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When he sets up to monitor the IVRT (isovolumetric relaxation time) on the echocardiograph, and then gives supplementary oxygen by mask to a person with CFS, he finds that the IVRT increases, as compared with normal, healthy people, in which it does not increase. The IVRT is a measure of diastolic dysfunction, which is caused by insufficient rate of ATP production by the mitochondria of the heart muscle cells. This indicates that the mitochondria are not being limited by insufficient oxygen. Rather, they are self-limiting due to oxidative stress, and if more oxygen is added, the degree of oxidative stress becomes worse, thus causing more severe mito dysfunction.
Pulse oximetry data is necessary whenever a patient's oxygenation may be unstable, as in intensive care, critical care, and emergency department areas of a hospital. Data can also be obtained from pilots in unpressurized aircraft, and for assessment of any patient's oxygenation in primary care. A patient's need for oxygen is essential to life; no human life thrives in the absence of oxygen (cellular or gross). Although pulse oximetry is used to monitor oxygenation, it cannot determine the metabolism of oxygen, or the amount of oxygen being used by a patient.
Pulse oximetry measures solely of oxygenation, not ventilation, and it is not a substitute for blood gases checked in a laboratory because it gives no indication of base deficit, carbon dioxide levels, blood pH, or bicarbonate HCO3- concentration. The metabolism of oxygen can be readily measured by monitoring expired CO2.
Oximetry is not a complete measure of respiratory sufficiency. A patient suffering from hypoventilation (poor gas exchange in the lungs) given 100% oxygen can have excellent blood oxygen levels while still suffering from respiratory acidosis due to excessive carbon dioxide.
It is also not a complete measure of circulatory sufficiency. If there is insufficient bloodflow or insufficient hemoglobin in the blood (anemia), tissues can suffer hypoxia despite high oxygen saturation in the blood that does arrive.
Thanks Rich, I look forward to the reply and reading the rest of your reply but about this
Can you really say for sure that diastolic dysfunction is caused by insufficient ATP production?
Why not fibrous areas in the heart muscle? How about improper signaling from the nervous system? Or ??? Are you sure that ATP production is at cause here?
This is from Wikipedia on pulse oximetry. I could be way off but I thought I put this out. The problem is that I don't really trust Cheney!
Thanks so much Cort for your pertinent questions, and Rich, thanks a lot for your so detailed and comprehensive replies!
I look forward to read Dr. Howard's response to Vermeulen paper, if this finally happens!
Rich, let me take the advantage to ask you something, a bit off-topic:
As I have told you a few times in the past, it seems incredible to me that a theory so well designed and built (GD-MCB theory), that is able to incorporate almost everything --even the new discoveries!--, from a Hg poisoning to a retrovirus infection in order to explain CFS, is not giving the expected results when brought to practice...On paper it is utterly brilliant, so, what occurs in practice?
Which are in your opinion the most feasible "pitfalls" where the body is not able to recover and repair on its own, as it should do in theory?
From your scientific and very knowledgeable perspective on CFS, do you think we can be missing some essential things to decipher the CFS puzzle, or could it be more a matter of finding the right order for the known pieces?
Thanks in advance and best wishes,
Thanks for putting all this info together, and adding some new thoughts. I read very carefully this message of yours a few months ago. Let me give you my opinion on some things, as a patient who has followed most of these techniques without much success. This is just my impression, and I’d really like to know other’s.
1- The lack of key nutrients: Those of us who were following the full Dr. Yasko's approach I think were covering this problem, by taking a good background of general supplementation, and also by satisfying the individual needs as shown by aminoacids and organic acids tests results. We (PWCs following this protocol for CFS) usually modified the protocol in those points you suggested (because of the differences between CFS and autism), like taking normal-high amount of protein and/or taking B6. However, my impression from PWCs who were or still are following this protocol, is that most of them improve to some extent, and then, they either plateau or became intolerant to the supplements.
2- Accumulated toxins: This is for sure a problem, but in practice, the measures that should work (chelations, saunas, supplementation for the detox routes, etc.), are not giving the expected outcomes. I know better the mercury poisoning issue, and, to put this as an example, although it is very likely that Hg has been in many cases the trigger of CFS, most of people don’t improve by removing this toxic from the body…It’s clear that the damage is done, so the question would be: what’s the damage? Of course the chronic block on the methylation cycle would explain this, as would the accumulation of other toxins and chronic infections (or all of this together!).
3- Damaged mitochondria and DNA: This is one of the main concerns many people have. If this were so decisive in determine the recovery from CFS, one should expect to see great recoveries in people who has not been sick for long. Although it is true that the later are the PWCs with best prognosis, it seems to me that after 2-3 years of disease, people response to treatment is quite similar to other patients who have being ill much more time…
4- Chronic Infections: I remember you expressing your concern about this –especially for viruses that enter into the brain like HHV-6--. It is curios that XMRV is this kind of viruses, and that it is so dependent on methylation. However, I cannot avoid to compare it with HIV in AIDS, where, it seems that it is not as simple as “VIH=AIDS”, in the sense that it could be necessary a predisposed body (depressed immune system, low selenium…) in order for the body to be chronically infected. In this sense, we’d need to treat the infections together with the rest of the issues…
In sum, I agree with you in all the points, and I really hope XMRV (or other MLVs) is the key for many of us who don’t improve with the therapies that should work on paper…This is why I am going to focus on it as well as on restoring the methylation cycle, and hopefully, if I recover enough to work, I’d like to follow a therapy with stem cells afterwards, because of the reasons you have pointed out.
It is just very frustrating not to be able to improve with treatments that do make sense…Let’s hope the retroviruses turn out to be important in this disease, or that we find other missing pieces of the puzzle soon...
Thanks for your wholehearted support,
PS. Pardon the English...I am very tired today:In bed: