Hyponatremia and Central Pontine Myelinolysis

What is hyponatremia? Information regarding CPM and EPM.

Archive for the month “January, 2015”

It’s 4 O’clock in the morning…..

So for those of you new to this brain damage/ CPM/EPM experience, you might soon realize you don’t sleep normally anymore. You might sleep too long. You might not sleep long enough. You might sleep for 2 hours only to find yourself awake until the crack of dawn, so that you can suddenly fall back to sleep at 6:45 am when you need to get up at 7.

What do you do?

For me, I would usually turn to FB to surf cute animal videos and lament on my current insomnia kick, but after several fruitless debates with the general public on topics that I have considerable knowledge, I realized two things: FB stresses me out, and I have no self control in walking away from fruitless debates with the general public. It results in HOURS of going back and forth with people. It results in hours of me trying to find research articles that prove I’m right, that have no sway with the unreasonable.

So, I walked away from FB, at least for now, but tonight, after two hours of sleep, I found myself wide awake. What do I do? My hands twitched for my go to drug, my cell phone. I surfed through my email. Spam. My fingers twitched. Should I log onto FB to just vent my frustration of how much I hate not being able to sleep?

Ugh. I grab my phone and go to medicine cabinet and pop a Xanax along with a TUMS. I need sleep. Now, I just want to mention. You should not combine TUMS or any other antacid with your prescription meds. No. You won’t self destruct if you do, but the absorption of your meds can be greatly hindered by your antacids.

I drag myself back into my bedroom, and I stand there, hovering over the bed like some crazy horror movie serial killer, except instead of a knife, I have an IPHONE. I literally sway back and forth debating with myself–pale, crazy eyed, sleep deprived, hair a mess. I sway left—go write on my blog. I sway right–go back to bed.

Finally, I set down my phone. I climb back to bed, staring at the ceiling. It could be an hour before the Xanax kicks in, and I fall asleep. FB ? No, FB? Oh, the dilemma!

I desperately want to tell everyone about my 6 year old daughter’s recent rant.

Izabel: “Mom! Tomorrow, you need to call Mrs. Morrison (her teacher) and tell her I am NOT coming back to school tomorrow. I NEED A BREAK- EXCLAMATION POINT (waiving her hands up and down for emphasis). EXCLAMATION POINT! (Saying the words-“exclamation point”) EXCLAMATION POINT!  EXCLAMATION POINT! Sometimes, a 6 year old kid just needs a break from school,” she reasoned, “I am not learning ANYTHING new.”  She continues on making her very cogent point. Tom, comes from the kitchen, “This seems like a monologue.”

“It is,” I reply. How can you possibly reason with such a dramatic argument from your 6 year old? I didn’t try. Instead, I used a diversionary tactic, “Oh, look dad has dinner.”

I love my six year old daughter. She is hilarious, and this is just one of those stories that my friends on FB love to read about, so my fingers are itching to jump on and tell them, but I’m also thinking of my last debate that left me leaving FB, and how much I went to get back on the conversation and tear apart the people with facts and statistics and research, which will to no where but will cause stress, fatigue, emotional distress, etc.

That brings me to here. Time is ticking towards 5 am now. I am tired but awake, and I’m trying to figure out what’s the next step. Sleep? Or trying to figure out a new series of posts for either a new blog–a spin off that discusses politics, vaccines, other medical topics, etc. or researching more about brain injuries: newer treatment options, medications, alternative medicines, diets, etc.

This is another problem with brain injury–making choices, wanting to do everything but hardly doing anything because you can’t decide. Just look at how long it took to decide to write this post.

It’s working though. The Xanax is kicking in. I’m getting sleepy, and I’ve decided any decisions about what to do next can wait until 8 O’clock in the morning. 🙂

Have a good night, morning, day!

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Hyponatremia Recent Stats:

I have meant to do this for awhile, and I apologize for it taking so long. I guess, better late than never.

The HCUP website reformulated the way that they record statistics. Now, I did not read why or how, but it did show that the previous stats that they recorded before July of 2014 were across the board higher, than what they are listing now. For 2011, I will include all the data points that I found, ie old and newer stats.

Hyponatremia diagnosis codes: ICD-9: 276.1

ICD-10: E87.1

To obtain the date, I used the ICD-9 code: 276.1

For 2011, hyponatremia was recorded as this:

2011 National statistics – principal diagnosis only (hyponatremia only -from all hospitals in US)

Outcomes by 276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 100,215 2,333
In-hospital deaths 1,085 (1.08%) 73 (0.07%)

Therefore, there were a total number of patients that had hyponatremia specifically, 101,300 +/- 2406

If you look at all possible combination of hospitalized patients that had hyponatremia AND an additional condition (ie severe burns, cancer, liver transplant, etc):

2011 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”

276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,940,211 51,938

Now, these are the NEW reference points, the older version listed for 2011 hyponatremia only diagnosis: 104,744 (discharged), 1,124 people died.

If you include all possible diagnoses with hyponatremia, it is 2, 019, 550 +/- 53,454.

Yeah, that’s a lot of people who are at risk for CPM/EPM if hyponatremia is not diagnosed and managed correctly.

For 2012:

2012 National statistics – principal diagnosis only

Outcomes by 276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 101,330 1,139
In-hospital deaths 1,160 (1.14%) 75 (0.07%)

There is no older version of documenting with this system.

However, if you look at all hospitalizations that included hyposmolality:

2012 National statistics – all-listed
You have chosen all-listed diagnoses. The only possible measure for all-listed diagnoses is the number of discharges who received the diagnoses you selected. If you want to see statistics on length of stay or charges, go back and select “principal diagnosis.”

276.1 Hyposmolality
276.1 Hyposmolality Standard errors
Total number of discharges 1,934,996 22,563

I love numbers because they don’t lie. What I don’t like with this 2nd break down (all hospitalization that listed 276.1 with another condition), it is impossible to tell if hyponatremia actually killed the person or the other illness.

Regardless, there an extremely HIGH number of people who are diagnosed with hyponatremia each year, even if it is or isn’t with a secondary diagnosis. More people should be aware of the condition, and how it should be treated! Hopefully, you will spread the word on how common it is to get it, and how it should be treated.

Blessings!

(Use the link below to find the statistics above: http://hcupnet.ahrq.gov/HCUPnet.jsp)

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