Recovery line · BP correction · rev 7.8

Durable Day-Sheet · Telmisartan Restart

The everyday sheet from 7/9 through 7/31. Breakfast is cut, telmisartan is back, potassium is out. The 3 PM meal holds until ~Aug 1, when this collapses to canonical IF.

What changed from rev 7.7

Telmisartan restarts today. 40 mg at 6:30 AM through 7/15, then 80 mg from 7/16. The 7.7 sheet said "BP holding without it" — that was read off a filtered iHealth export. Apple Health held 39 readings, not 18, and the missing 21 were the high ones.
Potassium (K citrate) removed from all three meals. K was 4.6 unsupplemented. In a K-replete person a potassium load is natriuretic, and Na just reached 134 for the first time.
Breakfast cut. The 8:30 meal is gone as of 7/9 — the 6:30 protein bite is sufficient. Holy Basil Force #2 moves to noon, into the fat it needs.
Synapsa BID split restored. 160 mg at 6:15 AM + 160 mg at Meal 1 = 320 mg/day.
BP protocol is now a regimen slot, not a note. 5:55 AM triplicate (discard #1) + a 1:30 PM postprandial reading through 7/15.
Adderall is 60 mg, XR-only. The two IR 5 mg doses are shown held — confirm this is current before the sheet is trusted on it.
Truvaga moves to mid-August from 7/28 — after 80 mg settles. Morning fasted only, never postprandial.

The finding that drove this rev

Two blood pressures, not one. Fasted you run 138–152 / 68–80. Ninety minutes after a meal you run 115–128 / 50–62.

That is a >35 mmHg postprandial fall — postprandial hypotension, and in Type 3c it points at autonomic involvement. The low readings were meals. They were never the drug working.

Everything below is built on the full 39-reading Apple Health set (Jul 4–8). Session means, first reading discarded: 135 / 67. Full BP card →

What the eating day looks like now

6:30 AM protein bite (Creon + fed Adderall anchor) · Meal 1 at noon · folded Meal 2 at 3 PM · dinner 6:30 · dessert 8 PM.

~Aug 1 is the last gate. Pending a positive Wancata check-in and draw, the 3 PM meal stays where it is and the day becomes canonical 12 PM–8 PM IF. Nothing else moves.

Single-variable rule still holds: each staged addition gets its own clean day. If a day isn't clean — new nausea, cramping, stool change, lightheadedness on standing — nothing new starts.

Telmisartan

40 → 80

Adderall

60 mg

BP log

5:55 + 1:30

Omeprazole

→ 7/14

3 PM meal

→ 7/31

Cascade ahead — dated stages

~7/10 · ProBiota HistaminX — Meal 1. Gate opened by stent removal. Single-variable.

~7/11 · SPM Pro-Resolve — Dinner, fat-anchored. Fish oil stable ~1 wk.

~7/13 · MegaSporeBiotic — Dinner. Only after ProBiota tolerance.

7/16 · Telmisartan → 80 mg — unless a postprandial reading went below 100/55, or standing made you lightheaded. Then hold at 40.

~7/16 · R-ALA (OptimALA) — after the 7-day Berberine CGM window.

~7/21 · Bilberry · ~7/26 · Panax GS15-4 — each its own CGM window.

~7/19 · Lion's Mane / Erinamax · ~7/28 · Turkey Tail · ~8/5 · Cordyceps — the mushroom track. Protocol →

~mid-Aug · Truvaga Plus — moved from 7/28. Restart after 80 mg settles. One 2-min bilateral session, morning fasted, never after a meal.

NAC ramp runs alongside: 1,200/day → +500 per clean 7-day step → 4,800. Overnight 1,800 + Selenium 75 mcg lands last. Every addition stays ≥72 h from a NAC step — and the 7/16 telmisartan step counts as an addition.

Still open — none of it blocks this sheet

UACR (urine albumin:creatinine). Add it to the ~Aug 1 draw. Microalbuminuria means RAS blockade is indicated regardless of what the cuff says.

Orthostatic vitals. Supine, then 1 and 3 minutes standing. Postprandial hypotension plus Type 3c is a screenable pattern and nobody has looked.

24-hour ABPM. Would settle the dose question in a day instead of two weeks. Needs an order.

Med reconciliation. The chart at both Virginia Mason and Providence says telmisartan 80 mg daily. You were taking zero, at 149/74 fasted. It was a perioperative hold nobody reconciled — not a discontinuation. Portal message to Dr. Kuhlman documents the hold and the 7/9 restart.

Ferritin + iron saturation. Not drawn 7/7. It's the difference between letting Hgb rebuild and actively repleting — and iron is mucosally irritating into a healing duodenum.

PPI plan past 7/14. Sets the ulcer runway and the acid environment the probiotics land in. Rebound hypersecretion peaks in the two weeks after stopping.

These are a phone call, not a supplement question

Dark or tarry stool · visible blood · new dizziness · resting HR climbing · fever or rigors · any reading ≥180/120. Pause every addition and call the team. Clinical suspicion outweighs a normal WBC — your inflammatory markers run supplement-suppressed.