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IV Bags May Not Be Necessary to Rehydrate Patients

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Re: IV Bags May Not Be Necessary to Rehydrate Patients

#121

Post by Shivetya »

mabbo wrote: post #9

> You can also make good oral rehydration solutions yourself at home for pennies: Just take 32 ounces of water and add 6 teaspoons of sugar and a half-teaspoon of salt. > resist the temptation to drink at a normal rate... An ounce at a time every few minutes This should be something everyone learns. Many common headaches are just dehydration. When you've got a cold or flu, dehydration is common and makes you feel eve…

I am curious but I suspect the sugar would still be fine to keep a diabetic from entering Diabetic ketoacidosis (DKA) which occurs from dehydration. this hits particularly close to home as this is what happens to my own mother when she gets sick, she stops drinking and being diabetic it can escalate.

example, while sick and headed to hospital her blood sugar being pass two hundred. This is having only eaten once in three days. Two hours later it hit seven hundred plus in emergency. They got her out of it but the simple reason is, you dehydrate and toxins build up plus your body starts to break down what it can to get sugar.

anyone you know who is diabetic, nah scratch that, proper hydration is key. Take it from the Dune, water is life.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#122

Post by ceejayoz »

amorphid wrote: post #99
aidenn0 wrote: post #66

Earlier quoted context omitted.

Quick tip: for kids, you can make popsicles out of the solution, which will moderate the rate at which they drink it.

Not if you eat popsicles the way I do! Lick, lick, crunch, more please.

My teeth hurt just from reading your comment.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#123

Post by phaedrus441 »

inetsee wrote: post #76

A neighbor of mine became dehydrated because of an infection (I think it was a kidney infection, but I'm not sure). She went to the emergency room and they pushed IV fluids, and I mean pushed. They hung a total of three bags, and at one point they were squeezing the bags to increase the flow of fluids. They over-hydrated her, and then they had to give her something to deal with the over-hydration. The over-hydration,…

This sounds more like the patient had previously-undiagnosed heart failure, didn’t respond well to rehydration (since it’s easier to become volume-overloaded with heart failure), and required further work-up.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#124

Post by logfromblammo »

awakeasleep wrote: post #63
nradov wrote: post #60

Earlier quoted context omitted.

Would drinking oral rehydration solution mixed with vodka prevent the hangover from occurring in the first place?

A lot of the hangover effect comes from acetaldehyde, a somewhat toxic product of the metabolism of alcohol. A big part of the hangover is waiting for your body to get rid of acetaldehyde. Drinking more reduces your awareness of the effects of acetaldehyde, but increases the total amount of it in your body, prolonging the hangover.

Aldehyde dehydrogenase enzymes employ the sulfur chemistry of cysteine. Taking n-acetyl cysteine before you drink helps your body to synthesize the ALDH. Glutamate (easily available from monosodium glutamate) is required, along with water, for the enzyme to process aldehydes into carboxylic acids. The reaction is powered by NAD+/NADH, so adequate niacin and tryptophan in your diet would help you have enough of that, but that system also powers the alcohol dehydrogenase that is producing the aldehydes.

Whether you get hangovers or not largely depends on the relative efficiency of your ADH versus your ALDH enzymes. If you clear aldehyde faster than you can metabolize the alcohol, you never get hangovers unless you have some odd sulfur-based chemistry happening in your body. If you clear aldehyde slower than you metabolize alcohol, you get hangover effects. If you have an ALDH defect, or are taking a drug that antagonizes it, you might experience "Asian blush", with immediate unpleasant reactions to drinking alcohol.

Dehydration has its own unpleasant symptoms, and since alcohol is a diuretic, it can dehydrate you. Drinking water or electrolyte rehydration solutions will help with that. You can be fully hydrated and still have a hangover, but at least you won't have a hangover and be dehydrated too.

I have never had a hangover, but the chemistry suggests that if you get them routinely, supplementing your diet with NAC might help. Eating tofu and shiitake (high in tryptophan/niacin) with MSG as you drink or after you drink might also help. It's mostly your genetics, though. If you get bad hangovers, there's no easy cure for it other than to drink less alcohol.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#125

Post by na85 »

inetsee wrote: post #76

A neighbor of mine became dehydrated because of an infection (I think it was a kidney infection, but I'm not sure). She went to the emergency room and they pushed IV fluids, and I mean pushed. They hung a total of three bags, and at one point they were squeezing the bags to increase the flow of fluids. They over-hydrated her, and then they had to give her something to deal with the over-hydration. The over-hydration,…

Excellent anecdata.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#126

Post by rsync »

nscalf wrote: post #88

I think the best place that this is illustrated is in the UFC. When they banned rehydrating through IV's (I read they test for it by checking for by products of rubber in the blood, which presumably would have come from running liquid through rubber tubes into the arm) we expected to see the entirety of the sport move up in weight classes. It was not a big secret that everyone was cutting large amounts of weight to g…

"One of the big concerns from this change though is that some doctors are claiming you don't rehydrate fully in a short period of time this way. Fighters weigh in the day before a fight, so they're peak dehydrated roughly 24 hours before they fight. There are claims that it takes the brain many days to fully rehydrate after a weight cut if you're not using IV's, so people paying attention in the sport are really worried that brain injuries are going to start going up."

I have always been skeptical of this notion that rehydration takes hours or days or whatever.

First of all, practical experience shows that mucus, urine, sweating[1], etc. very quickly revert to full hydration. You can go from dark yellow urine to clear urine in less than two hours.

Second, what mechanism could there possibly be to restrict water absorption in your body while dehydrated ?[2] I don't think you could slow down rehydration if you tried to[3]. Your body doesn't have to digest it and it can transport nearly immediately outward to every tissue (as evidenced by nasal mucus production which reverts as quickly as your urine color does).

I think it's just bro-science and it's surprising that it is so persistent (I have heard it in the gym, at basic training, in the fire service, etc.) because immediate, practical evidence contradicts it.

[1] I am not talking about heatstroke, etc., which are separate issues.

[2] The only thing I can possibly think of is stuffing yourself with very absorptive food prior to rehydrating ... which would be odd.

[3] Assuming normal water with normal mineral content. Obviously, distilled water will cause problems.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#127

Post by dkarl »

gasgasgas wrote: post #97
pdpi wrote: post #39

Earlier quoted context omitted.

Yes, that is precisely what the article says: use the cheaper less invasive treatment if you can, save the IV bag for when you can’t

That is done already.

Thanks to some bad luck my father has been in the hospital more than half a dozen times in the last couple of years. He has always been given IV fluids. This week he went in for pneumonia, just coughing and shortness of breath, and they put him on an IV. I never thought twice about it until today.

Having a needle in your arm for hours is not pleasant. My dad doesn't heal so quickly these days, so he's going to have bruising and tenderness for a week where they put the needle in. Watching my dad go through this, and my girlfriend's brother who has mental disabilities a couple of years ago, and now realizing it would have been a lot more comfortable for them if they'd just let them sip on some Gatorade seriously pisses me off.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#128

Post by inetsee »

phaedrus441 wrote: post #123
inetsee wrote: post #76

A neighbor of mine became dehydrated because of an infection (I think it was a kidney infection, but I'm not sure). She went to the emergency room and they pushed IV fluids, and I mean pushed. They hung a total of three bags, and at one point they were squeezing the bags to increase the flow of fluids. They over-hydrated her, and then they had to give her something to deal with the over-hydration. The over-hydration,…

This sounds more like the patient had previously-undiagnosed heart failure, didn’t respond well to rehydration (since it’s easier to become volume-overloaded with heart failure), and required further work-up.

To the best of my knowledge, she was in good health before she developed the infection. Her body mass index was in the normal range, and she did the recommended amount of aerobic exercise (150 minutes, moderate intensity / week).

It sounds to me like an intern over-reacted to her dehydration, and over did it with the IV fluids.

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#129

Post by masklinn »

breatheoften wrote: post #119
masklinn wrote: post #71

Earlier quoted context omitted.

The article isn't about IV being ineffective, rehydration IV are absolutely effective. The article is about them being un necessary unless absolutely humongous amounts of rehydration are necessary (emergency rehydration), "modern" oral rehydration is amply sufficient, cheaper, simpler, and less risky (ORS requires clean water but IV requires aseptic fluid and procedure and even then there's a risk of infection).

Thank you for this. The use of 'unnecessary' is super interesting to me and makes me empathize with the spectrum of problem's Dr.'s must have in deciding treatment plans ... I feel that arguing convincingly about the lack of necessity of a given effective technique would make for an incredibly hard communication/decision-making problem ... Also interesting, the presence or absence of necessity was not at all a factor…

> Also interesting, the presence or absence of necessity was not at all a factor in my usage. I elected to pay a bunch of money for what was certainly an 'unnecessary' use of an I.V. with a goal of enhancing well-being/accelerating recovery time.

When I commented about unnecessary, I wasn't commenting about the goal but the means. You get the same benefits from ORT as you get from IV rehydration[0], at lower risk, and lower cost.

> In the context of opt-in usage: not in a hospital full of sick people and disease, where provider can simply refuse to offer any service to patients if risk factors are present, with ability to pay premium market-based prices for supplies/storage since its an upscale opt-in product …

Also not in a hospital full of professionals used to aseptic procedures and products.

> I would imagine the actual complication rate from such opt-in usages are likely to be lower than would result from unnecessary uses in a hospital environment…

I would imagine the opposite.

> I still think I might opt-in to this treatment again from time to time …

Or you could use regular ORT and get the same benefits. But it's your health and money so you do you.

[0] again unless it's a case of emergency rehydration, or the patient is unable to drink, obviously

Re: IV Bags May Not Be Necessary to Rehydrate Patients

#130

Post by kragen »

albertgoeswoof wrote: post #16
mabbo wrote: post #9

> You can also make good oral rehydration solutions yourself at home for pennies: Just take 32 ounces of water and add 6 teaspoons of sugar and a half-teaspoon of salt. > resist the temptation to drink at a normal rate... An ounce at a time every few minutes This should be something everyone learns. Many common headaches are just dehydration. When you've got a cold or flu, dehydration is common and makes you feel eve…

what does the sugar and salt do in this case? edit: it's in the article: > for rehydration, glucose is basically as important as sodium. The two compounds work together to pull water into shriveled cells that have been deprived of ample water.

The article is wrong. I moved my response to https://news.ycombinator.com/item?id=16440309
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