# Autonomic Neuropathy



## moore2me (May 6, 2012)

(The following two paragraphs are from Imfree's posts on another forum.)

I saw the term "*Autonomic Neuropathy*" on the screen of my "Health Buddy" telehealth terminal, yesterday, along with a little info on the condition. I googled the term today and it looks like that condition could easily have caused my digestive distress and also be responsible for my need to be on oxygen, despite nothing being wrong with my lungs. Interestingly, the condition can also cause one to have a swollen belly. Autonomic Neuropathy is a type of peripheral neuropathy.

COULD YOU PLEASE PUT MY "AUTONOMIC NEUROPATHY" post on the Health Board? Thank you. (Edgar)


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## moore2me (May 6, 2012)

From http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001780/

*Prevention*
Preventing or controlling disorders associated with autonomic neuropathy may reduce the risk. For example, diabetics should closely control blood sugar levels. Alcoholics should stop drinking.

*Complications*
 Fluid or electrolyte imbalance such as low blood potassium (if excessive vomiting or diarrhea)
 Injuries from falls (with postural dizziness)
 Kidney failure (from urine backup)
 Malnutrition
 Psychological/social effects of impotence

*Expectations* (prognosis)
The outcome varies. If the cause can be found and treated, there is a chance that the nerves may repair or regenerate. The symptoms may improve with treatment, or they may continue or get worse, even with treatment.

Most symptoms of autonomic neuropathy are uncomfortable, but they are rarely life threatening.
Autonomic neuropathy is a group of symptoms that occur when there is damage to the nerves that manage every day body functions such as blood pressure, heart rate, bowel and bladder emptying, and digestion.

*Causes, incidence, and risk factors
Autonomic neuropathy is a form of peripheral neuropathy. It is a group of symptoms, not a specific disease. There are many causes.*

Autonomic neuropathy involves damage to the nerves that run through a part of the peripheral nervous system. The peripheral nervous system includes the nerves used for communication to and from the brain and spinal cord (central nervous system) and all other parts of the body, including the internal organs, muscles, skin, and blood vessels.

Damage to the autonomic nerves affects the function of areas connected to the problem nerve. For example, damage to the nerves of the gastrointestinal tract makes it harder to move food during digestion (decreased gastric motility).

Autonomic neuropathy affects the nerves that regulate vital functions, including the heart muscle and smooth muscles. Damage to the nerves supplying blood vessels causes problems with blood pressure and body temperature.

*Autonomic neuropathy is associated with the following:
* Alcoholic neuropathy
 Diabetic neuropathy
 Disorders involving scarring and hardening (sclerosis) tissues
 Guillain Barre syndrome or other diseases that inflame nerves
 HIV and AIDS
 Inherited nerve disorders
 Parkinson's disease
 Surgery or injury involving the nerves
 Use of anticholinergic medications

*Symptoms*
Symptoms vary depending on the nerves affected. They usually develop gradually over years. Symptoms may include:

*Gastrointestinal tract
* Constipation
 Diarrhea
 Feeling full after only a few bites (early satiety)
 Nausea after eating
 Swollen abdomen
 Vomiting of undigested food

*Heart and lungs
* Blood pressure changes with position and causes dizziness when standing
 Shortness of breath with activity or exercise

*Urinary tract
* Difficulty beginning to urinate
 Feeling of incomplete bladder emptying
 Urinary incontinence (overflow incontinence)

*Other symptoms*
 Abnormal sweating
 Heat intolerance brought on with activity and exercise
 Male impotence and ejaculation changes in men
 Vaginal dryness and orgasm difficulties in women
 Weight loss without trying

*Signs and tests*
The doctor will perform a physical exam. A neurological exam may show evidence of injury to other nerves. However, it is very difficult to directly test for autonomic nerve damage.

*Signs of autonomic neuropathy include:*
 Abnormal sounds in the abdomen
 Decrease of blood pressure upon standing up (postural hypotension)
 Sluggish pupil reaction in the eye
 Swollen belly (abdomen)
 Swollen bladder

Other signs and symptoms that occasionally suggest a problem in the function of the autonomic nervous system include:
 Difficulty swallowing
 Excessive sweating
 Irregular heart rhythms
 High blood pressure
 Rapid or slow heart rate

Special measurements of sweating and heart rate are called "autonomic testing" and can assist in diagnosis and treatment.

Other tests include:
 Measurement of blood pressure lying down, sitting, and standing
 Measurement of changes in heart rate
 Upper GI
 Esophagogastroduodenoscopy (EGD)
 Isotope study
 Voiding cystourethrogram (VCUG) or other tests of bladder function

Other tests for autonomic neuropathy are based on the suspected cause of the disorder, as suggested by the history, symptoms, and the way symptoms developed.

*Treatment*
Treatment is supportive and may need to be long-term. Several treatments may be attempted before a successful one is found.
Various strategies may be used to reduce symptoms of light-headedness or dizziness when standing. These include:
 Extra salt in the diet or taking salt tablets to increase fluid volume in blood vessels
 Fludrocortisone or similar medications to help your body retain salt and fluid
 Sleeping with the head raised
 Wearing elastic stockings

Comments from IMFree)
I saw the term "Autonomic Neuropathy" on the screen of my "Health Buddy" telehealth terminal, yesterday, along with a little info on the condition. I googled the term today and it looks like that condition could easily have caused my digestive distress and also be responsible for my need to be on oxygen, despite nothing being wrong with my lungs. Interestingly, the condition can also cause one to have a swollen belly. Autonomic Neuropathy is a type of peripheral neuropathy


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## imfree (May 6, 2012)

I posted in "Internet Neighbors..." before this thread showed on my computer. I'll keep DimmerLand updated from here, should the VA do any follow up on me.


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## moore2me (May 6, 2012)

(Here's more on the subject I captured from IMFree's Thread in the Lounge.)

That's awesome, M2M! Granted, it scared the hell out of me, when I had it, and maybe could have even killed me, but by God's Grace and my strength, I survived it. Now it is really rich to be able to share this knowledge with others. I've asked the VA to look into this issue, armed with my new awareness of Autonomic Neuropathy. I've even heard that neuropathy can improve as the body and brain find new neural pathways. Dr TJ, the endo, even told me of a case she knew of in which a woman who had severe neuropathy, for 50 years, made full recovery after her sugars were brought under control!

The changes that helped me heal were:

1) I stopped abusive overeating of carbs and using insulin to "squash the sugar numbers back down".

2) I stopped using chocolate to medicate insulin reactions.

I'm sure overuse of insulin and chocolate have many undocumented side-effects.

Blood sugar swings from that insanity were making me especially prone to leg infections.

Thank you very much, M2M. It is well.


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## moore2me (May 6, 2012)

From http://www.fpnotebook.com/neuro/pharm/AntchlnrgcMdctn.htm


*(Moores note  I recognize some of these drugs as heart meds, asthma meds, allergy meds, parkinsons drugs, blood thinners, pain meds to name a few. Some of us take more than one of these drugs together and on a daily basis, which I assume would multiply the problem of adding to the autonomic neuropathy damage potential.)*

Medications with anticholinergic effects (most anticholinergic first)

1. *Atropine* (100% of maximal anticholinergic effect)
2. Scopolamine
3. Tolterodine
4. Hyoscyamine
5. *Cholinergic Parkinsonism agents*
1. Trihexyphenidyl
2. Benztropine
6. *Prednisone* (55%)
7. *Diphenhydramine ( AKA Benadryl)*
8. Amitriptyline (Elavil)
9. *Digoxin*
10. Nifedipine
11. Phenobarbital
12. Oxybutynin (20%)
13. Isosorbide Dinitrate
14. Hydroxyzine
15. *Warfarin (AKA Coumadin)*
16. Dipyridamole
17. *Codeine
*18. Ranitidine (10%)
19. Dyazide
20. Furosemide (Lasix)
21. Nortriptyline (3%)

*(Moore's notes cont.)*
*Also, one more note on your endo's comment about nerve signals rerouting. Hopefully this will work in most cases of nerve signals. However sometimes it will not. A classic example is the late Christoper Reeves. For years he hoped and tried to get his nerve rerouted so he could walk, etc. Unfortunately, he never did - but that brave man died trying.

Another example is I have optic nerve damage in my left eye. My eye doc has told me this is permanent. There is nowhere to reroute to. I am not blind, but he said that any potential future damage will be added to the past damage. He also said the best thing I can do to protect my eyesight is to maintain normal blood sugars*. *One of the major rules of dealing with autonomic neuropathy is treat, control, and manage the symptoms that crop up.*


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