CASE: 52 yo male in Haiti drank 3 beers the night before, awoke and drank 3 liters of water. During the AM, he continued to drink another 4-5 liters of water, had a late lunch. By Dinner time, he feels nauseated, gets `2L ringers lactate. He is checked on but shows worsening with facial and peripheral edema. VS: 150/80 HR 80, RR 16, SaO2=86%. He is treated presumptively with a drug that completely reverses his condition within a few hours.
Diagnosis???
SEVERE HYPONATREMIA.
NA=117!!!
This was our friend, Rick's, condition last night. We gave him 40mg lasix (no 3% saline here....), with IVF, Na corrected to 121 after 6L of urine output in the next several hours. With diligent care by Kyonna, our ICU nurse, who replaced his urine output cc for cc, titrated his IVF drips per my orders, emptied his catheter (yes, he got a foley catheter), by morning, his sodium is corrected. He is raring to go back to work , but we are encouraging him to take it easy. Thanks everyone for your prayers and giving us the ability to treat him in the most sublime of conditions.
