IV Bags May Not Be Necessary to Rehydrate Patients
slate.com
slate.com
> 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 even more miserable. Got a hangover? This will make things better for you.
The only part of this I've never realized was how much sugar is needed to optimize it. Good to know for next time.
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.
And the sodium also (and originally) serves to combat hyponatremia, as lost fluid generally brings sodium along for the ride if you rehydrate with non-electrolytic water you find yourself with mild to severe low sodium levels.
There's many a time, I believe, I've mistaken a loss of appetite control for some "emotional event" when it's been mere dehydration.
I recently traveled for several days without drinking much and sugar binged when getting home. I assumed the travel had stressed me, rather, I was just severely dehydrated.
Thanks for the link.
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.
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.
Simply drinking a large glass of water before going out, and having a glass of water after each alcoholic drink, is a pretty good way to avoid a hangover.
(also the water will help you pee out a lot of toxic crud that your kidneys have kindly removed from your bloodstream for you).
At the start of my bachelor party (and possibly later on that night? It gets blurry) we brought workout hydration powder, the kind you use during and after a gym session. Drank a lot of it ideally to prevent or reduce hangovers.
I have no idea how much it helped, because I was still hungover the next day.
Adding - 1/2 tsp of salt is 2.5 grams of which it is 1 gram of sodium. G2 - 435mg sodium, 120mg potassium; normal - 400mg, 100mg.
Note that the label says it contains 21g sugar, 150mg sodium, 35 mg potassium - per 12 fluid ounces. Multiply by 2.66 if you drink the whole bottle.
In table format:
DIY Oral Gatorade Gatorade Powerade Pedialyte
Solution G2
Sugar (g) 25 19 56 56 24
Sodium (mg) 1000 435 400 400 986
Potassium (mg) 0 120 100 93 780
It's striking how similar the regular Gatorade and Powerade are. Also, the powerade.com nutritional info site is "down for maintenance", had to search elsewhere: http://archive.is/2018.02.22-160258/https://www.powerade.com.... They have the Coca-Cola logo.gif on the site, but unfortunately no animated orange construction barrels.
Edit: Added Pedialyte
Gatorade has glucose (aka dextrose, the same sugar as an IV bag) while Powerade has high fructose corn syrup.
Glucose can be used directly by your cells while fructose is metabolized in the liver first. So for quick relief from dehydration I choose Gatorade.
* Glucose = 100% dextrose
* table sugar / sucrose = 50% dextrose
* high fructose corn syrup = ~40% dextrose
I have seen in stores sodium-free salt, and reduced-sodium salt, which both substitute potassium for the "missing" sodium, which can be a source of potassium if the added benefit is worthwhile.
So for 32oz, that 986mg sodium, and 24g sugar, which seems spot on to the articles recommended ratios.
Hydration is no joke.
Simply because they are probably more likely to drink and eat that :)
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.
It worked so well that I barely needed any painkillerss during my recovery after that. Quite surprised my doctor didn't suggest it to me though.
I'll be adding some sugar to it to see if it improves things.
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.
Sure, then athletes might show up to the scales hungry, but that's more healthy than sweating.
And by 'they', sure, the UFC could make a big change...but where this really needs to start is the high-school wrestling mat, where you have kids establishing a culture of 'grit' as defined by running in hoodies. I haven't been a wrestler myself - I was a track kid in high school - but I can vividly remember swiftly passing our varsity wrestling team during winter training on the indoor track in our gym. They shuffled along in their uniform, heavy sweats, fists bunched up to their chests (from too much bench pressing and curling and not enough triceps/lats work) while I wore nothing but some short shorts and was dripping with sweat anyways.
UFC fighters are appropriately compensated and informed of their risks. High school kids are not.
State wrestling finals for my state are in two days. It's 11:45 here, so right this minute, a lot of kids are just wrapping up their lunch and some of the best wrestlers across the state are going back to class hungry and dangerously thirsty - on purpose - so they can make weight this weekend.
http://bleacherreport.com/articles/2555772-weight-cutting-so...
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.
It sounds to me like an intern over-reacted to her dehydration, and over did it with the IV fluids.
You're being down-voted, but I know a number of military medics and hospital employees who do this after heavy drinking. Seems to work like a charm.
Even if the person has nausea, they can drink a bit at a time
> Second, she says, is to resist the temptation to drink at a normal rate—let alone chugging the stuff. An ounce at a time every few minutes decreases the odds that the liquid will, um, return from whence it came.
Not necessarily. Sometimes the nausea is so severe that even a teaspoon of water gets sent back the way it came in… a most unpleasant feeling when the body refuses to take anything and ends up vomiting fluids beyond the stomach—e.g. bile.
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.
Indeed, it wasn't a solution!
As a physician we do occasionally see folks die from hyponatremia (low salt) from overly correcting dehydration with water. It’s a terrible tragedy.
Plain water still works fine. It's just slower.
I did this several years ago, after dehydrating myself while working outside on a hot day. Water didn't touch my thirst, then I realized I needed electrolytes. I used lemon juice, sugar, and a good amount of salt. It was delicious.
“take around 4700 mg of potassium per day max 2000 up to 3000 mg of sodium per day max” into a liter of water for a full day’s worth
Edit: Nevermind, I should have read the entire thread first...
I wonder how much. Obviously not $2000, that's absurd. But maybe $200. Or $2. Or maybe the insurance company gets paid $20 by the hospital so they get to make $180 off of you for the IV.
I have it on good authority that saline IV bags are dirt cheap. The hospital used a machine to control the delivery rate, but that cost should have been amortized over hundreds or thousands of patients. The nursing labor involved was negligible, not more than a half-hour for the whole stay.
Also, I've heard, but have not verified, that coconut water is a decent approximation. I'm not sure if this is true, but it's certainly delicious.
By the way, the Amazon product searches for this return a cesspool of magic woo. I recommend going to your local drug store, looking for the powdered Pedialyte, then looking in the meter-or-so surrounding that area for the cheaper store-brand version.
Then again sugar and salt also keep forever. I guess the sealed unidoses help though.
In the UK its pretty rare to get an IV bag, unless you are a celebrity.
What I was talking about was walking in to A&E with a slight cold and a headache, you might get a drip if your totally drunk, but you're going to get a grey needle (the largest one you can get.) and its not going to be comfortable.
The higher the cost, the higher value of the percentage skimmed off the top from insurance.. there is no cost incentive here from the POV of the charging institution.. this has nothing to do with 'measurable upside'
The glucose is important because it enables the _enteric_ sodium-glucose cotransport mechanism to work, allowing the sodium to get out of your gut and _into your blood_ many times faster.
Neither glucose nor sodium directly help with rehydration; on the contrary, glucose and sodium in your gut decrease osmotic pressure and reduce rehydration. However, kidneys tightly regulate the osmotic pressure, and in particular the sodium content, of your blood. If you take in water without taking in sodium, your kidneys will work to excrete the water without the sodium, producing hypotonic urine. If you overwhelm this mechanism with too much water, or if your kidneys are damaged, you can go into hyponatremia, which can kill you.
So, even though sodium interferes with rehydration in the sense of "absorbing water", it is necessary for rehydration in the sense of retaining water.
This is where the glucose comes in. In addition to simple diffusion of sodium out of your intestines, it was discovered in 1968 that the small intestine has a much faster active sodium-glucose cotransport mechanism, which allows you to absorb sodium about ten times as fast. It transports a single ion of sodium together with a single molecule of glucose across your intestinal wall. Until this discovery, as explained in the UNICEF page linked from the article, diarrhea was the leading cause of death among children. Oral rehydration solution diminished that problem enormously, as the article points out, and now respiratory infections are the leading cause of death among children.
(In a stunning example of the failure of diffusion of knowledge, it turns out that enteric sodium-glucose cotransport had been discovered by Crane in 1960, but the discovery wasn't applied to save lives on a large scale for some 11 years. You can read more about the mechanism at https://en.wikipedia.org/wiki/Sodium-glucose_transport_prote... or PubMed.)
The article claims that this cotransport mechanism is important in absorption of sodium from the blood by all the cells in the human body, not just in kidneys and intestines. As far as I know, this is a novel medical claim, and should be treated as alternative medicine. I am not aware of any evidence that adding glucose to an IV drip speeds recovery from dehydration.
However, the article's recommendation that dehydration should be treated with oral rehydration solution when possible, rather than intravenous fluids, is sound, already an official recommendation of the WHO, and should be more widely practiced.
(Originally posted at https://news.ycombinator.com/item?id=16440265)
But I happened to try an elective iv clinic on Sunday — after a hard workout and long night the previous day — https://www.onusiv.com. I’ve never had an iv before — but the experience was genuinely awesome — muscle pain decreased, I felt lighter and energized, and my mood improved dramatically.
It’s funny to read about how iv’s aren’t useful so quickly after having used one for the first time and been genuinely persuaded that it was effective ...
The article is about them being unnecessary 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).
The (possibly apocryphal) article also went into modern educational efforts in rural India, where people were being taught the proper handfuls of sugar and salt to add to water, to combat cholera there.
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.
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 ... 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... (Or perhaps this line of reasoning is simply me trying to rationalize this unnecessary behavior to myself -- regardless of the lack of necessity in a hospital setting, I still think I might opt-in to this treatment again from time to 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
Now, however, I think you might be guilty of extending the argument beyond its original domain in pursuit of snarkiness. Is it your claim that an IV is useful for no purposes beyond rehydration? It’s certainly possible to include other substances in the iv which are rapidly absorbed into the bloodstream.
It seems to me like studies showing suitability of ORT to rehydration wouldn’t necessarily offer insight into these other uses ...?
Also regarding complication likelihood — I think your argument glosses over the fact that the sheer complexity of the hospital environment introduces all sorts of incidental complexity not present in a simpler context. A “factory” that does one thing is much easier to optimize (including to optimize for safety) than a place like a hospital which has to house the entire complexity of the full medical process.
In Taiwan, it used to be a thing to get vitamin B shots all the time for no good reason. The placebo affect was probably involved. It turns out that the vitamins were almost certainly useless, but some 90% of the population got Hepatitis B. Guess who didn't sterilize everything properly?
I would stay the fuck away from quacks who want to inject magic solutions. At least the detox crowd just drinks that stuff.
Also, jeez, for the cost of one of those infusions, you can drink a lot of delicious, potassium-loaded fresh coconut water, even at restaurant prices.
Unless you are vomiting, unconscious or potentially going into surgery, using an IV to administer the fluid is unnecessary.
32 ounces ≈ 0.95 litre
As someone who only uses traditional units, I wish that more articles would use them. Perhaps a good compromise between us would be for articles to use both!
There was a program that taught women in developing countries to make oral rehydration solution for their children - the result was decreasing deaths due to cholera by an order of magnitude. Many of these women didn't have tools for measuring the ingredients, and the program didn't distribute them - requiring such tools would restrict the spread of the program.
The heuristic is a liter of water, a handful of sugar and a generous pinch of salt. The result may not be exactly the optimal concentration, but it's essentially always close enough to have the desired effect. This heuristic has saved millions (probably tens of millions) of lives.