My grandmother slipped into a coma about seven years ago after suffering from a stroke. I wouldn't say it was surprising -- her health had been up and down over the several years previous, and this was her third "event," shall we say, in twice as many months. But what surprised me was why she actually lapsed into quasi-dreamland unconsciousness -- suffering from a condition known as hyponatremia. She survived the stroke with the bravado her redheadedness warranted (go NaNa), but what actually nearly killed her was the resulting imbalance of salt in the blood. She was hooked up to monitors, poked and prodded, given the appropriate intravenous fluids, and eventually woke up. Thank goodness for health insurance.



So, this summer, I was watching one of the many televised marathons on one of my many sleepless nights, marveling at the training these athletes endure, how well their bodies are conditioned, and how, never in a million years, could this body, my body, do such a thing. It's not that I necessarily lack confidence; I just don't believe I have the bone or muscle structure to make it happen. But then it happened to one of them -- to one of my Greek god-like, nearly-supernatural marathon-runner heroes. He went down and then out. Flat on his back, I say. It was later reported the runner consumed only pure drinking water (without salt) during the race, and the lack of sodium severely threw off his blood balance; i.e., he suffered from hyponatremia. "Well, I'll be damned," I thought. "Water took him out."

Over and over (and over) again we are warned of the dangers of dehydration, or the lack of water, especially in the midst of a very hot summer. States like Texas, with temperatures soaring above 100 degrees F on a regular basis, are on particular watch. The concrete jungles of Dallas, Austin, and Houston can be especially dangerous, as so much heat is trapped and held, the buildings and sidewalks acting like parts of a giant oven eager to roast humans for sacrificial dinner. While drinking enough water is obviously extremely important, hyponatremia can be caused by just the opposite, and can be just as fatal. If one consumes too much water, or doesn't ingest enough salt, the sodium levels in the blood can become dangerously low.

Normal concentrations of sodium in blood plasma are 136 -145 mM, about 80 times the amount in intracellular fluids. This asymmetrical balance is necessary for the proper conduction of nerves, passage of certain nutrients into cells, and the maintenance of blood pressure. If blood plasma levels fall below 125 mM, the condition is considered one warranting immediate attention, and can lead to seizures or even to that ominous, possibly long-term dreamland state, coma.

While such a severe excess of water or a deficiency of salt can be caused by our own diet, this is not the most common cause. Hyponatremia more often comes about as a result of various diseases, including those of the kidney, pituitary gland, and hypothalamus, and by certain medications, such as diuretics. Normally, the kidneys and intestines regulate salt levels, performing checks and balances amongst themselves, but there are times they simply cannot keep pace.

It's difficult to say how many will actually experience hyponatremia in their lifetimes, as the first stages of it produce only mild symptoms, and are similar to those caused by dehydration -- tiredness, disorientation, headache, muscle cramps, and nausea. Thirty percent of marathon runners, in fact, suffer from mild hyponatremia during the course of a race. While the condition itself is easy enough to treat before it becomes severe -- usually an intravenous fluid infusion of a 5% sodium chloride solution -- the underlying causes are of far more concern. For most of us non-superhuman types (who do not run 50 miles at a time), hyponatremia would probably indicate a more severe underlying problem.

My grandmother has since passed, dying peacefully in her sleep, and fully salt-balanced. It's strange the things you remember and why. "Hyponatremia," is not exactly a term most would find warrants particular attention, and, actually, they would be right. The majority of us will never be particularly bothered by a severe imbalance of sodium in the blood. Somehow, though, it keeps cropping up for me maybe because with all the health food crazes -- "No Fat!" "All the Right Fat!" "No Carb!" "Low Sodium!" -- I forget I actually need those things. We're only human -- we need fat. We need carbohydrates. We need natural sugars and yes, we even need the infamous, often-slain, but oh-so-beautiful and very basic, salt. So grab a saltlick for yourselves, Texans, and don't be afraid. Go ahead, take a nice, big slurp with that gulp of purified water. You'll thank me for it next time you step into the concrete jungle.

Keeping track of your fluid and salt intake is an important part of keeping up on your health, especially during these hot summer months. How you take care of yourself will certainly affect you as you age, and eventually your wallet, as well.