What The Published Literature States About Habitual Flat Bed Rest

Too Much Bed Rest Harmful?
Dear Reader: Bed rest is an absurd form of treatment. The only time a person needs to be in bed because of illness is when he has an illness that requires him / her to lie down, as being in traction, or from an aesthetic or shock.
Otherwise a person is usually better sitting up than lying down, except to sleep. When you are sitting up, that column of blood in your arteries between your heart and the top of your head is affected by gravity and even helps to fill the coronary arteries to supply blood to your heart muscle.

If you have a fairly severe cold, you probably should sit up and can walk around the house. Moving around at that level of activity is good for you.
It is far better than being in bed. You will lose a lot of body water by lying in bed continuously for just 24 hours. That will make you weak and have a tendency to faint when you get up. Sitting up helps to prevent this, and walking around in the house is even better.

Snip

It is wise to remember that staying in bed can cause bed disease. Even 24 hours is too much unless you have to stay there and the longer you are in bed the more your normal body functions for being up and about will deteriorate.



Dr Lamb The Victorian Advocate Oct 6 1986

www.news-medical.net/news/2007/03/22/22680.aspx
22. March 2007 14:31
Increasing evidence shows that the long periods of bed rest can be harmful to the health of a pregnant woman, the New York Times reports.

Studies by NASA scientists, who used bed rest to simulate weightlessness in space, found that complete immobility during a long period of time can cause degeneration of person's musculoskeletal and cardiovascular systems.

According to the Times, degeneration can begin within 48 hours of bed rest, but it usually is "after birth that many bedridden mothers realize the extent of their deconditioning."

www.abc.net.au/rn/talks/8.30/helthrpt/stories/s62065.htm
Bed Rest and Sickness
Monday 25 October 1999

Summary: A review of the scientific literature on bed rest has turned up no evidence that bed rest is beneficial.

A Radio Interview Transcript.

Talking about the use of bed rest in medical practice:
Rae Fry: "So give me an idea historically of where we got this idea in the first place, that lying down would speed recovery?"

Chris Del Mar: "Well I don't really know where it comes from,"

Too Much Bed Rest Harmful? 1954 The Deseret News

Too Much Bed Rest Harmful
By C.A. Dean M.D. The Deseret News - Jan 28, 1954

Meditorial: The human body was designed to keep moving. Fewer older people die of pneumonia today simply because doctors now know that prolonged bed rest promotes this disease. Snip

Stiff joints, bedsores and flabby muscles may also be complications of bed rest.

Even heart cases do better out of bed in many instances. Swelling of the legs is less harmful than engorged lungs, and sleeping in a rocking chair is better than no sleep in a bed.

Bed Rest May Not Help and It May Actually be Harmful
The following is reprinted from Right from the Start, by Gail Sforza Brewer (Krebs) and Janice Presser Greene, 1981.

"Bed Rest", p.50

Bed rest is the current "in" treatment [as of 1981] for everything from multiple pregnancy to high blood pressure, despite its deleterious effects on anyone, not just pregnant women, put to bed for prolonged periods of time. A classic review article, "The Hazards of Immobility," published in the April 1967 issue of the American Journal of Nursing, discusses the effects of bed rest on cardiovascular function, respiratory function, gastrointestinal function, motor function, urinary function, metabolic equilibrium, and psychosocial equilibrium. Awareness of just a few of the drastic alterations in body processes brought about by bed rest should make anyone for whom it is casually prescribed think twice about following the doctor's or midwife's order:


# reduced metabolic rate;
# tissue atrophy;
# protein catabolism and negative nitrogen balance;
# bone demineralization;
# fluid and electrolyte imbalance;
# formation of urinary tract stones;
# formation of blood clots;
# increased sweating and excess fluid loss;
# psychologic and physiologic stress reactions, including a rise in blood pressure due to anxiety (worry over one's condition, rather than getting the "rest" one supposedly needs);
# reduction in hormone production;
# increased need to urinate at first, then urinary retention;
# decreased motivation to participate in social encounters (talking, taking meals, pastimes);
# depression/anger/aggression/apathy;
# exaggerated emotional responses;
# decreased perceptual abilities;
# loss of sociocultural and economic status;
# loss of appetite resulting in malnutrition;
# constipation and complete bowel obstruction;
# muscle spasm;
# increase in systemic infection due to malnutrition;
# fall in serum proteins due to malnutrition;
# upon arising, weakness, dizziness, falling in a faint due to a falling off in the body's ability to equalize the blood supply (this can happen in as little as a week on absolute bed rest and, where the rest has been imposed for three weeks, the ability of the body to respond effectively to the upright posture is not regained for five weeks or more);
# increased work load on the heart;
# decreased respiratory movement and decrease of the movement of normal secretions, leading to bronchitis, tracheitis, or pneumonia;
# diminished exchange of oxygen and carbon dioxide, resulting in respiratory acidosis and reduction in oxygen supply to the unborn baby--just what the doctor did not mean to order!

A reprint of the article, appropriate for sharing with medical professionals, is available from: American Journal of Nursing Company, Educational Services Division, 10 Columbus Circle, New York, NY 10019.

Note from Joy: This contact information is from 1981, so you could check online to see if it has been changed.

How important is it to stay in bed if you have a cold or flu How important is it to stay in bed if you have a cold or flu?

Gainesville Sun - Feb 3, 1990

Dear Dr Lamb
How important is it to stay in bed if you have a cold or flu? How important is it to stay in bed if you have a cold or flu? [/url]My husband claims that bed rest is actually harmful and it doesn’t do any good at all. I know it rests the heart because when you have a heart attack they always put you in bed. I have also heard that older people in nursing homes, should not be at bed rest and that it is harmful for them. How can bed rest be harmful? Is sitting up any better, and if so why?

Dear Reader: Even a full day resting in bed without getting up can have bad effects. Unless you get up from time to time, the normal water content in your lower body will be mobilized and eliminated through the kidneys, then you are apt to feel faint when you stand up. The loss of water from the tissues will allow blood to accumulate in your legs, not leaving enough to be pumped around your brain.

Putting a person to bed who has had a heart attack doesn’t rest the heart any more than if he were sitting up. But it helps for administering oxygen and monitoring the heart beat. Lying flat is also useful if there is any tendency for shock. If you are getting medicines for pain and are sleepy, it is necessary. Bed rest does help to keep some people from being overly active, as would be prone to do if they were left to sit in a chair.

The heart tends to beat faster if you stay at bed rest and it loses its work capacity. Many patients who were required to lie flat in bed for six weeks after a heart attack, in years past, developed “bed disease”—or major changes caused by inactivity.
Recovery to normal living under these circumstances was much slower.

Bed rest also causes calcium to be mobilized from the bones, making osteoporosis much worse. It really bothers me to see many older people drugged-out and in bed in some nursing homes. That may make life easier for the staff, but it is not a desirable treatment for the individual.
When you are sleepy and miserable with a cold, resting in bed for the day is not catastrophe, but it is not necessary. If you do stay in bed, get up from time to time and walk around the room, or sit up and watch t.v. Sitting helps to prevent fluid loss of normal body fluids.

Dr Lawrence Lamb,

The Bad Side Of Bed Rest Horizontal Can Be Horrible For Your Body If You Stay That Way Too Long.

August 4, 1986|By DR. LAWRENCE E. LAMB, Special to the News
When you are sick, doctors often advise getting plenty of bed rest and taking lots of fluids. But there are reasons that prolonged bed rest is not so good for you. Prolonged bed rest affects the amount of fluid in your body and the pressure at which blood is pumped, making it difficult for the body to adapt to activity again. It causes changes in the size of the heart, too, and the body`s ability to replenish blood.
In short, the disadvantages of prolonged bed rest can outweigh the benefits.

CHANGES IN PRESSURE
Lying down eliminates much of gravity`s influence upon the body. When you are lying down, the blood pressure at the outlet of your left heart, just outside the aortic valve, is the reference pressure. Think of it as 120/70. The pressure will be about the same in all of your arteries, regardless of where they are in the body.
Blood flows through smaller and smaller arteries until it reaches the capillaries, the smallest blood vessels of all, and from there it drains into the veins to return to the heart. In the process, it loses its pressure. Fluid leaves your capillaries to provide nourishment and oxygen to your cells. Fluid returns to the most distant part of the capillaries that join to form the veins. The pressure in the veins in your legs, while you are lying down, will be about 10 millimetres Mercury. In the right atrium, where all the veins drain into the heart, the pressure will be about 5 millimetres Mercury.
Drastic changes occur when you stand up, and gravity asserts its influence on your body. Your blood vessels form an upright column of blood, like a water tower. The ``tower`` is the height of the distance between the top of the heart and the ankle. In the average adult male, this alone creates an added pressure of 100 millimetres Mercury. The pressure at the heart level would still be 120/70, but the pressure in the ankle would be 220/170. The leg arteries constrict to prevent all your blood from running into your legs.
Gravity also affects the blood pressure in the veins, acting on the column of blood in the veins between the top of your heart and your ankle. So venous blood pressure also will increase by 100 millimetres, Mercury. That means the pressure in the veins in your ankle will be 110 millimetres Mercury, not just 10 millimetres Mercury.
GRAVITY AND BODY WATER
All that increased pressure in your veins makes it more difficult for fluid to flow from your cells back into the veins. As a result, as you stand, you accumulate fluid in your tissues. Each leg, from the hip down, will gradually fill to capacity.
When you lie down, you eliminate that increased venous pressure. When lying down, fluid more readily flows from your tissues back into the veins. The large volume of blood that accumulated in your legs also shifts to your chest, and expands the right atrium, where blood from veins accumulates.
There are stretch receptor nerve cells in the wall of the right atrium (upper chamber of the heart). As these stretch, they send a signal to your brain. The brain, in turn, controls an endocrine mechanism that causes the kidneys to start to eliminate water. A person who is normally hydrated may lose 5 or 6 pounds of water in 24 to 48 hours of lying down.
The problem begins when you get out of bed, after the period of bed rest. The loss of water from the legs that has occurred during bed rest decreases the pressure that keeps the thin-walled veins from expanding. The veins expand readily, and a lot of blood pools in the legs. Also, the loss of water from the blood during the time of lying flat has reduced the volume of blood circulating in your body. The combination of pooling of blood in the legs and lower blood volume means that there may not be enough blood getting back to the heart, which can cause fainting.
THE HEART SHRINKS
A well-conditioned athlete, such as a distance runner, tends to have a large heart. The heart must be able to store a large volume of blood between each contraction. The large-chambered heart is able to pump even more blood during exercise. That makes it possible to deliver lots of oxygen to supply the working muscles.
The opposite happens with inactivity. The heart actually gets smaller. Since the heart is not worked at high levels, there is no requirement for it to be able to pump large amounts of blood and it loses its ability to do so.
The heart muscle behaves much like other muscles in the body. It increases in size and strength as a response to being asked to do more frequent and harder work. When it is not exercised adequately, it gets flabby or weak, and loses its capacity for work. That may lead to early fatigue of the strained heart muscle and signs of impending heart failure.

articles.sun-sentinel.com/1986-08-04/fea...ssure-veins-bed-rest