low sodium

Hi everyone; I have not written in quite awhile. My question is about low sodium. My dad was diagnosed with limited stage sclc back in January. Before diagnosis, he had a low sodium level, finally they figured out it was sclc. The tumor is in his left lung and lymph nodes. The dr thought it was in the adrenal gland, but after he received chemo there was no change in the size of the adrenal gland, and dr. said it was not there. Went thru chemo, radiation to chest (x30) and proph. radiation to the brain. This finished up in early July. Dad was feeling pretty good, had gotten his strength back (not all but a good portion), and then starting in mid August we could tell that he was becoming more tired. An appt. with Dr. was scheduled for September 21st. Well within the last week and a half, headaches, weakness and not eating well. Brought him in early, sodium was 117. Was admitted to the hospital, sodium dropped to 115. They finally(!!) started him on fluids. Scans all came back fine. Nothing on the brain, no change in tumor size in lung, adrenal glands still same size. I guess my question is... with the low sodium, does this mean that the tumor is "active" again, and his the cancer traveling? Just worried, he is still in the hospital and they started him on a sodium pill (the name I am not sure of at this time), level has only gone up to 121 with the IV so hopefully the pill will kick in. I have read up on the low sodium in sclc, no real answers out there to answer my question. We will be discussing this with his dr., just wanted some input from this wonderful group. Thanks! As always, you are always in my thoughts and prayers!!

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Is he on any diuretics? Was he drinking fluids with electrolytes, which is preferable?(sports drinks)
•If your blood test results show sodium levels are severely decreased, he or she may suggest that you restrict your water intake
•Avoid caffeine and alcohol, as these can cause you to have electrolyte disturbances
I am sure they will get it under control as you didn't wait long to get him in. No it doesn't mean the tumor is active again. It is probably side effects from the treatment. Hang in and try not to worry to much. Keep us posted. Take care, JC

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hi, ssgirl
low sodium often goes with sclc - this is not fun, but fairly normal. what happens is that his body is not squirting out enough of a hormone that regulates sodium in the blood - the thing is called the syndrome of inappropriate anti-diruetic hormone, or SIADH. you NEED to memorize these letters -if he ever goes into the hospital, shout it out at whoever will listen, as they typically will stick a "normal saline solution" into patients, and this will drop sodium content into the ditch, and dad will get miserable. you need to slow them down.

there are several treatments for SIADH.
* salt pills - they taste bad, are huge, and are fairly gaggy - altogether a fairly sucky option
* potato chips, chicken soup, and pretzels - if you look, the sodium content on these foods are fairly high. my daddy's onc had him eat a bowl of potato chips a day and this kept his levels good for a real long time. I wish my doctor would give me this kind of prescription....
* dodeclymycin - this is an antibiotic that sucks at antibiotic things, but has the side effect of really raising blood sodium - it has few other side effects - works real good.
you need to talk with his onc about low sodium (this is also called hyponatremia) and what would be best for your daddy. also - when they try to raise blood sodium, they have to do it slowly or other bad things happen - they aim for about 1 point a day.

your daddy is real lucky to have a warrior like you by his side. as we all know - daddies are real precioius people, and we need to take special care with them!!!

sending hugs and prayers to you and your daddy!
Pat

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Good answer Pat, give him those potato chips, it is the most tural way to get that sodium level to rise, Drinks also like your soda pop cans full of sodium, I think a snack a day, a can of pop and a bag of chips ask the doc if this is okay and see that level rise on its own.
I do not think this means tumor activity, any time you have doubts and fears always call in and talk with the nurses they will get answers for you, mine do most of the time.

God bless Sandy

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As noted above, this condition is known as SAIDH, the same thing as hyponatremia. Left unchecked, it can result in coma, seizures, and death.
So it is a very serious condition and should be watched very carefully. Blood tests to check his sodium levels should be done at least weekly until his problem subsides.
I had this same problem twice with my sclc. The first time my sodium level was 118, so they hospitalized me. Then I had chemo, which destroyed the tumor enough to make it quit producing the hormone that causes the kidneys to dump salt but retain water. When the tumor began to grow again, the sodium problem returned and did not leave until radiation once again shrunk the tumor enough to shut it down from producing that terrible hormone again!
The first time they put me on Demeclocycline (a sorry antibiotic), but I was allergic to it. It is in the Tetracycaline family. In addition, it was over $600 a month! I could not find any salt pills, so I had to take salt by spoon three times a day to keep my sodium levels up. And yes, my fluid intake was greatly limited. To me, that was worse that having to gag down the salt! I felt thirsty so much of the time. And yes, I was fatigued and had headaches, too.
It was the same story the second time around. As suggested above, it is a very good idea to just eat a lot of salty foods instead of having to gag down the salt and chase it with water.
Also as noted above, it is VERY important to make sure nobody ever administers regular saline solution to him.
Whether his tumor is growing or not, I couldn't say. But evidentally it is active enough to be producing that horrible hormone. Sigh. Sorry. You may have to PRESS his onc to monitor this salt condition carefully. I never could get mine to do that, so I had to get my family doctor to do that for me. It's the only way I could find out if I was taking enough salt or not.
I hope this helps, though I really don't like writing somewhat disturbing information. But in our fight against this horrible Beast Cancer, knowledge is power. There's a scripture in the Bible that says, "My people are destroyed for lack of knowledge." So perhaps this knowledge of the facts may save your dad's life. I sure hope so. Just remember --- there is ALWAYS HOPE! Try looking at this as just another bump in the road --- one that you will roll over and keep goiing forward. If I can be of any further help, please let me know. My prayers are with you and your dad.
DS

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Your story is almost the same as my father's with the sodium. Water restriction is used for him and the antibiotics. He also has to watch his magnesium. He takes an antibiotic, potasium pill and magnesium one. He is stable now but when the low sodium got real bad he was a bit confused and dehydrated with delerium. Scary if not caught early. Now we know.

Best wishes- kristin

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Thank you all for your thoughts and prayers. My dad is hanging in there. He is still in the hospital. The sodium level has gone up and down, as of right now the level is at 125. He is on iv fluids, and fluid restrictions for free water, and medication. We will be discussing with a kidney doctor along with the onc. to make a plan for when he goes home. He is feeling a little stronger, though his spirits are down in the dump, but he HATES the hospital and this has been his is his first time ever to stay overnight in a hospital. But we are there for him. His onc. did say they did see something on the liver and wants him to have a PET scan to check this out. Hopefully it is nothing. I will keep you all informed, going to go buy him a big bag of lays potato chips. Thanks again, as always keeping you all in my thoughts and prayers.

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