Hydration, your Heart and Blood Flow

December 26, 2010 at 2:12pm

Did you know that when you are not drinking enough water, you are straining your heart and vascular system, and depriving your brain of good blood flow?

Dehydration causes strain on your heart. The amount of blood circulating through your body, or blood volume, decreases when you are dehydrated. To compensate, your heart beats faster, increasing your heart rate and causing you to feel palpitations. link

When we do not get enough hydration from water, our blood volume decreases. Water is essential for our vascular system.

Hypovolemia means low blood volume. This condition can be very serious and can be due to blood loss from injury.  It can also happen in a body that is dehydrated or inactive, or not functioning well. Hypovolemia occurs often to the elderly and disabled.

Low blood volume can cause orthostatic hypotension. This is when there isn't enough blood getting to the brain when you change position from lying down to upright. This can lead to dizziness, confusion and falls, and often happens in the elderly. But it can happen in people with MS, too. Orthostatic hypotension is well-documented in MS and has been a mystery for researchers.

For many women, pregnancy offers a time of blessed relief of MS symptoms. This has lead to studies of hormones and MS, and a clinical trial of estrogen in MS patients. But looking at pregnancy from the vascular paradigm, what else can we learn?

When women are pregnant, their blood volume increases dramatically. This sends blood pumping throughout the body.

Perhaps the most striking maternal physiologic alteration occurring during pregnancy is the increase in the blood volume. The magnitude of the increases varies according to the size of woman, the number of pregnancies she has had, the number of infants she has delivered, and whether there is one or multiple fetuses.The increases in blood volume progress until term;the average increase in volume at term is 45-50%. The increase is needed for extra blood flow to the uterus, extra metabolic needs of fetus, and increased perfusion of others organs, especially kidneys. Extra volume also compensate for maternal blood loss during delivery. 
link

After delivery is the time during which many women report having exacerbations in their MS, or a return of MS symptoms. Yes, hormone levels are fluctuating, but so are blood volume levels. Pondering this fact has lead me to do more reading on blood volume, and I am finding some interesting things to consider.

Thinking about blood volume in terms of CCSVI treatment and restenosis of veins has been very interesting to me. If angioplasty is returning good, open routes of flow, but the body is not able to compensate by providing adequate blood volume, then these opened vessels will not have the necessary pressure to remain opened. And the areas of prior stenosis might re-collapse, just like an old garden hose with low flow.

I hope to bring this avenue of discussion to the doctors. Perhaps aftercare needs to include additional hydration, salt intake, maybe even intravenous fluids--all to keep blood levels adequate. Inactivity and remaining in the supine position increase hypovolemia--therefore, movement, exercise and upright activities would encourage blood flow and blood volume. Something to think about as we move forward with CCSVI research in 2011.

With wishes for good flow in the New Year!

Joan 

CCSVI treatment: a lifetime commitment

May 31, 2010 at 8:01am

I think there is a disconnect happening in the MS community approaching CCSVI treatment, and it's worrisome. There is a sense that someone can be treated with venoplasty for CCSVI, come home, and be done with their problem. This couldn't be further from the truth--and I just want to put out another warning.

I've written about Jeff's multiple visits to Stanford for follow-up (three times, now) as well as his working with his GP and neurologist to keep tabs on his blood numbers and other symptoms. There is a need for patients to stay local and work with doctors in their area, which I sadly realize is just not possible for all. But it goes beyond this.

Patients need to look at lifestyle, medical regimen, diet and exercise-- as if they were recovering heart attack or stroke patients. Just as a heart patient is sent home after angioplasty and stenting with a new low fat diet, exercise regimen, blood thinning regimen and program for healthy living, CCSVI patients have to consider the same factors. Heart patients have ongoing relationships with their cardiovascular doctors--it should be the same with CCSVI.

We've seen patients' blood numbers return to hypercoagulated states after they decide to discontinue blood thinning regimens on their own. Patients have no access to medical follow-up after returning home, no blood monitoring or after care. And this scares me.

Please--if you are traveling to another country, at the very least have a relationship with a local doctor BEFORE you leave. Someone who can check your blood numbers (INR and PT testing-which measure coagulation), listen to your heart, monitor blood pressure and your veins, watch your rehabilitation and look out for complications (like clotting). It can be another vascular doctor, your GP or your neurologist. But make sure you have this in place before you go anywhere. And if you can stay close to home, PLEASE try to do this first.

So much has happened in the year since Jeff's first procedure. He has stayed on his supplements, exercise and lifestyle program, he is keeping those veins flowing, but it hasn't been a breeze.  This isn't a one time deal. It is a lifetime commitment to a new vascular reality. OK?

More than anything, I hope for treatment for all MS patients suffering with CCSVI--but I want you all to have follow-up care, too.

Joan