[tytd]

Hi Chirley, I admire your fortitude and courage. You have been through a lot. Autonomic hypotension can be very tricky to treat and the Florinef (fludrocortisone) and midodrine are usually tried to get the sitting or standing BP up but they can actually cause hypertension when you are lying down at night. The Florinef works by increasing the retention of salt by the kidneys. It also promotes excretion of potassium so your potassium can certainly get low while on it but that all depends on how your kidneys are functioning. It is not the same as Prednisone. It can cause weight gain, edema and congestive heart failure due to salt retention. Of course the trick is to get enough salt retention to elevate your upright BP without putting a volume load on your heart. I agree with others' suggestion to see a cardiologist or internist in order to rule out congestive heart failure on the Florinef if your GP is unwilling to check this out for you. Do they have any kind of home health system in Australia where a nurse could be sent out to check on you? Since you have a BP monitor, I would start keeping a record of your BP when you are lying down and then when you sit or stand up. Continue to monitor your weight everyday. Get your potassium, magnesium and BUN, creatinine checked. If your BP is high at night lying down, you can try sleeping in a semi-sitting position. I hope your doctors can do some tweaking of your meds and get this problem solved for you. Good luck