h2o Intoxication

[Vein_Banger]

Just wanted to let the other swimmers know that you can majorly over-do the water flushing to pass drug screens. Swim went through this a while back trying to flush for a drug test later in that afternoon. He stated drinking water like crazy, after bout 6-7 Medium sized Mickey D's cup-fulls in less than an hour he started feeling veeeery weird. His head felt like a pressurized vessel, his hearing went all fuzzy and echoey, it felt like some sort of trip/drunk combo, very very uncomfortable feeling. So swim looked on wiki and there it was.....h2o intoxication. According to the article, very bad thing to have! Often fatal! So, before swiy starts consuming massive amounts of water, read this article, swiy can find it simply by searching h2o intoxication in any search engine!

Reputation Comments on this post:

Nice harm reduction post!

[Potter]

"Intoxication" isn't really the best word here, "near lethal overdose" would be better. There is NO reliably safe way to play with H2O ODs. When you get enough water in your system, it dilutes the electrolytes that facilitate the transmission of nerve signals between cells, eventually the nerve cells can no longer communicate and you die from total system failure. There's not a whole lot of treatment for this condition, you're pretty much fucked.

Just two years ago in the states there was a radio show that offered a video game system to the first person to drink a gallon of water. They received a number of calls from medical professionals warning them of the shear stupidity and lethality of the stunt. Some stupid bimbo, egged on by equally stupid DJ's ignored these calls and dropped dead.

[Vein_Banger]

Yeah, so, swimmers who dont know about this should be warned, right?!

[fnord]

Originally Posted by Potter

There's not a whole lot of treatment for this condition, you're pretty much fucked.

Would administration of electrolytes work?


@jatelka, hehe not sure if you meant to do it on purpose but that was a swell pun!

[Vein_Banger]

Not sure, maybe Helikophis would be willing to drop some knowledge on why or why not said tek would work!

[helikophis]

Originally Posted by fnord

Would administration of electrolytes work?

For sure. The cause is primarily low concentrations of sodium in the body, and making sure to eat salty foods or drinking electrolyte beverages is good way to avoid acute poisoning. Absolutely, if someone suspects they are getting water poisoning, they should immediately eat some pretzels or other salty, non-sugary food, or an electrolyte tablet. Even just a pinch of salt could be good. Also, although you're probably already peeing like mad, a caffeine tablet might help. If you think you are suffering water poisoning and _aren't_ peeing like mad, definitely consume some caffeine if you can. There are also fancy drugs that they usually give to old people (my gramma called them "water pills"), especially in cases of cirrhosis of the liver, that'll make your body work to restore proper mineral balance (i.e. pee like crazy).

In a situation like the ones I or the OP described, I would be wary of IV saline or electrolyte beverages that are coming with more water. What is needed here is a solution with a higher concentration of sodium than is normally present in the blood, otherwise you're only adding to the problem, and sports drinks generally don't have that. Also sports drinks have the problem that they usually contain sugar, and the stomach has a tendency to hold sugary things inside it for longer than non-sugary things, so they electrolytes don't get into the system as quickly as they would without the sugar.

Reputation Comments on this post:

Good advice, good relation of experiences

[chibi curmudgeon]

Originally Posted by helikophis

In a situation like the ones I or the OP described, I would be wary of IV saline or electrolyte beverages that are coming with more water. What is needed here is a solution with a higher concentration of sodium than is normally present in the blood, otherwise you're only adding to the problem, and sports drinks generally don't have that. Also sports drinks have the problem that they usually contain sugar, and the stomach has a tendency to hold sugary things inside it for longer than non-sugary things, so they electrolytes don't get into the system as quickly as they would without the sugar.

I'm posting here because this is actually related to what I'm supposed to be studying.

If you drink a whole crapload of water, without enough sodium to match, you're diluting the fluid in your body. Osmotic pressure pulls the water into your cells, like Jatelka said, and they swell. As you might guess, swollen cells are particularly bad when they're brain cells. That's why you get symptoms like confusion, lethargy, and, when your serum Na gets below 110 mEq/L, seizures, coma, and death. Like helikophis said, this is why it's called "intoxication," because you get into a stupor like you're drunk. Obviously, there's nothing fun about it and drinking alcohol is much safer.

How this is treated depends not just on your Na concentration but also on the other stuff in your body fluids (glucose--is it normal or is it elevating your serum osmolality as well?) and total fluid volume.

If your volume is high or normal, as in the case of someone with normal kidneys, etc., who just decided to drink a whole crapload of water, you can just stop drinking so damn much water, or if necessary, administer 3% saline (normal blood is 0.9%) and/or diuretics which will get rid of the water by making you piss like a racehorse. If it gets to this point, simply eating salt won't work fast enough, especially since you might be unconscious. It'll have to be IV. 3% saline adds water, but since it's adding significantly "more" Na, concentration-wise, it's okay.

Problem is, your brain cells are sensitive little fuckers and don't like being inflated and deflated like balloons. So your serum Na has to be adjusted slowly--max 8-12 mEq/L/day--or you'll get what's called osmotic demylelinization syndrome: permanent problems from damaging the coating surrounding your brain cells.

Long story short, your water/Na balance is serious business. Don't screw with it.

(Also, I'd appreciate feedback on this explanation--not necessarily reputation points, but feedback because I'll probably have to explain this to a patient at some point. Y'all are a bit more edumacated than the average patient, though.)

Reputation Comments on this post:

	That explanation deserves rep, informative and easy to comprehend.
	thanks for providing numbers. this should be pretty comprehensible to a patient I think

[sirmoonie]

H2O is a gateway drug. I don't know one person who uses drugs who didn't start with H2O early in life. When you start mixing it with Kool-Aid, you're pretty much fucked, man.

Reputation Comments on this post:

Excelent point abuot gateway drugs.

[Potter]

Vein Banger: Oh yeah, no doubt. I'm simply disagreeing with the term (abeit the proper medical term) of "intoxication" which lends it self to ideas of drunkeness and good times.

When a subject this risky comes up, it's usually a good idea to have a few different people write up perspectives on the risks and issues at hand so as to give more body to the argument. People are foolish and don't always look things up, so pounding it over and over can help get the point across.

This is just one of those realms where there is no real benefit to exploration, the way it works isn't going to "open doors" or "expand your mind" or "numb your pain", it's just going to put you in the hospital or morgue. Blood loss will produce these sort of symptoms too, so will nitrogen narcosis (deep sea diving), like water OD, neither is something any sane person should be playing with. The patient in the case above is quite lucky.

Helikophis once treated someone for this problem, I'll have him stop by and transcribe his notes too.

Reputation Comments on this post:

Excellent pounding! Agree with concept and intent, good harm reduction :)

[Vein_Banger]

Swim thanks Potter for his excellence this topic, and agrees "intoxication" is putting it "very lightly" at best!

[helikophis]

I encountered an individual who had heard about water poisoning from a news item on the radio. This individual decided to attempt to poison himself with water, "just to see what it's like." Stupid, I know.

His method was simple: he filled a two-litre Pepsi bottle with water, and started drinking it, while watching housemates play video games. For the next hour and a half or so, every time he went to the bathroom to pee, he drank more water (probably around 500ml each time, although he wasn't strict on the quantity. Total volume of water was not measured. It was a lot though.). Needless to say, this quickly results in rapid cycling between the toilet and the PlayStation.

Somewhere around the hour mark he began to feel unwell - nauseated, dizzy, confused. The word intoxication is actually an excellent description of the feeling, as it very closely resembles alcohol intoxication. He vomited a little bit, but since it was just water, it wasn't so bad. The feeling lasted several hours, in fact until he went to sleep. The next day he didn't feel hung over or anything like that, but he certainly wasn't at full strength.

So nobody do this. It's dangerous, and unpleasant.

[Vein_Banger]

^^^Yep, thas pretty much exactly what swim experienced during his "water-drunk" lol. But as he thought, this is NO laughing matter and alot of people probably dont know about this so hopefully they'll read this thread before they go binge on water!!!! And thanks also to SWIhelikophis and SWIjatelka for their most-pertinent additions to the thread!

[Jatelka]

Intoxication?

Think hyponatraemia (low sodium), leading to recurrent/resistant seizures. Oh! And your brain swells (cerebral oedema), add in the pulonary oedema and you're in for a swell time

I've uploaded something here...

http://www.drugs-forum.com/forum/loc...id=145&id=8025

that looks at acute water intoxication, and outlines some of the bodies homeostatic mechanisms for dealing with sodium and water

Please remember, that it was water intoxication that killed Leah Betts

Reputation Comments on this post:

nothing like peer reviewd literture to solidify an argument