Relaxing time in the Sierra Nevada foothills with my family.  Lots of good food and company.  We had a blessed Christmas together, and send
out our best wishes to all of you.  Free time allows my mind to

wander...and I'm thinking about blood flow and blood volume this week.

 Perhaps its from watching the rainwater rush and wend its way down our

mountain trails....here's what I've been thinking about.

For many women, pregnancy offers a time of blessed relief of MS symptoms.
 This has lead to studies of hormones and MS, and a clinical trial of

estrogen in MS patients.   But looking at pregnancy from the

CCSVI/vascular paradigm, what else can we learn?  

When women are pregnant, their blood volume increases dramatically.  This sends blood pumping throughout the body.

Perhaps the most striking maternal phisiologic alteration occurring
during pregnancy is the increase in the blood volume. The magnitude of

the increases varies according to the size of woman, the number of

pregnancies she has had, the number of infants she has delivered, and

whether there is one or multiple fetuses.The increases

in blood volume progress until term;the average increase in volume at

term is 45-50%. The increase is needed for extra blood flow to the

uterus, extra metabolic needs of fetus, and increased perfusion of

others organs, especially kidneys. Extra volume also compensate for

maternal blood loss during delivery. 

After delivery is the time during which many women report having
exacerbations in their MS, or a return of MS symptoms.  Yes, hormone

levels are fluctuating, but so are blood volume levels.  Pondering this

fact has lead me to do more reading on blood volume, and I am finding

some interesting things to consider.

Hypovolemia means low blood volume.  This condition can be very serious and happens due to
blood loss from injury, but it can also be mild and happens in a body

that is dehydrated or is inactive or not functioning well. This happens

often to the elderly.   Low blood volume can cause orthostatic

hypotension. This is when there isn't enough blood getting to the brain

when a person changes position, from lying down to upright.  This can

lead to dizziness, confusion and falls, and often happens in the

elderly.  But it can happen in people with MS, too.  Orthostatic

hypotension is well-documented in MS and has been a mystery for

researchers.  It is thought to be due to autonomic dysfunction.

Thinking about blood volume in terms of CCSVI treatment and restenosis has been
very interesting to me.   If angioplasty is returning good, open routes

of flow, but the body is not able to compensate by providing adequate

blood volume, then these opened vessels will not have the necessary

pressure to remain opened.  And the areas of prior stenosis might

re-collapse, just like an old garden hose with low flow.

I hope to bring this avenue of discussion to the doctors.  Perhaps
aftercare needs to include additional hydration, salt intake, maybe even

intravenous fluids--all to keep blood levels adequate.  Inactivity and

remaining in the supine position increase hypovolemia--therefore,

 movement, exercise and upright activities would encourage blood flow

and blood volume.  Something to think about as we move forward with

CCSVI research in 2011.

All this talk about dehydration is making me thirsty!  Time for some fresh, mountain water and a walk in
the pine trees with Jeff and our dog, Angel.  

With wishes for good flow in the New Year!

Joan 

http://www.facebook.com/notes/ccsvi-in-multiple-sclerosis/flow-and-ccsvi/484466877210