Hello!
I'm posting on behalf of my Dad. 59 y/o who is only 10 months post injury. Rehab was 7 hours from home, so he was away for 9 month....but he's home now. He's started off with high blood pressure issues, and now is having lots of lows. I know many episodes have to be from meds (I'm a pharmacist...and my hardest job yet has been trying to figure out what works best for him... still haven't found it!)

So, he is a complete, with no feeling from the chest area down. Arms work well all the way down to his hands, where he has limited function. He isn't able to grasp anything.... and also has had horrible pain in his hands. BEcause of the pain, he is currently taking 900 mg Neurontin 4 times a day (HUGE dose!). He still has some pain... and I think he's a zombie because of it. Probably plays with his BP too. Thats a whole different topic!

He says he spasms all the time, but it's never that visible, but he feels it. He's on Baclofen 10mg, 15mg, 20mg, 20mg daily. Recently tried zanaflex only 2mg and he was in and out of it, all confused with low BP for about 40 minutes yesterday morning. So, we nixed the zanaflex.

I think I have 2 questions....... just wanting to know about how common the low BP is, what the best thing to do for it is. Does it go away? Second, I need advise on how to control the pain in his hands, but turn him back into my dad! He's soooooo tired all the time. I personally think it's from the Neurontin, but he's scared to come off of it because of his hand pain.

Thanks!!!!!!!

I believe most people with SCI at a high level have low blood pressure. Its very common. My husband used to take midodrine for BP. This raises the bp. Right now he takes nothing because we have no insurance and it is very very expensive. The more active you are as far as getting up and out of bed and things helps. If you don't sit up that much then when u do its gonna drop. My husband used to take neuroutin for pain, but it never helped so he quit a long time ago. He pretty much just deals with pain. His hand pain used to be much worse. Its not as bad anymore. He also got botox injections in his hands which has helped with his hand function and he can open and close them now. He can grab things. He just has no pinch. His hand used to be stuck in a fist and they hurst worse then. Good luck. I hope things get better.

Low blood pressure is quite common in higher injuries. Is it causing problems and if so how severe are these? Low impact solutions include using TED stockings and abdomen binders. During rehab I used to take ephedrine (sp?) before getting up or my BP would drop so low I'd be on the point of passing out. It does get better with time and I now do nothing for it.

Sorry I can't help with the pain thing but it might be worth trying Lyrica in place of the neurontin as some people react better to this newer version of essentially the same drug, if his spasms aren't visable then I'd suggest that they're under control - everyone around can certainly tell when I get my spasms.

Hope that helps

When I was first injured I had low BP and would pass out each time they sat me in a chair. I then started sitting up gradually and eventually over come it; it just takes time for your fathers body to adapt.

If his BP is still low, he could always take Ephedrine 30 minutes before getting up. If his BP drops after eating then a small dose of Ephedrine 30 minutes before meals is worth trying.

For nerve pain, Gabapentin worked for me. But as always, ones body becomes tolerent to a drug, as I'm sure you're aware of.

Hope this is of some help.

Mike

Thank you.

I never thought about EPI (epinephrine). When he was in the ICU it took him an extra few days to get out because he couldn't get off the dopamine drop (which helped keep his BP up).
The issue we always dealt with was the fact that pre-accident, he had high BP and was always on meds. And early in his recovery, we had MANY bouts of dysreplexia, and many ER visits due to that. Now, it's the opposite, and it's low more often........I think we hesitate because we dont want it to shoot hight either!

He usually doesn't go low during the day.... 90% of the time it's in the morning.
Today, he was fine.... still ran a little low 80's/50's or so, but no passing out (we didn't give the zanaflex).

is it common to go low with meals? Because that has happened. (I guess I always thought eating would make it higher, or stay normal, not drop it!)

Thanks!

Thanks!
You are a good resource because your husband must have a real similar injury to my dad. I know my dad has gotten the botox. That seems to be a better idea than all of this neurontin (Especially because his pain is so local, as to only his hands...he doesn't complain of pain anywhere else).

My dads hands have always been ass-backwards from everyone else's. His hands were from day 1, real flat. He couldn't even come close to bending his hands into a fist. He would lay them on the table, and they'd be just flush with the table. It was so weird looking. Now, he has been stretching them (which was impossible before because of the pain) and they actually have a normal curve to them when he is at rest. He can grab a chip between his fingers, sometimes, but normally has to use 2 hands to eat everything. He has no strength whatsoever in either hand. He's come a long way though, which is nice.

He was such an active man, hunter, fisher, etc........ before the accident, so I think he's come to terms with being paralyzed, but he never thought he'd be able to move his arms, but have so little function of his hands!

Wow that is different his hands being flat. It's been a year and a half since my husbands accident. At first he couldn't feed his self or anything. Now he can smack me on the rear and it hurts. lol! His arms and hands have gotten so my stronger. It just takes time and it's seems like such a slow process it sucks for sure.

As far as your question regarding pressure dropping after a meal, yes that's common also. All the blood rushes to the digestive tract after eating, causing a bout of light headedness. The longer he's used to being up, the quicker this feeling goes away. I'm almost 3 years post and still get it to some degree, now and then. It's usually just a quick, uncomfortable inconvenience now, nothing more.

qbounce has stolen my thunder and already answered the queastion about low BP and eating. I was fine before, but I've been injured 50 years and started having severe bouts of low BP after eating. It was eventually diagnosed as a type of 'Dumping Syndrome', which has started to show up in long tearm SCI 45 years plus. I now take a small dose of Ephedine 30 minutes before meals. Its cured me.

WHOA THERE!!!

There is a HUGE difference between Ephedrine and Epinephrine (adrenaline)!!!

Ephedrine is a good a good idea, can be taken orally etc, epinephrine is not a good idea at all, for blood pressure it can only be given intravenously (unless you're wanting to get really complex!) in a monitored environment, in hospital.

I could bore you further, but I won't! Please please please don't confuse these 2 drugs!!!!

Trinity XXX

wow. duh.
No idea what I was thinking.
I know that:)
Thanks!