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By Carla McClain
ARIZONA DAILY STAR
Sometime in the middle of the night, Carol Tufts began to feel very
strange. Dizzy, confused, disoriented.
By midmorning, she had collapsed into a chair, unable to walk, unaware
of what day it was. She was, in fact, dying.
The reason? She drank too much water.
Too much water? In the Southern Arizona desert? Where the never-ending
mantra drummed into our heads tells us to drink water constantly to
ward off the perils of our extreme, dry heat?
Well, Carol Tufts - always vigilant about her health - followed that
advice for years, drinking lots of water daily, to stay hydrated and
healthy. And it almost killed her.
"This was a tremendous surprise to me. It's a fascinating phenomenon,"
said Tufts, 80, a longtime Tucsonan and mother of the late Randy Tufts,
co-discoverer of Kartchner Caverns.
"I just think people really need to know there is such a thing as
drinking too much water - even here - and that it can be very
dangerous. I think there were warning signs this was happening to me,
but I had no idea what they meant."
Her warning is timely, coming on the heels of a major medical study of
endurance athletes that found drinking too much water during heavy,
prolonged exercise may be an even greater threat than drinking too
little.
In fact, that phenomenon has unexpectedly developed into one of the
most common health threats to Grand Canyon hikers, where nearly a fifth
were ending up as "water intoxication" emergencies until signs went up
all over the natural wonder warning of the danger.
This year, the once-unrecognized problem made medical headlines after a
study showed more than 10 percent of runners in the 2002 Boston
Marathon finished the race with below-normal sodium levels, a condition
called hyponatremia.
The reason? They drank too much water during the hours they were
running, so much that they flushed sodium from their bodies,
dangerously upsetting their electrolyte balance.
When that happens, water enters the body's cells, which then swell. If
swollen brain cells start pressing against the skull, the result is
brain damage, paralysis, coma and sometimes death.
"We observed that hyponatremia occurs in a substantial fraction of
marathon runners and can be severe," the authors of the study,
published in the New England Journal of Medicine in April, concluded.
"(It) has emerged as an important cause of race-related death and
life-threatening illness among marathon runners."
Hyponatremia did in fact kill one runner that year - a 28-year old
woman who was struggling badly the last six miles. Suffering nausea,
fatigue and muscle weakness - symptoms similar to dehydration - she
assumed that was the problem, chugged 16 more ounces of fluids, then
collapsed and died.
Her blood sodium levels had plunged to 113 millimoles per liter of
blood. Hyponatremia begins to occur at sodium levels below 135, and
becomes life-threatening at about 120.
When Carol Tufts got to Tucson Medical Center the day she collapsed
recently, her sodium level had plunged to 122.
"She was zoned, completely out of it. She was on her way down," said
Tufts' daughter, Judy Rodin, who found her mother that morning during a
routine stop and called 911.
"I thought maybe she'd had a stroke, she was so bad," she said.
Obviously, at 80, Carol Tufts was no marathon runner or Grand Canyon
hiker. But she faithfully drank about 10 glasses of water a day,
practicing what she thought was a good habit. That morning, when she
felt so bad, she downed four glasses of water quickly, thinking
hydration would help what felt like an irregular heartbeat.
That was enough to throw off her electrolytes, especially her sodium,
almost fatally.
"We see this frequently, especially in elderly people. The cause
usually is all the water they're drinking, combined with the
medications they may be taking," said Dr. Ramakrishnan Subbureddiar, a
geriatric specialist who treated Tufts during her rehabilitation, after
she was left physically weak and mentally unclear for weeks.
"I see some who drink as much as two to three liters of water a day,
and with certain drugs - especially high blood pressure medicine - that
can cause severe problems."
Tufts was on medication for hypertension and osteoporosis, and also
suffered mild hypothyroidism - a condition that can exacerbate sodium
loss.
"I had been noticing some problems with balance and fatigue - my brain
just seemed to get foggy off and on. Now, when I look back on it, I
think I may have been bringing this on for some time, sort of like a
gathering storm," Tufts said.
Now restricted to six cups of fluids a day, Tufts has recovered, and is
more clearheaded than she has been in months, both she and her daughter
say.
"I'm drying out, so to speak," Tufts laughed.
But all the recent publicity on the problem has prompted a warning
about "creating a fear of drinking" from the American College of Sports
Medicine. "The fact is both heat illness and hyponatremia are serious
conditions for marathoners," the group said.
ARIZONA DAILY STAR
Sometime in the middle of the night, Carol Tufts began to feel very
strange. Dizzy, confused, disoriented.
By midmorning, she had collapsed into a chair, unable to walk, unaware
of what day it was. She was, in fact, dying.
The reason? She drank too much water.
Too much water? In the Southern Arizona desert? Where the never-ending
mantra drummed into our heads tells us to drink water constantly to
ward off the perils of our extreme, dry heat?
Well, Carol Tufts - always vigilant about her health - followed that
advice for years, drinking lots of water daily, to stay hydrated and
healthy. And it almost killed her.
"This was a tremendous surprise to me. It's a fascinating phenomenon,"
said Tufts, 80, a longtime Tucsonan and mother of the late Randy Tufts,
co-discoverer of Kartchner Caverns.
"I just think people really need to know there is such a thing as
drinking too much water - even here - and that it can be very
dangerous. I think there were warning signs this was happening to me,
but I had no idea what they meant."
Her warning is timely, coming on the heels of a major medical study of
endurance athletes that found drinking too much water during heavy,
prolonged exercise may be an even greater threat than drinking too
little.
In fact, that phenomenon has unexpectedly developed into one of the
most common health threats to Grand Canyon hikers, where nearly a fifth
were ending up as "water intoxication" emergencies until signs went up
all over the natural wonder warning of the danger.
This year, the once-unrecognized problem made medical headlines after a
study showed more than 10 percent of runners in the 2002 Boston
Marathon finished the race with below-normal sodium levels, a condition
called hyponatremia.
The reason? They drank too much water during the hours they were
running, so much that they flushed sodium from their bodies,
dangerously upsetting their electrolyte balance.
When that happens, water enters the body's cells, which then swell. If
swollen brain cells start pressing against the skull, the result is
brain damage, paralysis, coma and sometimes death.
"We observed that hyponatremia occurs in a substantial fraction of
marathon runners and can be severe," the authors of the study,
published in the New England Journal of Medicine in April, concluded.
"(It) has emerged as an important cause of race-related death and
life-threatening illness among marathon runners."
Hyponatremia did in fact kill one runner that year - a 28-year old
woman who was struggling badly the last six miles. Suffering nausea,
fatigue and muscle weakness - symptoms similar to dehydration - she
assumed that was the problem, chugged 16 more ounces of fluids, then
collapsed and died.
Her blood sodium levels had plunged to 113 millimoles per liter of
blood. Hyponatremia begins to occur at sodium levels below 135, and
becomes life-threatening at about 120.
When Carol Tufts got to Tucson Medical Center the day she collapsed
recently, her sodium level had plunged to 122.
"She was zoned, completely out of it. She was on her way down," said
Tufts' daughter, Judy Rodin, who found her mother that morning during a
routine stop and called 911.
"I thought maybe she'd had a stroke, she was so bad," she said.
Obviously, at 80, Carol Tufts was no marathon runner or Grand Canyon
hiker. But she faithfully drank about 10 glasses of water a day,
practicing what she thought was a good habit. That morning, when she
felt so bad, she downed four glasses of water quickly, thinking
hydration would help what felt like an irregular heartbeat.
That was enough to throw off her electrolytes, especially her sodium,
almost fatally.
"We see this frequently, especially in elderly people. The cause
usually is all the water they're drinking, combined with the
medications they may be taking," said Dr. Ramakrishnan Subbureddiar, a
geriatric specialist who treated Tufts during her rehabilitation, after
she was left physically weak and mentally unclear for weeks.
"I see some who drink as much as two to three liters of water a day,
and with certain drugs - especially high blood pressure medicine - that
can cause severe problems."
Tufts was on medication for hypertension and osteoporosis, and also
suffered mild hypothyroidism - a condition that can exacerbate sodium
loss.
"I had been noticing some problems with balance and fatigue - my brain
just seemed to get foggy off and on. Now, when I look back on it, I
think I may have been bringing this on for some time, sort of like a
gathering storm," Tufts said.
Now restricted to six cups of fluids a day, Tufts has recovered, and is
more clearheaded than she has been in months, both she and her daughter
say.
"I'm drying out, so to speak," Tufts laughed.
But all the recent publicity on the problem has prompted a warning
about "creating a fear of drinking" from the American College of Sports
Medicine. "The fact is both heat illness and hyponatremia are serious
conditions for marathoners," the group said.