INSOMNIACS place to talk in the wee hours

We all know I'm crazy and I love you all for accepting that, I wrote this to another member on a different thread today, But you each may benefit.

member name deleted, maybe this will help your study. Most of the bodies systems(7) have a "negative feedback mechanism" That allows the system to check if it's working.  Say the control is A. A sends a message to BCD to do something. EFG senses whether BCD are doing their job. E, F, G all sense something different. They independently send messages back to A. A decides what to do. If B,C, or D aren't performing right A sends out another message. A >>>BCD>>>EFG>>>A>>>BCD>>>EFG>>>A>>>etc.  It all happens rapidly and continuously. Until something interferes.

"blood vessel dilation which leads to collapse of blood pressure...." " the vasodilation causes all the blood to pool to the extremeties "  First a description of the vascular circuit>>>heart>>Aorta(artery, slang Big Red) >>branching arteries>>arteriole>>capillary>>venule>>vien>>Vena Cava(vein, big Blue)>>Right heart>then lung circuit>then left heart.

The arteriole is responsible for constricting or relaxing which will increase or decrease  the pressure. Analogous to a garden hose with thingy on the end that you turn to change flow. Lol can't think of word.  When the arteriole doesn't work right then pressure changes can cause problems. If it constricts without responding to A's messages to relax, it results in too much tension in the line. i.e hypertension. Conversely, if the arteriole relaxes too much, there's too little tension in the line i.e. hypotension

In the case of the vascular system ---hypertension= high blood pressure, hypotension= low blood pressure. The arteriole is responsible for the changes. The ANS is responsible for changing the tension on the arteriole.

There is a pressure gradient in the vascular circuit. The arterial pressure is higher then the venus pressure. If the arteriole malfunctions and dilates the pressure within the capillary changes. This allows leakage of fluid from the capillary into the space outside the capillary. This fluid can flood the space outside the vascular circuit.  This happens in certain conditions i.e ANS dysfunction; Septic shock; Drugs that are meant to lower BP, but are working beyond what they are meant to do, infection, immune response

 If the pressure in the venus side changes by becoming to high, then it can reverse the flow by changing the pressure in the capillary . The capillary can't withstand the pressure and the fluid floods out into the space outside the vascular system.

Increased capillary permeability is the official wording. Causes>>changes in either pressure gradient from the arterial side or venous side. Changes caused by drugs. Changes caused by chemicals either internal, or external.

Flooding from the capillary can occur b/c of two different reasons. Either the arteriole failed/changed, or the venous system pressure was too great and back flowed.

Work to understand why the arteriole fails

What drugs are you on.

When edema occurs in the lower  extrmeties or anywhere, it creates a logjam. When the logjam occurs nothing flows right. Other structures are compressed because there too much pressure on them from the extra fluid.

A river logjam is an excellent analogy. Logs pile up the river stops flowing. The river banks overflow. What is around the river is covered. Say there was a pumping station that usually filtered the water from the river to be taken and cleaned to be dumped back into the river. The pumping station can't work right. It no longer is filtering the water from the river.

The logjam creates the flooded area, the pumping station can't get the gunk out of the water. It all is a mess. All this stuff just stagnates. Things start to grow.  The growing stuff affects the things around it.

The bodies usual protective mechanism is the lowly lymph system. The reason I say lowly lymph system is people in general don't know about the lymph system. The high and mighty nervous and cardiovascular system, even grade schooler's can talk about. But the lowly lymph system is ignored until something goes wrong.

The lymph system is analogous to the filtering pump station in the logjam example. The lymph system filters i.e. cleans the area around the cells, picks up the garbage thrown out by the cells, moves it to the transport system i.e. lymph network. The lymph fluid is taken to the lymph nodes which further cleans up the garbage. The fluid then continues from the lymph node and is transported to the thoracic duct where it's dumped back into the vascular system.

With edema, the lymph pathways can be compressed. It can't pick up the waste products that the cells throw out, and carry these waste products away. Those waste products can cause multiple problems, infection-cellulitus, rash associated with bodies immune response to stuff that's irritating cells.--release of histamine which causes an itch.

This is an area to study. --"what is the bodies response when edema occurs". Hope some of this helps

I am such  a biatch, this is a post on 2D6, a repost from what I wrote on the ASCO site. _Oh such a troublemaker, but I do love Paintball therapy

May  3, 2014 12:55AM, edited  May  3, 2014 01:47AM    by sas-schatzi

Just posted the following on the ASCO thread announcing new guidelines . I will bring the link to the topic back here

http://www.cancernetwork.com/survivorship/asco-gui...

If you are going to recommend a drug such as Duloxetine, then you are obligated to make sure the patients body can metabolize it. Duloxetine is primarily metabolized by CYP2D6 and CYP1A2.. You have not been known to support CYP testing in the past. Yet, you support targeted therapy or targeted molecular therapy for use and development of cancer therapies.

Why you don't support the one, and support the other is a mystery.

I coined the phrase many years ago Paintball Drug Therapy and Paintball therapy. It is the antithesis of Targeted Drug Therapy or Targeted therapy

Providing the NCI definition of Targeted therapy first, and then defining Paintball therapy

The term Targeted  therapy which is defined by NCI  as: A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells with less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins, or other molecules involved in the growth and spread of cancer cells.

Conversely, Paintball therapy is a type of treatment that uses drugs or other substances that are given as a general treatment without knowing if a patients individual genetic metabolism can allow the treatment to be successful i.e when a paintball is thrown how it splatters is unknown. A portion of the paintball may hit it's target, thus effective by chance. The splatter of the paintball is unknown. The effects, thus, may be harmful ranging from mild to major. Also, the Paintball approach to therapies may entirely miss the target or be substantially limited because the ability to metabolize is absent or limited.

How can you justify the support of targeted therapy for some drugs and use the paintball approach for other drugs.

If Paintball therapy  or Paintball drug therapy enters the lexicon. I certainly would like to be credited with it's origin. 

Blessings what you accomplished today, puts me in bed. The problem may be another doc appointment tomorrow. I've reached the stage --PCP (by aletter written by me)---define blood work needed for next year with cpt codes, define need for scans with cpt codes. Nothing will be done outside these parameters per patients requests.

DBF awake Maybe BBL

sorry folks too much di sarrno