deb60

Thanks Dr. Corenman,
Yes I am sure you are right, it seems many medications can lead to malabsorption syndromes and some medications such as furosemide lead to needing to replace more of the water soluble vitamins. With diabetics when sugar levels get to high the kidneys rid the extra through urine and along with that goes any water soluble vitamins. Many of those vitamins are really important for the autonomic nervous system and possibly be the reason for autonomic neurapathy, the symptoms are a lot like that of autonomic dysreflexia which you had mentioned. I have learned so much, but I wouldn’t have found this with out your help and the time you take to answer my questions. I really appreciate your time and your help. Thanks again.

Thanks so very much Dr. Corenman, My husband has been a very unusual case which up until now have had no explanation of all his symptoms, but this is as close as can bee explained so far. Your information has been very helpful and led me to information about Autonomic dysfunction which could explain the changes in his bladder, kidneys, digestion and breathing. At the time of the accident his kidneys and bladder were normal now his kidneys are mildly atrophic and his bladder is distended with wall thickening, his kidney function is on and off. His digestion seems to slow down or stop at times where the stomach area is very swollen and distended. As I said before it always seems to happen after light physical activity which confuses me unless it puts compression on the nerves and triggers it. Of course he would need test to confirm it. Your information led me to this abstract from PubMed.

Autonomic dysfunction in spinal cord injury: clinical presentation of symptoms and signs.
Spinal cord injury and especially cervical spinal cord injury implies serious disturbances in autonomic nervous system function. The clinical effects of these disturbances are striking. In the acute phase, the autonomic imbalance and its effect on cardiovascular, respiratory system and temperature regulation may be life threatening. Serious complications such as over-hydration with the risk of pulmonary edema or hyponatremia are seen. The cord-injured person suffers from autonomic nervous system dysfunction also affecting bladder and bowel control, renal and sexual function. Paralytic ileus may cause vomiting and aspiration, which in turn interferes with respiratory function in those with cervical spinal cord injury. The cord-injured person is at risk to develop pressure sores from the moment of the accident. Two to three months post-injury the cord-injured person with a lesion level above the fifth thoracic segment may develop autonomic dysreflexia, characterised by sympathetically mediated vasoconstriction in muscular, skin, renal and presumably gastrointestinal vascular beds induced by an afferent peripheral stimulation below lesion level. The reaction might cause cerebrovascular complications and has effects on metabolism. Some of the autonomic disturbances are transient and a new balance is reached months post-injury, while others persist for life.

Yes I am sure you are right, I just found the nerve conduction test following surgery and it showed there was damage, at the time they said there was no damage but the document said there was. The respiratory failure is very strange, it comes on very fast and oxygen can’t be brought up with home oxygen. He feels as if he were not sick after the 1st day in the hospital unlike pneumonia. Seems to always happen after doing light physical projects. He gets a low grade fever around 99 then his abdomen swells his pupils are dilated, his oxygen drops the doctors tell me his lungs are clear and with in about 15 to 20 minutes his lungs fill with fluid. His heart is functioning fine, I had him checked out by a heart doctor on more than one occasion because I thought it could be the problem. I have also had him to kidney doctors who have said this isn’t the cause. Pulmonary doctors monthly if not more. 30,000 miles in just doctors care. In the last year and a half. He has so many problems every where in his spine especially the areas where the nerves control the diaphragm. A x-ray 4 months after the accident showed a unchanged fractures in C2 from there I have no idea if they healed as they said they didn’t need to see him again, it also showed central canal stenosis at C4-C5 with disk herniation, diffuse uncinate arthropathy this was July of 2015 so I am sure it has got worse. Since then he has had images done for reasons of his respiratory problems and many new spine problems have showed on them. Reverse lordosis of the neck, several compression fractures in the thoracic region. Loss of disk space height C3 thru C6. 5 images showing decreased bone mineral density,degenerative morphology through out his spine. All images of the lungs show atelectasis which could be a sign of diaphragm dysfunction. I know that his doctors are doing there best, ( I research and find the best doctors) I am just wondering if the accident did more damage than can be seen and is being overlooked along with the decreased bone desity, as the nerves functions the entire body and because of the spine stimulator he feels no pain in his back only some neurapathy pain in his feet as it is hard to reach the foot with spine stimulater’s. This is definitely a complicated case Maybe a internist or vascular specialist could help but I can’t rule out neurological with all the problems in his spine.