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Dehydration is something that can sneak up on you. I was hospitalized for dehydration myself just last week. I had been living in a house that had really foul-tasting, sulfurous well water, and I had been eating  low-sodium "diet" meals. I didn't get enough water from my food and I wasn't drinking enough water between and with meals. I started having chest pains and feeling weak. I've had a couple of heart attacks, so it seemed like a good idea to get to the hospital. The primary problem, though, was I didn't have enough fluid in my body so I didn't have enough blood volume, either. Because I had been on Lasix to remove fluid and sodium so my heart wouldn't have to work as hard, my bloodstream had become depleted of sodium, fluid moved out of my bloodstream into my muscles, and my blood pressure plummeted as if I had been bleeding. 

Four bags of saliine and a $25,000 bill later, I was OK.

How Can You Tell If You Are Dehydrated?  

Here are some warning signals.

  • You just don't feel 'with it." You have trouble concentrating, your vision is blurry, or you are experiencing mood swings.
  • Your heart seems to be OK but your skin is dry and your muscles are "shrunken." This happens when you get enough salt but not enough fluid. Water remains in your bloodstream as other tissues dehydrate.
  • Your blood pressure is low (causing you to feel weak or dizzy, especially when you stand up) but your skin isn't dry and your muscles haven't shriveled. This happens when your kidneys are removing sodium (after you take a diuretic, for example) and water both. This can happen when you try to rehydrate with pure water.
  • You have been on a diet and not getting enough fluid or enough food. You have had diarrhea, or you have been vomiting. You are on medications that increase urination or change sodium balance.

You don't have to have a gastrointestinal infection to suffer diarrhea. Taking more than about 2,000 mg of vitamin C a day, for example, often causes diarrhea. Some people even mistakenly believe that you have to induce diarrhea to be sure you're getting enough vitamin C. The only way to get a true megadose of the vitamin (something you might want to do in cancer treatment) is to get it intravenously. This requires a doctor's supervision, but it's a simple procedure.

What Do You Do When You Are Dehydrated? 

First of all, stop any activity that is making it worse. Get in out of the sun. Stop exercise or work.

Then rehydrate. Just drinking water usually doesn't make the situation better. You need to replace both water and electrolytes, unless you have somehow received an overdose of salt that has caused your kidneys to work overtime. You can use a commercial rehydration drink such as Pedialyte, Gastrolyte, Ricelyte, Resol, or Drip Drop, but you can also improvise. Clean water with a spoonful (up to 5 gtrams or one teaspoon) of table sugar and up to half a teaspoon (2 grams) of table salt in a liter (quart) of water is better than nothing. Sugar is not ideal in a rehydration drink because it can draw water into the intestine, but when it is consumed with water, it powers absorption of fluid. The standard American treatment of Coke or Seven-Up only works if there is enough water in the gut along with the soft drink. Most adults need about 10 glasses, or 2 liters, of fluid to rehydrate when they become dehydrated. About half of that fluid can be water, but all of it cannot be just water.

Dehydration is a very serious condition in infants and small children. When a baby is severely dehydrated, the fontenel (the soft part) of the head may be depressed. Don't press on it. The skin may be dry. The child may be fussy, and hot. Rehydration in infants may be started at home with a produce like Pedialyte, but medical attention is still needed as soon as possible. In adults, the inability to sweat when it is extremely hot is a sign that medical attention is urgently needed, that home remedies will not be enough.

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