Paula’s Adventure: ER and ICU
We arrived at the ER and Paula was checked in on Tuesday morning, February 4. The cough was obvious as well as the difficulty breathing. They took her vitals, and her blood pressure was very high. Most likely because of the hallucinations, they did a CAT scan of her head, but there were no apparent issues. Also, no cats (that’s a family joke from Paula’s dad). They also took an x-ray of her lungs: mostly clear but a little sign of pneumonia in a lower lung. That seemed about all.
Then the results of her blood tests came back, and yikes. Normal sodium levels are 135-145 mEq/L; hers was 105 mEq/L. Her potassium was also below the normal range. She wasn’t going anywhere because she was in danger of having seizures, and our doctor said she’s surprised she hadn’t had one.
They immediately began to replace sodium and potassium in the ER before her admission. The trick is that it must be done slowly; if it went up too fast, she would also have been in danger of seizures and heart problems. She was transferred to a room in the ICU, because she needed constant monitoring, frequent blood draw—every two hours around the clock for the first few days—and they needed to be sure she wasn’t contagious because of the cough that was still present. (She was not.) I asked about her sodium level after each blood draw, and it consistently went up over the next five days. Once it hit 135 mEq/L, she was ready to be released.
My observation was that she was vastly improved by the day after her admission. However, that didn’t mean she was out of danger and she wasn’t going anywhere until she hit that 135 number. By that time, I had to leave for a speaking gig in Nashville. She was organizing the room, so I knew she was close to normal; still a little shaky but normal. She was on a heart monitor the whole time, and as she was organizing the room, a nurse came in and said, “What are you doing? Your heart rate’s up.” He suggested she quit futzing and sit down for a while.
She was released and brought home on Saturday by one of our pretend daughters, and I got home a few hours later.
What caused the sodium and potassium loss? More than that, what can we learn from Paula’s adventure? I’ll let you know on Saturday. I’ll also tell you when and where my next Nutrition in the 21st Century Seminar will take place.
What are you prepared to do today?
