There’s no doubt about it.  Humans came from the water.  We’re practically fish.  Approximately 60% of the average man and 55% of the average woman is composed of water.  Water is found within cells (intracellular fluid), where it is critical for multiple, complex, and various cell functions.  Water is found outside of cells, including as extracellular fluid which bathes our tissues and support countless life-sustaining activities.  Extracellular water also makes up the liquid component of our blood, pushed by our pumping hearts to deliver oxygen and nutrients and retrieve carbon dioxide and cellular waste from all parts of our bodies.

Clearly, with too little water, we can get into trouble.  Even serious trouble.  The state of having too little water is, of course, dehydration.  With hot summer days just around the corner, it’s worth a momentary pause to understand those who are at greatest risk of developing dehydration, the people for whom even a little dehydration can be very dangerous, the signs and symptoms of dehydration, the treatment of dehydration, and dehydration prevention.

Those at greatest risk of becoming dehydrated and at greatest risk from dehydration:

  • It may surprise you that newborn babies (up to a year) can more easily become dehydrated.  That’s because the newborn body is around 78% water!  In addition, unlike older children and adults, newborns (with their big heads) have a greater surface-area-to-body-mass ratio.  In plain terms, they don’t weigh much for how big they are.  The extra skin surface can definitely play a part in water loss, particularly on a hot day.  So these little ones can quickly dehydrate, and they need even more water (in breast milk or formula) than the rest of us.
  • Then there’s the other end of the age spectrum.  Older adults are also at greater risk of developing and being hurt by dehydration.  Their organs are less capable of adequately retaining water.  And elderly folks often drink less than they should.  Not only are older people thus more prone to dehydration, they are at a much greater risk of serious consequences should their bodies get too dry, as even mild dehydration can rapidly worsen existing heart or kidney disease, diabetes, or other condition, as well as altering the effects of prescription medications.
  • Which leads us to people with existing medical conditions who, regardless of age, can experience rapid decompensation in their health with even mild to moderate dehydration.  Those with heart disease, for example, may experience a sudden worsening of their cardiac condition as water is lost from their bloodstream.  Similarly, those with borderline kidney function can develop mild kidney failure, again the result of reduced blood flow.  In addition, some chronic disorders, such as diabetes, can actually cause dehydration.
  • People with diarrhea and/or vomiting due to an acute illness can cause rapid dehydration due to fluid loss, often exacerbated by the inability to drink liquids without throwing up.
  • Anyone exposed to the heat for too long, especially when exercising.  Again, the risk of dehydration and the risk to your health is increased if you have a medical condition and/or are elderly.

Chances are you’ve experienced the symptoms of dehydration more than once in your life.  Perhaps you were jogging on an exceptionally hot day.  Or you’ve been “giving back” in the bathroom all night thanks to the stomach flu.  Or you’ve just been way too busy at work to drink anything for hours.  You feel it.  You suddenly get dizzy (often when first standing up after sitting or lying down for a while).  Or a sudden wave of nausea sweeps over you.  You break out in a sudden, cold sweat.  Your heart races.  You feel a pounding headache.  You feel woozy or confused.  Maybe your throat feels dry.  You’re thirsty.  And when you go to urinate, your pee is dark yellow.  Maybe even tea-colored.

This, my friends, is classic dehydration.  Your blood vessels aren’t full, meaning that your organs aren’t getting what they need.  The fluid bathing your cells as well as the fluid within your cells is low.  And now, like the car with not-quite-enough coolant, your engine is feeling it.

First of all, sit down!  The last thing you need now is to fall down or pass out and hit your head, break your hip, whatever.  Just sit down.  Even if that means sitting down on the floor.  If there is a bed or couch near you, lie down.  Doing either shunts blood to the more important parts of your body (your brain, heart, kidneys, liver).  Sitting or lying down usually relieves the dizziness, nausea, cold sweat, but not always (not in more extreme dehydration).  Some of your symptoms may lessen but not disappear completely.

Next, rather than stand up again, call out for assistance if anyone is near you.  Tell them that you’re dehydrated and that standing made you dizzy.  Ask them to bring you a drink (preferably cool), such as water or juice.  Remain seated or lying down as you slowly drink whatever they return with.  No need to guzzle a full bottle in seconds.  Slow sips.  Stay put over the next many minutes as you rehydrate.  And while you’ll likely “feel” when you’ve had enough, err on the side of drinking a little too much.

Don’t get up too soon!  And when you’re ready to stand, don’t be proud:  ask them to help you up, to make sure you’re steady once upright.  If some or all of your symptoms return (especially dizziness), sit or lie back down and slowly drink more over the next 15 to 30 minutes.

Once you’re doing better, monitor yourself for the next several hours.  If your tank is truly full again, it shouldn’t be long until you pee.  And by that second urination (often the first), your pee should be that light yellow color again.

If your symptoms don’t completely resolve fairly rapidly, or if they return, call the nearest Urgent Care.  Within minutes of receiving some intravenous fluids, you’ll start feeling better.  Most often, once they “fill ‘er up,” you’ll feel well enough to go home and maintain your water level.

If you live in a region like I do (Central Florida), major-league heat is coming to steal your body water.  And if you like to exercise and/or have any risk factors, you’re at higher risk of dehydration and possible complications of water loss.  So plan ahead.  If your plans put you at any risk of dehydration, drink water of juice before you go.  And take plenty of water or juice with you.  Leave extra water or juice in a cooler in the car.  And be on the alert for the earliest symptoms of dehydration.  While serious complications from dehydration are uncommon, they can and do occur, especially on hot, humid days.  And unlike dehydration itself, organ damage from excessive water loss isn’t always easily corrected.

So, drink up.  And here’s to light yellow pee!

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