[OldDragon (OP)]

Okay, I'm new here, and at the suggestion of an existing member.

As the title says, and within reason according to my circumstances, I'm willing to offer my living body as a subject for serious medical research in areas that may help me achieve some benefit/s whilst still around to enjoy it/them, and to further research and understanding of particular conditions whilst I'm able to give verbal feedback.

I have quite a complex medical history that includes spinal damage; fibromyalgia and recently diagnosed breast cancer - oh, and I need to lose around 4 stones to aid mobility but without that impacting on pending chemotherapy (following lumpectomy and full lymph node axillary clearance) and fibro associated IBS sensitivities.

My background is psychology related and I write.

Open to genuine suggestions and discussion.


[MOD - Subject heading altered to make it a question, in line with the forum style - CS]

[RD]

So you want to be a guinea-pig?.

You could volunteer to participate in a drug-trial to test a new treatment for an illness you have...
http://www.entertrials.co.uk/clinical-trials-home
Testing new medicines is not a risk-free exercise.

[OldDragon (OP)]

That's probably not an option open to me at this present time - chemo pending, and all that. Not really what I had in mind, either.

It could be that elements of my case history tie in with research already being undertaken? Spinal trauma links with fibro and/or drug sensitivities, for example, or perhaps someone is looking into the options for fulfilling the dietary needs of those with compromised mobility that precludes a healthy exercise regime?

With an immune system already compromised by FM, possibly feedback on the effects of undergoing chemo as that might relate to fibro might be of interest to someone?

All I am doing is offering an opportunity that might be of use to someone in the medical science research field, is probably unique, could benefit others and, if it's workable, a willingness to assist them with feedback.

I've been hospitalised twice during the past month and undergone two surgical procedures. During that time I had to cease taking anti-inflammatory medication because of the risk of excessive bleeding during surgery, and the knock on effect of that, possibly coupled with the surgery, on my spinal damage has been severe, and includes crippling muscle spasms and pain that did not respond to any analgesics prescribed, and only minimally to muscle relaxing medication at the prescribed doses. My biological time clock appears to have taken on a mind of its own, and insomnia a whole new meaning known only to itself. I've no idea what my natural brain chemicals are doing - gymnastic exercises off the tops of electricity pylons for all I know, amd judging by the sensations akin to bouncing a cattle prod around and between my shoulder blades. (And they have me on corticosteriods in an attempt to settle that down at the moment - something that's been resorted to successfully in the past.

Before anyone makes any assumptions - no, I'm not further frying my brain with worry or anxiety over the cancer. If I could lie down for long enough to fall asleep before the next electrical spasm strikes, I assure you I'd sleep like the snoring dog without a care in the world and currently taking advantage of the chance to keep the sofa warm for me!  Fact is, I've not been able to sleep in a bed - other that the hospital one that helped kick this whole performance off over a month ago - in over 12 years. Sometimes I've gone for weeks without sleep, just a few minutes dozing here and there between the spasms.

I am not afraid of death and I'm not afraid to talk about it. Like I said before, my background's psychology related, and if anyone wants to ask questions, and for the right reasons, feel free. I retain the right to withold an answer, but generally prefer to shoot straight from the hip and as honestly as my level of self-awareness and understanding allows.

The fellow who introduced me to this forum said you probably wouldn't know what to make of me. You are not alone! My doc's at a loss too. I gather I'm to have an MRI and bone scan at some point in the near future. Perhaps... just perhaps, there might be some clues there?

[RD]

Hi OldDragon,
I am not suggesting that you stop taking corticosteroid treatment, however this medication may explain your "fried brain" and insomnia symptoms...

The steroid psychoses we saw presented as a spectrum psychosis with symptoms ranging from affective through schizophreniform to those of organic brain syndrome. No characteristic stable presentation was observed in these 14 patients, but the most prominent symptom constellation to appear during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy and hypomania

Since our study, several other critical reviews of the literature and new studies have become available. This newer literature provides longitudinal insight into the nature of steroid induced mental change. The incidence of steroid psychosis varies widely in the literature ranging from 13 to 62%, with a weighted average of 27.6% for some steroid induced mental change, the vast majority of which are mild to moderate and do not herald the development of a full-blown psychosis or affective syndrome. The incidence of a severe psychiatric syndrome in the more than 2,500 patients reported in the literature ranges from 1.6 to 50% with a weighted average of 5.7%.

http://www.drrichardhall.com/steroid.htm

TABLE 2
Adverse Effects of Steroid Therapy and Cautions.
Neuropsychiatric:
Headache, vertigo, seizures, increased motor activity, insomnia, mood changes, psychosis.
Use with caution in patients with convulsive or psychiatric disorders. Use may aggravate preexisting psychiatric conditions. Steroid-induced psychosis is dose-related, occurs within 15 to 30 days of therapy and is treatable if steroid therapy must be continued.

http://www.aafp.org/afp/980800ap/zoorob.html

[OldDragon (OP)]

Thanks for that, although the symptoms described by me were present prior to the introduction of a short, 6 day course of Prednisilone 5g gasrto resistant three days ago and and at a dosage of 6 6 6 3 3 3 per day. This in an attempt to reduce swelling and inflammation between my shoulder blades. I've had to resort to this on two previous occasions, and when it has proven successful. The last time was in 2003 and at exactly the same dosage.

At this present time, I don't feel as if my brain is 'fried' - although it was heading that way prior to commencing the Prednisilone course, and after having had the anti-inflammatory medication withdrawn. In my case, that was simply a minimal dose of common aspirin taken only as required as a maintenance dose, due to experiencing undesired side effects when prescribed such as Diclafenic, Mobic, Ibroprofen and their ilk. Heck, I've enough to contend with without extra side-effect symptoms! Lol

Assess for yourselves, if interested, the state of my mental capacity to function rationally. Warn me, please, if you can identify anything I'm failing to register. Three days ago I knew I was not far away from verbally removing the head of the next idiot to cross my path. Well, if they lead with the chin...

[RD]

If your cognitive problems preexisted the corticosteroid treatment then they could be the "brain fog" associated
with fibromyalgia, a.k.a "fibro fog"...
http://en.wikipedia.org/wiki/Fibromyalgia

[OldDragon (OP)]

Oh, I am very familiar with the Fibro-fogged brain and cognitive impairment, but am not aware of having such affectng me at the present time - although perhaps you have spotted something in what I've posted above and that I've failed to recognise? It can happen. Feel free to point it out if so. I appreciate honesty and directness. Thanks.

[OldDragon (OP)]

(Strange... Did I imagine a post from you above this, D? No, surely you deleted it?)

Okay, thanks - but seriously, RD, if you (or anyone else) should spot something that indicates it, please warn me. That way I am in with a chance to address it as early as possible.

I'll be logging off shortly - helper arrives at 8am, district nurse soon after to attend to the drain that I still have in situ from the ANC op last week. The former is sure to 'tell' me I 'should' have got some sleep last night. Bless her, she means well, but I doubt could walk a few yards in my shoes, let alone a mile. Lol (Who the devil would want to?)

 

[RD]

Just a couple of thoughts...

If you want to participate in research perhaps someone on a Fibromyalgia forum may be able to put you in touch with researchers.

Medications are available to prevent muscles going into spasm (spasticity),
these include Baclofen, Tegretol, Tizanidine, even Botox injections.
 
These treatments would only be available from a doctor.


http://www.scoopshare.com/Health/Fibromyalgia/Drg_Baclofen.cfm

Tizanidine
From Wikipedia, the free encyclopedia
Routes Oral, Intranasal, Injection
Tizanidine (brandnames Zanaflex, Sirdalud) is a drug which is used as a muscle relaxant. It is a centrally acting α-2 adrenergic agonist. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as multiple sclerosis, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system. It is also prescribed off-label as a sleep aid, seizure inhibitor, and for some symptoms of fibromyalgia.

http://en.wikipedia.org/wiki/Tizanidine

Some anticonvulsant drugs are effective in treating bipolar disorder, fibromyalgia...
The anticonvulsants are also known as anti-epileptics. They were designed -- and are approved by the Food and Drug Administration -- primarily to treat people who have various kinds of seizure disorders, including seizures or convulsions caused by epilepsy, strokes, and brain tumors. Several -- phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol,), ethotoin (Peganone), and valproic acid/divalproex (Depakene/Depakote) -- have been on the market since the 1950s. But a "second generation" of anticonvulsants was developed in the 1990s. These include gabapentin (Neurontin), lamotrigine (Lamictal), pregabalin (Lyrica) and topiramate (Topamax).

http://fibrotoday.blogspot.com/2007_09_01_archive.html
 

[OldDragon (OP)]

I've been prescribed Diazepam for the muscle spasms. First dose reasonably effective, second moderately so... third and guess what?

I get the same problem with many analgesics. My system seems to adjust rapidly to counter their effects, dosages are increased, and suddenly my system decides it's had enough of that, and rejects it... puting my back into a spasm in the process of retching. First time I tried Dihydrocodeine I got eight hours relief from pain and rode a horse for the first time in a year. Second tablet's effect lasted five hours... A couple of days later the doc doubled the dose and the system rejected the lot.

I am already a member of a fibro forum or two. Probably too complex a case history for them to touch, although some interested in any outcome from here, should anything materialise that could prove useful.

Personal logic applied to this, and these severe flare periods, has me concluding it is the inflammation kicking off, then applying pressure  to the nerve endings in the thoracic vertebrae that must trigger changes in the production of brain chemicals, so likely neurological. If I am able to manage the inflammation effectively, I have had quite long periods of relatively little pain or other symptoms.

[OldDragon (OP)]

Seems that so far no one wants to take up the offer, but in case someone does and it means anything at some future date, I am STILL awake! Nothing so far that I have tried to knock myself out with has worked and all I have left that is remotely likely to have any effect, and that I can safely take, are  the hayfever pills! (And I haven't even sneezed today, so perhaps there is a God after all? Lol)

This, by the way, is how I was several years ago and when the doctor I was then consulting told me to go away and learn to live with it. Only difference between then and now, apart from how much I have aged, is that then I didn't also have cancer. (And I am still trying to learn to live with it.)

One final laugh for you before I let the PC do an AV scan... I went to the front door for a breath of air and a neighbour stopped to tell me how well I was looking! LOL I must remember to steer well clear of them if I see them behind the wheel of their car! (Or perhaps they are lying through their eye teeth just to try and make me feel better?)

[OldDragon (OP)]

I don't know if any of this is of interest at all to anyone here, or could be in future, but for the record, I am still awake and in a sitting position. The action of attempting to lie down results in some type of nerve compression that brings on the sentation of an electric shock and muscle spasms that wake me up even more.

I still feel as if my head is rational and not fogged either by fibro or lack of sleep - I feel quite awake mentally, although aware that physically my body is in need of sleep. I have been told by ex-military pals that there are similarities between this apect and what is referred to as battle fatigue as experienced by front line troops fighting in a war zone. I'm not ex military, and have no medical qualifications.

I don't want to bore anyone here with this, or take up space if what I am doing or saying is inappropriate, or unlikely to strike any chords that could be useful to research or furthering knowledge into any of the condtions I have. All I can do is to tell it as it is from my perspective and hope.

If the moderators here feel I'm wasting their space and my time posting, I will not take offence if they say so. Neither will I take myself off feeling angry or rejected. As long as my head remains reasonably rational, or someone with the ability to recognise signs of deterioration in that respect and warns me, I am quite capable of dealing with my emotional needs and addressing those. Well versed, in that respect, in fact. Lol

Perhaps someone can answer one simple question?

Do you think it appropriate, or potentionally useful to medical science for me, as a talking guinea pig, to continue updating this thread?

[neilep]

Please do not be disheartened !

This is a most unusual offer/invitation you have made. You have also made it on the cusp of the weekend where things notoriously slow down......not just here but in all forums.

I just wanted to quickly post a ' wishing you well ' comment and to welcome you here....


It's possible that you might achieve quicker responses by contacting research institutes/teaching hospitals directly. I personally don;t have any contacts in this area but it's a suggestion nevertheless....

...though the main premise of my posting was just to offer a virtual hug and to say please do not be upset if an offer to accept your invitation fails to materialize here.

[OldDragon (OP)]

Thank you, Neilep - make it a gentle virtual hug though! Thanks to the muscle spasms, the ribs feel like are already broken.

To reassure you, I don't feel disheartened at all, or upset at the lack of response. Simply a little uncertain as to how others here might be reacting to my post. I am well aware that my style of telling things as they are can be intimidating to some, although felt that the science world could take me on the chin, and in the spirit meant. Post as I have here on a fibro forum, or even worse, speak it aloud at a meeting of a local CFS/ME/FM support group, and one starts to hear the knicker elastics snapping and folk looking for oxygen cylinders. I stear clear of the latter now and have done for years. I already have what they have, plus a bit more, and do not desire to dwell in the illness whilst sitting on the pity-pot - I am a looking for the recovery. Tea I've substituted for apple juice in the hope it can help detox my system after all the ineffective meds I've taken over the past hours of wakefullness. As for sympathy, to me it belongs in a dictionary and somewhere between sick and syphilis.

With the ongoing cancer treatments pending, there would be little point at this stage in contacting those research institutes or hospitals you suggest, but something to bear in mind for the future, perhaps? (Not that I can travel far, anyway.)

Before I go, I repeat... do you think it appropriate, or potentionally useful to medical science for me, as a talking guinea pig, to continue updating this thread?

[RD]

If I were you I’d try the medications which some people with fibromyalgia have found effective before I would volunteer to be a guinea-pig for an untried drug. The anti-spasticity medications I listed above are different from Valium (diazepam); you should not let your negative experience with previous medications put you off trying others to relieve your muscle spasms.

Forums created for individuals in similar circumstances may provide you with more feedback than this one.
If your views are too frank to be acceptable on those forums you could write your own uncensored blog.

Links which may be useful …

The Fibromyalgia Research Blog: The latest in Fibromyalgia research, news, and clinical trials.
http://fibroresearch.blogspot.com/search/label/clinical%20trials

National Fibromyalgia Research Association (USA)
 http://www.nfra.net/

Questions and Answers About Fibromyalgia
By National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
http://counsellingresource.com/distress/chronic/fibromyalgia/fibromyalgia-qa.html

More treatments for spasticity are listed here …
http://en.wikipedia.org/wiki/Spasticity

PS
Unfortunately this study is in the USA but may give you some ideas...

Cognitive Behavioral Insomnia Therapy for Individuals With Fibromyalgia

This study is currently recruiting participants.
Verified by National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

The purpose of this study is to evaluate the effectiveness of cognitive behavioral insomnia therapy in reducing sleep disturbances and improving other FM-related symptoms.

http://clinicaltrials.gov/ct/gui/show/NCT00321451;jsessionid=7CEC7FE003038B778468A7D78C80444C?order=21

[OldDragon (OP)]

Thanks, RD. I will certainly explore with my own GP (on leave at present) some of the options that you have suggested, and recent experiences indicate to me an urgent need to review my medication situation.

However, to clear any misunderstandings, I'm not looking at present towards volunteering myself as a guinea pig for drug trails. To me, knowing considerably more of my medical history than has been revealed here to date, that would be an act of lunacy!

Helping the medical profession to better understand the nature of the condition, or similar,  related conditions, the ups and downs, and effects on the daily life of someone with such, is an area that I may well be useful in. In fact, and to be fair to anyone reading this, I am being urged to attempt to do this by a number of other people. It is possible some may, in their own time, come forward here and reveal themselves. That will be up to them, but I have suggested they do so and as a result of private email correspondence that I've received.

One has mentioned the difference that one of the drugs that you mentioned has made to them, and we are exchanging an interesting dialogue, so even if there's not a great deal of feedback forthcoming, as yet, in this thread, some good is coming from it, which is encouraging.

Negative experiences with particular drugs won't put me off trying others, obviously with my doctor's approval and discussion. He freely admits (something I have great respect for him over) that he doesn't know how best to help me, or what to try next! Let's face it, it's not quite as straightforward as me asking for anti-biotics to treat a sinus infection or haemorrhoid ointment for piles. Lol

Regarding other forums and blogging, perhaps I should 'fess-up' a little more here - I do already write uncensored articles and blogs for specific groups or on other online forums. These pitched accordingly. I'm also one of a team of administrators for another website forum, albeit not science related, that does have a strong foundation dating back to psychological research carried out in the early 1970s.

I will certainly check out the links you have posted. Have those saved for when I am better placed to follow them up.

On a personal note, I finally managed to lie down without bringing on another series of spasms at 6 am this morning and slept until 8am when my helper called but she left me to sleep on through her activities until 10.30am.

Having attempted a bit of a detox last night using apple juice, and refrained from any caffeine intake, I had the anticipated withdrawal headache. Easily cured with a mug of tea.

When the district nurse came in to deal with the drain and dressings, I asked her to also check my BP and blood sugar levels. I am not diabetic, but after the severe FM/neurological pain, muscle spasms, perspiration loss, insomnia and minor vomitting of the last few days, suspected there was an imbalance. BP was 140/90 and blood sugar 4.9. Better than I expected, but I'm no doctor.

She questioned me and voiced concerns about my recent dietary intake - which I am aware wasn't ideal yesterday, consisting largely of fruit juice and raw veg/salad with a bit of cold quiche, and a beef sandwich. All at irregular times and snatched as and when able. Lol

At least I ate! During past flares of this intensity, that's not always been possible.

Today, I feel rational and am not aware of any fibro-fog; reasonably refreshed from the sleep achieved; but extremely sore and tender from the effects of the muscle spasms, and there is still some obvious spinal inflammation present in the C6 - T5 region. Ribcage feels as if I have done a few rounds in a boxing ring and as if wearing a tight corset! Lol

The only medication I have taken so far today is two x 300g soluable aspirins. Will be taking the penultimate Prednisilone corticosteroid dose of 3 x 5g tablets shortly. The key to recovery from this flare, TO ME, seems to be to deal with the inflammation and settle that down if possible.

NB: Just checked out this link, RD - http://clinicaltrials.gov/ct/gui/show/NCT00321451;jsessionid=7CEC7FE003038B778468A7D78C80444C?order=21 - will be interested to follow up on the results, although obviously don't qualify personally due to geographical location and other exclusion criteria.

Pity no studies are going on in the UK re. FM and the impact of surgery etc.

[neilep]

140/90 is what I think most doctors would say is just at the upper regions of normal....and I bet you that within 5 minutes it would have come down further. My BP is always up there too.....

Pomegranate juice is a wonderful detoxifier and green tea............drink green tea (with no milk)...it's wonderfully refreshing !!

Try to reduce your dairy products, drink semi-skimmed and cut down the red meat....eat little and often rather than just main meals....oily fish, red berries, green veg....and if you're going to drink juice...tray and drink freshly squeezed...and not from concentrate (Tropicana for instance)

...oh....and yes..........please do keep updating.

Hugs (gentle ones)


neil

[RD]

If you do try the medications I have mentioned and feel they are not having any effect, they should be tapered-off over a week or longer, (like steroids), not stopped suddenly as this can temporarily increase spasticity, (a temporary withdrawal effect).

Your GPs should be able to advise you on this matter; they should have a copy of the BNF, (as should your local library) ...

It includes the BNF details medicines prescribed in the UK, with special reference to their uses, cautions, contraindications, side-effects, dosage and relative costs. Updated in print every six months, the BNF reflects current best practice as well as legal and professional guidelines relating to the use of medicines.

http://www.drugguides.co.uk/index.asp?details=957509&t=9790853697763+%26ndash%3B+British+National+Formulary+55&gclid=CM3etfmS9JMCFQuJ1QodyShGWg

[OldDragon (OP)]

RD…

Thanks for that, although from experience, I have learned the hard way to thoroughly familiarise myself with as much information as possible, including contra-indications, before taking anything prescribed nowadays.

On several occasions, I have queried things with the pharmacist or referred back to my doctor to confirm something - and been proven right to have done so. A few times, I’ve had to return a prescription to the chemist’s untouched. My reasons ranging from  being unfamiliar with differences in generic and common names that, had I known them to be the same, could have alerted me at the time prescribed, to contra indications relating to medical conditions not yet mentioned here -  e.g. allergies and allergy related asthma.

Having only recently (and accidentally) discovered some minor errors and queries in the district nurses information folder left here - these relating to my current medications and a reference that IBS was not detailed on their computer records - I decided to query these things. It appears that, when medical records are transferred from the old paper folders onto the new computerised systems, the people employed to enter the data are not medically trained, and therefore unfamiliar with the terms and significance of some information. It may not be significant to omit a diagnosis of IBS (made about 14 or 15 years ago) from my medical notes, but to record on a friend’s notes ‘Can take penicillin’ instead of ‘CANNOT take penicillin’… and you will soon see my drift.

The doctor was well aware I’d had IBS for years, but confirmed there was no record of it or when they’d first diagnosed it. Between us we came up with an approximate time that coincided with the early diagnosis of CFS and sero negative poly-arthropathy. (Circa 1993/4)

I’d be most interested to see how many other errors and omissions there might be, and that I can recognise in my own medical notes following computerisation. That if only to help ensure I’m not accidentally medicated with something lethal to me a little sooner than I might choose… and assuming choice to become possible in the UK before I naturally turn the toes up or whatever. (Having already survived a few near death experiences – e.g. walked away from a motorway RTA at 80mph; a couple of fires; falling tree 5’ behind my car etc… I know only too well how these ‘whatever’ things can happen.)

Neil…

I think 5 minutes probably wouldn’t have made much difference at present, but perhaps a little further away from this flare and if I can follow some of your dietary suggestions, there’s certainly potential for improvement.

To show willing, I have managed to search the shelves of the local village store and acquired a litre of pomegranate smoothie, which includes blueberries and acai – all natural and no additives. That is described as a natural detox on the carton, but the only thing resembling what you describe. I was amazed to even find that locally.

I may need to be a little bit careful and try experimenting with the green tea. I’ve tried a few herbal teas and with mixed results. Unfortunately, I can’t recall the ones that proved anything but refreshing for me! Lol (I do recall a 60s party where the contents of dried herbal tea bags were being turned into spliffs though… Could this mean my memory is experiencing restoration?)

I already have semi-skimmed milk on a regular basis, even skimmed on occasions when semi-skimmed in out of stock.

Can up the red berries as they come into season and if I can beat the birds to them, also increase the green veg, but have to be careful with things like cabbage, sprouts etc., and the IBS.

Red meat is a failing of mine, but I do enjoy tuna, salmon, various white fish and other seafoods, and eat those regularly.

If anyone here IS looking to test healthy dietary things and needs a subject for a case study, and think I might be useful for this purpose, then I am more than willing to assist. I don’t even mind posting my (not so vital) statistics openly on this forum.  Lol  (Although think I’d prefer to avoid posting any ‘before’ and ‘after’ photos, and most others would probably prefer that too!)

Having already said I have a weight(y) problem to address, I don’t mind openly discussing that here, if anyone has any questions. No embarrassment on my part there. No worries about openly revealing my age, sex, height, weight etc. and dealing with emotions IS my main area of expertise, so I am quite at home on that front.

In about three weeks I’ll be seeing the oncologist and have a better idea of what my follow-up cancer treatments will involve. I am sure there will be people here who have far more knowledge of that that I have, but it would make sense to me to have a good, healthy eating plan prepared and in place prior to any chemo cycles commencing. Pre-op my weight was 196 lbs (14st). If the batteries hadn’t packed up in my scales I could give you an update on that now, but it will have to wait until Monday, when I can replace the batteries. Those scales will also detail the BMI and various other things, too, should anyone want those things, and explore my case further, as it relates to diet.
 

[Andrew K Fletcher]

Ok have read your posts and now have an understanding of what it is you are up against and if you feel like joining our study into varicose veins and pressure changes in blood pressure, you might find a lot more than may be obvious at first glance.

Have you had an epidural at any time?

Stay away from the pomegranate juice as it is a very powerful oestrogen loaded drink that will play havoc with your other problems.

IBT will give you the leverage to rapidly detox s it increases urine density markedly over flat bedrest and daily activity.

And with your psychology background you may be able to give an accurate description of changes, so please make a note of anything which we can reflect upon down the road to some significant recovery.

Please feel free to google "andrew K fletcher" and "inclined bed therapy" to learn a little more about myself and my research which I am sure you will find very interesting.

Thank you for your kind offer to monitor your varicose veins also as this will prove very useful in say 4 weeks from when you tilt your bed. I say bed because when the bed is tilted it will be far more beneficial than sleeping on the couch. The dogs will love it also If you could take discrete photographs of the veins you are monitoring so we can see a before and after it would prove very useful, if not don’t worry about it.


Kind regards Andrew


Andrew