Careful monitoring of medications medically necessary as we age

DEAR DR. ROACH »

Your recent article on electrolytes reminded me of my mother’s experience.

At 89, she was dizzy, fainting and falling.

I took her to her doctor.

Her blood tests showed dangerously low levels of electrolytes, and I was told to get her to the emergency room quickly.

The doctor there determined that her problem was caused by drugs — essentially, the blood pressure medicine prescribed by her doctor.

She was hospitalized, put on appropriate IVs and recovered fully after four days.

A doctor told me a person of advanced age who is on a diuretic has to be monitored as carefully as a baby. Needless to say, she hadn’t been.

It seems the body can’t regulate electrolytes properly in the face of poor doctoring.

— G.B.

ANSWER » I am sorry for your mother’s experience. I wish I could say it was unusual, but I have seen this before as well.

Especially as we get older, our ability to maintain correct body functions, such as electrolyte levels, decreases.

That leaves us susceptible to changes brought about by the environment or by medications.

In the case of hydrochlorothiazide (HCTZ), a common diuretic, the result can be low sodium and low potassium levels.

Careful monitoring is medically necessary.

I mentioned that my professor, Dr. Fred Coe, often remarked that a kidney is smarter than 10 interns.

This was not just him being impressed by the kidney, but a reminder that physicians — junior and sometimes senior — can make mistakes

Additionally, sometimes even the remarkable abilities of the kidney to maintain balance of salt and water can be overwhelmed by medications and diet choices.