Salt before bed

[Weney3777]

As you know, my symptoms are the worst in the morning, every morning. Last night I had a salt-loaded snack just before bed and this morning I felt better than I have, in a morning, for over a year! Does anyone think there is a correlation? (I usually don't eat at bedtime.)

[Weney3777]

Hope you feel better.
Wen

[Heiferly]

Always a good idea to get actual results.  Will say more on this when I am feeling better myself, sorry.

[supineallthetime]

Well.  Even if its not consistent, I'd try the salt before bed for a while and see if you can get more mornings better than not, just in case it still helps a bit overall.  Make sure BP isn't going too high or anything.

In regards to electrolytes, mine have always tested normal too but I do think I tend to feel better now that I drink an electrolyte drink more often (used to just drink water or water+salt).  Then again, stuff just changes all the time for me mysteriously so I never really know what is behind it... though I keep hunting.

[Weney3777]

Yes. Both my EP and my GP have tested those. I see my GP on the 2nd and I'll ask him again to look at the results. It has only been about 6 weeks since they were tested. I want to see the results for myself. They both said the levels were fine. I actually suggested the potassium and electrolyte tests myself. I even suggested a hormone test. The doctor says he tested all of them.

[Heiferly]

This is probably a ridiculous question because we've all had 9 million blood tests, but they've tested your electrolytes, right?  Your potassium level is normal?

[Weney3777]

I tested my glucose this morning, and it was 98. Don't think there's a problem there. But this morning all my symptoms were back with a vengence. Even had a salty snack before bed. Maybe I just happened to have 2 good days in a row. It happens. Forgot how bad I feel in the mornings for a minute. It was nice. My stomache hurts(went to gastro.), my chest hurts(even though tachy is under control now), and my body(mostly legs) ache like crazy. Took midodrine and had a cup of coffee. Feeling minutely better now. Do symptoms like this happen to anyone else in the morning? Ugh!

[Weney3777]

Thanks for the site, but my husband is a diabetic. I have 2 or 3 glucose monitors at my disposal at ant given time. I will definitely check mine in the morning and let you guys know how it looks. Also, I had the salty snack again before bed, and I woke up feeling great! It is 6pm here now and I am feeling very, very fatigued now(could be because I haven't taken Midodrine for 6 hours). I'm trying to follow the doctor's orders on that until I see him on Thursday. I think I might cheat and take one. One can only drink so much coffee without getting dehydrated.

[halbashes]

At one point I had tried Ritalin every four hours, and through the night to achieve the same effect.  Yikes!  Luckily, Pyridostimine can work through the night as well.  :)

[halbashes]

I too always try to keep snacks, and drinks by my bedside.  I keep my morning medications by my bed as well, and take them about a half hour before attempting to stand.  (Of course, there are some days when I don't quite follow that process exactly, but I will usually regret it.)  I usually keep a blood glucose monitor, and a juice pack by my bed as well.

Here is one example of an inexpensive blood glucose monitor:
http://walgreens.com/store/catalog/Diabetic-Supplies/TRUEtrack-Blood-Glucose-Monitoring-System/ID=prod4199473&navCount=0&navAction=push-product

[Heiferly]

Alright, since AireScottie broke the code of silence I'll admit it too.  :-p  My docs knowingly have me on a 24-hour dosing schedule of Midodrine, every 6 hours including overnight.  I also wake up in the middle of the night to take a dose.  Again, it's against the manufacturer warnings regarding supine hypertension, so it's definitely not for everyone.  I guess that's why I'm always reluctant to mention it because, like AireScottie said some docs will flip their lids over it.  I'm not sure how I lucked into having docs that would okay me doing this, or what the best approach to asking your own doc about this without causing WWIII would be.  :-p

[AireScottie]

I also got a glucose meter and tested, and mine actually is low at times, even though I have absolutely no signs of diabetes whatsoever, so that's not a bad idea.  I wasn't aware other people have this problem.

If the midodrine helps, you might consider taking it through the night.  I know this causes doctors to have hairy conniptions, but it's what I do.  My BP drops drastically when I don't move around, and it's even worse when I relax to sleep.  Now, some people have trouble with their BP going up when they lie down, so it's not a good idea for everyone.  Yes, it means I have to interrupt my sleep to take meds, but I don't feel like death warmed over when I wake up in the morning.

[supineallthetime]

Very glad you have found something that helps (the salt loading).  Just for fun (if you are the "gadget type") you might do some sampling of glucose levels too.  Since I wake up "tremulous" I decided to screen myself for hypoglycemia so I did this for a while.  Sadly, the darn test strips are so expensive but at least you can usually find a glucose meter on sale (or even free) every now and then!  It's like those ink jet printers and their cartridges.  But anyway, also make sure your glucose isn't crazy low first thing in the AM.  It is probably not the case (was not the case for me either), but is safe and easy to check.  This is not strictly speaking a "hypoglycemia test", but it would just be a spot check sort of thing at a moment you typically have symptoms.  BTW, POTS people have a statistically increased incidence of reactive hypoglycemia (or sensitivity to glucose fluxuations) even if they don't have increase measured fluxuations (or so I have read).

[supineallthetime]

I think you're well informed.  If you know you are having a fall in BP when standing... then that is the likely suspect for an associated tachycardia.  Also, if you find that maximizing blood volume, using support hose, etc. keeps your BP more stable and the HR ends up more stable at the same time, you are confirming that presumption.  In other words, you are confirming that the heart rate rise was an attempted compensation for the BP fall.

However, this is not universally the case!  Some people have stable or rising BP upon standing AND tachycardia so there are other possibilities (like hyper-adrenergic state... or my favorite explanation... a messed up autonomic response :)

[Weney3777]

I will definitely try the 'bedside' snacks and electrolytes. I also like the 'coffee on the nightstand' ritual, but when I first get up is when my tachycardia hits, usually. Don't get me wrong, I definitely drink coffee, but I wait at least half an hour after waking before I drink it. I have it under control by the Lopressor(beta-blocker), but I wonder if taking my Midodrine before getting out of bed might prevent tachy in the first place? Doesn't that occur because of low BP? Or am I misinformed?

[Heiferly]

Oh, I should add that tweaking med schedules can help too.  Obviously you need to work with your doctor to find the best dosing schedule for you.

For example, some people take their morning doses of meds (esp. Midodrine) and let those kick in before they get out of bed, so they're not trying to function without meds on board.  Some meds can be done on a 24-hour dosing schedule so you eliminate this morning issue of waiting on meds to start working.

[Heiferly]

Overnight/morning survival methods vary from person to person.  I've heard some people keep their coffee maker on their nightstand so that they can brew that morning pot of coffee and have their first cup (to boost BP) without even stepping foot out of bed.  Others have their first bottle of Powerade/Gatorade before emerging from bed.  

If the salty snack at night helped, you may want to start keeping salty snacks and electrolyte drinks at your bedside so you can hit them before bed, in the morning before you get out of bed, and even in the middle of the night if you happen to wake up.  All of that can help counteract the dehydration that happens while you sleep.

[supineallthetime]

Certainly could be.  Some people apparently have dips in BP that trigger disturbed sleep too (just like with apnea and similar stuff, even hypoglycemia, the body "panics" to try to restore basic functions).  If something along those lines is going on for you, addressing it can make a big difference, not just each morning but cumulatively as your body is able to rest better for days or weeks.  Let us know if this pattern keeps up for you.