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Sunday, January 27, 2019

Dehydration is a Medical Emergency

I finally got home yesterday after being hospitalized for a couple of days. I began to get really ill last week and I could not stop vomiting. Finally, early Tuesday evening, the room started going black and I was going to pass out right away if I did not sit down. The room was spinning, even while I was sitting down. I thought maybe I was hypoglycemic because I experience the same symptoms when my blood sugar gets low and I had been unable to keep down anything for five days, including water. I went downstairs to my kitchen to eat a banana (at my husband's suggestion to coat my stomach). I grabbed the banana and then the room started going black again. I ran to try to make it to the kitchen chair and my knees gave out before I could reach it. I fell on my knees and landed on the stone kitchen floor with my jaw. To top it all off, I landed on the banana. It was like something out of a Monty Python movie. I passed out for a bit but when I came to, I managed to drag myself to my laptop (my phone did not charge because of a faulty cable - go figure) and called my husband. He took me to the hospital, mostly to make sure I did not fracture anything since I fell hard.




When we got there, my husband got me a wheelchair because every time I stood up, my vision started going black. Then, I went back to the triage nurse who took my blood pressure. She could not believe what she was seeing and took it twice more. My blood pressure was 74/41 (normal blood pressure is 120/80). They called me back right away and put me into a room. The lab tech came in and took seven vials of blood from my foot because I had no more veins. I kept passing in and out of consciousness. I came to as the doctor was talking to my husband. She told me that I was in acute renal failure (my kidneys were failing), my blood pressure was dangerously low, and that my potassium was dangerously low, so they were going to admit me. I was so scared. Usually when I go to the Emergency Room, they treat me like a drug addict. They may give me one bag of fluids, if I'm lucky, and then send me home. However, none of the Emergency Room doctors or staff treated me that way in the slightest.





Source: On Image





I was admitted onto the Internal Medicine floor and given medication through an IV to try and get the nausea and vomiting under control, and to get my kidneys to kick back in. Additionally, I received four IV bags of potassium and my potassium was STILL low! So, they just kept giving me more. I was in the hospital for three days. I finally got to go home Friday night and I'm so glad because I really wanted some much needed sleep and rest. It is so hard to rest in a hospital with people coming in to check your vitals, draw blood, give medications, and/or bring food in. I talk more about this in my video I recorded below, but it honestly just felt like a normal Gastroparesis Attack to me, and I just thought I was hypoglycemic. That wasn't the case at all, and it was a serious emergency. I hate to think of what might have happened if I had not gone. I could have died and I am still processing that. I talk about that more below.




Dehydration is VERY serious.






Source: Google Image







My personal Story From This Week



I do not know if a lot of places have these yet, but Atlanta has Hydration Stations. According to their website,

"Walk into Atlanta's Hydration Station on a Sunday morning and you'll find a dozen people in dimly lit rooms lying on recliner chairs with needles stuck in their arms.

Most of them are hungover from heavy drinking the night before. The needles are pumping sterile saltwater and a cocktail of vitamins and anti-nausea drugs into their veins.

The treatment costs upwards of $29 and it has become so popular in Atlanta that Hydration Station is opening a second location down the road just nine months after launching the first, according to CEO Keith McDermott.

McDermott describes the concept as a cross between a spa and a doctor's office. It attracts a mix of athletes and hungover partiers, depending on the time of week. On the weekends, about 75% of Hydration Station's clientele is hungover, McDermott said.

He wants the business to eventually cater more toward athletes, but he's not discouraging the traffic from partiers. Hydration Station is sponsoring a pub crawl this weekend and a New Year's Eve ball on Dec. 31.

Customers rave about the services on Yelp and Facebook and a number of them have been posting photos of themselves on social media hooked up to the IVs.

'Love this place!' someone wrote in a Yelp review on Oct. 21. 'Did a little bit too much drinking the night before and decided to come here... After I left here I felt instantly better — didn't even need so much as a nap throughout the day. I got the water IV and [vitamin] B12.'

Another reviewer wrote: 'After a long party weekend, Hydration Station hit the spot. I felt horrible until I got my IV. It was quick and easy.'

Luke Davis, an athlete and owner of the gym CrossFit Tucker in Tucker, Ga., told Business Insider that he has visited Hydration Station about 10 times since it opened 'and would be there a lot more if I didn't have such a crazy schedule.'

'It really helps with recovery after a really strenuous workout,' he said. 'We can recover so much faster and can train again the next day.'

Davis said he usually gets the $99 'Niagra Falls' package for his training purposes, even though it's advertised for people in 'deathbed territory' on the Hydration Station's website.

The package includes up to two liters of hydration (or two IV bags), a cocktail of Zofran (anti-nausea), Toradol (anti-inflammatory) and Pepcid (anti-heartburn), 30 minutes of oxygen, vitamin B12, and oral antioxidant and multi-vitamins to go.

Davis said he omits the anti-nausea medicine from his treatment because that's for people who are ill or have hangovers.

Dr. Robert Shesser, chairman of George Washington University's Department of Emergency Medicine, told Business Insider that the 'Niagra' is a perfectly safe concoction of drugs for someone with symptoms of a hangover or anyone suffering from dehydration after an athletic event.

'All of these medication are used quite frequently and their safety profile is excellent,' Shesser said. Hydrating someone who is suffering from over-intoxication is also a routine procedure, even though the science behind it 'isn't necessarily the strongest,' he said.

'The only scientific basis [for the treatment] is that alcohol is a diuretic so people who drink will have an increase in urinary output and theoretically become dehydrated,' he explained. 'But unless you are drinking shots of scotch in the middle of the desert,' you probably won't lose enough water to need an IV, he said.

'But if it makes people feel better, then great,' he added.

The most popular package at Hydration Station is the $29 'Baptism,' which includes one IV bag and 15 minutes of oxygen, according to McDermott. One IV bag is equivalent to drinking more than two gallons of water, he said.

The treatments, which typically last up to 45 minutes, are administered by paramedics who work for the Hydration Station part-time. The company employs about eight to 10 paramedics on a rotating basis at the Buckhead location.

To pass the time, customers have a choice of playing with Hydration Station's assortment of tablets or watching TV.






'People have a fear of needles and apprehension when coming in, especially if they haven't done it before, so we try and make them as relaxed as possible,' McDermott said.



It Started With A Wedding Hangover

Before launching Hydration Station, McDermott was the vice president of marketing and business development for Biomass Gas & Electric (BG&E). He came up with the idea for the Hydration Station several years ago after attending a wedding where many of the guests, including himself, had overindulged on the night of the rehearsal dinner.

'We were playing golf the next day and the groom told me that they had a nurse who was giving IVs to people to help them get over their hangovers,' McDermott said. 'It felt super' and guests were raving about it, he said.

Coincidentally, McDermott had experienced his first IV treatment 10 days earlier when he felt ill after several weeks of traveling for work.

After the wedding-day IV, it dawned on McDermott that the service could work as a business. A Google search told him that there's a similar service in Las Vegas that operates out of a bus. There's also one in Chicago called IVMe Hydration Clinic.

But there wasn't anything like it in Atlanta, aside from hospitals.

McDermott hired Dr. Thomas Roepke, a board-certified physician and friend of his, as medical director and opened the Hydration Station in Atlanta's Buckhead neighborhood in March. Roepke developed the company's range of treatments based on his own research and nearly 20 years of treating patients, according to the company website.

When designing the office, McDermott said he assumed people would prefer private rooms, but 'it has become the exact opposite.'


'People come in, they want to share stories about the last marathon they were in, or if they are here for a little over-indulgence, they like to talk about their night out,' he said.

Some people even make a date out of it, he added.

'They meet, go out on dates and stuff on Saturdays and then they come in Sunday morning,' he said. 'It's become a social thing.'

He describes the new office, which is being built five miles down the road in Atlanta's Brookhaven neighborhood, as 'sleek and spa-like.'

'It's going to be a cross between the W Hotel and an Apple store,' McDermott said."







Source: Flickr



According to Life Signs Blog,

"How Much Water Do You Need to Drink Every Day?

Did you know that you’re mostly made of water? If you’re an adult female, you’re about 55% water. Men are about 60% because they typically have more lean tissue (which contains more water) and women have more fatty tissue (which contains less water). Younger people have more (babies are born at about 78%) and older folks have less (about 50%).

Approximate percentages of water in various body parts:

Blood 92%
Lungs 83%
Muscles and kidneys 79%
Heart and brain 73%
Skin 64%
Bones 31%

Yes, even your bones are nearly one-third H2O. And yet two-thirds of us — nearly 70% — aren’t drinking enough water to keep our bodies functioning properly. It doesn’t take much to throw off the balance and become dehydrated. Don’t let something as simple as drinking enough water send you to the ER — it’s really not a story you’ll look forward to telling around the water cooler.





Source: On Image and Google Images





When does dehydration occur?

At just 1% dehydration, or when you’ve lost 1% of your body’s water, mental performance and physical coordination start to become impaired — and you’re not even thirsty yet


At 2-3% dehydration, you’ll feel thirsty and possibly some of these other symptoms:

Fatigue, lethargy, fuzzy thinking
Irritability
Dizziness
Headache
Dry mouth and skin
Muscle cramps
Rapid pulse (100 beats/minute or higher)
Fever and chills




Source: Google Images





Bryan Thibodeau, MD, ER medical director at Medical City Las Colinas, cautions parents to look for these signs of dehydration in infants and babies:

Sunken fontanelle (soft spot on the head)
Limp/inactive
Dry lips/tongue/mouth
Crying without tears
Pale or mottled skin


Dehydration can be very dangerous, especially for infants, children and older people. If someone you know shows signs of dehydration, seek immediate emergency medical treatment.




Source:https://articles.mercola.com/dehydration-symptoms.aspx




Why Our Bodies Need Water

Besides being the primary building block for all cells, water is vital to the health of every system in our bodies.

Among other important functions, water:

Regulates body temperature
Transports nutrients and waste materials
Aids digestion
Cushions the brain and spinal cord
Keeps eyes and mouths moist
Lubricates joints
Can prevent heartburn, constipation and kidney stones
Manages heartbeat, blood pressure and electrolyte (sodium) balance


Did you know water can also help prevent heart attacks? A study at Loma Linda University found that dehydration thickens the blood, making it harder for the heart to pump and increasing the risk of blood clots. Study participants who drank just 40 ounces of water a day cut their risk for heart attacks by 54% for men and 41% for women.








How Much Water is Enough?

The old advice to drink at least eight 8-ounce glasses of water a day is just that — a good starting point but outdated because it was never really accurate.


According to the Cleveland Clinic, there isn’t a one-size-fits-all recommendation for daily water intake. How much you need depends on:

How much you weigh (a larger person needs more water)
Your activity level
Your metabolism
Your geographic location (people who live in hot, dry climates need more water)
The weather
Your diet (how much water are you getting from the foods you eat?)
Your health (fever, vomiting, diarrhea and some medications and conditions can increase your water needs)


The Mayo Clinic suggests that if you drink enough water so that you’re rarely thirsty and your urine is colorless or light yellow, you’re probably doing fine. If you’re always thirsty and your urine is dark yellow with a strong odor, you need to get chugging. If you just don’t like water, try getting it in soups, smoothies and high-water content fruits and vegetables."




Source: Google Images






According to Dr. Mercola,

"Dehydration happens when you’ve lost too much water in your body without replacing it, which prevents your body to perform its normal functions

Infants and children are especially prone to dehydration since their bodies are composed of 70 percent and 65 percent water, respectively

Beverage companies claim that sports drink will help replenish the electrolytes in your body during exercise or outdoor activities, but the truth is the ingredients of your favorite sports drinks will not hydrate and benefit you, and may even be detrimental to your health

When you nourish your body with structured water, you are restoring your body to a balanced and whole state
By Dr. Mercola

Dehydration is not a simple health issue. Anyone can run out of liquids in their body due to various reasons, so it is important that you always hydrate yourself with water. Read on to learn more about symptoms of dehydration and how to prevent it.

What Is Dehydration?
Water makes up at least two-thirds of the human body. It plays a large part in your normal functions, such as lubricating your joints and eyes, keeping your skin healthy by eliminating toxins, and facilitating proper digestion. Once the water in your body is reduced, it needs to be replaced because an imbalance between the salts and sugar in your body can affect the way you will perform.1

If your body has lost one to two percent of its entire water content, you will feel thirsty, a sign that you need to replenish the lost liquids.

Dehydration happens when you've lost too much water in your body without replacing it, preventing your body to perform its normal functions. Mild dehydration can easily be treated but if it reaches extreme levels, it can be life-threatening and will require immediate medical attention.





Signs and Symptoms of Dehydration

Aside from the common symptoms like intense thirst or sweating too much, here are some of the mild and severe symptoms of dehydration:2

Mild to Moderate Dehydration
Severe Dehydration
Dry, sticky mouth Extreme thirst
Sleepiness or tiredness Irritability and confusion
Dry skin Sunken eyes
Headache Dry skin that doesn't bounce back when you pinch it
Constipation Low blood pressure
Dizziness or lightheadedness Rapid heartbeat
Few or no tears when crying Rapid breathing
Minimal urine No tears when crying
Dry, cool skin3 Fever
Muscle cramps Little or no urination, and any urine color that is darker than usual




Source: On Images and Google Images




In serious cases, delirium or unconsciousness.

Infants are more vulnerable to dehydration, that's why immediate attention must be given to them especially if you see these symptoms:

Sunken soft spot (fontanelle) on their head
Few or no tears when they cry
Dry mouth
Few wet diapers
Drowsiness
Fast breathing
Chronic dehydration may affect your organs and lead to kidney stones, cholesterol problems, constipation, and liver, joint, and muscle damage.

Whether it is mild, moderate, or severe dehydration, the lost liquids in your body must be immediately replaced. If you start to develop severe diarrhea with or without vomiting, fever, moderate diarrhea for 24 hours, bloody stool, or you can't drink any liquids, you must get professional treatment as soon as possible.




Source: On Image




What Causes Dehydration?

There are various reasons for dehydration like intense physical activity, which makes you lose so much water – fat and calories are counted as well – so proper hydration is necessary. Other causes of dehydration include:


Diarrhea. It prevents your intestinal tract from absorbing water from the foods that you eat, which makes it the most common cause of dehydration.
Vomiting. Common causes include foodborne illnesses, nausea, and alcohol poisoning.
Sweating. Vigorous sweating may happen due to various reasons like fever and engaging in intense physical activity. Profuse sweating can also occur when you are working in a hot condition.5
Diabetes. Aside from having high blood sugar levels, some medications for diabetes like diuretics may cause diabetics to frequently urinate.
Frequent urination. It can be cause by alcohol and certain drugs like antihistamines, blood pressure medications, and antipsychotics.





Source: HERE





Who Is at Risk of Dehydration?

While everyone is prone to dehydration, there are people who are at a high risk for it like those who engage in mountain climbing. It is especially hard for hikers to stay hydrated because the pressure in high altitude places makes them lose more sweat and breathe harder. The increased gas exchange causes your body to lose more water vapor.6

Athletes, particularly those who are involved in marathons, triathlons, and cycling tournaments, are also predisposed to dehydration. The longer they exercise, the more they lose water in their bodies.

One study even revealed that dehydration can affect basketball players' performance. The study focused on 17 males ranging from 17-28 years old, and determined their performance based on different dehydration levels of up to 4 percent. The result showed that when there's an increase in dehydration, skill performance decreases.

Infants and children are especially prone to dehydration since their bodies are composed of 70 percent and 65 percent water, respectively. Since their bodies are more vulnerable to water depletion, their need for water is greater than adults.

Elderly people are also at risk for dehydration since the thirst mechanism weakens as a person grows older. According to BBC News,8 research revealed that one in five seniors is not getting enough water every day, as aging causes people to lose their sense of thirst mainly because of minimal social contact or forgetfulness. Those with dementia were found to have a six-fold increased risk for dehydration.

Ill-stricken people, like those who are inflicted with kidney disease, diabetes, cystic fibrosis, and adrenal gland disorders, are also more prone to dehydration. Alcoholics may also be susceptible to this condition.





Source: HERE






How to Prevent Dehydration

Since dehydration can be a life-threatening condition, it is important that you replenish your body with water immediately after you've lost so much. Water plays such an immense role in your bodily functions, making it an essential part of your everyday life.

Always bring a bottle of water with you during exercise or any physical activity, especially when the temperature's too hot. One good rule of thumb to prevent dehydration is to drink as much water until your urine turns light yellow. Dark urine means that your kidney is retaining liquids in order for your body to perform its normal functions.

It is especially important to pay attention to people who are sick with fever, vomiting, or diarrhea, so they may not become dehydrated. They should be given lots of water to replace the liquids that they've lost.




Source: HERE





Drinking Sports Drinks Will Not Keep You Hydrated

Sports drink is one of the highly commercialized beverages today – from its TV advertisements to its popular athlete endorsers – as mainstream media makes it look like drinking it will keep you healthy and well-hydrated. Beverage companies advertise that sports drink will help replenish the electrolytes in your body during exercise or outdoor activities, but the truth is the ingredients of your favorite sports drinks will not hydrate and benefit you, and may even be detrimental to your health.

A typical sports drink contains high-fructose corn syrup (HFCS) and artificial sweeteners. It has two-thirds of the sugar content of soda, and is 30 times more erosive to your teeth than water. High-fructose corn syrup could cause negative health impacts like preventing the natural production of your body's human growth hormone (HGH). It also contributes to almost all chronic diseases like diabetes, cancer, and heart disease.





Source: HERE





Aside from sports drinks, there are also other sweetened beverages that you don't benefit much from, like sodas. These are also equally unhealthy for your health, as just a 20-ounce bottle of cola gives you 16 teaspoons of sugar through high-fructose corn syrup. Diet soda makes no difference either because a study revealed that diet soda drinkers have a 70 percent increase in waist size than those non-diet soda drinkers in a 10-year period.9

Commercial fruit juices are another sweetened drink that you must avoid because they do not have any hydrating properties and are actually loaded with sugar. For example, Minute Maid's 15.2 ounce bottle actually contains 49 grams of sugar.

What's more, most processed fruit juices are made with little resemblance of what an actual fresh fruit juice would be. Commercial fruit juices are pasteurized and their oxygen is removed to preserve them for a long time, making the juices less nutrient-dense. Store-bought fruit juices with an expiration date of 60 days or more is a sign that it is heavily processed, so I encourage you to boycott these kinds of beverages.




Source:HERE






Choose to Drink Living Water

I advise you to avoid drinking tap water at all costs as it contains fluoride, heavy metals, and disinfection byproducts that may have ill effects on your health. Install a water filter in your home to ensure that these harmful contaminants are strained.

If you want the best water for you and your family, I suggest drinking structured or "living" water, such as deep spring water. According to Dr. Gerald Pollack, one of the world's leading research scientists about the physics of water, structured water or EZ "exclusion zone" water is the same type of water found in your cells. It has a negative charge, and works just like a battery by holding and delivering energy.

Since distilled water is too acidic and alkaline water is too alkaline, only structured water contains the ideal PH range of 6.5 to 7.5. That's why I truly want you to nourish your body with structured water, as it can restore your body to a balanced and whole state.

I personally drink vortexed water since I became a fan of Viktor Schauberger, who did so much work about vortexing hundred years ago. By creating a vortex in your glass of water, you are putting much energy in it and increasing EZ as well.

Ideal EZ water can be found in glacial melt but since it is practically inaccessible for almost everyone, natural deep spring water is a good source. Just bring glass jugs and avoid plastic bottles since they contain bisphenol A, bisphenol B, and phthalates, which are harmful to your health.





Source: HERE





Other Natural Thirst-Quenchers for Preventing Dehydration

If you want to drink something flavorful than water, you can opt for raw, organic green juice made from fresh vegetables. However, I recommend refraining from drinking juice with too many fruits as it will have high amounts of sugar and calories. Go for a green juice recipe that combines one or two fruits and larger amounts of greens like spinach, celery, or kale. That way, you can minimize your sugar intake and still get all the nutrients from the fruits and vegetables in their purest forms.

I advise keeping your fructose consumption below 25 grams per day. If you have type 2 diabetes, insulin resistance, or heart disease, it is wise if you will minimize your total fructose to 15 grams daily.

Coconut water also serves as a great replacement for commercially sold sports drinks. It provides optimal health benefits due to its anti-inflammatory, amino acids, and antioxidants. A word of caution: coconut water also contains sugar, so you should drink it in moderation. Drink it preferably after a cardio workout, when you need to replace minerals and fluids.

The Key to Avoiding Dehydration: Listen to Your Body
No one can determine if you have dehydration better than yourself. If you feel that you are already thirsty or sweating profusely, you have to replenish your body with water immediately. Do not wait for severe symptoms to show before you take action, since this can be life threatening.

Everyone is practically at risk for dehydration, even without any physical activity, so it is important to always keep a bottle of filtered water to always keep you hydrated. Remember that a healthy person urinates seven to eight times each day, so if you're not urinating frequently it means that you're not drinking enough water.

Remember to always listen to your body. Once you feel that urge to drink, opt for structured or filtered water rather than artificially sweetened beverages, which can have dire effects on your health. Nothing feels more refreshing than cold water to replace the liquids that you've lost."




Source: HERE




According to The Stomach Flu Edition, here is a recipe on how to make homemade Pedialyte and foods that have hydration:


Source: HERE


Source:HERE




Until I was doing research on this, I had no idea that dehydration could cause back pain,





According to Science Alert,

"Here's What Happens to Your Body When You're Dehydrated
TOBY MüNDEL, THE CONVERSATION
5 FEB 2016

This article was written by Toby Mündel from Massey University, and was originally published by The Conversation.

Water is essential for human life. It accounts for for 50-70 percent of our body weight and is crucial for most bodily functions. Any deficit in normal body water – through dehydration, sickness, exercise or heat stress – can make us feel rotten. First we feel thirsty and fatigued, and may develop a mild headache. This eventually gives way to grumpiness, and mental and physical decline.

We continually lose water via our breath, urine, faeces and skin. Most healthy people regulate their body’s water level remarkably well via eating and drinking, and are guided by appetite and thirst. But this is more difficult for infants, the sick, the elderly, athletes, and those with strenuous physical occupations, especially in the heat.
What happens when you dehydrate?

By the time you feel thirsty your body is already dehydrated; our thirst mechanism lags behind our actual level of hydration.

Research shows that as little as 1 percent dehydration negatively affects your mood, attention, memory and motor coordination. Data in humans is lacking and contradictory, but it appears that brain tissue fluid decreases with dehydration, thus reducing brain volume and temporarily affecting cell function.

As you 'lose' body water without replacing it, your blood becomes more concentrated and, at a point, this triggers your kidneys to retain water. The result: you urinate less.

The thicker and more concentrated your blood becomes, the harder it is for your cardiovascular system to compensate by increasing heart rate to maintain blood pressure. When your dehydrated body is 'pushed' – such as when exercising or faced with heat stress – the risk of exhaustion or collapse increases. This can cause you to faint, for instance, when you stand up too quickly.

Less water also hampers the body’s attempts at regulating temperature, which can cause hyperthermia (a body temperature greatly above normal). At a cellular level, 'shrinkage' occurs as water is effectively borrowed to maintain other stores, such as the blood. The brain senses this and triggers an increased sensation of thirst.




How much should I drink?

Normal water needs range drastically due to a number of factors, such as body composition, metabolism, diet, climate and clothing.

Surprisingly, the first official recommendation about water intake was made as recently as 2004. According to the Institute of Medicine, the adequate water intake for adult men and women is 3.7 and 2.7 litres per day, respectively.

Around 80 percent of total daily water should be obtained from any beverage (including water, caffeinated drinks and alcohol!) and the remaining 20 percent from food.

But of course, this is just a rough guide. Here’s how to monitor your own hydration:

Track your body weight and stay within 1 percent of your normal baseline. You can work out your baseline by averaging your weight (just out of bed, before breakfast) on three consecutive mornings.

Monitor your urine. You should be urinating regularly (more than three to four times per day) and it should be a pale straw or light yellow colour without strong odour. If less frequent, darker colour or too pungent, then drink more fluids.

Be conscious about drinking enough fluids. Your fluid consumption should prevent the perception of thirst.

Toby Mündel, Senior Lecturer, School of Sport and Exercise, Massey University."




Source:HERE





According to The Encyclopedia Britannica,

"The symptoms of dehydration depend in part on the cause and in part on whether there is associated salt deprivation as well. When loss of water is disproportionately greater than loss of electrolytes (salt), the osmotic pressure of the extracellular fluids becomes higher than in the cells. Since water passes from a region of lower to a region of higher osmotic pressure, water flows out of the cells into the extracellular fluid, tending to lower its osmotic pressure and increase its volume toward normal. As a result of the flow of water out of the cells, they become dehydrated. This results in the thirst that always accompanies “pure” water depletion.

In those diseases in which there is loss of salt in excess of water loss, the decreased concentration of sodium in the extracellular fluid and in the blood serum results in decreased osmotic pressure, and water therefore enters the cells to equalize the osmotic pressure. Thus there is extracellular dehydration and intercellular hydration—and no thirst.

Water deprivation produces distinctive symptoms in humans. Weight loss, amounting to two to three pounds per day, occurs. Thirst is the most prominent symptom, with the dryness of mouth, decreased production of saliva, and impaired swallowing that accompany it. It is probable that thirst is the result of this subsequent intracellular dehydration and increased intracellular osmotic pressure. Experimentally, thirst can be produced when the cells have lost about 1 percent of their intracellular water.

As dehydration progresses, the tissues tend to shrink, the skin becomes dry and wrinkled, and the eyes become sunken and the eyeballs soft. Fever develops, possibly from mild to marked, as dehydration progresses. Dehydration itself probably affects the temperature regulatory centres in the brain. As dehydration and salt loss progress, however, the plasma volume and heart output decrease, with a consequent decrease in blood supply to the skin. Sweating decreases and may stop completely, and the main avenue for heat loss is closed. The body temperature may then rise precipitously.

There are marked changes in the volume of the extracellular and intracellular fluids, but the blood plasma volume changes the last and the least. The plasma volume is maintained more or less constant at the expense of the tissue fluids. If, however, the plasma volume does fall, the output of the heart also falls, and the pulse rate climbs, all of which indicates a dangerous physical state.

The renal (kidney) changes that occur in humans during prolonged water depletion similarly tend to maintain a normal balance. If water deprivation continues and the plasma volume falls, however, the output of urine will be drastically reduced. As long as urine output of more than 30 millilitres (1 ounce) per hour is maintained, the kidney can excrete nitrogenous and nonnitrogenous solids with maximum efficiency. Once the urine flow is decreased below this level, the kidney is unable to function efficiently, the substances are retained in the body, and their concentration in the blood rises.

The final result of prolonged dehydration is now apparent. The normal distribution of salt and water in the body is destroyed, the plasma volume decreases, and the blood viscosity increases. As a result of these changes renal function is impaired, the urinary output falls, and waste products accumulate. Far more life-threatening, however, is decreased loss of moisture from the skin, with the subsequent rise in temperature, and the fall in cardiac output with the attendant irreversible shock.

Once renal failure occurs, about 8 percent of the total body water has been lost (4 litres [about 4.25 quarts]). When 5 to 10 litres (about 5.25 to 10.5 quarts) of body water have been lost, a person is acutely and severely ill, with contracted plasma volume, increased concentration and viscosity of the blood, renal failure and excessive urea in the blood, and falling blood pressure. In a previously healthy adult, death follows the loss of 12 to 15 litres (about 12.5 to 15.8 quarts) of body water. In the very young, the very old, or the debilitated, death occurs at a lower level of dehydration."





Sources: On Images




For any doctors and/or medical health professionals, I have a business card:

Tuesday, January 8, 2019

Gastroparesis Medical Studies Update; Join and/or Keep Up With Clinical Trials







Source: Unknown


Source: Unknown


Source: On The Image but one of my favorites on how to explain Gastroparesis.









Clinical Trials - We Need Better Treatments

I apologize for taking so long to write an article. I, myself, have had a rough year like everyone else seemed to in the GP Community. I lost A LOT of friends last year in my support groups, people I started support groups with, and people I talked to regularly. I logged into Facebook this morning to check on my groups, as I've been sick with pneumonia on top of Gastroparesis for the past week and a half (before that, my husband and I were passing a respiratory virus back and forth) and found another one of my friends had died. She was someone I've known since I first started advocating for Gastroparesis. She was apart of the handful of women who helped start Gastroparesis support groups and build up the Gastroparesis Community. I wanted to dedicated this article to her, and the other friends I've lost. Last year, we lost 48 people. This year, so far, I think the total is four or five people. It's heartbreaking. We need better treatments. Having invasive "treatments" like feeding tubes, which can cause infections and worse, and then on the other end of the spectrum, medicine like Reglan, which can lead to irreversible, neurological disorders. We need medication to help our stomachs, to keep them from cramping so badly, to help them contract.

We need SOME kind of help. I'm so upset at watching my friends suffer and die. I get scared every time I throw up, wondering if it's going to be the last time - if this is the time I'm going to rupture my esophagus and die. I get panic attacks logging on to Facebook, scared I might read another one of my friends has passed away, which always upsets me right away, not only because they passed, but I feel like when I take breaks from Facebook, that I'm letting them down for not being online. I feel like I didn't get to say what I wanted to say to them before they passed. Most of that is on me. I've been not terrified to log into Facebook, but just



If you are interested in joining a clinical trial for Gastroparesis, The National Institute of Diabetes, Digestive, and Kidney Diseases are having people sign up for one now: https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/clinical-trials


Centerwatch has a long list of clinical trials that need volunteers as well: https://www.centerwatch.com/clinical-trials/listings/condition/72/gastroparesis/


ClinicalTrials.gov has a current trial happening as we speak: https://clinicaltrials.gov/ct2/show/NCT03500354

The Trial Says,
"Brief Summary:

Gastroparesis is a chronic, morbid and costly neuromuscular disorder of the stomach characterized by delayed gastric emptying in the absence of gross structural abnormalities. The periprandial symptoms associated with this disease can preclude adequate oral intake and often lead to weight loss and nutritional deficiencies 1. These manifestations are largely due to impaired gastric accommodation of meals and delayed transfer of food boluses from the stomach into the duodenum2. Consequently, the investigators hypothesize that dietary supplementation with a low volume, hypercaloric nutritional drink can help prevent malnutrition, decrease symptom burden and improve health-related quality of life in this population. Due to the paucity of such a supplement, the investigators developed a novel nutritional drink designed to maximize tolerability in patients with gastroparesis . This nutritional drink was tested on healthy volunteers (phase I) and passed the palatability test. The investigators now aim to test the tolerability of this drink on gastroparesis patients.

Condition or disease Intervention/treatment Phase
Gastroparesis Dietary Supplement: Nutrient drink Not Applicable

Detailed Description:

Primary objective:

To evaluate the safety and tolerability of the nutritional drink in gastroparesis patients.

Secondary objective:

To evaluate the efficacy of the nutritional drink in gastroparesis patients.

Study Procedures This study will be a pilot, open-label, trial in gastroparesis patients. A total of 20 patients will be recruited from the gastroenterology gastroparesis clinic. If the volunteer meets eligibility criteria, a co-investigator will contact the patient to schedule a study visit with a nutritionist and obtain a written consent. The contact and screening information of patients that are successfully recruited will be documented, placed in the participant's study folder and stored in a locked cabinet in the research unit. Any information documented during the screening process for patients who do not meet basic eligibility criteria or do not wish to participate will be immediately destroyed.

Patients will be given enough supply of the nutrition drink for (4 weeks) and asked to consume 200 ml of the drink three times daily. A follow-up call will be scheduled on day 2, day 7 and at the end of the study to make sure patients are tolerating the drink. Participants will be allowed to consume water and food as desired during the study period but will need to maintain an accurate food diary for at least one week prior to enrollment and during the study (at 2 weeks and at 4 weeks) along with weight measurements at baseline, 2 weeks, 4 weeks and 6 weeks. The participants will be asked to complete a palatability questionnaire. They will also complete the Gastroparesis Cardinal Symptom Index (GCSI) daily diary and the PROMISE scale prior to enrollment as a baseline for their symptoms and again at 2 weeks, 4 weeks (end of the study) and 6 weeks. Changes in these scales from baseline will determine the efficacy and possibly side effects of the nutritional drink.

Study duration and number of study visits required of research participants:

4 weeks, initial study visit with a nutritionist for screening and consenting followed by 3 follow-up phone calls on day 2, day 7 and at 4 weeks (the end of the study) and a final study visit at 6 weeks (2 weeks after finishing the study)


Study Type : Interventional (Clinical Trial)
Estimated Enrollment : 20 participants
Intervention Model: Single Group Assignment
Intervention Model Description: Pilot feasibility open-label study
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Nutritional Drink in Gastroparesis
Estimated Study Start Date : February 1, 2019
Estimated Primary Completion Date : May 2019
Estimated Study Completion Date : August 2019




Primary Outcome Measures:

Tolerability will be measured by the Palatability Questionnaire at 2 days [ Time Frame: 2 days post-intervention ]

Patients will be given enough supply of the nutrition drink for 4 weeks and asked to consume 200 ml of the drink three times daily. A follow-up call will be scheduled on day 2 of the study to make sure patients are tolerating the drink.

Tolerability will be measured by the Palatability Questionnaire which rates six items on a scale of 1 to 5 (1= strongly disagree and 5= strongly agree. The six items are:
The formula/supplement tasted very good.
The formula/supplement tasted very bad.
I had no problems drinking the supplement.
Drinking the supplement made me feel ill.
I could drink more of this supplement anytime
I would never drink more of this supplement again

Tolerability will be measured by the Palatability Questionnaire at 7 days [ Time Frame: 7 days post-intervention ]

Patients will be given enough supply of the nutrition drink for 4 weeks and asked to consume 200 ml of the drink three times daily. A follow-up call will be scheduled on day 7 of the study to make sure patients are tolerating the drink.

Tolerability will be measured by the Palatability Questionnaire which rates six items on a scale of 1 to 5 (1= strongly disagree and 5= strongly agree. The six items are:
The formula/supplement tasted very good.
The formula/supplement tasted very bad.
I had no problems drinking the supplement.
Drinking the supplement made me feel ill.
I could drink more of this supplement anytime
I would never drink more of this supplement again

Tolerability will be measured by the Palatability Questionnaire at 4 weeks [ Time Frame: 4 weeks post-intervention ]

Patients will be given enough supply of the nutrition drink for 4 weeks and asked to consume 200 ml of the drink three times daily. A follow-up call will be scheduled at 4 weeks to make sure patients are tolerating the drink.

Tolerability will be measured by the Palatability Questionnaire which rates six items on a scale of 1 to 5 (1= strongly disagree and 5= strongly agree. The six items are:
The formula/supplement tasted very good.
The formula/supplement tasted very bad.
I had no problems drinking the supplement.
Drinking the supplement made me feel ill.
I could drink more of this supplement anytime
I would never drink more of this supplement again

Safety will be measured by the NIH PROMISE scale at baseline [ Time Frame: Baseline ]

This will be measured by the NIH PROMISE scale. This is a 10 point scale (0=none and 10= most severe) that rates the following symptoms:
Pain, especially in the abdomen, chest or back
Abdominal distension (bloating, sensation of excess gas)
Difficulty eating, sensation of food being stuck in the stomach.
Difficulty with bowel movements (constipation or straining)
Nausea and/or vomiting
Thirst
Weakness, lack of energy, fatigue, difficulty moving.

Safety will be measured by the NIH PROMISE scale at 2 weeks [ Time Frame: 2 weeks post-intervention ]

This will be measured by the NIH PROMISE scale. This is a 10 point scale (0=none and 10= most severe) that rates the following symptoms:
Pain, especially in the abdomen, chest or back
Abdominal distension (bloating, sensation of excess gas)
Difficulty eating, sensation of food being stuck in the stomach.
Difficulty with bowel movements (constipation or straining)
Nausea and/or vomiting
Thirst
Weakness, lack of energy, fatigue, difficulty moving.

Safety will be measured by the NIH PROMISE scale at 4 weeks [ Time Frame: 4 weeks post-intervention ]

This will be measured by the NIH PROMISE scale. This is a 10 point scale (0=none and 10= most severe) that rates the following symptoms:
Pain, especially in the abdomen, chest or back
Abdominal distension (bloating, sensation of excess gas)
Difficulty eating, sensation of food being stuck in the stomach.
Difficulty with bowel movements (constipation or straining)
Nausea and/or vomiting
Thirst
Weakness, lack of energy, fatigue, difficulty moving.

Safety will be measured by the NIH PROMISE scale at 6 weeks [ Time Frame: 6 weeks post-intervention ]

This will be measured by the NIH PROMISE scale. This is a 10 point scale (0=none and 10= most severe) that rates the following symptoms:
Pain, especially in the abdomen, chest or back
Abdominal distension (bloating, sensation of excess gas)
Difficulty eating, sensation of food being stuck in the stomach.
Difficulty with bowel movements (constipation or straining)
Nausea and/or vomiting
Thirst
Weakness, lack of energy, fatigue, difficulty moving.





How Gastroparesis Acts in The Body. Source:https://www.pinterest.com/pin/278026976974184742/?lp=true









Secondary Outcome Measures:

Improvement in gastroparesis symptoms [ Time Frame: Baseline, 2, 4 and 6 weeks ]
Change in weight compared to baseline

Improvement in gastroparesis symptoms [ Time Frame: Baseline, 2, 4 and 6 weeks ]

Changes in the Gastroparesis Cardinal Symptom Index (GCSI) daily diary as compared to baseline. This is a six point severity scale (0-5 with 0= none and 5 = very severe) that rates the following symptoms
Nausea
Early satiety
Postprandial fullness
Bloating
Upper abdominal pain
Retching
Vomiting
Stomach fullness
Loss of appetite
Stomach or belly visibly large



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study: 16 Years and older (Child, Adult, Older Adult)
Sexes Eligible for Study: All
Gender Based Eligibility: Yes
Gender Eligibility Description: Female or male
Accepts Healthy Volunteers: No
Criteria

Inclusion Criteria:

Patients with gastroparesis confirmed with symptoms and a gastric emptying study.
Inability to maintain adequate caloric intake by standard dietary measures for gastroparesis due to gastrointestinal symptoms

Exclusion Criteria:

Recent diagnosis of disorder other than gastroparesis that could affect food intake
Oropharyngeal dysphagia or other condition with risk for aspiration from oral ingestion.
Allergic reactions to any of the ingredients of the nutritional drink
Current pregnancy. Pregnancy status will be determined by questioning the potential subject.
Patient with gastrostomy/jejunostomy tube feeds or on total parenteral nutrition
Currently taking any anti-coagulant


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03500354

Contacts

Contact: Pankaj J Pasricha, MD 4105027173 ppasric1@jhmi.edu
Contact: Carmen Roberts 4105027173 ccroberts@jhmi.edu

Locations

United States, Maryland
Johns Hopkins University Active, not recruiting
Baltimore, Maryland, United States, 21287
Sponsors and Collaborators
Johns Hopkins University
Investigators

Principal Investigator: Pankaj J Pasricha, MD Johns Hopkins University
More Information
Go to


Responsible Party: Johns Hopkins University
ClinicalTrials.gov Identifier: NCT03500354 History of Changes
Other Study ID Numbers: IRB00157677
First Posted: April 17, 2018 Key Record Dates
Last Update Posted: December 19, 2018
Last Verified: December 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No


Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Johns Hopkins University:

malnutrition


Additional relevant MeSH terms:

Gastroparesis
Stomach Diseases
Gastrointestinal Diseases
Digestive System Diseases
Paralysis
Neurologic Manifestations
Signs and Symptoms"





Source:https://preferredresearchpartners.com/gastroparesis-infographic/