Great thread guys...
 

I have seen multiple cases of hyponatremia as well as "water intoxication" - the condition preceding true hyponatremia. It is interesting to ibserve to say the least.

The gatorade question brings up an interesting point as well...salt sontent in full strength gatorade is high enough to actually PULL water from your surrounding tissues in order to process the drink through your gut. You trade short term loss of fluids for processing of the electrolyte compounds in the "sports drink" This is a fine and accepted practice for actvity of short duration. Over long periods however (> 4 hours) this creates and imbalance of it's own...it has required more fluid to process than has been able to be replaced.
Current sports medicine recommendations include alternating bottles of HoH and sports drinks if more than 4 bottle of ANY fluid are anticipated to be consumed.
The alternative is to cut the sports drink by 1/3 to 1/2 with HoH producing a mixture that is less concentrated, thereby allowing your pbody to absorb some of the HoH while still processing small amounts of electrolyte.

Agree 100% with TR's observations, Doc Keaton would be proud Sir!

Eagle

QRQ,
Been reading Gabe Suarez?:munchin

"It is interesting to observe to say the least."

Well, it's even more interesting to go through it! Especially after they put Lasix in the IV. It's rather humiliating to have someone measure the amount you pee. "Let's see, that was 800cc, good job, only a couple thousand more to go!" Meanwhile, the whole time, I'm zoned out on some anti-nausea drug and just desperately want to be left alone to die........

Here is an excellent link to a case study of a soldier: http://www.physsportsmed.com/issues/...9_00/flinn.htm





Here is a description from a website:

Overhydration is disruptive to nerve cell function and can produce symptoms of lightheadedness or mild vertigo. Severe overhydration is known as water intoxication. It produces neurological symptoms ranging from disoriented behavior to convulsions, coma, and death. This increase in intracellular water concentration can also result in a decrease in hydrostatic pressure. As the pressure drops, water moves out of the plasma, causing a loss of blood volume in the body and this can lead to circulatory shock.

Overhydration and water intoxication can be avoided with careful monitoring of fluid intake when sweating heavily or when ill with diarrhea or vomiting. Under these conditions, drinking plain water will not restore sodium loss nor will it adequately rehydrate the body. Simply adding a little bit of salt to water, to fruit juice, or vegetable juice can help the body to restore the lost sodium. Sport drinks contain sodium to help athletes to quickly restore sodium loss. Additionally, when vomiting and diarrhea are present, sport drinks can help to restore sodium and other electrolytes that are quickly lost during these types of illnesses.

Better red (in the face) than dead. P' if that's the most humiliating thing a medic ever does to you, you ain't hangin' with the right medics....:D

HEY! I trained him first!

none of your labs are all that abnormal...I am actually surprised you were symptomatic...but all labs have mildly different ranges for normal. The low end of Na is typically about 135....

doc t

[x

I don't know anything about blood levels, etc. All I can tell you is that I drank no less than 3 camelbaks full of water that day and pee'd once. When the clinic did the bloodwork, they seemed all worried, called an ambulance and sent me to the ER. When I got to the ER, they gave me another IV with Lasix (sp), which started me urinating every few minutes for 3 hours. Then they made me drink a thing of potassium prior to releasing me, with orders to continue more potassium.

I've never felt worse in my life.

x

I didnt think the labs were significant either. The Na wasnt critical, the glucose was wnl as was the Ca, but the K was a little low. Were I work we replace potassium as it can cause dysrhythmia.

Perhaps he might need a supplement or better yet eat foods rich in K once in awhile-

ccrn

ccrn,
The patient in question, P36, is a female.:D

Doooohh!

Been waiting for that shoe to drop.

Just shows why it is hard to practice medicine on the internet.

TR

I failed to pick up on that during my H&P sir-

ccrn

That would be Ma'am, in case you missed the previous.

TR

TR, I think ccrn was talking to NDD... or was that a shot at NDD from his boss! LOL

Aahhhh.... that makes more sense to me P36. YOur original post made it sound to me like you had drank 100oz over several hours of exercise in a desert- which would not be overhydration. I missed that part about refilling at the Ranger station-just thought you put salts in it. Even then, it is surprising to find the symptoms you were having.

THat is why I wondered about your pre-exercise regimen. NOw, I am more clear on what happened. I knew there had to be more to the story than what I interpreted from your first post.

CCRN-
WTH? ;) She went on a "jaunt" instead of describing it some other way, she said pee instead of piss... OBVIOUSLY she is a female and not a crude male. LOL situational awareness..HAHA

Correct sir.



One can never be too sure these days sir.


ccrn