jeshyr

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I'm reading, or rather listening to the audiobook for, "Debt: The First 5000 Years". It's as much about behavioural economics as it is about finance - it's fascinating!!! Highly recommended.

Audible tends to put these stupid little announcements at the end of audiobook segments: "This audiobook has been broken into multiple parts to make the download faster. You have reached the end of a part, but not the end of the book." And some message about fetching the next bit. Breaking a file into multiple smaller parts does NOT make the download faster of course, but it does shorten the time between when you start downloading the first bit and when you finish downloading the first bit and start listening to it, so there is an illusion of it being faster. But every time I hear that bloody announcement there's a little demon in my head shouting "NO IT DOESN'T! YOU LIE!"

I'm booked to be at the hospital Monday/Wednesday/Friday for the next 4 weeks for saline infusions. You can all imagine how utterly exhausted this will probably make me - I've pretty much cancelled everything else in m5y life for those four weeks. If the infusions help me to feel better, we'll jump over the epic amounts of paperwork and bureaucracy needed to have it done at home, but since the paperwork is renound for it's epicness I agreed to 4 weeks of it at the Alfred infusion centre first. I have no idea whether it'll help, but it has helped others with dysautonomia in the past so there's a hope ... cross your fingers and toes for me.

r

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From:

acelightning

1. some computers are capable of downloading multiple files at once. so if you download all the pieces of a multi-chapter audio book at the same time, even though it'll be slower than just downloading one file, it'll still be faster than downloading them sequentially.

2. i take it that "saline infusions" means they attach a bag of saline and just let it drip slowly into your vein, like they always do in hospitals no matter what you're being treated for? and that this has something to do with your blood pressure, whether because of the salt, or the increase in fluid volume, or both?

anyway, *great big enormous hugs*

From:

jeshyr

Pretty much any modern browser will download multiple files at once, actually, unless the user has specifically told it not to. It's just the literal inaccuracy that gets to me!!

Yes, IV saline just like regular. It's about increasing blood volume - you can google stuff like "saline infusion POTS" or "saline infusion dysautotonomia" for the rationale and this is a good article to start with if you're interested : http://potsgrrl.blogspot.com.au/p/in-support-of-iv-saline-therapy-for.html

From:

acelightning

i wonder why nobody ever thought to figure out the patients' blood volume, not just their blood count? back in early 2011, when i had some very heavy bleeding, i looked stuff up and found many references to "hypovolemia", talking about things like how much of your total blood supply you have to lose to develop various symptoms (and why), how long it takes for your body to replace the lost blood, and how drinking lots of water, or IV fluids if possible, would help while your body was working on replacing the blood. and when i was finally admitted to the hospital, of course the first thing they did was give me a bag or two of saline. (and a few units of blood, too. hmmm, why don't they give you blood transfusions?)

anyway, i hope it helps you, and i hope you either get to do it at home, or it isn't so bad while you're doing it because the positive effects negate the negative effects of traveling and being in the hospital. and i'd come and hug you every day if i could.

Edited Date: 2013-07-26 12:43 pm (UTC)

From:

jeshyr

They can measure blood volume, but it's a non-trivial thing to do - basically they give you some radioactive stuff via IV, wait a few hours for it to evenly disperse through the body, then draw some blood and measure the radiation level. They can figure out the dilution and hence the volume of circulating blood from that. But it involves exposure to radioactive stuff, and a bunch of hours of waiting around, so it's a lot harder than just blood count (which is basically a measure of density). There's only one hospital in Melbourne that does it and it's not my local hospital, so we figured that just trying the saline was easier than spending months arranging a test...

Blood transfusions have their own problems, I guess saline is used because it's safer and easier/cheaper to obtain?? Honestly I don't know that one!

Thanks for the intention-of-hugs :)

From:

acelightning

when i became hypovolemic, a couple of EMTs estimated what percentage of my blood volume i'd lost by various symptoms. unfortunately, i don't remember exactly what they were, and i'm a bit confused about the difference between "hypovolemia" and "shock". but they're apparently pretty accurate criteria for blood volume if you don't need to know down to the nearest 5% or something. according to the estimates, i was missing about 40%; the ER staff was surprised i could still walk - slowly and carefully - and make sense when i talked. and my complexion was the loveliest gothick-pale white... :-)

*even more virtual hugs*

Edited Date: 2013-07-27 05:20 am (UTC)

From:

jeshyr

I am pretty sure that the symptoms thing only works for acute hypovolemia - the chronic type like I (might ) have the body starts compensating so the symptom picture is much less clear.

Definitions I am good at!

"Hypovolemia" means low blood volume, for any reason and can be acute (yours) or chronic (mine) etc.
Medical "Shock" is when your cells aren't getting enough oxygen to function, which can be caused by hypovolemia or other things like heart not working properly or lungs not working properly or septicaemia or severe anemia etc etc.

Love you :)

From:

acelightning

the transfusions and saline made me feel a whole lot better rather quickly. may your treatment do the same for you, and without unpleasant side effects negating the positive benefits!

love you too, dearest Penguinissima!
*hugs*

From:

geekosaur

You need a certain amount of liquid for stuff to flow ("perfuse"); you can get away with having not quite the normal quantity of actual blood cells, in many cases, as long as the fluid's there to get them where they need to be.

But the fluid has to have the right electrolyte balance as well, or the cells that encounter it will try to match electrolyte balance with it and end up destroying themselves (more or less turning themselves inside out) or shutting down since they no longer have the ions that make things go, having tried to sync up with blood that also doesn't have the right ions. The most important ion in question is sodium, hence saline; potassium and calcium also figure into it, but sodium is most critical generally.

From:

jeshyr

Thank you, I didn't know perfusion was so closely related to the actual amount of blood! I have been measured to have very low cerebral perfusion when they SPECT scanned me, but at the time nobody was really sure what to do about it so they looked at the result and went "that's bad... umm ..." and then filed it away :/

From:

geekosaur

Most cells are fed by the tiniest of capillaries, often barely wide enough for a single blood cell at a time and only kept open by blood pressure; loss of blood volume or blood pressure means those capillaries get squeezed shut.

(Strictly speaking, "perfusion" refers to another mechanism where the blood just oozes where it can through tissue, but this only works in a few loosely-knit / jellylike tissues such as the brain; there needs to be some organization to the flow in denser tissues or blood wouldn't reach internal parts at all. But the two cases end up being fairly similar in practice, and in either case not enough blood volume or too low blood pressure means blood flows around rather than through.)

From:

exor674

but it does shorten the time between when you start downloading the first bit and when you finish downloading the first bit and start listening to it,

Not even that. If you know what you are doing, most audio and video files can be started while you are downloading them, as long as "time to download" < "length of file" -- as long as you don't do something silly like try and seek.

From:

jeshyr

True!! I usually download them and then load them into iTunes which requires that the file is complete, but there's no actual reason I *have* to do it that way ... it's just my habit :)

From:

kaberett

Toes crossed for you xx

From:

jeshyr

*huggles* thanks!

From:

pauamma

*slips you some vintage Pusat Tasek seawater for you to pour into your saline bag*
*winks*

From:

jeshyr

There are a frightening number of POTS/Dysautonomia sufferers who claim that "natural" or "organic" salt gives them completely different results to "artificial" salt when eaten.

It makes my inner organic chemist cringe a lot.

(Note that these people also usually drink electrolytes or other mineral supplements, so any trace minerals in the less processed salt is NOT going to have any significant biological effects. I can comprehend that if you were deficient in a trace mineral present in less processed salt forms it could have a different effect but I don't think this is the case here).

From:

jesse_the_k

One of those people is, sadly, my acupuncturist. She brings wonderful healing to my body, and she also reminds me monthly that I shouldn't cook vegetables in the microwave because it will alter their liquid's molecular structure.

Kirrilian photography, anyone?