URGENT - FLOSSAM or anyone with a medical background......

[NeedHelpButAnonymously]

Can anyone help me with understanding sodium levels in the body?

MIL v ill still in hospital, being artificially fed, dh has asked me to try and find something out. He is with her now.

[NeedHelpButAnonymously]

I have to go and collect dsfrom nursery soon, so will post info and see if anyone can help, will check when I get back.

MIL still v unwell, v distressed, weak, shaking which is v distressing for dh - cause can't be found, although some things have been ruled out.

Doctors are talking about her sodium levels.

On admittance to hospital she had a count of 125. Now has a count of 114.

DH wants to know what's normal - was 125 normal? How low is 114?

Doctors think her artificial feed may be too rich? and this is leeching sodium from her system.

[swiperfox]

Not sure if this is any help? Will keep searching and hopefully have something for you when you get back

[swiperfox]

I think this explains it a bit more

Hope it helps you out a bit.

[Flossam]

Sodium is usually about 130, or just above. 125 is slightly low, and can cause some of the above symptoms. Her feed should be given with the specific advise of a dietician, who looks at bloods and see what is lacking and matches up the most appropriate feed. Sodium cholide is usually given as a drip, although as sodium raises as a patient becomes dehyrdrated, I'm really not sure how well it would work. Is she on a drip as well as the feed? How often is she having water flushes down her tube? Is she drinking normally? Perhaps the water flushes could be kept to a minimum as these are often used to bring down high sodium.

I'm not sure of what can be causing it, I'm sorry. I am a nurse, not a doctor, so I don't know everything . Are all her other bloods ok? Is her creatinine and urea ok for example? Sodium is I think related to the kidney sometimes. I really hope she turns a corner soon though and a diagnoses is found. She really is in the best place, and if the doctors know there is a problem with her sodium I am sure they will be looking at ways to right it for her and causes. I'm sorry you are having such a worrying time.

[Flossam]

Sorry SW, crossed posts.

[NeedHelpButAnonymously]

Thanks so much for the info .

Dh wants to fully understand what is being said to him without coming across as an irritating wotsit , by asking a barrage of too many questions.

[nailpolish]

what was the initial reason for her admission to hospital?

is she on an ng feed or ivi?

im sure your dh is in no way an irritation - tell him to find a nice nurse to barrage the questions to

[NeedHelpButAnonymously]

nailpolish - she was admitted because of her continued weight loss went down to 5 stone 2 from 10 st 4 over about 18 months or so, the cause for which could not be found.

The feed she is on goes into her nose, she doesn't have anything into her arms (IV?).

She has now had the psychological assessment and the psychiatrist says she isn't depressed (except v fed up about being so ill) and is not anorexic. The nursing manager told dh she thought it was anorexia, he was convinced it wasn't, from what he knows of his Mum, so at least this theory has been put to bed.

So far tests have ruled out achalasia and Addison's disease (this was tested for because of the low sodium levels).

[NeedHelpButAnonymously]

sorry, her weight went down to 6 st 2lbs (on admission to hospital).

[NeedHelpButAnonymously]

nailpolish, is the way she is being fed impt?

As far as I know, she was just being given glucose through the tube.

Dh doesn't understand why just being fed glucose would make her sodium levels drop like this.

She says she knows she is dying .

[NeedHelpButAnonymously]

.

[Flossam]

NHBA, I don't mean to sound patronising but try to calm down a bit.I could be wrong but I feel like you are panicking a great deal and both of you are very tense. I know this is understandable, but it won't make things happen any quicker or change things. Please don't hate me - but relatives always need to look after themselves too, having a relative in hospital is stressful on everyone. I don't like to think of you this worried by it all.

IMO, she is in a better position than she was a week ago. You know some terrible potential diagnoses aren't the case. She is being thoroughly investigated, and though never pleasant, every investigation hopefully brings you closer to the correct diagnoses, whatever that may be. She is also being monitored nutritionally, and is hopefully going to leave better nourished.

I assume you mean she is having glucose through the line in her vein? I would doubt that this would affect her glucose. They may want to consider changing it for sodium chloride, but they are probably giving her the glucose for the calories it contains. They may want to monitor her sodium level for another day, to see if it starts to resolve with the extra fliud she is getting, so she will not loose out on calories. Or there is even a bag of fliud with glucose and sodium in.

Is she being fed via her nose? I mean a tube in her nose, this is called NG feeding. If so, is she managing to keep this feed down?

[Flossam]

I mean doubt the drip would affect her sodium levels sorry

[Flossam]

I hope I haven't offended you.

[NeedHelpButAnonymously]

Flossam - you're not being patronising at all . Dh is very tense - he's carrying the load of looking after her, visiting regularly etc, as the other person who should be involved isn't bothering to turn up when they have promised to etc etc, which his Mum finds hurtful and confusing.

I'm trying to keep him calm and have said that hopefully, they are gradually finding out what the problem is.

You are right, she's better off than she was last week, because she is being investigated.

She didn't have any lines into her arm. She is being fed by a tube into her nose.

[NeedHelpButAnonymously]

Sorry, forgot to say, she is managing to keep the feed down.

I think she is being taken off this to see what is happening to her sodium levels without it.

[Flossam]

Thats good that she is managing to keep it down. I don't know that glucose is usually given via NG, I have never known it. Not to say it isn't done. It is usually a bag or pouch of yellow coloured liquid which goes through a pump? Seems odd to take her off it completely - the dietician should be able to give her a feed which would not affect the sodium, unless it's the usual friday afternoon scenario, she can't be available, and stopping the feed overnight to retest bloods in the am should show some change quickly, sorry rambling now. Have a nice drink this evening and get a good nights sleep. Will you let us know tomorrow how things are?

[NeedHelpButAnonymously]

She's in a v small hospital Flossam, so I'm not sure a dietician has been available in the last few days - the doctors wanted to transfer her to the main hospital for the region, but there's no bed available currently.

I will update you.

Thanks so much for your help .

[Flossam]

Fingers crossed the consultants in the big hospital will have a good clear out of the patients on their monday morning ward round and MIL can get over there then.

[nailpolish]

i agree floss, the ng feed shouldnt affect her sodium. a low sodium is simple to recitfy, just give iv sodium chloride, or sodium orally (which can be flushed via the ng tube)

i ask if the feed is ng or iv because iv feed is prescribed very specifically to the patients needs, ng feed is given by the nurse or dietician and is not really specific to a prescription.

low sodium levels are not really too much to worry about, unless any treatment she is receiving is not doing the trick, then any underlying cause will have to be investigated.

i hope they dont keep her off her feed for too long, unless she is starting to eat something?

that is a big weight loss, have the doctors started doing any more investigations into the cause? or is she just not eating, or has she not been eating over the last 18 months?

you dont have to answer the questions, its not really any of my business, sorry

i hope she is better soon, and you and your dh need to look after yourselves too remember

xxx

[NeedHelpButAnonymously]

A very sad update unfortunately, dh's Mum died on Saturday night.

At 4pm on Friday, dh was still trying to convince her doctors that she was very ill.

8 am Saturday, she lost consciousness and was rushed to the regional hospital where she died that evening.

The doctors at the main hospital said they could tell from tests they had done, that the low sodium problem had been going on for quite some time and were surprised that it had not been investigated earlier. Also, that it was a symptom of something v serious, most likely a form of cancer.

Dh accepts that it's likely she would have died anyway at some point, but feels very bitter that she suffered for so long, with only him really listening to her.

Too little, too late.

[gingernut]

Really sorry to read this NHBA, I had been following your threads but hadn't posted because I didn't have anything useful to add. Thinking of you and your family.

[Flossam]

Oh, NHBA, I have only just seen this. I am so sorry. How frustrating for you to have fought so long to get treatment for her and nothing been done about it sooner.

My thoughts are with you and your husband. If you need any more help CAT me anytime.