DEAR DR. DONOHUE: What can you tell me about a low sodium level? My visiting friend (from England) was refused embarkation on his cruise because he was acting belligerent and confused. The ship’s doctor sent him to a hospital. He had scans, an EEG and numerous blood and urine tests. Everything was normal except he had low sodium. His insurance carrier sent a doctor from England to accompany him on a flight back to London. He has since seen his own doctor. His sodium level has risen. What happened to him? — B.L.
ANSWER: Sodium has many functions. It keeps body fluids at the right level. It maintains blood pressure. It’s essential for muscle contractions. It participates in generating the heartbeat. It carries a positive electric charge, so it balances the negatively charged body substances.
A drop in blood sodium leads to fatigue, nausea and weakness. If the level dips farther, people become confused and dizzy. At very low levels, they could have a seizure and lapse into a coma.
Your friend’s doctor has the task of finding out why your friend’s sodium level fell. In quite a few instances, it comes about from an inappropriate release of a body hormone called ADH, antidiuretic hormone. This hormone stops kidney urine production. The result is too much water in the body. The extra water dilutes sodium and produces a low reading. Liver diseases, troubles with the adrenal glands and a sluggish thyroid gland are other causes for a lowering of blood sodium.
Restoring the body’s sodium content is not too difficult. Tracking the reason why it dropped is.
Has your friend’s mental function normalized now that his sodium level has returned to normal? If it has not, then his doctor has to look for explanations of his erratic behavior that have nothing to do with his sodium.
The booklet on sodium and potassium explains why these minerals are so important and what happens when they are out of kilter. Readers can order a copy by writing: Dr. Donohue — No 202W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have been eating ice cream and cookies sweetened with Splenda for about four years, enjoying them very much and not experiencing any bad side effects. Then someone told me that Splenda is really bug poison and that it has made a lot of people sick, so I stopped using it.
I have noticed no improvement, but I didn’t have anything wrong in the first place. I miss Splenda foods. What is your opinion? — N.B.
ANSWER: Splenda is not bug poison. It’s made from sugar. It’s a product that is 600 times sweeter than sugar. It is not absorbed, so it contributes no calories to those who eat it. It’s FDA-approved, and I trust the people at the Food and Drug Administration more than I trust your informant. There’s no reason for you not to use it.
Some people delight in passing on alarming information. Your “someone” has to be one of them.
DEAR DR. DONOHUE: I’m beginning to get little knobs on my finger joints. I believe this is arthritis, and I have seen it in the advanced stages. What can I do to prevent it from getting worse? — Anon.
ANSWER: The knobs on the finger joints below the fingernail are Heberden’s nodes, named after an English doctor who died at the start of the 19th century. Knobs on the middle finger joints are Bouchard’s nodes, named after a French doctor who died in the early years of the 20th century. Both of these knobs are signs of osteoarthritis — the common kind of arthritis, the kind that most seniors have at least a touch of. They’re similar to bone spurs seen on backbones and other bones, another consequence of osteoarthritis.
Osteoarthritis comes from fraying of the cushioning cartilage inside joints. How extensive or how incapacitating it will be is unpredictable. Most people manage to get along in spite of it. However, it can be a great burden to others.
There is no preventive medicine to stop osteoarthritis in its tracks. It has a predilection for the fingers, hips, knees and spine. Should it strike larger joints like hips, knees and backbones, muscle strengthening will serve you well. Strong muscles protect joints. The exercise should not be so vigorous that it causes pain, but it should be vigorous enough to encourage strength building. Being overweight increases the stress on knees and hips, so you should strive to stay on the lean side.
Many people swear to the effectiveness of chondroitin and glucosamine, both of which are available without a prescription, and often they come in combination. Not a lot of evidence exists to endorse them wholeheartedly, but if you want to give them a try, they won’t hurt you.
The arthritis booklet deals with osteoarthritis, also called degenerative arthritis. Readers can order a copy by writing: Dr. Donohue — No. 301W, Box 536475 Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: For quite some time, my right shoulder has hurt. I saw an orthopedic doctor, who says I have a tear of my rotator cuff. He suggested surgery. What do you think of surgery for this?
I am scared that I could be worse off after the operation than I am now. I am only 44 and am quite active. — K.M.
ANSWER: The rotator cuff is a band made up of the tendons of four back muscles. The tendons wrap around the topmost part of the upper arm bone, the humerus, to keep the bone in the shoulder socket. Tears of the rotator cuff are a common problem and one of the principal causes of shoulder pain. Small tears can heal on their own. Larger tears almost always require surgical correction. All surgical procedures demand respect. Something can always go wrong. Most people who have had surgery to correct a rotator cuff tear are glad they had it. By most, I mean more than 95 percent. I would not hesitate to have this surgery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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