So I have talked in past posts about journaling for Chronic Illness and doing good Habit & Health Trackers.  If I had practiced what I preach and had done the proper mindful journaling and paid attention to mindfully reading it, I would not be in the mess I am in now.

I would have realized the symptoms were creeping up and I would have known I was really going ever so slowly down hill. I had no idea how very sick I was and should have known enough to sound the alarm with my doctor.  He would have made sure that I got the attention and meds that I needed. But I didn’t pay attention, I didn’t read what I was writing when I put pen to paper.  When I wrote it and turned the page, I didn’t go back to revisit.

I am in total shock about how bad my numbers could be in such a short amount of time!  I thought I had a cold or a virus that I may need antibiotics, and I just hoped NOT to have a side of Steroids.  If only it had been that easy.

The Experiment

 

My numbers had been good back in the spring when it was determined that I was stable.  Things were going well except my weight and large areas of steroid bruising on my arms and hands. I couldn’t get either problem under control and I asked the doctor if I could cut back on my steroid puffers. He agreed to make it an experiment and monitor me closely as I did it.

 

It took a lot longer than expected to make the original cut from 200 to 100 mcg of Symbicort. That process took a good two months of a long slow reduction. The thought process was that I would slowly shed pounds as I lowered my intake of steroids.

Symptoms

 

For the last 6 to 8 weeks my breathing has been steadily getting worse. Symptoms include headaches, runny nose, dry cough, wheezing and extreme lethargy.  As I look back I realize that it has been months since I have used my treadmill or been on any daily walks. Slowly I had less and less energy.  I had only been using oxygen for exertion and exercise but it now seemed impossible to keep my 02 levels above 88 without it.  For the first time I had to wear oxygen to work.

The Results Are In

 

After the first month of cutting steroids my Sodium Chloride numbers, post blood work, were a little lower than usual but the doctor was cautiously optimistic that I would be able to rebound. He told me to start eating regular iodized table salt again. He also increased my Symbicort back to 200 mcg.

Then summer holidays happened, appointments were cancelled or delayed and when I finally saw my doctor my numbers were horrible. My breathing problem had nothing to do with my lungs and I did not have any virus or infections.

You Wouldn’t Believe It If I Told You….

 

By the beginning of October blood tests resulted in dangerously low level’s of sodium.  A condition called Hyponatremia.

According to the following by Merck Manuals the general symptoms include:

“As hyponatremia becomes more severe, muscle twitching and seizures may occur. People become unresponsive, aroused only by vigorous stimulation (stupor), and eventually cannot be aroused coma). Death may follow.”

“The brain is particularly sensitive to changes in the sodium level in blood. Therefore, symptoms of brain dysfunction, such as sluggishness (lethargy) and confusion, occur first. If the sodium level in blood falls quickly, symptoms tend to develop rapidly and be more severe. Older people are more likely to have severe symptoms.”

http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/hyponatremia-low-level-of-sodium-in-the-blood#v28394697

According to the above paper from Merck Manuals, in more severe cases patients could get a sodium drip intravenously but for me it is not an option.

History Counts Too

 

I have a history of Sudden Cardiac Arrests (SCA’s). I have had two SCA’s, both times transported to hospital vital signs absent. SCA’s are a problem with the heart’s electrical system. An arrest happens usually because of the heart going into a pattern that it cannot control. The heart just stops. No blood moves through the body, PERIOD. Lungs begin to fill with carbon dioxide and you die. Unless you get the paramedics that I got. Dispatch sent the same team both times. Amazing!

 

An overload of sodium could cause another SCA, and low levels of sodium can be just as dangerous.

 

Immediately diuretics were halted, water intake restriction to 1/2 of my normal intake and I was prescribed hefty does of pure Iodized Table Salt.  So now as I have lost my taste for salt and I have to have it with everything I eat.

 

 

Here’s Why I Think it Happened

 

  • I assumed I knew what the problem was but I didn’t know and didn’t get the right help earlier enough.
  • My water consumption every day exceeded 88 ounces, way more than necessary.
  • Following a Paleo lifestyle, but I further modifying it by cutting out all food that contained salt and eliminated all grains or breads.
  • Not eating enough vegetables.

Conclusion

 

We thought the obvious and quickly went back the way we came. My lower numbers had nothing to do with having problems with the decrease of steroids, but rather with the slow and steady decrease in my overall sodium chloride levels.  I did however need the increase in steroids  just to get past this episode.

Slowly I am starting to feel better and I am so grateful for my doctor who monitored me closely and knew what to do about it. The doctor has assured me that I had not turned another corner in my battle with COPD. My symptoms should return to normal as my minerals are increased.

So far I have had low potassium, low magnesium and now low sodium.

 

 

 

 

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