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I Have Necessary Spinal Surgery In Two Days. My Serum
Question: I have necessary spinal surgery in two days. My serum sodium is 127. It must be 134 to procede in 36 hours.. How can increase my sodium in two days. I have had diarrhea, due to taking cathartics for opiate induced diarrhea. I wak 2 miles per day to prepare from months from inactivit for months The heat index of 110 degrees F in S florida.
I re-hydrate with 2 liters of dilute Gatorade per walk How can I raise my serum sodium to frem 127 to 134 in two days? please help.
No diuretics, no thyroid disease. Response is urgent.
I re-hydrate with 2 liters of dilute Gatorade per walk How can I raise my serum sodium to frem 127 to 134 in two days? please help.
No diuretics, no thyroid disease. Response is urgent.
I have necessary spinal surgery in two days. My serum sodium is 127. It must be 134 to procede in 36 hours.. How can increase my sodium in two days. I have had diarrhea, due to taking cathartics for opiate induced diarrhea. I wak 2 miles per day to prepare from months from inactivit for months The heat index of 110 degrees F in S florida.
I re-hydrate with 2 liters of dilute Gatorade per walk How can I raise my serum sodium to frem 127 to 134 in two days? please help.
No diuretics, no thyroid disease. Response is urgent.
I re-hydrate with 2 liters of dilute Gatorade per walk How can I raise my serum sodium to frem 127 to 134 in two days? please help.
No diuretics, no thyroid disease. Response is urgent.
Brief Answer:
Low sodium due to loss of electrolytes
Detailed Answer:
Hello Beshapiro
Thank you for reaching out to Healthcaremagic.com. I understand that you will need to normalise your sodium before you undergo spinal surgery. From the history you have provided it looks like your sodium is low due to loss of it from diarrhoea and sweating. I am assuming that the sodium level was checked today. However, to be sure I would like you to answer the following questions
1. Do you have any ongoing kidney problems?
2. Are you still having diarrhoea? If not, when did it stop?
3. How much plain water do you drink per day? Apart from Gatorade.
4. Do you have any symptoms like giddiness, vomiting or difficulty in concentration ?
If you do not have any history of kidney problems then sodium gets corrected on its own because kidneys have the capacity to retain/absorb sodium. Consuming a slightly higher salt in food also naturally brings up the sodium levels. Please consume water to your thirst and not in excess. Drinking 2 litres of Gatorade is not something I would recommend to my patients.
Please get back to me, I am awaiting your reply.
Thank you
Warm regards
Low sodium due to loss of electrolytes
Detailed Answer:
Hello Beshapiro
Thank you for reaching out to Healthcaremagic.com. I understand that you will need to normalise your sodium before you undergo spinal surgery. From the history you have provided it looks like your sodium is low due to loss of it from diarrhoea and sweating. I am assuming that the sodium level was checked today. However, to be sure I would like you to answer the following questions
1. Do you have any ongoing kidney problems?
2. Are you still having diarrhoea? If not, when did it stop?
3. How much plain water do you drink per day? Apart from Gatorade.
4. Do you have any symptoms like giddiness, vomiting or difficulty in concentration ?
If you do not have any history of kidney problems then sodium gets corrected on its own because kidneys have the capacity to retain/absorb sodium. Consuming a slightly higher salt in food also naturally brings up the sodium levels. Please consume water to your thirst and not in excess. Drinking 2 litres of Gatorade is not something I would recommend to my patients.
Please get back to me, I am awaiting your reply.
Thank you
Warm regards
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Low sodium due to loss of electrolytes
Detailed Answer:
Hello Beshapiro
Thank you for reaching out to Healthcaremagic.com. I understand that you will need to normalise your sodium before you undergo spinal surgery. From the history you have provided it looks like your sodium is low due to loss of it from diarrhoea and sweating. I am assuming that the sodium level was checked today. However, to be sure I would like you to answer the following questions
1. Do you have any ongoing kidney problems?
2. Are you still having diarrhoea? If not, when did it stop?
3. How much plain water do you drink per day? Apart from Gatorade.
4. Do you have any symptoms like giddiness, vomiting or difficulty in concentration ?
If you do not have any history of kidney problems then sodium gets corrected on its own because kidneys have the capacity to retain/absorb sodium. Consuming a slightly higher salt in food also naturally brings up the sodium levels. Please consume water to your thirst and not in excess. Drinking 2 litres of Gatorade is not something I would recommend to my patients.
Please get back to me, I am awaiting your reply.
Thank you
Warm regards
Low sodium due to loss of electrolytes
Detailed Answer:
Hello Beshapiro
Thank you for reaching out to Healthcaremagic.com. I understand that you will need to normalise your sodium before you undergo spinal surgery. From the history you have provided it looks like your sodium is low due to loss of it from diarrhoea and sweating. I am assuming that the sodium level was checked today. However, to be sure I would like you to answer the following questions
1. Do you have any ongoing kidney problems?
2. Are you still having diarrhoea? If not, when did it stop?
3. How much plain water do you drink per day? Apart from Gatorade.
4. Do you have any symptoms like giddiness, vomiting or difficulty in concentration ?
If you do not have any history of kidney problems then sodium gets corrected on its own because kidneys have the capacity to retain/absorb sodium. Consuming a slightly higher salt in food also naturally brings up the sodium levels. Please consume water to your thirst and not in excess. Drinking 2 litres of Gatorade is not something I would recommend to my patients.
Please get back to me, I am awaiting your reply.
Thank you
Warm regards
Above answer was peer-reviewed by :
Dr. Kampana
serum chloride, serum clhride, serum potassium, BUN and Creatinine, are all normal
Only serum sodium is low (128 mg/dl). My surgeon requires that my serum sodium be at least 135 mg/dl, or necessary spinal surgery will be postponed 3-4 months.
MY medication list:
lamotrigine, tylenol 2000 mg per day, hydrocodone, 40 mg per day, , folic acid, 4 grams per day, zinc, 100 mg per day, diphenhydraine, 50 mg at bedtime, melatonin, 8 mg at bedtime, selenium, 200 micrograms per day, vitamin B12, 1000 IU per day, Vitamin D3, Atorvostatin, 80 mg per day, meoprolol, 50 mg prt fsy, naldemadine, 0.2 mg per day, mirslax, 1 serving three times per day, prune juice, 8 oz, three times per day, clindamycin 125 mg four times per day. simethicone, 80 mg for bloating, metoprolol, 50 mg per day. clonazepine 0.5 mg at bedtime., clonidine patch, 0.3 mg per day.
I do not eat cheese, I do not have red beets,
NO DIRUTICS, NO THYROID DISEASE,,NO KIDNEY DISEASE; NO TOBACCO OF ANY SORTI
I will ohly take lamotrigine, clconidine patch, metoprolol, oxcarbazepine, hydrocodone as needed. I am prepared to stop all other medicines.
MINIMAL CAFFEINE,
supplements I have stopped:, Folate, l lysine, Vitamin D3, Miralax (PROPYLINE gycol) , baby aspirin, 81 mg, , folic acid, Zinc, Lysine, Vitamin E, 200 IU. I have stopped sweating g to reduce insensible losse, simethicone stopped two weeks ago. nO MORE caffeine. .
My family doctor suggested that I drink 2 litres of Gatorade each day. No other RX was ordered. No water restricton, no workup for SIADH, no pedal edems, no history of congestive failure. Repeat serum sodium level in 36 hours. MUST be NORMAL.
Thank you for your prompt and professional expertise.
Sinderely, XXXXXXX E. Shapiro, M.D.
XXXXXXX
Only serum sodium is low (128 mg/dl). My surgeon requires that my serum sodium be at least 135 mg/dl, or necessary spinal surgery will be postponed 3-4 months.
MY medication list:
lamotrigine, tylenol 2000 mg per day, hydrocodone, 40 mg per day, , folic acid, 4 grams per day, zinc, 100 mg per day, diphenhydraine, 50 mg at bedtime, melatonin, 8 mg at bedtime, selenium, 200 micrograms per day, vitamin B12, 1000 IU per day, Vitamin D3, Atorvostatin, 80 mg per day, meoprolol, 50 mg prt fsy, naldemadine, 0.2 mg per day, mirslax, 1 serving three times per day, prune juice, 8 oz, three times per day, clindamycin 125 mg four times per day. simethicone, 80 mg for bloating, metoprolol, 50 mg per day. clonazepine 0.5 mg at bedtime., clonidine patch, 0.3 mg per day.
I do not eat cheese, I do not have red beets,
NO DIRUTICS, NO THYROID DISEASE,,NO KIDNEY DISEASE; NO TOBACCO OF ANY SORTI
I will ohly take lamotrigine, clconidine patch, metoprolol, oxcarbazepine, hydrocodone as needed. I am prepared to stop all other medicines.
MINIMAL CAFFEINE,
supplements I have stopped:, Folate, l lysine, Vitamin D3, Miralax (PROPYLINE gycol) , baby aspirin, 81 mg, , folic acid, Zinc, Lysine, Vitamin E, 200 IU. I have stopped sweating g to reduce insensible losse, simethicone stopped two weeks ago. nO MORE caffeine. .
My family doctor suggested that I drink 2 litres of Gatorade each day. No other RX was ordered. No water restricton, no workup for SIADH, no pedal edems, no history of congestive failure. Repeat serum sodium level in 36 hours. MUST be NORMAL.
Thank you for your prompt and professional expertise.
Sinderely, XXXXXXX E. Shapiro, M.D.
XXXXXXX
serum chloride, serum clhride, serum potassium, BUN and Creatinine, are all normal
Only serum sodium is low (128 mg/dl). My surgeon requires that my serum sodium be at least 135 mg/dl, or necessary spinal surgery will be postponed 3-4 months.
MY medication list:
lamotrigine, tylenol 2000 mg per day, hydrocodone, 40 mg per day, , folic acid, 4 grams per day, zinc, 100 mg per day, diphenhydraine, 50 mg at bedtime, melatonin, 8 mg at bedtime, selenium, 200 micrograms per day, vitamin B12, 1000 IU per day, Vitamin D3, Atorvostatin, 80 mg per day, meoprolol, 50 mg prt fsy, naldemadine, 0.2 mg per day, mirslax, 1 serving three times per day, prune juice, 8 oz, three times per day, clindamycin 125 mg four times per day. simethicone, 80 mg for bloating, metoprolol, 50 mg per day. clonazepine 0.5 mg at bedtime., clonidine patch, 0.3 mg per day.
I do not eat cheese, I do not have red beets,
NO DIRUTICS, NO THYROID DISEASE,,NO KIDNEY DISEASE; NO TOBACCO OF ANY SORTI
I will ohly take lamotrigine, clconidine patch, metoprolol, oxcarbazepine, hydrocodone as needed. I am prepared to stop all other medicines.
MINIMAL CAFFEINE,
supplements I have stopped:, Folate, l lysine, Vitamin D3, Miralax (PROPYLINE gycol) , baby aspirin, 81 mg, , folic acid, Zinc, Lysine, Vitamin E, 200 IU. I have stopped sweating g to reduce insensible losse, simethicone stopped two weeks ago. nO MORE caffeine. .
My family doctor suggested that I drink 2 litres of Gatorade each day. No other RX was ordered. No water restricton, no workup for SIADH, no pedal edems, no history of congestive failure. Repeat serum sodium level in 36 hours. MUST be NORMAL.
Thank you for your prompt and professional expertise.
Sinderely, XXXXXXX E. Shapiro, M.D.
XXXXXXX
Only serum sodium is low (128 mg/dl). My surgeon requires that my serum sodium be at least 135 mg/dl, or necessary spinal surgery will be postponed 3-4 months.
MY medication list:
lamotrigine, tylenol 2000 mg per day, hydrocodone, 40 mg per day, , folic acid, 4 grams per day, zinc, 100 mg per day, diphenhydraine, 50 mg at bedtime, melatonin, 8 mg at bedtime, selenium, 200 micrograms per day, vitamin B12, 1000 IU per day, Vitamin D3, Atorvostatin, 80 mg per day, meoprolol, 50 mg prt fsy, naldemadine, 0.2 mg per day, mirslax, 1 serving three times per day, prune juice, 8 oz, three times per day, clindamycin 125 mg four times per day. simethicone, 80 mg for bloating, metoprolol, 50 mg per day. clonazepine 0.5 mg at bedtime., clonidine patch, 0.3 mg per day.
I do not eat cheese, I do not have red beets,
NO DIRUTICS, NO THYROID DISEASE,,NO KIDNEY DISEASE; NO TOBACCO OF ANY SORTI
I will ohly take lamotrigine, clconidine patch, metoprolol, oxcarbazepine, hydrocodone as needed. I am prepared to stop all other medicines.
MINIMAL CAFFEINE,
supplements I have stopped:, Folate, l lysine, Vitamin D3, Miralax (PROPYLINE gycol) , baby aspirin, 81 mg, , folic acid, Zinc, Lysine, Vitamin E, 200 IU. I have stopped sweating g to reduce insensible losse, simethicone stopped two weeks ago. nO MORE caffeine. .
My family doctor suggested that I drink 2 litres of Gatorade each day. No other RX was ordered. No water restricton, no workup for SIADH, no pedal edems, no history of congestive failure. Repeat serum sodium level in 36 hours. MUST be NORMAL.
Thank you for your prompt and professional expertise.
Sinderely, XXXXXXX E. Shapiro, M.D.
XXXXXXX
Brief Answer:
Follow up
Detailed Answer:
Dear Dr XXXXXXX
Thank you for getting back to me and giving me the list of all your medications.
As you are otherwise fit and well with no co morbidities that could cause hyponatremia like the ones you have mentioned like thyroid disorders, kidney disorders and congestive heart failure it is very likely that your sodium will to correct to normal in the next 2 days. I understand how important it is for your sodium to correct.
As suggested in my earlier post, consuming a bit more salt in your diet. i.e adding a pinch more to your regular meal will certainly help.
I would not work you up for SIADH right away with a single reading low sodium and you have history of diarrhoea and dehydration as well. Water restriction is again something I would not recommend without a proper investigated diagnosis, drinking to your thirst is the most optimal thing to do at the moment
Please fell free to get back to me with any further queries.
Warm regards
Rakesh
Follow up
Detailed Answer:
Dear Dr XXXXXXX
Thank you for getting back to me and giving me the list of all your medications.
As you are otherwise fit and well with no co morbidities that could cause hyponatremia like the ones you have mentioned like thyroid disorders, kidney disorders and congestive heart failure it is very likely that your sodium will to correct to normal in the next 2 days. I understand how important it is for your sodium to correct.
As suggested in my earlier post, consuming a bit more salt in your diet. i.e adding a pinch more to your regular meal will certainly help.
I would not work you up for SIADH right away with a single reading low sodium and you have history of diarrhoea and dehydration as well. Water restriction is again something I would not recommend without a proper investigated diagnosis, drinking to your thirst is the most optimal thing to do at the moment
Please fell free to get back to me with any further queries.
Warm regards
Rakesh
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Follow up
Detailed Answer:
Dear Dr XXXXXXX
Thank you for getting back to me and giving me the list of all your medications.
As you are otherwise fit and well with no co morbidities that could cause hyponatremia like the ones you have mentioned like thyroid disorders, kidney disorders and congestive heart failure it is very likely that your sodium will to correct to normal in the next 2 days. I understand how important it is for your sodium to correct.
As suggested in my earlier post, consuming a bit more salt in your diet. i.e adding a pinch more to your regular meal will certainly help.
I would not work you up for SIADH right away with a single reading low sodium and you have history of diarrhoea and dehydration as well. Water restriction is again something I would not recommend without a proper investigated diagnosis, drinking to your thirst is the most optimal thing to do at the moment
Please fell free to get back to me with any further queries.
Warm regards
Rakesh
Follow up
Detailed Answer:
Dear Dr XXXXXXX
Thank you for getting back to me and giving me the list of all your medications.
As you are otherwise fit and well with no co morbidities that could cause hyponatremia like the ones you have mentioned like thyroid disorders, kidney disorders and congestive heart failure it is very likely that your sodium will to correct to normal in the next 2 days. I understand how important it is for your sodium to correct.
As suggested in my earlier post, consuming a bit more salt in your diet. i.e adding a pinch more to your regular meal will certainly help.
I would not work you up for SIADH right away with a single reading low sodium and you have history of diarrhoea and dehydration as well. Water restriction is again something I would not recommend without a proper investigated diagnosis, drinking to your thirst is the most optimal thing to do at the moment
Please fell free to get back to me with any further queries.
Warm regards
Rakesh
Above answer was peer-reviewed by :
Dr. Kampana
Are there any other electrolyte, or biochemical levels that would suggest that something other than Water and fluid management be needed?
Do either of the medications: 1. oxcarbazepine or 2. lamotrigine have the side effect of causing hyponatremia?, If so, how long would it take to correct once these medications are stopped?
Do either of the medications: 1. oxcarbazepine or 2. lamotrigine have the side effect of causing hyponatremia?, If so, how long would it take to correct once these medications are stopped?
Are there any other electrolyte, or biochemical levels that would suggest that something other than Water and fluid management be needed?
Do either of the medications: 1. oxcarbazepine or 2. lamotrigine have the side effect of causing hyponatremia?, If so, how long would it take to correct once these medications are stopped?
Do either of the medications: 1. oxcarbazepine or 2. lamotrigine have the side effect of causing hyponatremia?, If so, how long would it take to correct once these medications are stopped?
Brief Answer:
Follow up
Detailed Answer:
Hello
Thanks for getting back to me.
Both the medications you have mentioned could cause hyponatremia. Oxcarbazepine causes hyponatremia in a dose-dependent manner and Lamotrigine causes retention of water leading to low sodium in blood mimicking a hormone called Antidiuretic hormone. I would not recommend stopping this medication before speaking to your doctor. Correction of hyponatremia should happen within 2 days of stopping this drug if this is the cause as this medication has a short half-life.
Today is your operation, please do let me know what the outcome was.
I wish you a speedy recovery
Warm regards
Rakesh
Follow up
Detailed Answer:
Hello
Thanks for getting back to me.
Both the medications you have mentioned could cause hyponatremia. Oxcarbazepine causes hyponatremia in a dose-dependent manner and Lamotrigine causes retention of water leading to low sodium in blood mimicking a hormone called Antidiuretic hormone. I would not recommend stopping this medication before speaking to your doctor. Correction of hyponatremia should happen within 2 days of stopping this drug if this is the cause as this medication has a short half-life.
Today is your operation, please do let me know what the outcome was.
I wish you a speedy recovery
Warm regards
Rakesh
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Follow up
Detailed Answer:
Hello
Thanks for getting back to me.
Both the medications you have mentioned could cause hyponatremia. Oxcarbazepine causes hyponatremia in a dose-dependent manner and Lamotrigine causes retention of water leading to low sodium in blood mimicking a hormone called Antidiuretic hormone. I would not recommend stopping this medication before speaking to your doctor. Correction of hyponatremia should happen within 2 days of stopping this drug if this is the cause as this medication has a short half-life.
Today is your operation, please do let me know what the outcome was.
I wish you a speedy recovery
Warm regards
Rakesh
Follow up
Detailed Answer:
Hello
Thanks for getting back to me.
Both the medications you have mentioned could cause hyponatremia. Oxcarbazepine causes hyponatremia in a dose-dependent manner and Lamotrigine causes retention of water leading to low sodium in blood mimicking a hormone called Antidiuretic hormone. I would not recommend stopping this medication before speaking to your doctor. Correction of hyponatremia should happen within 2 days of stopping this drug if this is the cause as this medication has a short half-life.
Today is your operation, please do let me know what the outcome was.
I wish you a speedy recovery
Warm regards
Rakesh
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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