paralysis pain response // why pain can be dangerous even if you can't feel (autonomic dysreflexia)
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- Опубліковано 11 гру 2022
- I get asked a lot if I can feel pain below my level of injury. The answer for me is no, but not every person with paralysis has a loss of sensation.
People, especially kids, are surprised that I can't feel any pain, even really horrible pain like being stabbed. But just because my brain doesn't interpret the pain doesn't mean it doesn't exist. My body still reacts to the pain and in fact pain can be very dangerous when you're paralyzed.
In this video I explain why.
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Transcript
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Autonomic dysreflexia (AD) is the location of the upper motor neuron axons or arms. Also at risk are individuals with brain injury, stroke, and other neurological diseases if the upper motor neurons in the brain or upper spinal cord are affected.
After a nervous system injury, communications to and from the brain may be partial, absent, or misinterpreted messages. However, messages are still being sent and received through the nerves of the ANS. Nerves are throughout the body, including the area of injury. Your automatic nervous system is still working but perhaps not at the same level as before your injury. Instead of a small response to just a specific issue, an energy burst from the sympathetic nervous system is released as a radical correction. The parasympathetic nervous system is unable to slow the release. This is autonomic dysreflexia, an automatic reflex over-response that cannot be contained. Because the ANS is automatically controlled, you cannot consciously change or control your body’s autonomic dysreflexia response. Emergency treatment should be started immediately.
What is autonomic dysreflexia?
The nervous system is a complicated network composed of many parts and subsets. One of these parts is the autonomic nervous system (ANS) which controls all body functions that you do not think about to make occur. The ANS balances its subparts, the sympathetic and parasympathetic nervous system. The sympathetic autonomic nervous system (SANS) speeds up body reactions while the parasympathetic autonomic nervous system (PANS) slows these reactions. This combination keeps the body functioning in harmony. When threatened, the sympathetic nervous system speeds without containment by the parasympathetic system which results in the fight or flight response. If the body is threatened, a release of energy bursts through the nervous system as a reaction. This is the usual human response to a threat.
So then I actually had it sort of wrong! It's an exaggerated sympathetic response? Not just a normal one left unchecked? Thank you for clarification and for this comment! I will pin it to the top!
@@EmpoweredPara
I was sitting watching TV when I started to just pass out felt light headed I noticed my blood pressure going up & down & was told to go to the ER because they told me I could be having a stoke. I'm a T-12 - T-11ish paraplegic & they said because I was having a bowel restriction below my injury level & it was probably very painful but I couldn't feel it or notice it besides a fairly bad headache which I now know is a symptom of AD along with high blood pressure which I also had. So we treated the bowle issues & I was back to normal. The ER doctor told me to look up the article on AD on the Christopher Reeve organization website
Because it explains it the best. So Because UA-cam won't let's us link stuff I Copied & pasted it.
I was taught about AD in Craig hospital @ the beginning of my paraplegic life
But I didn't catch it, I was to worried about it being a stroke ect.
That fascinating. I hadn't heard of that, but it sounds very similar to something I read about why they give anesthesia to brain dead organ donors when removing their organs. They do it to prevent an autonomic response that sounds a lot like the response you described.
interesting! I'm gonna look that up!
its really cool that you share these insights, and sometimes the answers to really stupid, but sincere questions from ppl like me, who dont know what life is actually like with paralysis.
That was interesting, thank you. The human body and I suspect all living bodies have multiple signal paths over which information can be distributed with potentially undesirable effects when unbalanced.
Perhaps that explains why, at a different level, many doctors prefer to use 'sedation' for minor procedures, but their reluctance can sometimes be set aside allowing you to have some 'interesting' experiences. I certainly second your comment about not all medications having the same effect on all patients. Painkiller medication might knock some people out at the recommended dose, but others react as though they have had too much to drink. Dealing with an abreacting, apparently drunk toddler in a Japanese hospital, can be a rich experience - not to be repeated!
Explained better than a doctor ❤
Thanks! Doctors often think we are too dumb to understand 😕. So annoying.
This was so interesting! I was born with a birth defect called spina bifida that falls under SCI. I'm also a survivor of abuse and a certified trauma recovery coach. Needless to say how deeply trauma is linked to the body in mental health annoys the heck out of me!
Similar to an SCI caused by an accident-type injury we experience similar things physically as the defect can happen anywhere along the spine. But obviously in the case of things like fight or flight when you cant walk you aren't gonna run! It's always something I've questioned as to whether or not I could fully heal from my trauma or not and it's had some pretty detrimental affects as nobody seems to know the answer from a mental health perspective because they are only trained to understand the body as a fully functional system!
Years ago a broke my left leg after a good fall... Being a T6 complete I had no idea that I had. Later that night I woke up and noticed that my entire left side was drenched in sweat. My right side was totally dry. When I got up from bed, that's when my heart rate increased, and a headache hit right away. I was taken to the emergency room and told that I had a tibia and fibula fractures. As well as autonomic dysreflexia.
The body has a way to get your attention when something is wrong.
Great video explaining this subject.
How is it that you sharing your C-section epidural story… and I just learned so much about my own body😂 You are a true educator!
Thanks! I actually am a teacher in real life lol
@@EmpoweredPara 😂😂😂 Of course you are 😂😂😂
Gotta admit, I’m loving binge watching your content. One bonus to finding your channel so late. 🥰
I love your attitude towards life it’s beautiful honestly and so are you ❤
That was a better explanation than the one I got in the hospital. You should really do a video on pressure ulcers, after all, they do kill alot of wheelies.
You said it perfectly! One of the best breakdowns between sympathetic vs parasympathetic that I’ve heard in a very long time. Thank you.
Thanks!
That is -fascinating-, I've actually struggled a bit with the vagueness of most descriptions parasympathetic and sympathetic nervous systems, but on top of learning about a really interesting fact that's useful knowledge, it clarifies some things about how those things function. Thank you! I wondered if it was related to "shock" and it sort of is, but it also reminds me of how complicated the technological journey to surgery is and how the consequences of hacking in are so different, anaesthesia is not simple sleep!
So interesting. I literally had no clue.
Great video, I didn't actually know about this! You've explained it really well
A great explanation and also answered a question i had
There's the old saying, "Learn something new everyday." This is my 'learn new' today. Thanks! And Britney, or E.P., your being a "Science nerd" and Teacher has helped you, and us, so much. I'm not paralyzed; but I do have a disability of Multiple Chronic Soft Tissue Pains (5 areas). Job #1 is Managing Pain. By later aft/early evening Pain , BP, and Agitation ladder-up, boosting each other as I push and pull to finish the day's tasks so I can do what my body wants: 'Get off my feet, Get off my knee, Get off my back,' Lie down... During the day I use icing, {knee ice pack -changed every 20 min or so, & a bubblewrap like lower back icing}, compression {several Velcro'd wrap braces} medications, shifting body positions and activities...
I love learning new things too! And today you gave me something ro learn about: Multiple Soft Tissue Pain! Gonna look it up!
Great Job - complex subject. Keep up the great work and videos!
aye aye sir! Thanks!
Brilliant explanation. You are truly amazing ❤️
Thanks!
This was one of my favorite vids Brittany 🙏
Such a great explanation and very interesting! Thank you so much for explaining!
you're welcome!
Fascinating!
Your videos are very informative, thank you.
You're welcome!
Did not know this. Great explanation.
thanks!
Excellent topic, great explanation. Thank you. Would you also talk about SCI and nerve pain, neuropathy etc and why this happens to some SCI injuries? I feel so lonely, i would love some feedback from other SCI individuals. I cannot feel anything below my T4 injury but experience a blanket of nerve pain inside by body from T4 (breast line) down to my toes, 24/7. Some days are worse than others ranging from a 6-10 on the pain scale.
This was sk fascinating!!!!! Just found your channel
great informative vlog again. keep up to good work
thanks!
Interesting and great explanation.
It's important to distinguish between complete SCI (where no signals get past the injury period) and an incomplete SCI (where some messages can get through...but they may be garbled).
I had some text in the video clarifying that:)
@@EmpoweredPara I missed those...sorry.
Whoops, forgot to say, just like your recent video with Margaret, I have to watch these ones numerous times to learn and absorb all the information that you have given us. And think about all this. Plus look up things like PVP in catheters. And I hope to God, Brittney, that you’ve never been stabbed! Your example freaked me out!
no over never been stabbed lol
@@EmpoweredPara WHEW! That’s very reassuring to Deb and I !
Autonomic dysreflexia is a crazy phenomenon. As a nursing student in a spinal unit facility i learnt so much about the human body. As you know certain things can trigger this. A full bladder because of a blocked catheter or tight clothing etc. I remember walking along side a patient who was attending gym in his electric wheelchair and he had an episode of this, his hand pushed forward onto the wheelchair control and was unable to move his hand off it, I’m sorry to laugh but he just started going faster and faster and I had to chase after him and grab his hand off the control before he crashed or ran over someone! He was laughing also thank goodness. I had to quickly do a top to toe to check what could be causing this reaction, checking shoe laces were not too tight, a kinked catheter, if his trousers were twisted etc. it’s quite a scary thing to go through in situations like this and came on so quickly. You explained this really well. I’m a science nerd too and I have to know everything I possibly can if I come across something new that interests me.
I laugh uncontrollably when people fall too, lol....I know it's unkind, but I mean, come on, what's funnier than someone biting the dust 😅
@@EmpoweredPara your awesome ! I am
Bad I laugh at peoples misfortunes I can’t help it. I think it’s nerves lol. I just came across your channel last night and an inspiration to so many. A few years back I was in an accident which broke multiple thoracic vertebrae and herniated a disc which was protruding into the spinal canal. It took months before anyone took me seriously, they missed the fractures when I was taken to ED the night of my event. I’d had a seizure and collapsed backwards, smashing myself to bits. I’d gone into respiratory arrest as well for around 4 minutes and unconscious and fitting for over 20 mins. I was unwell. Hospital was hopeless they gave me two paracetamol and sent me home told me there was nothing wrong with me. The X-ray report said to ask patient if I had previous fractures as they were so acute that they were not sure if they were old or acute, plus they only did a front on Xray not a side Xray which would have shown the compression fractures more clearly. The attending Dr obviously didn’t even the X-ray report as I was sent home unable to breath , in so much pain and my tongue was just about bitten off, I was unbalanced and totally knocked off after being hypoxic for so long I didn’t know what the hell was going on. I was so unwell. I kept on going back to my Dr saying there is something not right. 6 weeks later they repeated the X-ray and sure enough it was picked up this time. They left me and did nothing, anc pain just got so bad as time went on they finally did a mri and saw that my spinal cord was being compromised and fractures not healing. A fusion thoracic T4,5,6,7 was done two years later. Two years after that a cervical fusion was don. Just last year august after composing of increasing pain and all sorts of problems and increasing hyperkyphoisus of 90 degrees and was I was unbeknownst to eat, getting tacky, nausea, fainting, weakness, short of breath, fatigue due to my organs being so limited in the chest cavity they finally did a pet/ct which showed 7 years later after the T fusion that the screws were in the wrong place, into the intercostal ligaments and the hot spots were all over the chest cavity. Metalware is now our but I’ve had so many problems and due to the fusion failure I know have four herniated discs C and L spine which is giving me terrible nerve pain in all limbs. It’s crap. I can’t imagine what you have been through personally over all of these years. Your truly an inspiration and I feel ashamed by whinging about my problems when people like yourself are so inspiring and take your disability and other problems and turn it into something positive. You helped me to feel grateful and lucky so I appreciate what you are doing your really helping others and that’s fantastic. You seem like a beautiful soul xx thank you xx thank you for listening x I needed that vent
Hi, first time here, I want to give everybody a present, "A Dance for your Head". I'm a songwriter and self-publisher. This is my latest song and I feel like, after 36 years, I finally found a song universally liked.
I have incompletes in C6 and T567 spinal cord injury and atrophied TBI Paritial and Temporal lobe from a Car accident 28 years ago. I am a patient at UC Davis in Sacramento California for possible MS and am having AD-like problems. I cant handle any pain meds well, especially muscle spasm meds. My BP and BPM jumps up and down for no reason, but usually not together. I was on a muscle spasm med last month, and it made both BP and BPM jump high together, and was having Black outs in the grocery store and made a scene with paramedics called, "so embarrassing"...since then...no more muscle spasm meds....do you know of one that doesn't mess with AD symptoms? I am being ghosted by UCD, I feel like either they know something or don't know, thats why No Response, anyway, I Hope you all like "Shapeshifting Dancing Me", by Mystic Fog Garden found at topdancesong.com and "Keep Dancing" in your head. Happy New Year. Any pain meds that don't mess with AD would be appreciated.
i hate not knowing english very well but most of the things you said i got it and others i had to google seach in spanish haha. It was interesting i didn't know about autonomic dysreflexia in a person with paralysis. Anyway you are good explaining things.
I should try to put subtitles in other languages
I have to watch it a couple of times...and I do know English...so don't feel bad at all 😉.
@@morgancalvi6675 hahaha thanks that makes me feel better at least I'm not the only one
@@julig7450 no, you certainly are not alone!
AD,the bane of my life C4/5 😩🤣
Wow, you've really done the homework on this topic and summed it up quite well. Thanks so much for sharing this knowledge with us. I have a T6 level injury as well, and I made the mistake of lying on a hard object while in bed. I try to keep track of all the hard objects that I use while doing bowel or bladder routines, but I lost track of one a couple of months ago. I was lying on my right side and had misplaced a metal paper clip (large black and silver binder) that I use for paper towels, etc. I noticed after about 10 minutes that one was missing, and I immediately knew that it was under my right hip. I got no response from my body that would warn me that something was wrong, so this could have gone on indefinitely. After 10 minutes, I sat up and found the clip under my hip at the lowest point of contact between me and the bed. And can I say that it looked quite bad when I sat up. It was a perfect imprint of the clip into the skin tissue at the hip. It was several different colors and looked really bad. It fortunately didn't break the skin, but I still had to prevent lying on that side until it healed enough to do so. After two months, the mark has faded to the point of almost normal. I really thought I messed up bad and would have a bad scar, but it's pretty much back to normal. I haven't made a mistake like this in the 22 years I've been this way, and I guess a careless mistake had to happen at some point. But it did awaken my awareness skills, and I now make a mental tally of all the hard objects that I use and where they are.
Thanks again, Britney, your a true gift with a beautiful Spirit! God bless you and family!!!
The worse is whenever I use a sewing needle lol. If I can't find it for a second I immediately think I've sat on it and it's stuck in me lol
@Empowered Para
It's bizarre being in a body like this, even after 22 years. I understand the Spiritual "Born Again" meaning, but to experience a physical "Born Again" experience would be unthinkable. I have so much more now that I didn't have before, having experienced this. You have to wonder how much you'd change if given the opportunity to be whole again.
Thanks for this channel, Britney, you're a sweetheart and a blessing! ❤️
Totally agree. I honestly feel like I was born again after my accident and had to go through all the stages of development again. I think my life is richer now!
@Empowered Para
Richer indeed! Keep shining the Light which dwells within you! Your Spirit glows bright, Britney!!!
That was so fascinating- thanks for sharing! Can your spinal injury become worse from movement?
I am a incomplete, I vote YES.
That was a really good explanation Brittney. I had absolutely no idea about any of this prior to today! I knew I should have taken Pre-Med in University! So, in your case, what do you have to do when AD occurs in order to lower your blood pressure, etc? I don’t think I heard that.
In all cases of AD, Brittney's included, you need to discover what is the stimulus and remove the stimulus as soon as possible. Brittney also mentioned some people using medication to help manage their condition. Like everything else related to having a spinal cord injury there isn't a one-size-fits-all solution. You have to find what works for your particular injury and you may have to adapt your routine as the years progress.
Remove the stimulus if I can find it and if not I have medication. Ultimately if I can't figure out the cause it's and emergency and requires a hospital visit
@@EmpoweredPara Thanks Brittney.
@@EmpoweredPara I was never able to find medication...it made my blood pressure worse. They amputated the offending parts...and I instantly got better.
@@morgancalvi6675 I hope you are joking...aaahhaahhh I would be just conscious at that point, probably still complaining about thinking about pain, OR Like a Head in a Bowling Ball Bag.... a new definition for "Just Zip it", would pertain to zipping the bag closed when I start complaining...such as "its a easy trap to get into".
I've been told that AD affects all spinal cord injuries by many doctors and nurses here in the Ohio. We all have different injuries and reactions.
Cardiologist told me, "Doctors NEVER give any kind of shots in the spinal area T4-T7 area" autonomic dysfunctions can be the result....probably medical malpractice issues by making things worse...who knows...
understood you completley you did that better than any doctor would just one question their are people that cant feel pain and their not parailized is that becuse their dysreflexia arent sending the signals to their body
Not sure! I would imagine it's a problem with their brain, but I don't know anything about that condition
Sorry!
Another great video Brittney! 👍👍In 28 years I've had many episodes of autonomic dysreflexia. The most dangerous part is that it can escalate rapidly depending on the stimulus and you don't even know what the stimulus is most of the time. I've had three episodes that escalated to unconsciousness. One of those episodes was the result of an untreated UTI and resulted in an ambulance ride to the emergency room (temperature 104.1, no discernable blood pressure, heart rate 30, unresponsive). There are medical alert bracelets that are recommended for individuals who may be at risk for severe episodes of autonomic dysreflexia.
Yeah it can be so dangerous! I'll do another video more about it for people that want to know specifically about the dangers and how manage it:) But knowing how quickly it can escalate is so important!
I just had my leg and hip amputated because of autonomic dysreflexia from my C4 injury. The hip and femur were fractured and wouldn't heal. I got rid of the injured things...and the autonomic dysreflexia subsided.
do you now have one leg? does that make life easier or harder?
@@EmpoweredPara yes, I now only have one leg. The foot still feels as if it's there though...and in a vice! It makes life way easier, It certainly presents challenges though...and I certainly wouldn't recommend that weight loss method. The phantom foot gets cold and I can't warm it 😳.
👍
My adrenal glands were damaged and I have to take steroids for the problem. So I do not respond quickly to situations. That being said-
I had polyps removed from my bladder with no numbing. And I woke up during my Colonoscopy and watched the 2nd half. My AD did not kick in for either event. Is this something I need to pay closer attention to, and if so what do I do?
Afaik a reflex reaction i.e burning your hand and jerking it away from the flame is just between the motor neuron in your spine and the brain and consciousness is not involved - it should still work even if your spine is broken - the motor neuron should still working even if the connection to the brain stem is disconnected ???.
yep reflexes still work fine when you're paralyzed they just can't be controlled (like if you wanted to put a hot pot down on a table even though it was buring you instead of dropping it all over the floor). My reflexes just do their thing even in annoying situations like at night when I've slept in one position too long.
@@EmpoweredPara Yep - the upper motor neuron in your brain can inhibit the lower motor neuron in your spine.
It probably says, "it is okay buddy just don't drop it - we not smelling burning flesh yet and it took her hours to make that dish".
What about bug bites? Do they itch? I’m guessing not.
nope! That's awesome! Mosquitoes love me haha. Like a feeding frenzy. Good for them and not a big deal for me!
I boxed in the Fleet. While fighting a Marine I broke his wrist. He didn't know this because he was stupid & practiced doing pushups on his fists which damaged his nerves. To this day (we still e-mail eachother) almost 30 years later he can't feel his hands & in particular his right hand (which I broke in 1993).
Not sure if this is the same or not.
interesting! Did he have severe carpal tunnel I wonder?
@@EmpoweredPara No, when you do 1000's of pushups on your knuckles, you destroy those nerves plus a few cm above the joint itself.
I asked him & he said he can not feel anything in his right hand to just above his wrist. His left hand is "dead" to his palm.
@@johnvelas70 wow. Never gonna do those push ups!
Can a paraplegic feel, as a man does? Does he have a heart? Does the breath of life flow in his veins?
do your feet ever fall off the footrest like when you go over bumps?
yes lots! have to keep an eye out them so I don't run over them!
@@EmpoweredPara do you ever use straps or any technique to keep hem in place?
Thumbs up 👍 ❤❤❤❤❤❤ 10:16
Another question if I may.
Considering the advances made by companies like Neuralink (the chip in the brain from Elon Musk) we might one day soon understand how the signals work and be able bypass broken connection in a spine - would you consider undergoing this experimental therapy with some risk factor to regain mobility or do you have you an outlook of "it is what it is" ???.
I think I would do it if there was a good chance that it would work. If it was a small chance then likely not
I pray something will come along for you. My brother is 20 years into Parkinson’s. He was starting to have trouble walking. They performed Deep Brain Stimulation Surgery. He was actually able cut and ain’t a room. I realize there are big difference but 2 years ago DBS was unheard of.
Why don't you read your comments from the TEN REASONS WHY BE IN A WHEELCHAIR IS AWESOME?? Make some comments back to us!!! I would like to hear a
Response from you!! You just let all this stuff fly out of your mouth but you do t even bother to comment back! That is very lazy or uncaring on your part!!! Joan