Preload: Lying Down

(This formula is used to help address problems of low blood volumte and orthostatic intolerance.) According to the April 2005 article of Dr. Cheney's thoughts on CFS:

"How do you augment preload—which is blood volume—to improve cardiac output? You lie down. When you lie down, you increase the cardiac output a whopping 2 liters per minute. Don't sit, don't recline—lie down. Some patients need to lie down and augment volume anytime, all the time.

But, what if you're one of the ones right near the top of the curve and you increase your volume (preload) 2 liters by lying down? You could actually go over the peak and down the other side. Do you know what that means clinically? Some patients can't lie down! Some tell me, "When I lay down I cannot rest well or sleep." They went right over the top and dropped their cardiac output by lying down!

Preload Chronobiology: Daytime vs. Bedtime

There is a chronobiology to this curve: the time of day affects it. In the daytime, patients need to increase blood volume by taking in fluids. That allows them to be up more. But some can over treat by drinking fluids and lying down in the daytime. [Some with this problem who can't be up find a semi-recumbent position helpful. Use pillows to raise your torso.]

However, at nighttime, the opposite happens. The chronobiology drops your cortisol and aldosterone so you don't hold fluids as well, and all that combines to allow this type of patient to lay down without this problem. Patients with this problem (lying down makes them feel worse) should only expand volume in the first six or seven hours of their day with the Hydralyte (Gookinaid) or HomeBrew mentioned below, then switch to water. And if they lie down while over-expanding volume with Home Brew or other supplements or drugs, they'll get creamed. These patients should not use the HomeBrew during the six or seven hours before bedtime. If they do, they may not be able to sleep.

Preload: Hydralyte (Gookinaid)/HomeBrew

"Volume loading using appropriate volume expanders can be quite helpful. This can be done in a variety of ways, but falls best under the term of isotonic [same salt concentration as normal cells and blood] volume expansion. Hydralyte (Gookinaid) is a well-documented isotonic volume expander and is used in athletic events such as marathon running." [Gookinaid.com] "It has an advantage of rapid absorption and is maintained in the intravascular volume far longer than hypotonic [less salt concentration] drinks such as water itself. The disadvantage to Hydralyte (Gookinaid) is that it has sugar in it in the form of glucose."

"Another option would be a HomeBrew mixture of sea salt and "No Salt."

HomeBrew recipe:

• 1 cup filtered or spring water
• 1/8 teaspoon of Sea Salt
• 1/8 teaspoon of "No Salt" salt substitute (potassium).
• Add lime juice or an herbal teabag as well as stevia for taste (or something to give it flavor without altering the electrolyte balance: peppermint, peach, raspberry zinger, etc.)
  

You can add 1 cup of Seltzer Water in there too, however, if you do, you need to double the amounts of Sea Salt & "No Salt" as has been done in the recipe below. See this earlier page for more information or read various posts on the subject on Yahoo!Groups CFSFMExperimental.

According to Dr. Cheney, "Four to eight glasses of Hydralyte (Gookinaid) or HomeBrew are recommended. Why is potassium in these drinks? Potassium induces Aldosterone , a hormone that significantly increases blood volume."