July 29, 2009 was an interesting day to say the least. It was the last day at my parents’ house in New Jersey before my return to Los Angeles. I cannot say that the trip was without incident. I spent a grueling two days of the two week trip brutally sick. I’d thought that I was going through a detoxification as I had done in a similar way in the past, but was to find out later that this wasn’t the case.
Just prior to the trip and more especially during the trip, I was struggling to get through routine bike rides. I’d been used to taking the heavier Gary Fisher mountain bike on brisk 30 mile rides in the high heat of summer when back at my parents’ in July. However, during this trip, that was not the case. I’d struggled to get through 20 mile rides and after would lay on the floor for 4 hours to recover. This was unheard of! Something was wrong but I didn’t realize quite yet how wrong.
That afternoon, preparing for my return, my father asked me why I’d missed so many spots shaving. I told him that I had a hard time holding my chin up. I kept feeling that I needed to eat greens and a lot of them. I would later find out why. It is amazing how the body knows what it needs when it needs it. I thought that when I got back to Los Angeles, I would eat greens by the pounds and I meant that night. However, as I was soon to find, it was too late for that, much too late.
By the time I had gotten on the plane and into the flight, I was beginning to lose my capacity for rational and cognitive thought. What was the problem? Maybe it was B12. As already mentioned, I definitely also thought that I needed more greens. My thought was to eat pounds of greens and take a B12 supplement when I returned.
By the time the flight touched down in Los Angeles, things went from bad to worse. While waiting for my bag, I had to sit. Standing required too much effort. When the bag finally came, lifting it was out of the question. I had to have my friend Greg, who picked me up, lift it.
When I got back, all thoughts of greens were off, although I did take a B12 supplement which did little good. My car was blocked in the driveway and at that point, I don’t think I could have driven it anyway. My thoughts were racing; they were weird, irrational and not ordered. Sleep did not come and in retrospect, I’m very glad that it didn’t. It was now 3:00 AM. My hands and feet were cold and very moist. I was getting desperate. It was time to do the unthinkable. I had to call 911.
By the time the ambulance arrived, I managed to walk out to meet them. I was hunched over, hands on knees to support my upper body. It was too much of an effort to stand upright. There we were, 3:30 in the morning, them trying to talk me out of going in, me trying to talk them in to taking me in.
“Are you sure you want to go? Wouldn’t you rather just stay at home and sleep in your own bed?”
“I have to go in.”
“They’re going to make you wait a few hours in the waiting room. It’s late. Are you sure you wouldn’t just rather stay at home and sleep in your bed?”
“I gotta go in.”
It’s a good thing that I didn’t listen to them. Had I taken their advice, I don’t know if I’d have made it through the night.
After the short ambulance ride and arriving at the hospital, it wasn’t long before I was attended to. The next thing I knew I was in a bathroom at Hollywood Presbyterian Hospital trying to conjure a urine sample. I was having difficulty with this since I’d emptied my bladder not long before. While there in this, what seemed like an eternal laborious process, I remember thinking over and over again that “I cannot die tonight.” I remember thinking of my parents and how I could not leave them. I remembered the television show that we watched while I was at their house, A Thousand Ways to Die, and that I couldn’t believe that I wasn’t far from being one of those statistics and could be before the end of this eventful evening. This wasn’t melodrama, this was life or death!
I managed to conjure that sample and next found myself on a cot in the emergency room. I remember looking up at the bag hanging from the IV assembly with the tube running down into the IV in my arm thinking how it was helping me, how I seemed to feel slightly better already. I remember thinking much more, that this was some elixir from Divinity Itself. It is amazing the things we take for granted until those things are gone.
At some point, I spoke with a couple doctors. The first asked what my diet consisted of. I told him fruits and vegetables. The answer, with my present state as well as my slight build led this man to conclude that I was anorexic. Foolish assessment, but at the time, I said to him that I didn’t blame him for thinking that. But there I was, lean, fit, and despite my current compromised situation, strong. Just a month before, I had been in one of the fittest, strongest times in my life. I was lean and powerful and felt absolutely amazing. If it was over 100 degrees and I was due to ride 60 miles, I wouldn’t ride 60, I would ride 85. I felt invincible and I suppose that was my mistake. In fact, I know it was.
So there I was, laid out in the ER, fragile, feeling frailer then ever in my life.
I was to spend the next two days in the ICU diagnosed with hyponatremia. The first doctor that I spoke with in the emergency room told me that I was critically low in sodium. The second doctor said that I was fatally low. I was to find out later, that the second was closer to the truth.
Normal sodium levels are between the serum level 136 mEq/L to 145 mEq/L. Anything below 135 mEq/L is considered hyponatremia or low concentration sodium. A serum level of 125 mEq/L is considered severe hyponatremia. At 115 mEq/L the symptoms are coma and death. My serum level that night when I checked into the hospital was 109 mEq/L! I was indeed near death, beyond critical. Had I not gone into the hospital when I did, as mentioned previously, I may not have survived the night.
Six months later, I suffered hyponatremia again. This time, I had a serum level of 125 mEq/L by the time I checked myself into the ER after three days of trying my best to get that level up. My sodium blood level initially must have been even lower than that.
So how did this happen and how have I managed since?
First we need to go back to January 2009. This is when I embarked on a low fat raw vegan lifestyle according to natural hygienic principles. If you’ve read my About section, you’ve seen that I’d been through various experiences with diet ranging from vegetarian to vegan to raw vegan to “low fat” raw vegan for a number of years.
More significantly, this was the first time in my life that I’d restricted salt intake. This is not necessarily a problem except that the summer of 2009 was exceptionally hot and I was exceptionally active. Still, this is not necessarily a problem providing that one takes the correct dietary measures.
In 2009, I’d been strongly influenced by the camp that believes that as long as you’re getting enough calories from fresh fruit, you will get enough electrolytes, sodium, of course, being an essential electrolyte.
I have found that to be a dodgy practice at best. I have found that greens are one of the best sources of sodium except for lettuce. Lettuce is one of the greens that is relatively low in sodium. Melons are also an excellent source of sodium except for watermelon. Unfortunately, both times that I had hyponatremia, I had been eating mostly lettuce. When I went low in the summer of 2009, I was also eating large quantities of watermelon which actually had the effect of flushing sodium from the body. Had I eaten the equivalent of other melons instead, for instance, cantaloupe or honeydew, I doubt that I’d have ever had any trouble with sodium levels.
The second time I suffered with hyponatremia, I was eating largely bananas and lettuce. Again, had I been eating bananas and celery or bananas and spinach, I again doubt that I would have had this problem.
Now, in the summer, I focus on melons like cantaloupe and honeydew rather than having watermelon in massive quantities, which again, actually flushes sodium from the body. I also eat plenty of other greens like spinach, celery, chard, collards, rather than just focusing on lettuce. I still eat lettuce, but eat plenty of other greens as well.
Since making these simple adjustments, I am glad to say that I have not had any sodium issues since January 2010 despite the fact that I am cycling more miles now than I was then and also am having little or no added salt.
I present this story as an object lesson. If one wants to start this lifestyle or has already been at it, there are certain pitfalls to avoid; a lack of sodium, especially if you are highly active, is one of them.
This experience and what it entailed led me to another pitfall which I will deal with openly in another entry.
Hyponatremia is an Epidemic in Sports Today by Michael Arnstein