Question
I am a Home Health RN. I have a patient who has been a Quadraplegic for almost 40 years.  He has experienced dysreflexic symptoms over the years that have been related to pain or infection.  Lately he has experienced more symptoms and we are not sure if he is really reacting to pain of some kind, or to an infection, which could be- but he has been receiving multiple antibiotics for a couple of months now. Could this be a change in his system and is this within the realm of "normal" progression?  He does not have access at this time to an MD who specializes in this kind of injury and I am not experienced in this area.
Thank you for any light you could shed on this.

Answer
Hi Toni-

I've never heard of developing AD as a result of normal progression. In fact I've only ever had it as a result of UTI or similar internal problems...

My guess would be that there is some manner of infection- the antibiotics won't matter if they are the wrong kind or if he is becoming resistant (a real drag, but something alot of us are at risk for). I'd think a regular GP could try to find the infection? Look for any other symptoms, ie incontinence maybe, that might give a clue as to location of the pain- as you know, I'm sure, you don't want to mess around with dysreflexia...

good luck- let me know if I can help further
leslie