Cronic Pain since 1 month

[ploader]

Hello everyone,

I'm not sure if I'm right here. It's about my brother's health. We're pretty desperate because nobody can help us. He is currently living abroad and cannot find the medical support he needs.

For a month his health has been going downhill.

The symptoms:
• Obscuration of consciousness
• Dizziness
• Weakness
• paralysis
• respiratory paralysis
• Shortness of breath
• restlessness
• Tremble
• Pressure in the head (sometimes less sometimes more)
• Insomnia/extreme tiredness
• Loss of appetite

Background:
He has gone through an extreme dietary change. He didn't eat any salt for 2.5 months, but he did eat plenty of nuts and beans (nothing else). After he started having muscle cramps, he suddenly started ingesting extreme amounts of salt with a lot of water. After which he got the symptoms mentioned above, which continue to this day.

Now to my questions, for which I would like your opinion:
If he eats something salty at the moment, the body reacts with severe paralysis/muscle paralysis, extreme tiredness (almost unconsciousness), and pain/aches in the head and muscles. The other symptoms are always there. If he doesn't drink it will get a little better after a while. The blood count shows something different each time. Sometimes potassium is too low, sometimes sodium.

Is it possible that he is hyperhydrated so that the cells are high in sodium and soaked with water? This would be supported by the fact that he has no dehydration symptoms (dizziness when standing up or standing skin folds).

So can it be some kind of salt/water intoxication or the opposite potassium intoxication?
Could this be seen on an MRI? (Swollen brain/ cerebral edema?)
He is not taking any medication, weighs 144 pounds and is 34 years old, male.

I would be very happy if you could tell me your opinion on this, even if it is of course difficult without practical investigation.

Thank you in advance!

[shadowmed]

He does need medical help. Do you know why he cannot access this? It sounds as if he needs help with mental health too as his dietary choices are extreme and unhealthy. He needs to eat a balanced diet, to have a salt quantity that is normal for where he is living (it may be more in a very hot, humid country than in a cooler climate) and to drink normal quantities of water. I would think it is highly likely he has become deficient in some nutrients and vitamins too. Deficiency in vitamin B12 can cause odd neurological symptoms. I would suggest he start to take a multivitamin and multi mineral supplement and go back to a normal diet. Is there an emergency care centre he can go to, because the faintness and dizziness could be heart related or may just be due to his very odd diet? He needs to see a medical expert. I don’t know why he cannot access anyone where he is, but if it is lack of funds, maybe there is a free clinic if he can phoned local health authority, or if he is in the country illegally, there may be a refugee organisation who could get him the help he needs. I’m sorry your brother is suffering and sorry that you have this worry when he is far away. I hope he starts to eat normally again.

[Ken_PA]

Hi, you already know that he should be under close medical supervision, and probably be hospitalized. But since that is apparently impossible, here are some guesses:

- The major cause of his symptoms might be mostly from severe electrolyte imbalances, rather than brain swelling
- I'd worry about heart attack. Is his heart rhythm irregular? Somebody can feel the neck pulse. Or does the pulse get sometimes too weak to feel ("thready pulse")?
- I'd also worry about a fall that results in a bad head injury. He needs a minder.
- I think pain is among the least worries.
- but yes, cells can swell (cellular edema). E.g., if there is more sodium inside a cell than outside that cell, water will move into the cell. Or vice versa. Brain cells can swell. Muscle cells, too.
- nerve cells can swell, but impulse conduction can be  a different problem relating to electrolytes
- yes, MRI should be able to see brain regions swelling, can see overall brain size, and also see water concentrations
- regarding dehydration symptoms: does his heart rate increase a lot or does the heart pump more strongly to effectively compensate upon standing? Low circulatory volume from dehydration can sometimes be compensated for in that way, so there's no resulting dizziness.
- regarding dehydration, how is urine volume and color?
- yes, if the kidneys are malfunctioning, hyper or hypo kalemia might be involved. The body tries hard at every moment to maintain electrolyte balance, and as you know NaK is one opposite pair and CaMg is the other pair ------  excitatoryrelaxing. Beans and nuts have Mg. NaK especially affects smooth muscles in blood vessels. Na makes high BP and excessive K makes low BP.

- I wouldn't let him choose what to eat or drink, since that was the original cause and his thinking is even worse now. Maybe he would have come out of this state by now if he wasn't whipsawing his sodium and water intake. E.g., maybe sipping water steadily throughout the day will be better than guzzling periodically. He needs a minder.
- he might benefit a lot from an IV electrolyte at home, but what concentration and what minerals? Only a knowledgeable doctor with appropriate and frequent blood tests would know.

Again, these are just my personal guesses. You can find online some doctor services to pay-for-advice. This is a serious case.

Good luck, to him and to you.

[Ken_PA]

Trying again, since the system changed my typing:

Na---K is one opposite pair and Ca---Mg is the other pair, being excitatory versus relaxing.