low sodium in elderly mother

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concerned son - 17 Jun 2006 08:08 GMT

i just got my mother out of the hospital today.she has a problem
maintaining a safe sodium level.last time she was in hosp. it was
124.this time it went to 121.she is on synthroid and phenobarbatol and
actonel.her age is 72.this time they said she had pneumonia.

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Robert CLS, MT(ASCP) - 17 Jun 2006 09:55 GMT

> i just got my mother out of the hospital today.she has a problem
> maintaining a safe sodium level.last time she was in hosp. it was
> 124.this time it went to 121.she is on synthroid and phenobarbatol and
> actonel.her age is 72.this time they said she had pneumonia.

Sorry to hear that.

The sodium level actually reflects water or hydration status.
A physical exam would reveal the nature of the low sodium on whether
she was dehydrated and hydrated rapidily or if she was edematous that
would reflect she is retaining water or non-edematous that would
include the hypothyroid group, the pneumonia group of inappropriate
vasopressin release (SIADH), and possibly the drug group including
barbiturates.

Unfortunately the definiton of syndrome of inappropriate anti-diuretic
hormone secretion (SIADH) can not be made in the presence of
hypothyroidism or certain drugs by laboratory methods as they are
similar and inseparable.

The problem is one of water handling and again I am sorry about the bad
news.

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Robert CLS, MT(ASCP) - 18 Jun 2006 09:37 GMT

> > i just got my mother out of the hospital today.she has a problem
> > maintaining a safe sodium level.last time she was in hosp. it was
[quoted text clipped - 18 lines]
> The problem is one of water handling and again I am sorry about the bad
> news.

Just to expand my answer on that.
The differential of causes for SIADH involves a variety of things
including neurological disorders and lung disorders of pneumonia, TB,
chronic obstructive pulmonary disease and tumors including lung cancer.
One such tumor is called oat-cell carcinoma also referred to as small
cell carcinoma.

Synthroid is for her thyroid, hypothyroidism. The Actonel is for
osteoporosis and the phenobarb is to prevent and or control seizures.

I am not a doctor and so I would defer any medical decisions and
treatment to those supervising her care. Any questions would be
answered by them I am sure over the phone. I am sure there are people
out there that can help and give support.

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