Hey, Drs.,
I’m a strength coach at a private gym in California. Our population is mainly geriatrics typically with lots of health problems. I just started with a gentlemen who’s doctors told him to not drink any water because of low sodium levels and currently has him pounding Gatorades. I’ve heard this before multiple times but thought I would ask here why would a doctor prescribe someone to longer drink water?
This is likely to be a complex situation, and there is unfortunately probably a lot being missed in translation here, because we never recommend someone “not drink any water” at all.
If I had to guess, he may have chronic hyponatremia, potentially due to something called the Syndrome of Inappropriate Diuretic Hormone (SIADH) and they are recommending a degree of water restriction in order to correct this. “Pounding Gatorade” will not help this situation, as Gatorade is also a mostly-water (hypotonic) solution. There are other possibilities as well, such as chronic heart failure, advanced liver/kidney disease, or if his dietary intake of food (in particular protein and salt) are very low. These are all hypotheses that would be teased out with a clinical assessment.
Clarification of what his underlying condition is, what the actual clinical recommendations are from the physicians, and how long this is expected to go on for / whether there is any more definitive treatment, would be more helpful.
Yes, there was a lot more here to report after meeting with my client. He did has SIADH which has been resolved but still being monitored through reducing water intake. This person also has recently lost 6 pints of blood from a nose hemorrhage which has not found a cause from. He has had a quadruple bypass in 1999 because of a long period of elevated cholesterol levels (I’m guessing LDL?) and came to see me after losing I believe 20-30lbs of weight from being bedridden from this nose hemorrhage which I’m assuming may have caused the sodium imbalance? Anyways basic strength training loosely based off the beginner with tweaks in movements of things he can perform. I see him 3x/ week with him doing some supervised walks on off days with his wife. I do not want to work outside my scope but anything I should encourage him to do with the information I have presented?
Got it.
Assuming he’s medically cleared for exercise, there isn’t anything in particular that this would change in terms of the approach. Assess where he’s at currently, what his goals, abilities, and limitations are, and program / adjust accordingly.