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Qs related to medical issues and my replies to them
When you don’t consume enough fluids, your blood can thicken and move slowly, potentially backing up in a blocked or narrowed blood vessel and resulting in stroke. So if you have other heart disease risk factors, such as clogged arteries, dehydration can be especially dangerous.
Dehydrated stroke patients tend to do worse than those who are hydrated, a Johns Hopkins team found. The next question is whether all such ischemic stroke patients should get fluids when they arrive at the hospital, contrary to current recommendations.
About half of a group is ischemic stroke patients were found to be dehydrated when they arrived at the hospital, a Johns Hopkins Comprehensive Stroke Center team reported—and they did poorly compared to the patients who arrived hydrated.
Doctors think that when patients don’t drink enough water, their blood gets sludgy. That could mean that as it travels through the brain, this thicker blood flows slowly and can back up in narrowed or blocked blood vessels
There are many possible causes of nocturia, depending on the type. The types of nocturia include: polyuria, nocturnal polyuria, nocturnal urinary frequency.
People with polyuria urinate >3,000mL in 24 hours. This is usually caused by there being too much water filtered by the kidneys. It can also happen if something is in the urine, pulling the extra water out, such as sugar (glucose).The causes of polyuria can include:high fluid intake, untreated diabetes (Type 1 and Type 2), diabetes insipidus, gestational diabetes(occurs during pregnancy).
Those with nocturnal polyuria experience a high urine volume only at night. Their urine volume during the day is normal or reduced. This is usually due to fluid retention during the day that often accumulated in the feet or legs. Once you lie down to sleep, gravity no longer holds the fluid in your legs. It can re-enter your veins and be filtered by your kidneys, producing urine.
The causes of nocturnal polyuria can include: congestive heart failure, edema of lower extremities (swelling of the legs), sleeping disorders, such as obstructive sleep apnea (breathing is interrupted or stops many times during sleep), certain drugs, including diuretics (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D, drinking too much fluid before bedtime, especially coffee, caffeinated beverages or alcohol, having a diet that’s high in sodium.
If you have nocturnal urinary frequency, you may urinate in small amounts or urinate more frequently. The total amount of urine produced is not elevated. This is usually due to an inability of the bladder to fully empty (this is why it fills up faster) or the inability of the bladder to fill completely before developing the urge to urinate (low bladder volume). This can also occur due to difficulty sleeping — you may wake up for one reason, but then go to the bathroom while you’re awake, which will make you think that you woke up because you had to urinate.
The causes of an inability to fully empty your bladder can include:bladder obstruction, benign prostatic hyperplasia (men), a non-cancerous overgrowth of the prostate that obstructs the flow of urine.
The causes of an inability of the bladder to fully fill can include: bladder overactivity (bladder spasms), bladder infection or recurrent urinary tract infection, bladder inflammation (swelling), interstiticial cystitis (pain in the bladder), bladder malignancy, obstructive sleep apnea.
Normally, you should be able to sleep six to eight hours during the night without having to get up to go to the bathroom. People who have nocturia wake up more than once a night to urinate. This can cause disruptions in a normal sleep cycle.
Symptoms of nocturia can include: waking up more than once a night to urinate, urinating more volume (if polyuria is present), fatigue, sleepiness — even after waking up. This occurs because the frequent urinations can interrupt your sleep cycle.
Treatment options for nocturia, regardless of cause, may include:
Interventions: restrict fluids in the evening (especially coffee, caffeinated beverages, and alcohol), time intake of diuretics (take them mid- to late afternoon, six hours before bedtime), take afternoon naps, elevate the legs (this helps prevent fluid accumulation), wear compression stockings (this also helps prevent fluid accumulation).
When you have urinary retention, it can be acute (sudden) or chronic (long-term). Acute means that it comes on quickly and it could be severe. Chronic urinary retention means that you’ve had the condition for a longer period of time.
The acute form of urinary retention is an emergency. In this case, you’ll need to see a doctor right away. The chronic form happens most of the time in older men, but it can also occur in women.
Urinary retention can happen for several different reasons. These causes can include: a blockage to the way urine leaves your body, medications you’re taking for other conditions, nerve issues that interrupt the way your brain and urinary system communicate, infections and swelling that prevent urine from leaving your body, complications and side effects of medications given to you for a surgical procedure.
When something blocks the free flow of urine through the bladder and urethra, you might experience urinary retention. The urethra is the tube that carries urine from the bladder to the outside of your body. In men, a blockage can be caused when the prostate gland gets so big that it presses on the urethra. This is the most common cause of chronic urinary retention in men. One cause in women is a bladder that sags. This is called cystocele. It can also be caused when the rectum sags into the back wall of the vagina – a condition called rectocele. Some causes can happen to both men and women. The urethra can get narrow due to scar tissue. This is called astricture. Urinary stones can also block the flow of urine out of your body.
Medications
Urinary retention can also be caused by certain medications. Drugs like
antihistamines(Benadryl), antispasmodics (eg. Detrol), opiates (like Vicodin) and tricyclic antidepressants (Elavil) can change the way the bladder muscle works. Other medications can also cause bladder control side effects, including anticholinergics, some blood pressure-lowering medications, antipsychotics, hormonal agents and muscle relaxants.
Nerve issues
Passing your urine happens when the brain tells the bladder muscle to tighten. This squeezes urine from the bladder. The brain then tells the sphincter muscles surrounding the urethra to relax. This lets the flow of urine go through the urethra and out of the body. Anything that gets in the way on the path from the brain to the nerves that go to the bladder and the urethra can also cause this problem. Causes of nerve issues can include: stroke , diabetes, multiple sclerosis, trauma to the spine or pelvis, pressure on the spinal cord from tumors and a herniated disk, vaginal childbirth.
If you have had a thin tube called a catheter in the past, you may be at greater risk for this condition. Your risk is also higher if your healthcare provider has used any other special device on you, such as an ureteroscope or cystoscope (these are telescopes with cameras that look in the urinary tract).
Urinary retention from nerve disease occurs at the same rate in men and women.
Infections and swelling: In men, an infection of the prostratecan cause it to swell. This causes it to press on the urethra to block the flow of urine. A urinary tract infection(UTI) can cause swelling of the urethra or weakness of the bladder, both of which can cause urinary retention. Sexually transmitted diseases (STI) also cause swelling and lead to retention.
Surgery: Medicine given before and during surgery to make you sleepy may cause urinary retention right after surgery. Procedures such as hip replacement, spine surgery, rectal surgery, surgery for women’s pelvic issues, and surgery to remove hemorrhoids can cause the problem afterward.
Symptoms of urinary retention:The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but can’t start. Others have to go a lot, while others still feel the need to go right after going. You may “leak” urine when you aren’t going because the bladder is full.
With the acute form, you’re all of a sudden not able to go at all, or only able to go very small amounts. This occurs even though you have a full bladder. See a doctor immediately if this happens to you.
My answers are for providing information only, not a medical advice. Please consult a qualified medical doctor if you face severe problems mentioned above.
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