenail finally fell off, and now he's got a new and pretty toe!  And no pressure sore since the beginning of May!!!!  Yay!!  (That's a long time for us!  His skin has gotten so weak since coming to school and being up so much for reading and writing papers).