Low sodium level causes symptoms
DEAR DR. DONOHUE: What can you tell me about a low sodium level? My visiting friend (from England) was refused embarkation on his cruise because he was acting belligerent and confused. The ship’s doctor sent him to a hospital. He had scans, an EEG and numerous blood and urine tests. Everything was normal except he had low sodium. His insurance carrier sent a doctor from England to accompany him on a flight back to London. He has since seen his own doctor. His sodium level has risen. What happened to him? — B.L.
ANSWER: Sodium has many functions. It keeps body fluids at the right level. It maintains blood pressure. It’s essential for muscle contractions. It participates in generating the heartbeat. It carries a positive electric charge, so it balances the negatively charged body substances.
A drop in blood sodium leads to fatigue, nausea and weakness. If the level dips farther, people become confused and dizzy. At very low levels, they could have a seizure and lapse into a coma.
Your friend’s doctor has the task of finding out why your friend’s sodium level fell. In quite a few instances, it comes about from an inappropriate release of a body hormone called ADH, antidiuretic hormone. This hormone stops kidney urine production. The result is too much water in the body. The extra water dilutes sodium and produces a low reading. Liver diseases, troubles with the adrenal glands and a sluggish thyroid gland are other causes for a lowering of blood sodium.
Restoring the body’s sodium content is not too difficult. Tracking the reason why it dropped is.
Has your friend’s mental function normalized now that his sodium level has returned to normal? If it has not, then his doctor has to look for explanations of his erratic behavior that have nothing to do with his sodium.
The booklet on sodium and potassium explains why these minerals are so important and what happens when they are out of kilter. Readers can order a copy by writing: Dr. Donohue — No 202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I had a foot reconstruction operation some months ago. The foot doctor said I had to be off Celebrex until the foot completely healed. I had been on it for several years. I have osteoporosis and rheumatoid arthritis. Since being off Celebrex for four months, I don’t have any more pain or stiffness than I did while I was taking it. Do I really need it? — V.M.
ANSWER: If a medicine isn’t doing anything for you, why take it? You’ve taken Celebrex for several years and now you’ve been off it for four months with no worsening of your symptoms. I’d say you made a strong case for not continuing it. Many, many other rheumatoid arthritis medicines are on the market. It’s time for a change, or perhaps for a medicine rest if your doctor agrees.
DEAR DR. DONOHUE: I am 90 years old. About three years ago I developed foot drop. A neurologist diagnosed the condition. My general health is good, considering my age. This foot drop has become debilitating. Is there anything I can do to take care of it? — M.S.
ANSWER: Foot drop isn’t really a diagnosis. It’s an observation of what’s happened to your foot. You cannot raise the front part of your foot off the ground when you take a step. The drooping foot makes it hard to walk. You have to lift the leg very high so the foot clears the ground. Finding out what made the foot drop is going to be your diagnosis.
Nerve damage, back problems, stroke, diabetes and muscle illnesses are some of the causes of foot drop, and they are the actual diagnosis. Many times, the problem is nerve malfunction. Quite often, health cannot be restored to the nerve, but things can be done. One of those things is a lightweight brace that keeps the foot from flopping downward when you take a step.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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