Discussions By Condition: I cannot get a diagnosis.

After Effects of Electrolyte Imbalance?

Posted In: I cannot get a diagnosis. 9 Replies
  • Posted By: princeessraye
  • April 24, 2008
  • 01:21 AM

Hi. I am trying to get help for my mother. She had a severe electrolyte imbalance due to diuretics the doctors gave her for a swollen knee (she was waiting for surgery) She went for her pre surgery phsyical. She told them she was exhausted, having trouble thinking straight, felt sick all over. To my surprise they did not blood work. They changed her pain meds which did not help at all. The day of knee surgery the doctor refused to operate due to her condition and had her go to the ER. She was hospitalized and treated for the electrolyte imbalance they discovered while doing blood work. This has been over a month ago. Her levels of sodium, potassium, blood calcium, etc are back to normal but she is not. The mental confusion is gone but nothing else. Two weeks ago she successfully went through knee surgery, is going to therapy for that and doing very well in that aspect. She is 80. She normally volunteers five hours a day now she is interested in nothing. She is so tired that she can't be interested. She just feels sick all over, like someone starting to get a flu or stomach virus but of course that isn't the problem. The doctors are not giving her any answers. They do not even seem to know the long term effects of having an electrolyte imbalance (if there are any) NOR what to do to help her.
Is there a certain type of physician that would deal with this? IF so, I will find one and get her an appointment. We are both at our wits end. I feel so helpless.
Anyone who knows anything about this and would be willing to share , I would appreciate it so much.
Thanks, Sharon

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9 Replies:

  • Hi did you ever get any answers on this ...i am going through the excat same thing with my mother who is 85...your description of your mothers condition and mental state is identical!! We are also not gettin any answers from our doctors...thx
    Anonymous 42789 Replies Flag this Response
  • Hello. Sorry to say we have gotten no answers. While my mom is much better she was never able to go back to the work she loved nor can she go to exercise any longer. She never regained her stamina. Her mental condition improved a lot but she is not the person she was before. (memory, ability to quickly understand something a bit complex when someone is telling her about an issue) I am sure some of this is her age as you can't bounce back as easily like you can when you are younger however it should have never happened !She has accepted the situation. I am very angry. When a person's diuretics are doubled and they become weak, sick and confused a doctor should know to check their Electrolytes ! I just wonder how many years she could have continued the things she loves if this had not happened ! Electrolytes affect all of your cells and are very important.It is important to give yourself time to recover. Although my mom's situation is probably permanant I am still looking for something to help her. If you find anything I would greatly appreciate you responding.Good luck and God Bless.
    princessraye 4 Replies Flag this Response
  • Hello. Sorry to say we have gotten no answers. While my mom is much better she was never able to go back to the work she loved nor can she go to exercise any longer. She never regained her stamina. Her mental condition improved a lot but she is not the person she was before. (memory, ability to quickly understand something a bit complex when someone is telling her about an issue) I am sure some of this is her age as you can't bounce back as easily like you can when you are younger however it should have never happened !She has accepted the situation. I am very angry. When a person's diuretics are doubled and they become weak, sick and confused a doctor should know to check their Electrolytes ! I just wonder how many years she could have continued the things she loves if this had not happened ! Electrolytes affect all of your cells and are very important.It is important to give yourself time to recover. Although my mom's situation is probably permanant I am still looking for something to help her. If you find anything I would greatly appreciate you responding.Good luck and God Bless. Has your mom by chance had her B12 levels tested? B12 deficiency is becoming an increasing problem and is very common in the elderly. She may do well to try a trial dose of 1000mcg of methylcobalamin B12. I recommend highly Jarrow's Methyl B12 - they are lozenges you slowly let dissolve under the tongue. My patients who take these notice a change within hours of taking them - increased energy, decrease in mood swings and more. You can find this at a good healthfood store or online at www.vitacost.com Could you please post all medications your mom is currently taking and how long she has been taking them? Is she taking any supplements? Best wishesDOM
    acuann 3080 Replies Flag this Response
  • Yes she has had her B12 checked. She was fine. She is slightly deficient in Vitamin D and working on fixing that.I am still searching, still angry. I want my mother back the way she was but it's not looking good.
    princessraye 4 Replies Flag this Response
  • Sorry I missed part of your question.She takes 1/2 Ativan per day, blood pressure medication (a mild one), Miloxican. Supplements - Multi Vitamin, Calcium with D, and as of a couple months ago an extra 1000 IU Vitamin D twice a week.Her heart and lungs are very healthy.
    princessraye 4 Replies Flag this Response
  • F, age 80 yrsInitial post (4/24/08)-diuretic therapy for "swollen knee"-preop eval : exhausted, trouble thinking straight, sick all over-no blood work (possible acetazolamide therapy?)-change in pain meds (narcotic analgesics can cause confusion, pain can cause confusion)-surg postponed, sent to ER --> hospitalized, treated for "electrolyte imbalance" -underwent knee surgery 2 wks laterMonth after initial episode-Electrolytes normal-Mental confusion resolved-lack of interest in anything (anhedonia); no longer interested in usual activities (volunteering)-feels sick all over like flu or stomach virusOne year later post (4/9/09)-"much better but...never able to go back to work she loved nor...exercise" never regained stamina-"mental condition improved" but "not the person she was before" -->memory, understanding-daughter suspects long-term effects of electrolyte imbalance and partly effects of age. still looking for helpRecent posts-B12 normal, slight Vit D def being treated-meds: 1/2 ativan (lorazepam) daily, anti-hypertensive (unspecified), meloxican (COX inhibitor), vit supplementsheart, lung healthy I will try to address the concerns raised in this thread: (1) Initial diuretic therapy: Many diuretics (such as thiazides and loop sparing diuretics) can cause hypokalemia (low potassium). Clinical features include weakness and arrhythmias. Generally, for a swollen knee, I would suspect an osmotic diuretic was likely given, such as acetazolamide, and this is not associated with hypokalemia, which may explain why your doctors did not do a blood work initially. (Also, there are potassium-sparing diuretics which do not cause hypokalemia.) It would be helpful to know which diuretic she was on. (2) Your mother was treated for "electrolyte imbalance" at the hospital. Presumably, hypokalemia had occurred and was treated with intravenous potassium. IV potassium should not be given at a rate of greater than 60 mEq/hr. when given correctly, the electrolyte imbalance is corrected, and there are no known long term effects of hypokalemia. (3) The mental confusion your mother experienced may have been due to pain or due to pain medications if they were opioid analgesics. This was resolved after the surgery. (4) Her electrolytes were checked and found to be normal. (5) Your mother's current seem to be loss of interest in her usual activities (anhedonia), vague feeling of sickness, psychomotor slowing, difficulty concentration, problems with memory etc. The set of symptoms you have listed seem to indicate a diagnosis of major depression. (6) Memory problems in the elderly raise concern for dementia. But, in the elderly, one has to be very careful in differentiating depression from dementia because elderly patients with depression can present with dementia-like symptoms (this is medically called "pseudodementia") (7) Ativan (lorazepam), which your mother is presumably taking for anxiety can also cause mental confusion, which may be misinterpreted as problems with memory or understanding. In addition, in the elderly, it may cause balance problems and falls which may result in fractures that may be very disabling or even deadly. (8) My opinion: your mother is likely suffering from unrecognized clinical depression. I think Ativan should be stopped and replaced with an antidepressant. (9) My recommendation: Please consult an internist, psychologist, or, preferably, a psychiatrist for evaluation of your mother's problems. These should not be taken lightly. If depression if what she has, you may notice a remarkable improvement in her personality and memory with proper treatment.
    m3dh31p 69 Replies Flag this Response
  • Thank you so much for the in depth info. I am not sure what diuretic she was given but may be able to find out.She was treated with anti depressants for some time. While I do think it helped her through the time immediately after leaving the hospital, that is all. Once she came to acceptance that she was no longer able to work or exercise, due to lack of stamina, she came out of the mild depression. She has since found other interests but they are at home or with her neighbor . (playing Scrabble,etc.) She seems reasonably happy however frustrated that her mind does not work as well as it did and still wishes she could go back to work and/or exercise. I have read that someone with an electrolyte imbalance that is allowed to go on for a long period of time can have permanent damage to their brain and other organs. She feels that is what has happened. While she is able to totally take care of herself, her finances,etc. she doesn't grasp concepts like she used to. She is seeing a Neurologist on Monday due to pain in her head that the Ear, Nose and Throat doctor could not diagnose nor her GP. I plan to tell mom to take her information regarding this electrolyte problem to her appointment and to tell the doctor what she has experienced since that time.She has taken a very small amount of Ativan for 40 years. At one time she was Agoraphobic and ATivan gave her life back to her. She takes less now than she did when she was younger. Generalized anxiety runs in our family. As well she and I both have Fibromyalgia. She for 50+ years and I for 20+ years.Thank you so much for your time. I will print this and let mom read it and see what she thinks.ThanksSharon
    princessraye 4 Replies Flag this Response
  • My friend had an electrolyte imbalance after fasting for a couple of weeks where she eventually stopped drinking water. She experienced an event she calls her spiritual awakening during this and has never been the same. She was admitted to the hospital for a psych eval and was diagnosed as being bipolar but no electrolytes were checked. My question is: Can a severe prolonged electrolyte imbalance cause brain damage and long term effects on the brain? It all occurred almost 15 years ago and she cannot concentrate for long periods of time, has irrational thoughts often and really is not the same. She often has aches and pains that go undiagnosed and just cannot seem to understand everyday life. I have heard of a couple other people this has happened to and their lives took very similar turns. Is there someone (a doctor) out there that can explain to me what has happened to her and let us know if anything can be done? Are there tests that can show if long term brain damage was done and would a GP even order those tests?
    Anonymous 42789 Replies Flag this Response
  • My friend had an electrolyte imbalance after fasting for a couple of weeks where she eventually stopped drinking water. She experienced an event she calls her spiritual awakening during this and has never been the same. She was admitted to the hospital for a psych eval and was diagnosed as being bipolar but no electrolytes were checked. My question is: Can a severe prolonged electrolyte imbalance cause brain damage and long term effects on the brain? It all occurred almost 15 years ago and she cannot concentrate for long periods of time, has irrational thoughts often and really is not the same. She often has aches and pains that go undiagnosed and just cannot seem to understand everyday life. I have heard of a couple other people this has happened to and their lives took very similar turns. Is there someone (a doctor) out there that can explain to me what has happened to her and let us know if anything can be done? Are there tests that can show if long term brain damage was done and would a GP even order those tests?My Mom is 72 and going through similar situation. She partly unconsious. I like to know more long term effect of this.
    Anonymous 42789 Replies Flag this Response
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