Question
QUESTION: i have been a c6 quad for 17 years now, i know about autonomic dyreflexia and have had some episodes with this.  i have reoccurring uti's and am in the process of scheduling a superpubic cath.  i have seen recently a neurologist who says the drug glycopyrrolate could help with sweating since it only occurs upon sitting upright.  i do have osteoporosis and i do not have any bed sores or breakdowns.  have you heard of this drug helping with sweating in sci patients? if the sweating would ease up i would be more comfortable , as you well know it causes me to be cold.  the doctor explained what i had was hyperhydrosis and that this could help.  any suggestions would be greatly appreciated. God bless

ANSWER: hi kirby-
i will see what I can find out but have not heard of the drug you mentioned. I want to give you a fair answer so please ask me a 'follow up' and I'll look around for it, deal?

as for my personal experience, that kind of sweating is usually a very early sort of dysreflexia- like a skin-level sensation (for example, i wear graduated compression socks that are forever cutting into my ankles- this can cause the sweating). are you sure that there's not something hurting you when you're sitting up?

ha, one person with no sensation asking another with no sensation what hurts-- i mean no offense, just have a black sense of humor...

otherwise let me look up the drug and condition you mentioned and i'll have a better answer. also have you looked at the re-routing of the urethra as a possible alternative to the superpubic?  it sounds kind of crazy, perhaps, but I knew a girl who had it done (c5 i think, cathing intermittently with very limited hand control) and loved it- no more uti's, no problems at all. anyway, just thought i'd mention it since superpubics are so often infection prone.

ok, ask me a follow up and i'll get back to you-
thanks
leslie

---------- FOLLOW-UP ----------

QUESTION: thanks for the response, I am actually asking these questions for my husband,  I am his caregiver,  To answer your question we aren't sure something is hurting him. We do know that it isn't a problem with bed sores, or clothes being in a bind.  He does sweat when he is up, and the only time he will sweat when he is down, is when he has a uti or bowel regimen.  He does have osteoporosis, he has been injured for 17 years, and he has done the in and out cath he has tried the antibacterial cath in&out, he has worn a indwelling cath, and has one in now.  That is why since we know that runs a high risk for infection, and discomfort if maybe the superpubic would help?  The glycoprrolate or Robinul has seemed to lessen the sweating, he has been on this medicine for 6 days.  We were told by the urologist(number 8) that this superpubic might help.  thanks so much for the return e-mail if we can help any others in any way we would be glad to do so.  May God richly bless each all.


Answer
Hey Kirby-
It's so hard to tell what's wrong when your sensation is limited! It sounds like you've checked out the usual suspects (for things that could be causing him pain, etc) so if you like your doctor and trust him/her, I've no grounds for disagreeing with the diagnosis.

As for the superpubic- I've always heard that they also run a high risk for infection...perhaps less so than intermittent cathing? But still, infections can get so much worse in people already stuck with SCI. Have you ever heard of the re-routing thing I mentioned? It sounds drastic, sort of, but if it puts an end to the infetions it might be well worth it. A urologist (it seems like there's alot of bad ones out there, doesn't it?, or maybe just inexperienced with SCI) routes the urethra to a very small stoma near your belly button. from the outside it just appears like a dimple- very much like my scar from the stomach tube, if that helps. The girl I knew with one was a c5-6, very limited hand use, had tried intermittent and indwelling catheterization and had ongoing problems with infection. This surgery had totally changed all that for her...

It might be worth asking about, anyway- I know how miserable uti's are (have one right now, in fact!) and I for one am really tired of eating cranberries!

good luck to you both- i hope the meds keep working and you find a good resolution to the infections. If you do, please let me know too! =)
leslie