Things are going along about as expected although we've hit a little snag. Paul has what is called
Autonomic Dysreflexia or Hyperdysreflexia
Patients that are most at risk for this condition are those with spinal cord injuries above T6. This tends to occur after the spinal shock phase. Autonomic hyperreflexia occurs because nerve messages that were once able to go up the spinal cord to the brain are blocked
Some of the symptoms include severe pounding headache, high blood pressure and sweating above the injury site. These are the symptoms that Paul has had and had at NIH. Dr. Sheehan diagnosed this pretty quickly and that will slow down the degree of pt a bit. The biggest concern is the high blood pressure. Paul's blood pressure is usually pretty low but when he gets some pain in his neck his blood pressure goes through the roof. His PT has added some analgesic tape to his back and neck to work on the pain. As that improves, his pt will increase. This is not uncommon but something that needs to be monitored closely. Since he has not had this problem before, Dr. Sheehan thinks it will resolve pretty quickly. More PT will be added as the situation allows.
We met with Paul's "team" today. Adventist has a great approach to their rehab and once a week there is a team meeting with his physical therapist, occupational therapist, physiatrist (Dr. Sheehan who heads up the team and is the main reason we are at Adventist), nurse, social worker, etc. It is a quick meeting but helps us understand the plan and gives us an opportunity to ask some quick questions. Dr. Sheehan also comes by daily to see Paul. Access to Dr. Sheehan is wonderful and critical so we are very lucky that Paul is at Adventist.
Paul had a great visit from Valerie over the weekend. To say she has been his physical therapist for the last four years would be a gross understatement. She has been his champion, his cheerleader and friend. She was able to give Paul some very encouraging news about his flexibility and prognosis. It is hard not to try and fast-forward the process but (we hear) patience is a virtue.
If you would like to visit Paul, please do. Just send him a text and he'll get back to you when he knows his schedule. If you can also let one of us know when you are going that would be helpful so we don't plan on being there at the same time.