Re: IV Saline and muscle pain and fatigueWas-->> Wasted Dr. Office Visits another perspective

[Guest guest]

Lynette,

Funny you should mention the IV saline. I take care of many chronic fatigue patients (CFIDS-for chronic fatigue immunodeficiency syndrome, which I believe describes it the best), and one of the treatments that seems to work to at least mitigate some of their pain and alleviate a tremendous amount of fatigue is 2 L IV normal saline. (the kind of fatigue I am referring to is when they tell me that they are so tired that " just thinking about breathing in and out makes me exhausted " ). You can watch their color change to a more normal pink from their characteristic grey as they get the fluid. Sometimes the effect on their fatigue symptoms last several months, sometimes it only lasts a couple of weeks, but they are so strikingly better that they always remember this and when the fatigue gets that bad, we pull out the IV normal saline again.

I got this idea after reviewing the results of the Ampligen study that was done on Chronic Fatigue patients back in the early 1990's. I noticed that the placebo group (who received IV normal saline instead of the IV ampligen) reported statistically significant reductions in their fatigue. Ampligen did not pan out as a treatment, but I was impressed by the " placebo effect " of the normal saline.

Durango, CO

I have many similar patients (my office gal would saw most ;-). One has quit going to the ER 'when my kidneys hurt' because they don't understand. I'm relieved that she has quit that habit because it costs the system hundreds of dollars. She really means 'I have had it and my shoulders hurt from carrying the weight of being a single mom with challenging children. Sometimes my shoulders give out, so now my back is sore from carrying the burden.' She usually feels better with 2L of IV fluid and some promethazine. Still may be overkill, but cheaper than the other approaches, and seems to help consistantly for 2-3 months at a time. The ER docs argue with her about wheither it's her kidneys or not. Wasted breath as far as I'm concerned. I don't care if she's right or not. I just assume she's 'speaking a foreign language' and this is the translation into my language.

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

Yep! Having been around before the term neurotransmitter (almost), I remember telling patients in residency about TCA's, 'We're not sure how they work, but they do.' Not sure when in the last 25 years we decided that the mechanism of action has to be understood before using a treatment ;-) My rule- if helps and the risk is minimal, go for it.

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

By the way, glad to see someone really reading the research. I'm thinking that is also a dying art. Don't even get me started on that one ;-)Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353

Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

Do you think oral re-hydration over 1-2 hours with 2 liters of a reasonable fluid

have the same effect? I think of the oral rehydration studies from the third

world and how they can do as well with oral fluids as with iv fluids.TimOn Tue, December 23,

2008 7:08 pm EST, wrote:

Lynette,

Funny you should mention the IV saline. I take care of many chronic fatigue

patients (CFIDS-for chronic fatigue immunodeficiency syndrome, which I believe

describes it the best), and one of the treatments that seems to work to at least

mitigate some of their pain and alleviate a tremendous amount of fatigue is 2 L IV

normal saline. (the kind of fatigue I am referring to is when they tell me that

they are so tired that " just thinking about breathing in and out makes me

exhausted " ). You can watch their color change to a more normal pink from their

characteristic grey as they get the fluid. Sometimes the effect on their fatigue

symptoms last several months, sometimes it only lasts a couple of weeks, but they

are so strikingly better that they always remember this and when the fatigue gets

that bad, we pull out the IV normal saline again.

I got this idea after reviewing the results of the Ampligen study that was done

on Chronic Fatigue patients back in the early 1990's. I noticed that the placebo

group (who received IV normal saline instead of the IV ampligen) reported

statistically significant reductions in their fatigue. Ampligen did not pan out as

a treatment, but I was impressed by the " placebo effect " of the normal

saline.

Durango, CO

I have many similar patients (my office gal would saw most ;-). One has quit

going to the ER 'when my kidneys hurt' because they don't understand. I'm relieved

that she has quit that habit because it costs the system hundreds of dollars. She

really means 'I have had it and my shoulders hurt from carrying the weight of being

a single mom with challenging children. Sometimes my shoulders give out, so now my

back is sore from carrying the burden.' She usually feels better with 2L of IV fluid

and some promethazine. Still may be overkill, but cheaper than the other approaches,

and seems to help consistantly for 2-3 months at a time. The ER docs argue with her

about wheither it's her kidneys or not. Wasted breath as far as I'm concerned. I

don't care if she's right or not. I just assume she's 'speaking a foreign language'

and this is the translation into my language.Lynette I Iles MD 301

South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may

contain information which is confidential and is only for the named addressee. If

you have received this email in error, please notify the sender immediately and

delete it from your computer.

---------------------------------------- Malia, MDMalia

Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton

Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com--

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for the sole use of the intended recipient(s) and contains confidential information.

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[Guest guest]

Nope. still need some of the mystery of medicine, for my patient at least ;-)

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way'

This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

Tim, Interestingly enough, oral hydration does not seem to work. In my little world of sufferers, I have tried basically everything. Initially, after reading the study, I did try oral rehydration, as I was also familiar with the WHO rehydration ideas and I abhor intervention with needles and sharp things unless absolutely necessary.

When I tried oral rehydration, they just increased how frequently they peed and had absolutely no impact on their fatigued. (Fact is it worsened it, as they had to go to the bathroom all the time and that wore them out.) I have often wondered if CFIDS sufferers have a basic problem with sodium balance or something related to intravascular volume depletion. They all act horribly volume depleted, with low BP and positive orthostatics almost all the time. I have also noticed that they all have positive tilt table testing.

With a population of folks that have totally misunderstood problems, like CFIDS, I do my best to read what information is out there about related issues and symptoms try to safely apply them to treatment ideas. I often feel like a lone ranger, but no one else is helping them. I always carefully document my thinking in their charts.

Durango, CO

Do you think oral re-hydration over 1-2 hours with 2 liters of a reasonable fluid have the same effect? I think of the oral rehydration studies from the third world and how they can do as well with oral fluids as with iv fluids.

Tim

Lynette,

Funny you should mention the IV saline. I take care of many chronic fatigue patients (CFIDS-for chronic fatigue immunodeficiency syndrome, which I believe describes it the best), and one of the treatments that seems to work to at least mitigate some of their pain and alleviate a tremendous amount of fatigue is 2 L IV normal saline. (the kind of fatigue I am referring to is when they tell me that they are so tired that " just thinking about breathing in and out makes me exhausted " ). You can watch their color change to a more normal pink from their characteristic grey as they get the fluid. Sometimes the effect on their fatigue symptoms last several months, sometimes it only lasts a couple of weeks, but they are so strikingly better that they always remember this and when the fatigue gets that bad, we pull out the IV normal saline again.

I got this idea after reviewing the results of the Ampligen study that was done on Chronic Fatigue patients back in the early 1990's. I noticed that the placebo group (who received IV normal saline instead of the IV ampligen) reported statistically significant reductions in their fatigue. Ampligen did not pan out as a treatment, but I was impressed by the " placebo effect " of the normal saline.

Durango, CO

I have many similar patients (my office gal would saw most ;-). One has quit going to the ER 'when my kidneys hurt' because they don't understand. I'm relieved that she has quit that habit because it costs the system hundreds of dollars. She really means 'I have had it and my shoulders hurt from carrying the weight of being a single mom with challenging children. Sometimes my shoulders give out, so now my back is sore from carrying the burden.' She usually feels better with 2L of IV fluid and some promethazine. Still may be overkill, but cheaper than the other approaches, and seems to help consistantly for 2-3 months at a time. The ER docs argue with her about wheither it's her kidneys or not. Wasted breath as far as I'm concerned. I don't care if she's right or not. I just assume she's 'speaking a foreign language' and this is the translation into my language.

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

---------------------------------------- Malia, MDMalia Family Medicine & Skin Sense Laser

6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450 (phone / fax)www.relayhealth.com/doc/DrMaliawww.SkinSenseLaser.com

-- Confidentiality Notice --This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments.

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[Guest guest]

Have you tried increased salt? I have one elderly chronic fatigue lady I treat with one tenderloin steak with salted french fries or chips twice a week. For her it works. I think she started out as a "Tea and Toast" syndrome person.

Joanne in Drain

I have many similar patients (my office gal would saw most ;-). One has quit going to the ER 'when my kidneys hurt' because they don't understand. I'm relieved that she has quit that habit because it costs the system hundreds of dollars. She really means 'I have had it and my shoulders hurt from carrying the weight of being a single mom with challenging children. Sometimes my shoulders give out, so now my back is sore from carrying the burden.' She usually feels better with 2L of IV fluid and some promethazine. Still may be overkill, but cheaper than the other approaches, and seems to help consistantly for 2-3 months at a time. The ER docs argue with her about wheither it's her kidneys or not. Wasted breath as far as I'm concerned. I don't care if she's right or not. I just assume she's 'speaking a foreign language' and this is the translation into my language.Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible

Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.------------ --------- --------- --------- - Malia, MDMalia Family Medicine & Skin Sense Laser6720 Pittsford-Palmyra Rd.Perinton Square MallFairport, NY 14450 (phone / fax)www.relayhealth. com/doc/DrMaliawww.SkinSenseLaser. com-- Confidentiality Notice --This email message, including all the

attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments.------------ --------- --------- --------- -