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Inclined Bed Therapy

Inclined Bed Therapy (IBT)

Sleeping Inclined To Restore and Support Your Health For Free. Fascinating Science, Discovery, History and Medical Research In Circulation And Posture, by Andrew K Fletcher

 

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    • IBT's Contribution to Fighting the Pandemic
    • ‘PRONING’ has become a very important part of the management of some of the most severely ill COVID-19 positive patients in hospitals. It is where a patient is turned to lie on their front (prone position) on an anti-trendelenburg (head raised) incline of around 30 degrees. (See ‘ICS Guidance for Prone Positioning of the Conscious COVID Patient 2020’ by the Intensive Care Society.) https://emcrit.org/wp-content/uploads/2020/04/2020-04-12-Guidance-for-conscious-proning.pdf THE TECHNICAL BIT (as I understand it). The deep infection of the virus into the lungs causes inflammation of the lung tissue (pneumonia). The air sacs (alveoli) at the end of the breathing tubes in the lungs become inflamed and fill with fluid or pus. This is known as Acute Respiratory Distress Syndrome (ARDS). It causes a drastic reduction in lung function, to the extent that the patient is unable to breathe properly and needs to be given oxygen. If the amount of oxygen transported into the bloodstream is still insufficient to oxygenate the vital organs, it can lead to multiple organ failure and death. WHY IS THERE A NEED FOR PRONING? It has been long known that lying in the traditional supine position (on their back) can be detrimental to the lung function of hospital patients with breathing difficulties. This is because the majority of lung tissue is at the back of the body, so the ability of the lungs to expand on breathing in is impaired when lying supine. In COVID-19 cases, the abnormal build up of fluid pools at the back of the lungs, leading to greater interference with lung function. HOW DOES PRONING WORK? Proning has been used to successfully treat COVID-19 patients when it looked like there was no hope of recovery. (The case of Stacey Fresco in England is an example of this.) Proning reduces the pressure on the lungs and allows them to expand more. The fluid in the lungs can then drain downwards with gravity, allowing greater lung capacity, enabling the patient to breathe in more oxygen. The patient can remain in this position for 12 hours before being returned to the supine position. Alternating supine and prone positioning of the body in this way has been successfully used to maximise the effects of this treatment. WHY ISN'T PRONING MORE COMMON? To start with, it takes up to 6 people, and 30 minutes, to safely turn a COVID-19 patient onto the other side. This procedure takes badly needed frontline carers away from managing the numerous other patients that are suffering in this pandemic. Secondly, there is more pressure on the patient’s heart when in the prone position. It has to work harder, and can lead to a potentially fatal heart attack. ANOTHER POTENTIAL USE OF IBT I’ve found an interesting ongoing trial called ‘Incline Positioning in COVID-19 Patients for Improvement in Oxygen Saturation (UPSAT)’, at Johns Hopkins University, in which 15 degree incline versus horizontal (flat) positionings are compared in the supine position. It is described as: ‘..a pilot study to examine the acute effects of inclined posture on oxyhemoglobin saturation and the feasibility of conducting randomized controlled clinical trial among patients with confirmed or suspected COVID-19-associated hypoxia.’ https://clinicaltrials.gov/ct2/show/study/NCT04344561
    • In IBT Forum / General discussion
    • Author Ani-Boo
    • 2 weeks 1 day ago

Dodging a bullet

For around 2 months, my wife and I lowered our bed and slept at 3.8 degrees, around half the normal incline for us, after reading from others that they found it was suiting them better than five degrees or more. So sounded like a useful experiment. In hindsight, I wish we hadn't, because I was shivering and we both developed  severe  leg cramps, My calf muscles felt like they were twisting and my foot was turning in. We experienced very poor sleep, frequent bathroom trips at night, cold hands and feet that didn't warm quickly, generally colder in bed too.  Though initially we both slept sounder, but woke up feeling very un-rested. It was as if we hadn't had any sleep.

We felt lethargic during the day, but in the interest of science continued with the lower incline until I began to struggle on walks. Breathing felt like the air was acidic and burning my lungs, the air was very cold and damp. I experienced crushing pain in chest with left arm aching, jaw aching and had to sit five times  to rest on way back to car.

When I got home, I took a teaspoon full of cayenne pepper in a glass of fruit juice. I'm pretty sure this stopped the heart attack from progressing further because the relief was almost instantaneous. (I had read about this a few years back) The bed and the sofa are now back to usual incline.

This experience told me I was probably having a heart attack.


Some interesting history
Many years before, we had lost a dog through heart attack on beach in exactly the same oppressive air and weather conditions. He was only 5 and was running around, keeled over and was gone within seconds. So I knew through my work on circulation and my experience working in Buckfastleigh, a river valley where the air was heavy and instantly drained all of our energy leaving us soaked in sweat and extremely lethargic. Which completely vanished immediately we left the valley and we were all back to normal. The locals have given it a name, calling it Buckfastis and on such days there is an exodus from the valley with people unable to endure the heavy laboured breathing.

This link with high humidity fits perfectly with IBT theory. Our lungs need to evaporate water as we exhale in order to alter our blood density and drive our circulation. Breathing in saturated air will adversely affect it! 



Prior to having respiratory distress and severe chest pain, on the 4th I had a blood test at Dr's, which caused a painful visible swelling near injection site. The nurse didn't take enough blood so had to go back for another blood test on the 6th,  where I told the nurse I had severe chest pains and pain down my left arm, particularly at the injection site, which was swollen and I had aching in jaw. The nurse said that's because of your blood pressure. I was sent away, but knew I was in trouble and didn't trust the nurses judgement. So I tried to call our GP but constantly engaged. It was now the weekend so I didn't manage to get through until 9th December. Told my Dr the same as I had told the nurse and was asked if I could get to the hospital A&E as soon as possible.

By now, the aching and pain had subsided a lot and the inclined bed was helping a great deal by calming everything down, but still there was a problem with my breathing, night sweats and aching, albeit somewhat milder and eased by our now correctly inclined bed.

We arrived in A&E and I must say, that despite being very busy, the attention I received was very good. I had a cannula inserted and various tests were done. I was then moved to a Cardiac / chest pain ward for 5 days.

It was fascinating watching people from all walks of life who were experiencing the same problems that I was. The good news is, finally got my blood pressure under control with “special drugs” that according to the cardiologist don't damage kidneys.

I'm pretty sure that lowering the bed as mentioned above, was probably a cause.

Anyway, I remained inclined at 5 degrees for my stay in hospital, and managed to bend the ears of doctors and nurses, and a few patients, as you can imagine.

One Doctor agreed with my theory and thought it fascinating. Most of the nurses could see the logic in it.

I had no pain whatsoever and recovered very fast on IBT in hospital. Though I did experience some aching in chest and arm while having hot showers. There’s that high humidity connection again!

I was allowed to walk around the ward and visit bathroom on my own.

The cardiologist came to talk to me about my options and told me he would need to introduce a colourless odourless liquid into my arteries and that it would negatively affect my renal function.

I replied, would that be gadolinium? He replied yes. I said; No thanks, it will trash my already damaged kidneys and I will end up on dialysis for life. He agreed it would damage my renal function and could completely shut it down.

There where two types of surgery on offer. One was an angioplasty, where a catheter is inserted into an arm artery or groin artery and fed to heart vessels, It can inflate to open up arteries and has a camera giving constant visual feedback. A dye containing gadolinium is then introduced via the catheter, which shows the flow through various vessels to identify a site for inserting a stent.

The problem here for me and many others is that it is highly toxic and destructive to the kidneys, brain and other organs which would have completely shut my kidneys down and led to dialysis for life. So no thanks.

A triple bypass, where veins are cut from legs and used to replace clogged arteries, again the dye would be used, so no thanks. https://en.wikipedia.org/wiki/Gadolinium Furthermore, the transplanted veins which then behave like arteries, are subjected to the same problem with platelets causing narrowing, so it’s a buy some time operation rather than a remedial intervention.

My decision appears to have been a reasonable call: https://www.verywellhealth.com/do-angioplasty-and-stents-prolong-life-4021221
https://www.acc.org/latest-in-cardiology/clinical-trials/2014/09/13/15/11/courage

One of the patients I met was happy to show me his scars on his legs, where is veins were removed and chest where his rib cage was prized apart. He also shared his concerns that he was still having angina pains after his surgery. Yet tried his utmost to convince me to go down the same route?

According to a nurse in the ward, over 90% of the population have some issues with clogged arteries, many are a ticking time bomb. One young lady in there had lost two sisters in their 20's to angina attacks and she was in there getting sorted after she experienced the same symptoms.

I asked the surgeon what had they used to do before catheters and the gadolinium dye? He said we gave statins, blood thinners and advise on fish oil supplements--which apparently do clear out fatty deposits. No more cheese (Doh) as this is the wrong type of fats, though not giving up butter, but will moderate it.

Smokers are the main source of inmates in the cardio ward. So Jude has had lectures from me about it.

I was asked which drugs I had been on, and reeled off a long list. He replied: “I would never have given a patient with kidney problems any of those drugs.” And assured me that the drugs he was giving me were completely safe and in his words, did not enter the kidneys, which I thought was a strange thing to say at the time? I told him that I would be researching all of the drugs when I went home.

At least someone had now confirmed my suspicions that drugs I had been prescribed for high blood pressure had caused further decline in my renal function. I have no doubt that most of the damage done to my kidneys was because of the drugs prescribed by my GP’s and renal consultant.

Apparently my heart is now operating at 38% ejection fraction.

Normal ejection fraction is (EF= 55-60%). Article on this: https://myheart.net/articles/heart-function-including-ejection-fraction-ef/

The drugs prescribed by the cardiologist were implicated in causing renal failure and premature deaths. He had lied to my face and was obviously very good at it!

Betablockers for example have caused over 800,000 deaths in 5 years in Europe alone. https://www.telegraph.co.uk/news/worldnews/1952818/Betablockers-have-caused-800000-deaths.html

My experience was that my fingers and toes would go blue, then turn white, with oxygen sats down to 72 about 30+ minutes after taking bisoprolol and this would subside over several hours.

Aspirin damages kidneys! https://www.ncbi.nlm.nih.gov/pubmed/10643705/

Statins damage kidneys!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874483/

I discussed with the cardiologist that the heart attack came while out walking in very cold damp air. Felt like I was breathing in acid, which was burning my lungs, followed by crushing pain in my chest, pain down left arm was excruciating and pain in jaw, with swollen glands in throat. I told the cardiologist and asked if it was common to have an attack in cold damp weather? He said yes it certainly is and is very common.

Confusing anomalies

1. For several months I had reduced the amount of water that I was drinking. \i was drinking a huge amount on the advice of Doctors, consultants and nurses, who advised me to drink plenty of water consistently. How much is too much and what damage was I doing by drinking several litres a day on top of beverages?

2. I had been drinking Kefir, which is a fermented full fat milk. Prior to heart attack, I was consuming Kefir, which is a bacterial and yeast culture made from whole milk. I guess I was probably causing the inflammation by overloading with bacteria, good or bad it get's into the blood by releasing it's waste products through the intestines. Add to this the lactic acid in kefir and it's a possibilty in understanding why I got into trouble. Especially when I'm lactose intolerant. I thought that the bacteria and yeast would have rendered the milk harmless to me, guess I got that wrong.  

Ironically, I wrote to Lucyane on the 5th of Dec telling her I had been sleeping at 3.8 degrees to see what would happen and decided to revert back to 6.5 degrees as was experiencing leg cramps, poor sleep, feeling cold in bed and going bathroom too much


Beta blocker Experience: Letter to Dr

Dear   Dr xxxxxxxxxxxxx Sent:
 27 December 2019 13:27

I have been getting some odd circulation issues that occur after taking my morning medications, which are getting progressively worse each day, with hands changing colour as if all blood has been drained from fingers. Numbness and tingling in toes and fingers. Looks like Raynauds Syndrome.  Also getting odd heart beats intermittently. All of these symptoms ease off later in the day and none return after evening meds. So logically, it is a drug that I take in the morning, so after quick research, it does appear to by bisoprolol fumarate that is causing the problems and I will not be taking this medication again. I do remember having problems with a betablocker in the past and had to stop taking the drug. 

It also appears to negatively affect renal function, which the hospital cardiologist assured me it wouldn't. "

Summary

The acute effects of bisoprolol 10 mg i.v., a new beta1-selective adrenoceptor antagonist, on heart rate, mean blood pressure (mBP), glomerular filtration rate (GFR), para-aminohippuric acid clearance (CPAH), sodium clearance, urine volume and plasma renin activity (PRA), were studied in 6 patients with essential hypertension. Heart rate decreased by 23%, mBP remained unchanged, and GFR decreased by 14% and CPAH by 23%. PRA was depressed on average by 25%. Urine volume and sodium clearance also declined by 9 and 13%, respectively, but the changes were not statistically significant. The fall in heart rate was significantly correlated with that in GFR and CPAH. Changes in GFR were correlated significantly with those in CPAH. The acute changes in renal function induced by bisoprolol are considered to be due to a reduction in cardiac output and increased systemic vascular resistance."

https://link.springer.com/article/10.1007/BF00870997

  

Possible Treatments

Viagra

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-014-0185-3

Giannetta, E., Feola, T., Gianfrilli, D. et al. Is chronic inhibition of phosphodiesterase type 5 cardioprotective and safe? A meta-analysis of randomized controlled trials. BMC Med 12, 185 (2014) doi:10.1186/s12916-014-0185-3

R E S EARCH  A R TIC L E  Is chronic inhibition of phosphodiesterase type 5 cardioprotective and safe? A meta-analysis of randomized controlled trials Elisa Giannetta1 , Tiziana Feola1 , Daniele Gianfrilli1 , Riccardo Pofi1 , Valentina Dall’Armi2 , Roberto Badagliacca3 , Federica Barbagallo1 , Andrea Lenzi1 and Andrea M Isidori1* Abstract Background: The myocardial effects of phosphodiesterase type 5 inhibitors (PDE5i) have recently received consideration in several preclinical studies. The risk/benefit ratio in humans remains unclear. Methods: We performed a meta-analysis of randomized, placebo-controlled trials (RCTs) to evaluate the efficacy and safety of PDE5i on cardiac morphology and function. From March 2012 to December 2013 (update: May 2014), we searched English-language studies from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and SCOPUS-selecting RCTs of continuous PDE5i administration that reported cardiovascular outcomes: cardiac geometry and performance, afterload, endothelial function and safety. The pooled estimate of a weighted mean difference between treatment and placebo was obtained for all outcomes using a random effects model. A test for heterogeneity was performed and the I2 statistic calculated. Results: Overall, 1,622 subjects were treated, with 954 randomized to PDE5i and 772 to placebo in 24 RCTs. According to our analysis, sustained PDE5 inhibition produced: (1) an anti-remodeling effect by reducing cardiac mass (−12.21 g/m2 , 95% confidence interval (CI): −18.85; −5.57) in subjects with left ventricular hypertrophy (LVH) and by increasing end-diastolic volume (5.00 mL/m2 ; 95% CI: 3.29; 6.71) in non-LVH patients; (2) an improvement in cardiac performance by increasing cardiac index (0.30 L/min/m2 , 95% CI: 0.202; 0.406) and ejection fraction (3.56%, 95% CI: 1.79; 5.33). These effects are parallel to a decline of N-terminal-pro brain natriuretic peptide (NT-proBNP) in subjects with severe LVH (−486.7 pg/ml, 95% CI: −712; -261). PDE5i administration also produced: (3) no changes in afterload parameters and (4) an improvement in flow-mediated vasodilation (3.31%, 95% CI: 0.53; 6.08). Flushing, headache, epistaxis and gastric symptoms were the commonest side effects. Conclusions: This meta-analysis suggests for the first time that PDE5i have anti-remodeling properties and improve cardiac inotropism, independently of afterload changes, with a good safety profile. Given the reproducibility of the findings and tolerability across different populations, PDE5i could be reasonably offered to men with cardiac hypertrophy and early stage heart failure. Given the limited gender data, a larger trial on the sex-specific response to long-term PDE5i treatment is required. Keywords: Phosphodiesterase-5, Heart failure, Hypertension, Endothelial function, Cardiac remodeling, Cardiac hypertrophy, Erectile dysfunction, Sildenafil, Pulmonary hypertension “

Case history brief: Viagra for Angina  (Author unknown) 

Sep 01, 2018 I was diagnose with clogged arteries over a year ago.  I even had a stent put in because one of my arteries was ecluded.  I still had stable angina every time I did some for of cardio activity or is I ate something with sodium.  I started using Nitroglycerin patches and even have the pills just in case my angina episode occurs.  

I had a date and I read online that you can't take viagra and any nitrates cause it can drop your blood pressure really low.  So I stopped using my nitroglycerin for about 48 hours so I can take the Viagra.  I noticed that I wasn't having chest pains a few hours after I took the viagra.  Then I didn't have angina for over a day.  Once I felt a little chest pain, I took another viagra and no angina.  I've been taken viagra for over 2 weeks and no angina.  I even have been doing cardio with no chest pain whatsoever.  I told my cardiologist this, but she says that it was not good and I should stop immediately and start using the nitrates again.  But she didn't give me a good reason to stop.  I have no angina whatsoever.  I was wondering has anyone else tried this?  If so, have you found any pros or cons?  I can't find anything and I've read that viagra was originally to prevent angina.  I want to keep taking the viagra but I don't want to damage the heart either,  Help please.  Thanks

Source: https://www.healingwell.com/community/default.aspx?f=42&m=4059786

 

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