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Fevers And Ans Dysfunction


firewatcher

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Just found this:

http://www.circ.ahajournals.org/cgi/content/full/109/18/e217

Dr Cheng is quite right in his comments on our article1 about

the value of simple measures in syncope. It is remarkable how

simple lifestyle changes can elicit such dramatic effects in

autonomic disorders and especially in autonomic failure.2 Standing

may lower blood pressure more than 50 mm Hg in such

patients, whereas lying down may take a patient?s blood pressure

up into the hypertensive range. The ingestion of food may lower

blood pressure 30 mm Hg while the ingestion of 16 ounces of tap

water may raise blood pressure by 40 mm Hg.3 Hyperventilation

may lower blood pressure by 30 mm Hg, whereas hypoventilation

may raise pressure 25 mm Hg.4 Exercise and straining, such

as the Valsalva maneuver, significantly lower blood pressure,

whereas immersion in water and the use of abdominal binding

are pressor.5 Another remarkable effect is that conditions that

elicit fever in normal individuals may more prominently lower

blood pressure in autonomic failure patients and have less effect

on temperature elevation. These observations indicate that patients

with autonomic disorders have a large armamentarium of

therapeutic maneuvers at their disposal. Careful application of

these maneuvers can greatly enhance their ability to tolerate their

illness.

Chih-Cherng Lu, MD

Che-Se Tung, MD, PhD

National Defense Medical Center

Taipei, Taiwan, ROC

Andr? Diedrich, MD, PhD

Sachin Y. Paranjape, BS

Paul A. Harris, PhD

Daniel W. Byrne, MS

David Robertson, MD

Vanderbilt University School of Medicine

Nashville, Tenn

Jens Jordan, MD

Franz-Volhard Clinical Research Center

Medical Faculty of the Charite

Humboldt-University

Berlin, Germany

1. Lu C-C, Diedrich A, Tung C-S, et al. Water ingestion as prophylaxis

against syncope. Circulation. 2003;108:2660 ?2665.

2. Shannon JR, Jordan J, Robertson D. Blood pressure in autonomic failure:

drinks, meals, and other ordeals. Clin Sci. 1997;94:5.

3. Jordan J, Shannon JR, Grogan E, et al. A potent pressor reflex elicited by

drinking water. Lancet. 1999;353:723.

4. Onrot J, Bernard G, Biaggioni I, et al. Direct vasodilator effect of

hyperventilation-induced hypocarbia in autonomic failure patients. Am J

Med Sciences. 1991;301:305?309.

5. Krediet CT, van Dijk N, Linzer M, et al. Management of vasovagal

syncope: controlling or aborting faint by leg crossing and muscle tensing.

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O.k., maybe I have a little brain fog but is that saying that people with autonomic dysfunction my not get a fever as easily???

Jen

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Just found this:

http://www.circ.ahajournals.org/cgi/content/full/109/18/e217

Dr Cheng is quite right in his comments on our article1 about

the value of simple measures in syncope. It is remarkable how

simple lifestyle changes can elicit such dramatic effects in

autonomic disorders and especially in autonomic failure.2 Standing

may lower blood pressure more than 50 mm Hg in such

patients, whereas lying down may take a patient?s blood pressure

up into the hypertensive range. The ingestion of food may lower

blood pressure 30 mm Hg while the ingestion of 16 ounces of tap

water may raise blood pressure by 40 mm Hg.3 Hyperventilation

may lower blood pressure by 30 mm Hg, whereas hypoventilation

may raise pressure 25 mm Hg.4 Exercise and straining, such

as the Valsalva maneuver, significantly lower blood pressure,

whereas immersion in water and the use of abdominal binding

are pressor.5 Another remarkable effect is that conditions that

elicit fever in normal individuals may more prominently lower

blood pressure in autonomic failure patients and have less effect

on temperature elevation. These observations indicate that patients

with autonomic disorders have a large armamentarium of

therapeutic maneuvers at their disposal. Careful application of

these maneuvers can greatly enhance their ability to tolerate their

illness.

Chih-Cherng Lu, MD

Che-Se Tung, MD, PhD

National Defense Medical Center

Taipei, Taiwan, ROC

Andr? Diedrich, MD, PhD

Sachin Y. Paranjape, BS

Paul A. Harris, PhD

Daniel W. Byrne, MS

David Robertson, MD

Vanderbilt University School of Medicine

Nashville, Tenn

Jens Jordan, MD

Franz-Volhard Clinical Research Center

Medical Faculty of the Charite

Humboldt-University

Berlin, Germany

1. Lu C-C, Diedrich A, Tung C-S, et al. Water ingestion as prophylaxis

against syncope. Circulation. 2003;108:2660 ?2665.

2. Shannon JR, Jordan J, Robertson D. Blood pressure in autonomic failure:

drinks, meals, and other ordeals. Clin Sci. 1997;94:5.

3. Jordan J, Shannon JR, Grogan E, et al. A potent pressor reflex elicited by

drinking water. Lancet. 1999;353:723.

4. Onrot J, Bernard G, Biaggioni I, et al. Direct vasodilator effect of

hyperventilation-induced hypocarbia in autonomic failure patients. Am J

Med Sciences. 1991;301:305?309.

5. Krediet CT, van Dijk N, Linzer M, et al. Management of vasovagal

syncope: controlling or aborting faint by leg crossing and muscle tensing.

Can any of you figure out which article that little gem of information is from? I can't find it in the reference articles.

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Can any of you figure out which article that little gem of information is from? I can't find it in the reference articles.
Came from this article:

Simple Self-Help Maneuvers Are Effective in Aborting Vasovagal Syncope

Interesting about the temp issue. I am the opposite and in fact nutty fevers are part of my dysautonomia.

I went a long time w/ having daily fevers ave 101 to 102 and as high as 105. I'd seen many docs but no one could figure it out. years later of course I'd find it it is just another one of my autonomic quirks.

W/ illness, I get fevers easily.

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