Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Hi, o. Thanks for posting your new results. Yes, it looks as though your earlier low oxygen numbers from your right arm venous blood are confirmed by these new numbers for your left arm. The difficulty you reported in getting a blood sample is consistent with low total blood plasma volume. An ejection fraction of 65% is normal, and it means that your heart is able to pump out the blood that it receives well. In other words, it doesn't appear that you have a cardiomyopathy. Your heart muscle is strong. Based on these results and all the things you have reported up to now, my best guess is that you have low total blood plasma volume and low total red blood cell mass. In order to produce the normal complete blood count results you reported, the total red blood cell mass must be decreased in nearly the same proportion as the total blood plasma volume is decreased, in order to produce a normal number of red blood cells per unit volume of blood. As a result of the low total blood plasma volume, your heart is not receiving venous blood fast enough to be able to pump blood out at a normal rate. The blood that it is pumping out is carrying normal amounts of oxygen per unit volume of blood, but because the total blood flow is low as a result of low venous return to the heart, the total oxygen flow in your blood is low, your tissues are drawing the oxygen level down below normal in the capillaries, and this low oxygen level then shows up in your venous blood. Your cold extremities also result from the lower than normal blood flow, and the difficulty in getting a blood sample results from the fact that your veins do not have as much blood in them as normal. All of this seems consistent. In order to confirm this hypothesis, it would be necessary to run a total blood plasma volume test and a total red cell mass test. These are offered by nuclear medicine departments of hospitals. The first involves taking out a blood sample, mixing a small amount of a radioactive isotope with the blood sample, performing gamma ray counting on the isotope-labeled blood sample, reinjecting the blood sample, waiting for it to mix with the rest of the blood in your body, then withdrawing another blood sample, performing gamma ray counting on it, and calculating the ratio of radioactivity in the initial sample to the final sample. Multiplying this ratio by the volume of the initial sample gives the total blood plasma volume. A somewhat similar procedure using an isotope that binds to the red blood cells is used to determine the total red blood cell mass. Another test that would confirm this hypothesis is impedence cardiography, which would give a measure of stroke volume, and combined with heart rate, this would give a measure of cardiac output. If the above hypothesis were correct, your stroke volume and cardiac output would come out low. It's also possible to measure stroke volume using a catheter, but this carries some risk, and I think it would be preferable to use the other approaches I mentioned rather than the catheter approach. In any case, you would have to get a doctor to cooperate in order to get any of these tests. If it does turn out that you have low blood plasma volume and low red blood cell mass, you would not be alone. This has been observed in many PWCs. Often it appears to be due to diabetes insipidus, but this does not seem to be true in your case, based on what you have reported about not experiencing excessive thirst. Dr. Barry Hurwitz (in Klimas's group at the U. of Miami) is conducting a study in which erythropoeitin (Procrit) is used to build more red blood cells in PWCs. The results of this study have not been reported yet. Means of increasing blood plasma volume in PWCs have included drinking extra water accompanied by extra salt, and being treated with Florinef (fludrocortisone). Florinef by itself has not been shown to help in CFS, but it has not been formally tested with salt and water added. In some PWCs, there is also pooling of blood in the veins of the legs. Sometimes this produces purple, splotchy-looking color of the legs. Some PWCs have found that wearing support stockings helps this. Rich > > Hi Rich: > > I just got my left arm venous blood gases test results: > > VENOUS GASES (LEFT ARM) > ------------------------ > > pH = 7.364 ranges (7.31-7.41) > pCO2 (mm/Hg) = 46.1 ranges (40-52) > pO2 (mm/Hg) = 21 ranges (30-50) > HCO3 (mmol/L) = 26.2 ranges (22-28) > tCO2 (mmol/L) = 28 no ranges defined > EBvT (mmol/L) = 1 no ranges defined > O2 SAT (%) = 33 ranges (60-85) > > I guess one thing in common with the right arm are the low pO2 and O2 > SAT values, which are very low in both arms. > > Also, in one of the questionnaire that you sent me some time ago, you > made me the following question: > > Do phlebotomists have difficulty getting blood samples from your > body? > > Let me tell you that I just went to get some blood drawn and the > phlebotomists could not get any blood from my right arm. He tried to > look for a good vein like 6 times and couldn't draw any blood, so he > had to switch to my left arm, in which he was able to draw blood. > > Could this be related to the low oxygen that is in my veins, or maybe > some couagulation problem? > > Also, I was looking at some of my heart tests results and I found one > that shows a lot of things about my heart (some of them which I don't > understand very well). > > One of those tests was one that you had previously asked me if I had > done it: > > It is Ejection Fraction and it's 65.09%. > > This test was done in an echocardiogram. > > I know that there are more sophisticated tests (like the impedance > cardiography), but so far, this is what I got. > > Thanks for your help, > o Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Rich, I have some strange question on my mind. If we have low plasma volume wouldn't that result in elevated plasma test results?If that is correct do you have any idea on what the percent deviation might be from normal results. Also is there a way for us to increase plasma volume before taking a serum test if the test does not have a requirement of being hungry? Would you think drinking isotonic salt solution help? Thanks nil Re: Rich, more results > > > Hi, o. > > Thanks for posting your new results. > > Yes, it looks as though your earlier low oxygen numbers from your > right arm venous blood are confirmed by these new numbers for your > left arm. > > The difficulty you reported in getting a blood sample is consistent > with low total blood plasma volume. > > An ejection fraction of 65% is normal, and it means that your heart > is able to pump out the blood that it receives well. In other > words, it doesn't appear that you have a cardiomyopathy. Your heart > muscle is strong. > > Based on these results and all the things you have reported up to > now, my best guess is that you have low total blood plasma volume > and low total red blood cell mass. In order to produce the normal > complete blood count results you reported, the total red blood cell > mass must be decreased in nearly the same proportion as the total > blood plasma volume is decreased, in order to produce a normal > number of red blood cells per unit volume of blood. As a result of > the low total blood plasma volume, your heart is not receiving > venous blood fast enough to be able to pump blood out at a normal > rate. The blood that it is pumping out is carrying normal amounts > of oxygen per unit volume of blood, but because the total blood flow > is low as a result of low venous return to the heart, the total > oxygen flow in your blood is low, your tissues are drawing the > oxygen level down below normal in the capillaries, and this low > oxygen level then shows up in your venous blood. Your cold > extremities also result from the lower than normal blood flow, and > the difficulty in getting a blood sample results from the fact that > your veins do not have as much blood in them as normal. All of this > seems consistent. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Hi, Nil. Do you mean that if the plasma volume is lower than normal, would the concentrations of substances normally dissolved in the plasma be higher than normal? If that's what you mean, I think that the answer would be no, because the amounts of substances in the plasma are regulated in terms of their concentrations, rather than in terms of their total amounts. I think that drinking salt solution that is more concentrated than isotonic will help to conserve water in the blood plasma, and thus to increase its volume. Of course, you may have to drink additional water to counteract the thirst, but that will add water to the blood plasma. If you are having blood tests to determine what the levels of things usually are in your blood, though, it might not be a good idea to load up on salt beforehand, because that may change the levels of electrolytes measured, and thus interfere with diagnosing your condition. Rich Rich > Rich, > > I have some strange question on my mind. If we have low plasma volume > wouldn't that result in elevated plasma test results?If that is correct do > you have any idea on what the percent deviation might be from normal > results. Also is there a way for us to increase plasma volume before taking > a serum test if the test does not have a requirement of being hungry? Would > you think drinking isotonic salt solution help? > Thanks > nil > Re: Rich, more results > > > > > > > > Hi, o. > > > > Thanks for posting your new results. > > > > Yes, it looks as though your earlier low oxygen numbers from your > > right arm venous blood are confirmed by these new numbers for your > > left arm. > > > > The difficulty you reported in getting a blood sample is consistent > > with low total blood plasma volume. > > > > An ejection fraction of 65% is normal, and it means that your heart > > is able to pump out the blood that it receives well. In other > > words, it doesn't appear that you have a cardiomyopathy. Your heart > > muscle is strong. > > > > Based on these results and all the things you have reported up to > > now, my best guess is that you have low total blood plasma volume > > and low total red blood cell mass. In order to produce the normal > > complete blood count results you reported, the total red blood cell > > mass must be decreased in nearly the same proportion as the total > > blood plasma volume is decreased, in order to produce a normal > > number of red blood cells per unit volume of blood. As a result of > > the low total blood plasma volume, your heart is not receiving > > venous blood fast enough to be able to pump blood out at a normal > > rate. The blood that it is pumping out is carrying normal amounts > > of oxygen per unit volume of blood, but because the total blood flow > > is low as a result of low venous return to the heart, the total > > oxygen flow in your blood is low, your tissues are drawing the > > oxygen level down below normal in the capillaries, and this low > > oxygen level then shows up in your venous blood. Your cold > > extremities also result from the lower than normal blood flow, and > > the difficulty in getting a blood sample results from the fact that > > your veins do not have as much blood in them as normal. All of this > > seems consistent. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Thank you very much for your detailed response Rich. I'll ask the nuclear departments of my local hospitals to see if they perform the total plasma volume and red cell mass tests. Regards, o > > > > Hi Rich: > > > > I just got my left arm venous blood gases test results: > > > > VENOUS GASES (LEFT ARM) > > ------------------------ > > > > pH = 7.364 ranges (7.31-7.41) > > pCO2 (mm/Hg) = 46.1 ranges (40-52) > > pO2 (mm/Hg) = 21 ranges (30-50) > > HCO3 (mmol/L) = 26.2 ranges (22-28) > > tCO2 (mmol/L) = 28 no ranges defined > > EBvT (mmol/L) = 1 no ranges defined > > O2 SAT (%) = 33 ranges (60-85) > > > > I guess one thing in common with the right arm are the low pO2 and > O2 > > SAT values, which are very low in both arms. > > > > Also, in one of the questionnaire that you sent me some time ago, > you > > made me the following question: > > > > Do phlebotomists have difficulty getting blood samples from your > > body? > > > > Let me tell you that I just went to get some blood drawn and the > > phlebotomists could not get any blood from my right arm. He tried > to > > look for a good vein like 6 times and couldn't draw any blood, so > he > > had to switch to my left arm, in which he was able to draw blood. > > > > Could this be related to the low oxygen that is in my veins, or > maybe > > some couagulation problem? > > > > Also, I was looking at some of my heart tests results and I found > one > > that shows a lot of things about my heart (some of them which I > don't > > understand very well). > > > > One of those tests was one that you had previously asked me if I > had > > done it: > > > > It is Ejection Fraction and it's 65.09%. > > > > This test was done in an echocardiogram. > > > > I know that there are more sophisticated tests (like the impedance > > cardiography), but so far, this is what I got. > > > > Thanks for your help, > > o Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Rich: Do you think gookinaid would do a good job in increasing blood volume? Thanks, o > > Rich, > > > > I have some strange question on my mind. If we have low plasma > volume > > wouldn't that result in elevated plasma test results?If that is > correct do > > you have any idea on what the percent deviation might be from > normal > > results. Also is there a way for us to increase plasma volume > before taking > > a serum test if the test does not have a requirement of being > hungry? Would > > you think drinking isotonic salt solution help? > > Thanks > > nil > > Re: Rich, more results > > > > > > > > > > > > > Hi, o. > > > > > > Thanks for posting your new results. > > > > > > Yes, it looks as though your earlier low oxygen numbers from your > > > right arm venous blood are confirmed by these new numbers for > your > > > left arm. > > > > > > The difficulty you reported in getting a blood sample is > consistent > > > with low total blood plasma volume. > > > > > > An ejection fraction of 65% is normal, and it means that your > heart > > > is able to pump out the blood that it receives well. In other > > > words, it doesn't appear that you have a cardiomyopathy. Your > heart > > > muscle is strong. > > > > > > Based on these results and all the things you have reported up to > > > now, my best guess is that you have low total blood plasma volume > > > and low total red blood cell mass. In order to produce the > normal > > > complete blood count results you reported, the total red blood > cell > > > mass must be decreased in nearly the same proportion as the total > > > blood plasma volume is decreased, in order to produce a normal > > > number of red blood cells per unit volume of blood. As a result > of > > > the low total blood plasma volume, your heart is not receiving > > > venous blood fast enough to be able to pump blood out at a normal > > > rate. The blood that it is pumping out is carrying normal > amounts > > > of oxygen per unit volume of blood, but because the total blood > flow > > > is low as a result of low venous return to the heart, the total > > > oxygen flow in your blood is low, your tissues are drawing the > > > oxygen level down below normal in the capillaries, and this low > > > oxygen level then shows up in your venous blood. Your cold > > > extremities also result from the lower than normal blood flow, > and > > > the difficulty in getting a blood sample results from the fact > that > > > your veins do not have as much blood in them as normal. All of > this > > > seems consistent. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Yes Rich, Thanks. What about thick blood problem? If my blood is thicker than normal people and if lab is taking same amount of blood from me as they take from normal people than wouldn't my mineral results be higher than normal people. If my blood was thinner,the volume they take would contain less amounts of minerals? Wouldn't it?Sorry if I have difficulty to understand. I was concentrated on mineral tests only at this time.Yes,other tests may alter as you say. Thanks. nil Re: Rich, more results > > > Hi, Nil. > > Do you mean that if the plasma volume is lower than normal, would > the concentrations of substances normally dissolved in the plasma be > higher than normal? If that's what you mean, I think that the > answer would be no, because the amounts of substances in the plasma > are regulated in terms of their concentrations, rather than in terms > of their total amounts. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Hi, Nil I think it's important to focus on what is meant by " thick " blood. This is not a precise medical term. Usually when people use this term, they mean that the blood has a greater tendency to clot than does normal blood. When people talk about " blood thinners, " they are usually referring to things like heparin, coumadin, Warfarin, nattokinase, bromelain, aspirin, etc., which tend to counter blood clotting, either by affecting the clotting protein cascade or the platelets, or both. " Thick " or " thin " blood does not refer to the concentrations of substances dissolved in the blood. These are controlled to be in normal ranges regardless of the clotting tendency of the blood. I think that the difficulty in semantics here comes because we are familiar with cooking. If we have a soup, for example, and we continue to heat it and drive off the water as steam, the soup becomes thicker, because the substances dissolved in the water become more concentrated as the water is driven off. This is a different situation than occurs with blood in the body, however. The terms " thick " and " thin " in relation to blood are misleading because of this. It would be better to say that the blood has a higher or lower tendency to clot. Rich > Yes Rich, > > Thanks. What about thick blood problem? If my blood is thicker than normal > people and if lab is taking same amount of blood from me as they take from > normal people than wouldn't my mineral results be higher than normal people. > If my blood was thinner,the volume they take would contain less amounts of > minerals? Wouldn't it?Sorry if I have difficulty to understand. > I was concentrated on mineral tests only at this time.Yes,other tests may > alter as you say. > Thanks. > nil > Re: Rich, more results > > > > > > > > Hi, Nil. > > > > Do you mean that if the plasma volume is lower than normal, would > > the concentrations of substances normally dissolved in the plasma be > > higher than normal? If that's what you mean, I think that the > > answer would be no, because the amounts of substances in the plasma > > are regulated in terms of their concentrations, rather than in terms > > of their total amounts. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 8, 2005 Report Share Posted April 8, 2005 Hi, o. In the past, several people who have posted on this list have said that it helped them. I think Dr. Cheney has used it for that purpose. Rich > > Rich: > > Do you think gookinaid would do a good job in increasing blood volume? > > Thanks, > o Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 9, 2005 Report Share Posted April 9, 2005 Thank you Rich, Now I got it:) Nil Re: Rich, more results > > > Hi, Nil > > I think it's important to focus on what is meant by " thick " blood. > > This is not a precise medical term. Usually when people use this > term, they mean that the blood has a greater tendency to clot than > Quote Link to comment Share on other sites More sharing options...
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