Monday, June 29, 2015

Medical Mondays: Water, The Poison We All Drink

Ever consider water as a means of sickening your characters in a novel? Yes? Well then, this post is for you. :)

Have you ever heard someone say, "Oxygen is poisonous. After all, 100% of humans who breathe it will eventually die."

Well, the same could be said about water. Except water can kill a heckuva a lot faster if the situation is just right (or wrong, rather). We're talking about water intoxication.

That's correct. Water can intoxicate you, and I do mean in a toxic way. It's also known as water poisoning, or the medical term, dilutional hyponatremia ("low salt in the blood").

There are several situations in which one can become seriously sick or even die from water intoxication.

  • Endurance athletes: Think of marathoners who collapse at the end of a race and need hospitalization. When you're sweating a lot of salt water, your body *thinks* it needs to retain fluid because you're sweating and exercising, AND you're drinking large quantities of pure water, it's a perfect set up for this condition. 
  • Heat Stress: It's a hot day. You're sweating buckets and drinking huge amounts of water to compensate, and then you get a headache...and confused...and pass out. Yep. 
  • MDMA use: Also known as "ecstasy", this street drug not only causes body temperatures to rise (hyperthermia), but users drink a lot of water because of it. On top of it, MDMA can cause the body to secrete a hormone called ADH (antidiuretic hormone) which slows down the ability to urinate out the excess fluid. 
  • Really Stupid Challenges and Games: I'm a huge non-fan of all those internet challenges and games. Like the Cinnamon Challenge, or the choking-somebody-until-you-pass-out challenge. Well, there's also a water drinking challenge, and guess what? People die. This unfortunate woman died after a radio contest was held to see if people could drink large amounts of water and not pee. This 12 year-old died playing water poker where she had to drink a glass of water if she lost a hand. 
  • Psychiatric Illness: All doctors learned about this in medical school. It's called psychogenic polydipsia, in which a sufferer feels compelled to drink water constantly. 
  • Accidental/Unintentional: Babies can become water intoxicated because it takes relatively little water compared to their body size to make them ill. Adults can drink too much water for the wrong reasons (for example, they get nervous before a medical test, or are trying to dilute their urine before a drug test, or are trying to suppress their appetite and drink too much water too quickly). 
  • Torture: Enough said. 
So what is the mechanism of water intoxication? Basically, a healthy pair of kidneys can clear about a liter of water per hour. If you overdue this and drink too much and too fast and retain more water than your body needs and can get rid of, your blood sodium will start to become dilute. 

When this happens, your body cells (which contain a healthy, well-regulated amount of sodium) start to take in water to try to even out the sodium concentration discrepancy between what's inside the cell, and what's outside. So cells start to swell. Like your brain cells. Which is really, really bad. 

Symptoms include headache, confusion, irritability, muscle cramping and twitching. When it's worse, nausea and vomiting, coma, seizures, brain damage, and death. 

How much can kill you? Drinking 3-4 liters of water too quickly could make you hyponatremic. The lady in the water drinking contest drank about six liters of water in a three hour period before she died (that's just over one and a half gallons of water). 

For all of you out there who are now pushing away that glass of water in abject fear and horror, don't! Remember--drink to satisfy your thirst, use common sense to stay hydrated, stay cool, don't do stupid internet challenges, and you won't end up on one of my Medical Mondays posts. :) 

Also, don't use Ecstasy. Bye now!


Heather said...

That is so cool! So like all things, water too must be drank in a sort of moderation. I had no idea it could cause such extreme effects.

Natalie Aguirre said...

I didn't realize this either, especially about the things we could inadvertently do.

Deb Salisbury, Magic Seeker and Mantua-Maker said...

This info will be useful for a character in a marathon-type situation, and too much water at hand. Swimming, maybe. Thanks for the plot bunnies!

Angela Brown said...

I remember the controversay behind that woman dying after participating in hat water drinking contest.

I knew there were various ways water could kill - beyond drowning - but this is interesting information that can help an imagination like mine work some interesting and mean things to do to my characers :-)
*cue author maniacal laugh*

H.R. Sinclair said...

I remember when that contest happened. It was so sad.

I love that last little aside..."Also, don't use Ecstasy."

Elizabeth Seckman said...

Don't use ecstasy- check.

We've always told our kids, who are athletes, to hydrate the night before. Or rather, continuously throughout the day. I see it as the oil in an engine. Flood it and it will ruin it; go too low, that's bad too. It's best to keep an optimal level throughout. Like, start the day with a tall glass and then each time you get rid of water (ahem, potty break), take in another glass. Works great for smooth skin and smoothing out wrinkles too. (I have no medical basis for that- I'm just a believer!)

Alex J. Cavanaugh said...

I'd heard about the lady who died after the radio contest. I knew it was from too much water, but not why.
I'll drink my eight bottles a day slowly.

J E Oneil said...

I remember reading about the woman who died after that contest. It was something I had never considered. Seizures and brain damage and death, all from water!

Dianne K. Salerni said...

I read about the woman who died in the radio contest. How incredibly sad and stupid and preventable!

Now, having said that, my author brain is coming up with plausible murder mysteries set up around water intoxication. Hmmm...

Leslie S. Rose said...

Fascinating as always. Is it wrong I'm super thirsty right now?

Tyrean Martinson said...

Thanks for this timely post! My youngest, who is training as a flat-water sprint kayaker, has been having headaches. She drinks lots of water and we realized recently that she isn't getting enough salt. After years of being taught not to cook with salt (my parents) and then years of not eating many pre-packaged foods due to some food allergies, I'm finally adding salt back into my diet and my family's diet.

We've even taken to tracking our salt intake to try to get close to the minimum that's needed for an "average" sized person.

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