Salt and water regulation in the body derailed by SIADH
DEAR DR. ROACH: I am a 75-year-old male who is 6 feet, 1 inch tall and weighs 195 pounds. I had a heart attack 20 years ago, and I was warned to cut down my salt intake. From that time on, I stopped using table salt and carefully selected foods with low salt content.
Eighteen months ago, I had an incident where I had confusion and passed out. In the emergency room, my bloodwork showed low sodium. IVs with sodium seemed to bring me back to near normal. My doctor recommended that I increase my dietary sodium. I found this very difficult after 20 years of carefully avoiding salt.
More recently, I had shoulder replacement surgery, for which I was scheduled to spend two days in the hospital. After the morning operation, I could not urinate. They wanted me to drink water to encourage urination.
The day after surgery, I suddenly felt confused, nauseated and weak, to the point of being unable to stand, plus I had violent dry heaves. I was put in a wheelchair and rushed back to my room. Blood tests showed that I had hyponatremia, with a sodium level of 116 (normal range is 135-145). Doctors explained that a sodium level this low could lead to brain swelling and death.