Podcasts about Hyponatremia

Your health isn't a number on the scale—it's how you treat your body every single day. In this recap, Lesley and Brad dive into the wisdom of Amber Romaniuk, an emotional eating, digestive, and hormone expert with over a decade of experience and host of The No Sugarcoating Podcast. This conversation challenges the myths we've been sold about health and inspires you to listen to your body, trust your instincts, and finally put yourself first.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co .And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe.In this episode you will learn about:Why Pilates footwork is a full-body exercise, not just about the feetWhy BMI is outdated and misleading as a health measure.Why we get stuck in suffering because it feels familiar.Daily habits that support hormones and digestion.How to advocate for yourself with providers.Episode References/Links:Follow Amber on IG https://www.instagram.com/amberromaniukAmber Romaniuk Website - https://www.amberapproved.caNo Sugarcoating Podcast - https://amberapproved.ca/podcastP.O.T. Chicago 2025 - https://pilates.com/pilates-on-tour-chicagolandCambodia October 2025 Waitlist - https://crowsnestretreats.comWinter Tour Waitlist - https://opc.me/eventsPilates Expo Journal - https://www.pilatesjournalexpo.com/los-angeles-pilates-expoThe Aligner from Balanced Body - https://opc.me/alignerSubmit your wins or questions - https://beitpod.com/questionsThe Aligner from Balanced Body - https://opc.me/aligner Camp Shame - https://beitpod.com/campshameEp. 400: Gay Hendricks - https://beitpod.com/gayhendricksEp. 177: Lindsay Moore - https://beitpod.com/ep177Ep. 39: Jessica Valant - https://beitpod.com/ep39Ep. 41: Dr. Kelly Bender - https://beitpod.com/ep41Ep. 183: Dr. Kelly Bender - https://beitpod.com/ep183FemGevity - https://beitpod.com/femgevityIf you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast https://lesleylogan.co/podcast/. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co mailto:beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe https://lesleylogan.co/podcast/#follow-subscribe-free. If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. https://lovethepodcast.com/BITYSIDEALS! DEALS! DEALS! DEALS! https://onlinepilatesclasses.com/memberships/perks/#equipmentCheck out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSox https://onlinepilatesclasses.com/memberships/perks/#equipmentBe in the know with all the workshops at OPC https://workshops.onlinepilatesclasses.com/lp-workshop-waitlistBe It Till You See It Podcast Survey https://pod.lesleylogan.co/be-it-podcasts-surveyBe a part of Lesley's Pilates Mentorship https://lesleylogan.co/elevate/FREE Ditching Busy Webinar https://ditchingbusy.com/Resources:Watch the Be It Till You See It podcast on YouTube! https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gLesley Logan website https://lesleylogan.co/Be It Till You See It Podcast https://lesleylogan.co/podcast/Online Pilates Classes by Lesley Logan https://onlinepilatesclasses.com/Online Pilates Classes by Lesley Logan on YouTube https://www.youtube.com/channel/UCjogqXLnfyhS5VlU4rdzlnQProfitable Pilates https://profitablepilates.com/about/Follow Us on Social Media:Instagram https://www.instagram.com/lesley.logan/The Be It Till You See It Podcast YouTube channel https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gFacebook https://www.facebook.com/llogan.pilatesLinkedIn https://www.linkedin.com/in/lesley-logan/The OPC YouTube Channel https://www.youtube.com/@OnlinePilatesClasses Episode Transcript:Lesley Logan 0:00  If you're feeling overwhelmed by what's going on in the world, because you've got stuff in your own life going on, it is your number one priority to heal yourself, to go figure out, like, what people, what services, what you need to heal so that you can go out there in the world and be this amazing, evolved human who helps and supports and inspires other people. Brad Crowell 0:19  Yeah. Lesley Logan 0:20  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started. Lesley Logan 0:59  Welcome back to the Be It Till You See It interview recap where my co-host in life, Brad, and I are going to dig into the beneficial convo I had with Amber Romaniuk in our last episode. Nailed it. If you haven't yet listened to that interview, feel free to pause this now. Go back and listen to that one, and then come back and join us. You guys, I also think last week, I don't even think I said Jon's last name correctly, like I, I gotta you guys.Brad Crowell 1:22  You got close. It's okay. We. Lesley Logan 1:23  Okay, I think it's really important you know, I went to speech therapy, okay, as a child, I had a stutter. I had a lisp. I do think I'm slightly dyslexic. I, I'm doing the best I can here. Brad Crowell 1:37  You're doing great, babe. Lesley Logan 1:39  Today is September 18th 2025 and it's World Water Monitoring Day. And I got some fucking neighbors I'm monitoring. Anyways, every year, around 150 countries come together to honor World Water Monitoring Day. It just rolls off the tongue, don't you think? Brad Crowell 1:55  Yeah. Lesley Logan 1:55  Water, as we've been learning since a young age, is an extremely important source for keeping all living beings alive and well, you can go without food for a long period of time, about three weeks, but your body will most likely start showing signs of shutting down if you haven't had enough water intake for even a short period of time, about three to four days. I can't even go fucking three to four hours without some water. So I just so you know, if I'm ever kidnapped and tortured, I don't think I'm gonna make it three days. I'm gonna I'm gonna, I'm gonna, I'm gonna drown. I'm gonna die. The human body is, after all, made of 60 to 70% of water. We're like cucumbers, everyone. Water is so important. I have, are cucumbers more than 60% water? Brad, will look it up. Water is so important that much of the space exploration budget is solely dedicated to finding water sources on other planets. A huge chunk of the earth's ecosystem.Brad Crowell 2:47  Cucumbers are 90, 95 to 96% water.Lesley Logan 2:50  Okay, so we're not like a cucumber, but we should act like we're, be it till you see it as a cucumber, guys. A huge chunk of the earth's ecosystem is also made of water, with countless organisms dependent on it, yet things like water pollution and climate change are threatening our water sources, which is why it has become more important now than ever to regularly monitor the water bodies around us. I kept interrupting myself, but I just want to say, like I did do a whole thing, you can drown yourself if you drink too much water, you can it's called hyponatremia,neutramia, nitremia, hyponatremia, nutremia, anyways, it's the opposite, and so.Brad Crowell 3:26  Hyponatremia.Lesley Logan 3:28  Natremia. So here's the deal. You do want to. Brad Crowell 3:35  The sodium levels in your blood become abnormally low because you're (inaudible). Lesley Logan 3:36  If you look at, like, cyclists or marathon runners, they're not just drinking water. They have electrolytes in it, you A.K.A., there's salt. So make sure that you be it till you see it like a cucumber, but put some salt in your water. Okay? Also, you know, while we're at it, research the companies who are putting salt in your water, because some of them are dick heads. Some of them don't believe in science, which is pretty fucked up, considering that they're fucking scientific. They're supposed to be scientific in what they're doing. Brad Crowell 3:59  I think we can call one out. Lesley Logan 4:01  Yeah, LMNT apparently supports MAHA. And I'm pretty pissed off.Brad Crowell 4:04  The two founders are, like, lockstep with RFK doing, you know, like de-science-sizing our science.Lesley Logan 4:14  So anyways, I'm pissed off because I really liked it. However, the great thing about being cookied and like algorithms following us is, I use Brad's phone several times to research different companies that are not LMNT, that don't have stevia or sugar, and not only do we come up with a few because of, like, a chat bot of Brad's, but now he's getting ads for some and I think one of the ads you got is brilliant, and I'm really excited about it, so. Brad Crowell 4:38  Yeah, it's a shame, because I really like their product. It was actually really great. Lesley Logan 4:38  It was really great, but, you know what. Brad Crowell 4:38  It still is great. I disagree with their. Lesley Logan 4:38  Clearly, since they don't believe in science. Brad Crowell 4:39  Well, I disagree with their opinions. Lesley Logan 4:43  But also, since they don't believe in science, there's probably a better scientific electrolytes out there. So we're gonna find those, and once we do, you'll know, because I'll just make us an affiliate, and we'll shout it up from the rooftops. But my fucking goodness, protect your water. Make sure, like, look, make sure that even if you live in a place where the water is abundant, we were, I could not believe how much water is in Idaho. I could not believe the amount of water in Idaho. I'm like, no one. California is like, just wasting water. There's no water. Like, when you live in the southwest, when you live on the west, like it's not exactly like, abundant. Brad Crowell 5:20  It's a desert, hello. Lesley Logan 5:21  Yes, I know. So anyways, it happened in Vegas. We found out that, like, when we use water out of our faucets and our sinks and our showers, like 98% of that, or something like that, is actually able to be reused, like cleaned and all that stuff. So, like, that's really nice.Brad Crowell 5:35  I don't know what the percentage is, but. Lesley Logan 5:36  It was over, it was over 90. Brad Crowell 5:37  Yeah, they're very intense in Nevada about water conservation and reuse. Lesley Logan 5:42  We're doing a great job in Nevada, because, we have. Brad Crowell 5:44  Specifically in Las Vegas. Lesley Logan 5:46  Yes, because our population has increased ridiculous amounts, and we've decreased our water consumption. And you know, the fact that people are fighting for their fucking green lawns pisses me off, because unless you live where it rains all the time, then by all means, like, lawn away, but like, if you don't, you know, lawns don't even capture water. Like, that was the shocking news to me. Brad Crowell 6:08  No. The only thing that grass does is look pretty. Lesley Logan 6:10  Looks pretty. Brad Crowell 6:12  That's it.Lesley Logan 6:12  So clearly, I'm against golf courses. But look, if water is natural where you are, and it rains and it can keep grasses green, then have them. But why are we doing the grass in the desert? It piss, like, those kinds of things are stupid. They don't make sense. It, just going with our you know, talk about believe in science. Anyways, at Be It Till You See It, we believe in science. We just got back from the U.K., literally two days ago. We are home, are catching up on work. We're filming stuff for OPC. We're recording stuff for this podcast, and then we're going to, this is our tour, we're gonna go to Chicago. I will be at POT for balanced body in Chicagoland in Burr Ridge. We're gonna celebrate our anniversary together, 10 fucking years married. Holy moly, can you believe that?Brad Crowell 7:00  That's insane. Lesley Logan 7:01  Yeah. I was like, are you still here? Brad Crowell 7:03  Yeah. Lesley Logan 7:04  So, 10 years married, and then from Chicago, we're gonna go to Cambodia, and we're gonna run our retreat in Cambodia. I'm so excited for the epic humans we're gonna hang out with in Cambodia. It's gonna be so (inaudible) and then we're gonna head up to Singapore on our way home. I'm teaching a workshop there. Go to crowsnestretreats.com for our retreat info. Brad Crowell 7:21  Yeah and if you're if this one is too close, because it literally is a couple weeks away, no problem. Get on the waitlist. Lesley Logan 7:24  You're not spontaneous, but they can't be spontaneous. Brad Crowell 7:31  No, you're allowed to be spontaneous. I get it. But also, like doing an international trip within a month can be challenging. So I understand that, I recognize that, if.Lesley Logan 7:39  My mom's friend did it in two weeks. Brad Crowell 7:41  She did. You're 100% right and you should do that, too. Drop your life and come join us. If that's not an option, then come join us next year, we are going to be doing this again in October of next year. We'll be announcing all the dates in January. So go to the website. Go to the website and get yourself on the waitlist. Go to crowsnestretreats.com.Lesley Logan 8:00  Then, on you on our way home, go to Singapore, and then we come home, we hang out for a month. Brad's parents are finally visiting. It's only been 10 years. Don't throw them under the bus. They're lovely people. Anyways, we love them very much. And I just, I just love this 10-year vacation that we're on. Every 10 years. But anyways, we'll announce the winter tour deets on October 1st, actually. So the winter tour is going to release before you leave for for Chicago. So you want to be on the waitlist. opc.me/events to make sure you get that link. Also, 2026 is literally around the corner. We come home from winter tour. I teach at a Pilates Expo Journal. Brad Crowell 8:35  That's in L.A. Lesley Logan 8:36  That's in L.A. adjacent. I just as an Angeleno, I have a really hard time saying that something is in L.A. when it's not in L.A., because I just feel like it's not in L.A., and then we'll be in Poland. So if you are wanting information about that, check out my Instagram account. I'll put that stuff up there. We'll get the links up here in an upcoming episode. Before we get into Amber's amazing takeaways, what is our question this time, babe?Brad Crowell 9:00  etaine.pilates, yeah, is asking legs in parallel, hip distance apart, legs together, zipped midline, either or both? And this is. Lesley Logan 9:01  A footwork question. Brad Crowell 9:05  A footwork question.Lesley Logan 9:06  We got so many footwork questions. I was like, I'll just and some of them are longer than I can type a character count of Instagram. So here is the deal, footwork from Joe, if you're doing it Joe's way, on the Reformer or on the Wunda Chair or on a Cadillac or anywhere footwork is, you start with heels together, toes slightly apart. Brad Crowell 9:33  But if you're doing it Brad's way, you just put your feet completely 180. Lesley Logan 9:37  Yeah, he does his own way. Brad Crowell 9:38  But don't do that. Lesley Logan 9:39  So don't do that. So slightly apart. Like, people like to say Pilates V Pilates V is not first position. So don't get them confused. There's actually no. Brad Crowell 9:39  First position, meaning dancing. Lesley Logan 9:40  Dancing. It's a little that's a little too externally rotated, so it's a slightly apart. The other thing is, it's like, actually your neutral position of your femurs, like, when the body is in neutral, your femurs are slightly turned out, like, that's what footwork toes is. So that's heels, the other toes apart. Then when you move to arches and heels, ideally, you are zipped, zipping the midline together. However, bodies are interesting shapes. We have some people have bony ankles. Some people have large calves. You know, some people have thigh abundance. Some people are Knock Kneed. So here's the deal, if you cannot zip your legs together and get everything to touch so ankles, you know, knees, thighs, what you can do is. Brad Crowell 10:29  Oh, the zip starts all the way down there? Lesley Logan 10:31  Oh, ideally. Doesn't your zipper start at the bottom of your coat? Brad Crowell 10:34  I don't know, whenever I hear that term, I think it's like zipping from my core, so like from my my belly button up, zipping my ribs and, you know, or. Lesley Logan 10:43  Yeah, you could think that, it's fine. Brad Crowell 10:45  But I didn't think about it all the way down to the heels.Lesley Logan 10:48  Sorry, from the bottom, now we're here, babe. So gotta start from the from the feet up. We are talking about footwork, yes, but if you can't, because of your body shape, Balanced Body makes a really cool thing called the Aligner. You can put that between your ankles or your thighs. They have two different ways you can use it. It's really, really cool. We have an affiliate link for that. We'll toss that in the notes, and then, if that's but if that's more than you need because it is a little bit bigger, just roll up a towel, um, or get a little squishy ball and or get a yoga block. Or, like, get a get the dog's toy, put it between your the place in your body that has a hard time, like that's touching, like you don't like when your ankles touch, or your knees knock, put up between something close the chain, so your inner thighs activate. It's really, really important that the inner thighs activate so that you're not just using quads in your footwork. We want the inner thighs, want the hamstrings, want the glutes to work. So it's a full body exercise. So it's all the things you asked Heather, all of them. Brad Crowell 11:41  It's all the things. Lesley Logan 11:42  If you want to dive in deep to footwork, one, I think I'm teaching a workshop. I taught a workshop in the U.K., so that's passed, missed out on it, but we have free tutorials on our YouTube channel, on any place you can do footwork, and it's in our flashcards, and you'll can hear why I'm obsessed with it. If you have a question, go to you can text us at 310-905-5534, we're plus one country code, I guess, so, +1-310-905-5534, or go to beitpod.com/questions, you can submit a win or a question. I want to shout your wins out. That's what makes a Friday episode fun, is your wins. Brad Crowell 12:17  That is what does it and you should definitely be doing that, so. Lesley Logan 12:20  You should be. If you're not doing that, you're doing life wrong.Brad Crowell 12:22  I mean, y'all, we should have so many wins that we don't, we have to pick between them. So, let's go, step it up. Go to beitpod.com/questions.Lesley Logan 12:30  Here's what people, my win's not very big or I don't want to take up space. You want to know something? That's what the fucking patriarch wants. They want you to not take up space. Because if you're quiet and you're humble and you think your win isn't anything, then you then they get have an easier time controlling you in your life. So take up space. Celebrate your wins. You're inspiring other people to see what they can do, and it makes the world a fucking better place to live in. Ladies, take up some fucking space.Brad Crowell 12:54  Take up some space. Lesley Logan 12:55  Share a win. Brad Crowell 12:59  By the way, the link for the Aligner is opc.me/aligner. Lesley Logan 13:04  Aligner. Good luck spelling that there is a silent G. Brad Crowell 13:07  A-L-I-G-N-E-R Lesley Logan 13:08  What's that comedian who, like, does a whole thing on like this, saying the silent letters in the U.S. and like, the English language, we call it aligner.Brad Crowell 13:15  Oh yeah. I don't know the name of the comedian, but that's hilarious. Yeah, go check it out. All right. Stick around. We'll be right back. Brad Crowell 13:22  Welcome back. Let's talk about Amber Romaniuk. Amber is an emotional, eating, digestive and hormone expert with over 11 years of experience and the host of The No Sugar Coating Podcast, which boasts 1.9 million downloads over 500 episodes and is listened to in over 88 countries. Her mission is to help guide women worldwide towards food and body freedom, a state where they understand and address their physical, hormonal, digestive and blood sugar issues, alongside the habits and mindsets that hinder their healing. Her backstory is very involved with her mission today. Her passion for helping women stem from her own profound struggles, which began at a very young age, and some of it was learned from family. Some of it was due to bullying. She shares a little bit about that on the interview. So if you haven't had a chance to go listen to that interview, definitely go, you know, hit pause. Go back. Listen to that. It's worth a listen. When she was a child, she developed an unconscious emotional connection to food, and it revolved around sugar and processed foods, and it led to full, full blown food addiction. And that's part of the story she shares. It's a bit shocking. And it's also, you know, I actually think it's something that is very relatable. And it's not just women who deal with this stuff, you know as well, food can become an addiction, just like cigarettes, like drugs, like whatever working out can be an addiction. For her, food became an addiction.Lesley Logan 14:47  Yeah, I just it's really interesting, because I, while we were on our tour, I listened to like, every podcast I could, and I actually ran out of episodes to listen to. I can tell we're on tour like I ran out of episodes I found this podcast. Podcast was about a camp that, like, heavyweights was based off of actually. And podcast series is really, really cool. It's called Camp Shame. You want to listen to it. And they did a really great job explaining, like, how, just how, historically, then this became associated with, like, healthiness and how, especially in the US, but in most Western cultures, we have really fucked people up by, including our medical world, by thinking that you just have to lose weight and that has created these food addictions and these other and these other ways of eating disorder addictions. And I think it's just.Brad Crowell 15:41  I think losing weight certainly can be the solution, but how could it possibly always be the solution?Lesley Logan 15:47  Oh, and that's exactly it. Because, like a lot of people who do have, do have a little bit more weight on them, doctors are always like, oh, go lose some weight first, before they even, like, listen to their fucking symptoms. And so then their issues get worse. Anyways, all this to say, I really enjoy that I really like when people are willing to share their stories of healing and then how they're going, because I think it's so important to normalize these conversations so that people can realize that, first of all, your weight often has zero to do with width of your health. And we know that now we have a lot of more information now than we did before, because, actually, of science and people studying these things and. Brad Crowell 16:09  Can you explain that? Because that's not intuitive. How is it that your weight could be? I mean, your weight has to have something.Lesley Logan 16:31  So first of all, everybody thinks a BMI is like your insurance companies will use your BMI to determine if you're healthy or not, and what your insurance rate should be. Your BMI was actually never supposed to be used for what health is? The scientists who did it was for another reason, and it was only sitting on men. And BMI means your height to weight ratio. Well, a bodybuilder could have what would be considered obese BMI because the weight. Brad Crowell 16:53  They could be short and huge, but they're intentionally huge. Lesley Logan 16:56  But their their muscles and their body so their body fat percentage is quite low, right, versus somebody who's the same height and maybe even the same weight, but doesn't work out, right? But, but by the way, we're we're acting like that guy with muscles is healthier than the guy without muscles, because we have been conditioned to think that that is healthy. That person might be on steroids, they might be under eating, they might. Brad Crowell 17:19  They could be starving themselves (inaudible) Lesley Logan 17:21  Correct. Right. And then the other thing is, is that, like, you're, a lot of our health conditions are actually genetic versus, you know, a lot of things, and we are, different races have different body shapes. And so we're saying, oh, if you're not heroin chic, then there's something wrong with you. Because the best way to describe the way that the 90s thought health and wealth and beauty was like fucking stick pencil thin. Those girls were eating cotton balls soaked in orange juice. Literally, you can go watch documentaries on this like that is how they were staying the shape that they needed to be to make money. And then we're all chasing this dream when our bodies actually don't want to look like that. They don't. That's not healthy. And so, at any rate, health, signs of good health, your weight is like, truly not one of them, unless you are on the very, very, very ends of a spectrum, but in the middle, there is a wide range of health that could be and your outside appearance is rarely able to to significant like, the indicator of what your health is, we have to look at your sugar levels. We have to look at like, do you digest sugar? Are you digesting your food? Are you absorbing nutrition? Like your microbiome is a better signifier of health than your weight on the scale. And so it's really fascinating, because we have a humongous population of women and men who are raised to think that I just have to be thinner. And so there's a lot of people, a lot of people, a lo t of people listen to this podcast who probably struggle with, I was at the gym today, right? And this woman, she is so, so sweet. She looks so cute. And she's like, yeah. She's like, I'm carrying 30 pounds more because of an injury. And like, the fact that she felt like she had to tell me that because she's a Pilates instructor. And so she's like, yeah, I was like. I was like, who cares? Like, I listen to her. Who cares. You are having the most fun. You're rocking your Pilates practice. Who cares? So the point is, all this to say, like, we, this country is fucked up, in how it thinks of health, and so people are worrying about what the scale says, versus, like, going to their doctor, getting their lungs listened to getting their heart listened to getting their blood checked, and then researching, like, what is, what's in range, hormones, hormone health, that kind of stuff. But like, we're, we're so obsessed with what the scale says, versus like, what does your blood fucking say? What does your blood say? So anyways, back to Amber. She said, we get comfortable in our comfort zones of suffering. And I think this is really, really important. A lot of us are afraid of being on the other side of whatever our addiction or whatever our thing is, because suffering has become comfortable. We know it. We know what to expect. We like certainty. We'll hear more about certainty in a couple weeks with Brad Bizjack. But like we like knowing these things, but we have to we, our comfort zone of suffering is not uncomfortable enough for us to want to get out of it. She said, we continue to do what is familiar because it feels safe to your brain. You can listen to Gay Hendricks or read his book about like your brain, like wanting to be in this comfort zone we will sabotage right? She described being terrified of the unknown. This is, I am familiar with this, like you're so terrified of, like the unknown, like I'll just stick in my suffering, because the other side, the thing that I want, is actually scary, because I don't know what's it going to feel like and but she said the suffering became bigger than the fear of change, and that is so key. Like, sometimes we just have to figure out what that's going to be for us. And she said your healing is one of the most valuable journeys you can choose, is going to help you grow and evolve in ways you can't even imagine. And I think this is so important, like, whatever is going on in your life, if you're feeling overwhelmed by what's going on in the world, because you've got stuff in your own life going on, it is your number one priority to heal yourself, to go figure out, like, who, what, what people, what services, what you need to heal so that you can go out there in the world and be this amazing, evolved human who helps and supports and inspires other people. Right? Anyways, so many good things in there. What did you love?Brad Crowell 21:32  I was digging where she's talking about, your actual body is always trying to heal. Doesn't matter where you are in your life cycle. And what she was talking about, what I what she was referencing there was the different, like hormonal stages of a female body, specifically with the perimenopause, menopause, you know, post she said, however, we have to look at what is in the way of healing. And it's not, not even just those stages, but it, you know, your mindset is so much a part of this healing, right? And whether you're seeing doctors or not, that's what we can contribute to the fix that we may be getting from an expert, right? But our mindset and our habits, the behaviors that we have. She said, she also, you know, when it comes to age and certain ages, right? I know from just being around people who are older than me, they have this idea that they're set in their ways, and there's nothing that can be done about it. And that's not true, you know, like, it doesn't matter when how old you are, you can start to create change and the internal, the way that we internalize, the way that we think about ourselves and think about the change and the hope and the shift in our health, will contribute significantly to whatever actual like, you know, whether we change our sleep or our food or our workout or our, you know, supplements or whatever, any of that, but the way we think about it is going to change, is going to support that or it's going to make it effective, right?Lesley Logan 23:15  Well, we talked about those habits, right? We have a whole habit series coming out, by the way, in December, so I'll dive in more there. But like, if you shame yourself after doing making a mistake in a change you want to make, your main mindset will keep you from making those changes again. Like you will not be able to do it even though your body wants to do it, even though you say you want to do it, like how your mindset is absolutely a huge part of making the changes and allowing your body to heal. Because your body wants to do it, but you're, you're getting in the way.Brad Crowell 23:43  Yeah and also your mindset of your provider, right? The, it's hard to change a provider, but I, you know the response that you mentioned earlier, oh, just go lose some weight first, and then we will do X, Y and Z, you know, like, that's some bullshit. That's such a cop out. Lesley Logan 24:00  Find a new provider. Brad Crowell 24:01  Yeah, and like, if you're getting told something like that, you are, you absolutely can go get a second opinion. Lesley Logan 24:08  You can also tell them, no, I've already have, like, there, in one of the FYFs, I think I actually brought up, like, things that you can say to a doctor. But like, and unfortunately, people who are in what's considered a larger body, you might have to say to the doctor, but I want you to know, come into this I've already lost X amount of weight. I have had this pain for this long. Unfortunately, no matter who you are, even if weight is not a thing, you're gonna have to say how long things happen. Because some people, some doctors, do not take some symptoms seriously until it's been a significant amount of time. Brad Crowell 24:45  Well, let's, let's, let's think about this here, like from the perspective of a doctor, it's a puzzle, okay, you are a puzzle to them, and they like figuring out puzzles, and they've educated themselves in a crazy way over many, many, many, many years to understand all the variables that are involved so, but, they're still human, right? And they're going to do what brains do, which is the fastest, easiest way to find the answer, the solution. That's what their brain is doing for them. So they're gonna look at it and go, well, step one is, is it fucking plugged in, right? Just like any of the stupid customer service calls. So what are they gonna say? They say, well, you're clearly overweight, so go lose some weight, right? And that is the easy answer for them, but there's more to it than just that. But they can say, well, this is definitely something that has to be solved anyway, and it could be a very likely contributor to whatever the problem is that you have. So what are they going to do? They're going to go to the easiest answer first. Now there could be far more to it, or if you can give them a clearer picture of the puzzle, you can already say, this is how long this thing's been happening. I have already lost X amount of weight. I have already done these other things. I have already changed my eating, my sleeping, my this. Yet the problem persists. Now they have a clear picture of the puzzle, and they can go, hmm, the easy is it plugged in response doesn't work here. What's the next thing on my mental checklist of things? Right? So it's really important to be communicative. It's important to be paying attention to yourself. It's important to have those numbers and statistics and like, you know, things that you've already tried, and to share that information, because otherwise you're gonna get the is it plugged in answer.Lesley Logan 24:53  And they don't, and to their to also like to be on their a little on their side, they are, they have to see a ridiculous number of patients in a day. They have, they're given six minutes with you, and so the more you can have your thoughts organized. Listen to the episode with Lindsay Moore and also Jessica Valant on, like, advocating for yourself in healthcare, but like, have these notes, because it will help your healing process if that's the route you have to go. And if you're going a route of a therapist or something like that, find one like it might take a few different people. And I know that's annoying. I know like, when you're when you are suffering and you're finally ready to make a change, it can be fucking annoying to start over week after week after week with a different therapist until you find what you like. But you have, you owe it to your future self and you owe it to the people that you're going to change their life by being yourself. Brad Crowell 27:05  Yeah, I mean, think about, think about it from the perspective of of a Pilates teacher or a fitness coach or whatever, like, if you are in the Pilates world, what we always coach our clients through Agency. We say not, you are not for everyone, and that's okay. The therapists are for everyone, and that's also okay. You're not going to connect the same way with this, with every person, but there is going to be one or more than one person that you're gonna be like, oh my gosh, I totally vibe with this person, and you'll be willing to connect with them in a in a better way. Doctors are the same way, right, like, so anyway, the Lindsay Moore episode is episode 177 and who else did you say? Lesley Logan 27:47  Jessica Valant, her first episode. Brad Crowell 27:49  Jessica Valant is episode 39 so go back and check out those interviews that both will be very helpful and supportive for this conversation as well. And yeah, the I think that you know, to sum this all up, if you're frustrated with the attention or lack of attention that you're getting from your provider, you are allowed to advocate for yourself. No one is going to advocate for you unless you hire someone to advocate for you or engage you know someone advocate for you, or maybe you have a family member who's willing to to play that role, but you can advocate for you, and it's also okay to go get a second opinion and to dig deeper. You know, you're allowed to do that, you know? So she, she said, we need to recondition ourselves, to normalize investing in our health. And what she's specifically talking about in that is that she's Canadian. They do have health care as a country. She said just because we get health care doesn't always mean that it's great health care, right? When she started having this, these deeper conversations with her doctors, she started cutting out some of the middleman and paying to go directly to the experts. Right, because she said, well, I couldn't get the referral, but I disagreed with them. I went to someone else. And just because the way the system was structured, it wasn't an option. So for me, I had to go straight to the expert, and that meant I had to pay out of pocket, and that sucks, because I did have access. I do have access to a healthcare system, however, that wasn't, that wasn't solving my problem and and I think in the United States, the irony is, we still have to fucking pay for things anyway, because our insurance system is so backwards. So, you know, I would say, you know, I agree with her that we need to recondition ourselves to normalize investing in our health, and that's that's exactly why we encourage people to go work out, too.Lesley Logan 29:44  And then, you know, call your fucking Congress person and tell them how much you would invest. Tell them what you want to see changes are. They work for us. And every country that you have some sort of voting system, the person who represents you is supposed to work for you whether you voted for them or not. So like be something in there, like be in their fucking bonnet about it, but first you have to heal yourself. And that does, unfortunately, there's like a statistic that it's like a ridiculous amount of money that women will spend on their health care versus men, because we are often getting second opinions because, unfortunately, they didn't study women's bodies. Brad Crowell 30:19  I think women also live longer than men. So maybe there's something to it.Lesley Logan 30:29  Especially if you don't get married. There's, like, a lot, so there's a fuck ton of study. Brad Crowell 30:53  Wait a minute. Lesley Logan 30:27  Yes. So it says if you're basically, the science is, if you're a man, you need to be married because you'll live longer, but if you're a woman, you should not get married because you will live longer. And so it's just, like, really interesting thing that, like women actually provided we still get to have our credit cards and our bank accounts and vote. You know, we will live longer if we just live by our like, live on our own or live in a commune with each other. Brad Crowell 30:53  Well, there's that. Lesley Logan 30:54  Sorry, babe. I love you, but.Brad Crowell 30:56  I love me too, so, you know. Lesley Logan 30:57  Okay. Brad Crowell 30:58  All right, stick around. We'll be right back. We're going to dig into those action items. Those Be It Action Items that we got from Amber Romaniuk. Brad Crowell 31:05  All right, so let's talk about those Be It Action Items. What bold, executable, intrinsic or targeted action items can we take away from your conver conversation with Amber? She said, hey, the best habits for hormone and digestive health, start getting into a mindful eating practice and start having good sleep hygiene. And what she was specifically saying about mindful eating practice, this is really interesting, y'all, because we're glued to our phones, I'm just as guilty of this, like 100%, she said, for eating, put down your phone, sit and eat your food mindfully. Why? What does she actually mean by that? She said, Well, there's two elements to eating, and we're distracting ourselves from one of the two elements when we're not focused on eating. What are those two elements? There's the physical state of eating, and then there's the emotional state of eating. And if we are not paying attention to our food, there's very high chance that emotionally we won't even realize it, and we will just keep eating, because we don't emotionally think, feel, you know, that we're full, right? And also, there's still that, that element with the physical you know, you're not necessarily paying attention to your stomach, you're paying attention to your phone, right? So you could just keep going past the point of being full. So I just thought it was really interesting. It's not the first time we've heard this. In fact, I think Dr, Kelly Bender also mentioned eating and putting your phone away and just focusing on eating. Can't remember which interview that was, because she's been with us for a few, but. Lesley Logan 32:39  Yes, but you can go listen to them. Brad Crowell 32:41  Yeah, she, she was in episode 41 and 183 Dr. Kelly Bender, so we'll put those links in the show notes. But she, she mentions the same thing, like put your phone away while you're eating. And I never thought about it as as a mindful practice, but disconnect from that technology. And she said, same goes with sleeping. And of course, we've talked about this before.Lesley Logan 33:00  Mindfully sleep, put your phone away. You can actually sleep.Brad Crowell 33:04  Yeah, not mindfully sleeping, but like preparing for sleep, like actually preparing for sleep. And I know you went through a couple different extreme things where you would leave your phone in the other side of the house.Lesley Logan 33:16  I know I still want to do that. I just haven't figured out how to do that. Brad Crowell 33:21  It's tough too, because their phones are our alarms all the things. But like, you know, disconnecting from tech, she said 15, 30 minutes before going to bed, you know. And then also, she said sleeping before 11pm especially for women, because optimal hormone balance occurs between 11pm and 1am I don't actually know how that statistic comes to be, I think every body is a little bit different. And so, you know, we all have our own sleeping patterns. So I think it's important to understand your own circadian rhythm, a tool that we use to help us find ours, has been a ring like the ring that monitors your heart, your health, your blood, you know, your blood, all that kind of stuff, your blood pressure, I mean. And then it actually can identify your natural rhythm.Lesley Logan 34:05  We'll have to, we'll have to find out where that is, because I do, there is information that our liver also does its own, like clean, like cleaning out thing around 2 to 4 a.m. and so that's why a lot of people get up at two in the morning having to pee. Like, it's actually, like, there are, there are some things that the body just does at a certain time. Brad Crowell 34:21  But, but also, like 2 to 4 a.m. for me is not 2 to 4 a.m. for somebody else. So that's what doesn't make sense like, because the time zones like so, so I think, I think there's a, there's a there's like a guideline there. But, you know, I think it's obviously different forever. We live in different parts of the world.Lesley Logan 34:37  Luckily, for you, Brad, you can be a lark, you can be up, or whatever it's called, owl, you you don't your hormones will be fine. If you stay up past 11, it's okay.Brad Crowell 34:44  High level, she said, get your hormones tested. So.Lesley Logan 34:47  Get them tested multiple times, multiple times, because they they do change throughout the day, but also throughout your cycle. And also find a doctor, if not working with Amber or FemGevity, find fucking someone who actually gives a fuck. Because it took me, I knew I did not have testosterone for years, and I had it took me forever to find someone who would fucking listen to me, and so it is annoying, and you gotta advocate for yourself, but you need to find someone who actually gives any fucks about hormones. So whatever it is, find the person you're and yes, it takes time. I know you're busy. Brad Crowell 35:11  I think we could talk about FemGevity here. I mean, you probably heard the commercials that we throw in occasionally here. But you know, Lesley has been working with a female telehealth medicine company that is only in the United States. Sorry, Canadians, but.Lesley Logan 35:33  That's why they have Amber and anyone can well, you can be outside the States, outside of Canada, and work with Amber as well, of course, I guess, but yeah, you gotta find people. So if so cannot talk to Amber, contact FemGevity, but contact interview people who and see if they fit your vibe. Do they understand what your goals are? Like are, does it make sense them? If they're not, it's okay. It's not like, oh my god, they're an asshole. They don't get me. They're not the right person for you.Brad Crowell 36:00  Yeah, they're not the right person for you, or they don't have the time for you and so you can find somebody else. What about you?Lesley Logan 36:06  Becoming in tune and learning how to listen to your body, most powerful gift you can give yourself. I think it's kind of free, guys, as well. Yeah, it's free. She said, do a self-assessment. What symptoms are you experiencing? Rate your intensity, a one to attend, to effectively commute with a healthcare professional. So you could just literally take notes on your phone. And when you wake up, you could just, like, ask yourself, like, well, how do I feel? What am I experiencing right now? Like, in the morning, I'm experiencing a runny nose, oh, it's because I need to take my allergy medicine, right like, or, and in the afternoon, might sit down for lunch. You can go, what am I experiencing right now? And it's like, oh, my nose is still running. Maybe this is not allergies, right? Like, you know? And then after dinner, like, what? Instead, it could be part of your gratitude practice like, I'm grateful because I feel hot, I'm grateful because I feel tired, part of it, but start to rate it, so that you have notes, and you can start to see patterns. And then when you actually do talk to a healthcare professional, they can see that you are paying attention to yourself. Yeah, like, you know, it's really hard when you go, I don't know it's been a while since I've been feeling this way. Since when? They're going to know since when? Because a while for some people is three days, and for some people it's three fucking years. So you want to say since January 27th, every night I feel like this. You know, like that is important information. Build a self-care routine, if we I mean, we know that this is a big thing. I'm a big fan of, you know, even if it's just sitting or slowing down and practicing the art of doing nothing. That's a great thing.Brad Crowell 37:29  Oh yeah, that was a whole interesting part of the conversation. She said, we need to take 10 minutes and literally do nothing to regulate our nervous system every day. And I thought, huh, do I ever give myself time to do nothing? No, you know why? Because I've got a damn phone and I'm like, scrolling Instagram. If I, if I'm doing quote, unquote relaxing, I'm still doing something.Lesley Logan 37:55  You know what? Also, even if, like, here's the deal, you can walk your dog, which is going to be doing something, but then do nothing while walking your dog. And like so, but find ways to get bored. You know, our yoga teacher always talked about, when his kids go, I'm bored, he's like, you're so fucking lucky. It was one of the greatest things you could ever be, is bored. And lastly, Amber advised us to be patient and compassionate with our with yourself. Try to build a friendship with your body. Whoo, that one, that one, if you do nothing on this world, but like, build (inaudible).Brad Crowell 38:25  I mean, you asked, like, how do we not be impatient when we aren't seeing immediate results? And that's where she said, be compassionate with yourself.Lesley Logan 38:33  Yeah, if you were your friend, telling your friend, I'm not seeing X, Y and Z results, you your friend, would be like, okay, but how long has it been? Okay, but you. Brad Crowell 38:41  It's been a week. Okay, it took me 40 years to get here. Lesley Logan 38:44  Yeah, be nice. You're not a robot. Speaking of not being a robot, I'm Lesley Logan. Brad Crowell 38:49  And I'm Brad Crowell. Lesley Logan 38:51  Thank you so much for listening to this episode. Thank you for sending in your favorite parts of the episode. Thank you for sharing what you love and your suggestions. Send your questions and your wins in to beitpod.com/questions. Share this episode with a friend who needs friend who needs to hear it, especially Amber's interview with your friends who are struggling with their health right now and their health journey. It gets really inspiring. Brad Crowell 39:09  beitpod.com/questions Lesley Logan 39:11  Oh, beitpod.com/questions that's more helpful. And until next time, Be It Till You See It. Brad Crowell 39:17  Bye for now.Lesley Logan 39:19  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 40:01  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 40:06  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 40:11  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 40:18  Special thanks to Melissa Solomon for creating our visuals.Brad Crowell 40:21  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Support this podcast at — https://redcircle.com/be-it-till-you-see-it/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Contributor: Taylor Lynch, MD Educational Pearls: Dilutional Hyponatremia: Occurs when there is an excess of free water relative to sodium in the body. Causes a falsely low sodium concentration without a true change in total body sodium. Commonly seen in DKA: Hyperglycemia raises plasma osmolality. Water shifts from the intracellular to extracellular space. This dilutes serum sodium, creating apparent hyponatremia. Corrected sodium calculation: Use tools like MDCALC, or apply this formula: Add 1.6 mEq/L to the measured sodium for every 100 mg/dL increase in glucose above 100. Clinical relevance: Considering corrected sodium in DKA is crucial, as the lab value may not be reflective of actual sodium depletion. True severe hyponatremia can lead to complications like seizures May require treatment with hypertonic saline. References: Fulop M. Acid–base problems in diabetic ketoacidosis. Am J Med Sci. 2008;336(4):274-276. doi:10.1097/MAJ.0b013e318180f478 Palmer BF, Clegg DJ. Electrolyte and Acid–Base Disturbances in Patients with Diabetes Mellitus. N Engl J Med. 2015;373(6):548-559. doi:10.1056/NEJMra1503102 Spasovski G, Vanholder R, Allolio B, et al. Diagnosis and management of hyponatremia: a review. JAMA. 2014;312(24):2640–2650. doi:10.1001/jama.2014.13773 Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/  

On this EM Quick Hits podcast: Pediatric Torticollis with Dr. Deb Shconfeld, Approach to Stable Wide Complex Tachydysrhythmias with Dr. Anand Swaminathan, Post-intubation Neurocritical Care 5 best practices with Dr. Andrew Petrosoniak, Hyponatremia Correction Rates with Dr. Justin Morgenstern, Paronychia Management with Dr. Andrew Tagg, and Women in EM Leader Series with Judith Tintinalli and Dr. Victoria Myers...Donate to EM Cases to help ensure continued Free Open Access Medical Education in the future here: https://emergencymedicinecases.com/donation/

Today, Dr. Monica Gray, Dr. Pradip Kamat, and Dr. Rahul Damania discuss two real-life pediatric cases of hyponatremia in the PICU. They talk through a case of a six-month-old baby with severe sodium depletion and a teenager dealing with cancer-related hyponatremia. The team breaks down the pathophysiology, walks us through the diagnostic workups, and discusses the careful management needed for these cases. They emphasize the importance of correcting sodium levels gradually and addressing the root cause of the problem. They share practical tips for intensivists and highlight why staying vigilant and following evidence-based care is so crucial when managing critically ill kids with electrolyte disturbances. Tune in to hear more!Show Highlights:Discussion of hyponatremia in pediatric patients, particularly in the PICUPresentation of two case studies illustrating different presentations of hyponatremiaExamination of the pathophysiology of hyponatremia, including its classification into hypovolemic, euvolemic, and hypervolemic typesOverview of diagnostic investigations for hyponatremia, including volume status assessment and serum/urine electrolyte measurementsManagement strategies for hyponatremia, emphasizing the importance of gradual correction of sodium levelsRisks associated with rapid correction of hyponatremiaImportance of fluid management in different types of hyponatremiaRole of pharmacological interventions in specific cases, such as SIADHClinical presentation and symptoms associated with hyponatremia in pediatric patientsEmphasis on continuous monitoring of sodium levels and clinical status during treatmentReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 71. Fluid and electrolyte issues in pediatric critical illness. Evans I, Joyce E. Page 866-872Rogers' textbook of Pediatric Intensive Care Chapter 108: Disorders of Water, Sodium and Potassium homeostasis: Schneider J & Glater-Welt L. Pages 1868-1880Harrison's Principles of Internal Medicine Volume 1. Chapter 53: Fluid and Electrolyte Disturbances. Mount D. Pages 338-347

In this episode of the Saving Lives Podcast, we review a 2025 NEJM-Evidence study analyzing over 21,000 cases of severe hyponatremia to determine the safest and most effective correction rates. Learn why moderate correction (8–10 mmol/L/day) may actually reduce mortality, and how central pontine myelinolysis (CPM) remains rare even with faster correction. The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://amzn.to/47qJZe1⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Affiliate Link)My Store: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Use "podcast" to save 10%)Citation: Seethapathy H, Zhao S, Ouyang T, Passos C, Sarang A, Cheung PW, Waikar SS, Steele DJR, Kalim S, Allegretti AS, Ayus JC, Nigwekar SU. Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis. NEJM Evid. 2023 Oct;2(10):EVIDoa2300107. doi: 10.1056/EVIDoa2300107. Epub 2023 Sep 26. PMID: 38320180.

A great time reminiscing over our worst mistakes as athletes and discussing what you can do to avoid these and not be like us!

GI distress. Muscle damage. Hyponatremia. Mental fatigue. Bad pacing. In this evidence-packed episode, we break down the five most common scientific causes of DNF (Did Not Finish) in ultramarathons—and how better training can help you avoid them.Whether you're training for your first 50K or aiming to shave time off a hundred-miler, this episode covers actionable strategies to improve your fueling, hydration, strength, mindset, and race-day decisions.

The FiltrateJoel TopfSwapnil HiremathAC GomezSopia AmbrusoNayan AroraSpecial Guests Michelle Rheault, Director, Division of Pediatric Nephrology, Professor of MedicineTiffany Caza, Nephropathologist, Scientist and self-described Freely Filtered fan girlEditing bySimon Topf and Sophia AmbrusoShow Notes10. Healthcare Cyberattacks9. ApoE in C3 glomerulonephropathy8. Workforce woes in Adult and Pediatric Nephrology7. Hyponatremia correction meta-analysis6. Microvascular inflammation increases risk of graft loss - in all of its forms5. Xenotransplantation4. KDIGO CKD Guidelines3. Hypertension control trials (ESPRIT, BPROAD)2. The Renaissance of IgAN: IgAN treatment trials1. FLOW: GLP-1 RAs in CKD

Hello everyone. Welcome to the latest episode of The Matchbox Podcast powered by Ignition Coach Co. I'm your host, Adam Saban, and on this week's episode we're entertaining a follow-up question from our nutrition episode, discussing whether or not sugar water is a viable option for fueling, and should you include easy Z2 in your training?   As always, if you like what you hear please share this with your friends and leave us a five star review and if you have any questions for the show drop us an email at matchboxpod@gmail.com with email title The Matchbox Podcast or head over to ignitioncoachco.com and fill out The Matchbox Podcast listener question form. Alight let's get into it!   For more social media content, follow along @ignitioncoachco @adamsaban6 @dizzle_dillman @dylanjawnson @kait.maddox   https://www.youtube.com/c/DylanJohnsonCycling https://www.ignitioncoachco.com  https://www.youtube.com/@DrewDillmanChannel   Intro/ Outro music by AlexGrohl - song "King Around Here" - https://pixabay.com/music/id-15045/    The following was generated using Riverside.fm AI technologies   Summary In this conversation, the hosts discuss various aspects of nutrition, focusing on the balance between healthy eating and enjoyment. They address listener questions about processed foods, the role of spices, and the importance of understanding food ingredients. The discussion emphasizes the personal nature of dietary choices and the need for mindful eating without falling into extremes. In this conversation, the hosts delve into various aspects of nutrition and training for endurance athletes. They discuss the balance between antioxidants and protein intake, the differences between homemade and pre-formulated sports drinks, and the critical role of electrolytes in hydration. The conversation also explores the debate over training intensity, particularly the effectiveness of zone one versus zone two training, and emphasizes the importance of balancing data analysis with personal perception of effort during training.   Takeaways Nutrition is a personal journey that requires experimentation. The healthfulness of food is often determined by its ingredients list. Spices can enhance the flavor and healthfulness of meals. Cooking at home allows for better control over food quality. Processed foods can vary widely in healthfulness based on ingredients. Meal prepping can help maintain a healthy diet without daily cooking. Enjoyment of food is crucial for sustainable healthy eating. Mindful eating helps avoid extremes and promotes balance. Whole foods are generally healthier than processed options. Understanding food processing helps make better dietary choices. Antioxidants are abundant in vegetables compared to pasta. Post-ride nutrition should include both antioxidants and protein. Pre-formulated sports drinks offer optimal absorption ratios. Homemade drink mixes can be effective but may lack precision. Electrolytes are crucial for hydration during endurance activities. Training intensity should be tailored to individual goals. Zone one training may not provide sufficient training load. Listening to your body is essential in training. Data can enhance training but shouldn't overshadow personal experience. Hyponatremia can be more dangerous than dehydration.   Chapters 00:00 Introduction and Listener Feedback 01:03 Nutrition and Processed Foods Discussion 05:59 The Role of Spices in Healthy Eating 12:14 Understanding Food Processing and Ingredients 20:04 Balancing Healthy Eating with Enjoyment 22:55 Mindful Eating and Avoiding Extremes 24:53 Antioxidants vs. Protein: The Nutritional Balance 26:21 Homemade vs. Pre-formulated Sports Drinks 30:40 The Importance of Electrolytes in Hydration 35:45 Training Intensity: Zone One vs. Zone Two 40:51 Data vs. Feel: The Balance in Training

In this episode, I sit down with Brooke Bjorge, the owner of Grit Sports Nutrition and an athlete herself, to dive into the critical role of sodium in endurance sports. We cover everything from the dangers of hyponatremia and how to avoid cramping in an ultramarathon, to the differences between sodium citrate and sodium chloride and why it matters for performance. Brooke also shares insights on sweat testing, building personalized hydration plans, and navigating the high-carb fueling trends in endurance racing. Whether you're training for a thru-hike, tackling a 100-miler, or just want to optimize your performance, this conversation is packed with practical tips and science-backed strategies. Follow Brooke: https://www.gritsportsnutrition.com/ takeaways Sodium is crucial for muscle contraction and cognitive function. Hyponatremia is more common than hypernatremia among athletes. Sodium citrate is better absorbed than sodium chloride. Athletes should aim to replace 60-90% of sodium losses during events. Sweat rate testing is essential for developing hydration protocols. Sodium intake can be adjusted based on environmental conditions. Recovery nutrition should include protein, carbs, and fats. Weight loss goals should not compromise athletic performance. Carbohydrate intake should be individualized based on athlete size and needs. Post-exercise hydration is critical for recovery. Sound Bites "Most people run the risk of consuming too little." "Sodium is in charge of so many essential functions." "Sodium citrate is much better absorbed by the body." "You want to replace 60 to 90% of sodium losses." "You don't want to go overboard either." "You can only right the ship to a certain extent." "Not everybody needs more carbs." "Recovery fueling and hydration is huge." Chapters 00:00 The Importance of Sodium in Athletics 03:08 Types of Sodium and Their Absorption 06:05 Sweat Rate and Sodium Replacement 09:13 Developing a Hydration Protocol 12:06 Methods of Sodium Ingestion 15:01 Addressing Sodium Deficiency During Events 17:52 Carbohydrate Intake and Performance 21:00 Navigating Weight Loss and Performance 23:49 Post-Run Recovery Strategies keywords: sodium, sports nutrition, endurance athletes, hydration, sweat rate, sodium replacement, electrolyte balance, carbohydrate intake, weight loss, recovery

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hyponatremia in a Euvolemic State as they share their predictions for 2025 Films. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hyponatremia in a Hypovolemic State as they share their plans to Rule This School. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Produced by: Dylan Walker Created by: London Smith

We have a short attention span in the ED….so it's okay to defer hyponatremia to the real nerds (psst internal medicine). But there are a few indications when we need to jump into action to save the day. Want to experience the greatest in board studying? Check out our interactive question bank podcast- the FIRST of its kind at here. Cite this podcast as: Briggs, Blake. 240. A Salty Solution: SCARY Hyponatremia. November 25th, 2024. Accessed [date].

Try TrainerRoad risk-free!

On this month's EM Quick Hits podcast: Ian Chernoff on the often elusive diagnosis of traumatic coronary artery dissection, Anand Swaminathan on proper use of insulin in DKA and in hyperkalemia, Brit Long and Hans Rosenberg on mesenteric ischemia pearls and pitfalls in diagnosis and management, Dave Jerome on recognition and management exercise-associated hyponatremia and heat illness and Jesse McLaren on the Queen of Hearts AI model in helping identify occlusion MI on ECG... Help Support EM Cases by Giving a Donation here: https://emergencymedicinecases.com/donation/

In this episode of the Elbows Tight podcast, host Travis interviews Riley Rogers, the owner of SALT Electrolytes and a brown belt in Jiu Jitsu. They discuss Riley's journey into Jiu-Jitsu, the importance of technicality and leverage in the sport, and the mindset of training at an older age. They also touch on rolling with lower belts and the significance of belts in Jiu-Jitsu. Riley shares his approach to teaching and preparing for classes, emphasizing the importance of curriculum and individualized instruction. In this part of the conversation, the principal themes revolve around the development of a jiu-jitsu coach and the use of strength and size in training. The subtopics include the reluctance to become a coach, the process of developing teaching skills, the use of strength and size in jiu-jitsu, and the importance of tapping early and controlling submissions. The conversation also touches on recovery strategies and the decision to decline rolling with certain partners. In this conversation, Travis and Riley discuss the importance of setting boundaries in Jiu-Jitsu and the negative connotation of turning down rolls. They also delve into the inspiration behind starting Salt Electrolytes, a clean and potent electrolyte drink. Riley shares his personal experience with dehydration and how it led him to develop a product that provides the necessary minerals for optimal performance. They also touch on the challenges of navigating the supplement industry and the importance of learning leverage in Jiu-Jitsu. Get $25 off the JordanTeachesJiuJitsu Theory Course and Wrestling for BJJ with ELBOWSTIGHT25 at Checkout - https://courses.jordanteachesjiujitsu.com Get 15% off at https://saltelectrolytes.com with code Elbowstight15 at checkout! Join the El-Bros Facebook and Discord Communities! https://www.facebook.com/groups/elbroscommunity/ https://discord.gg/sp2J8mPS LET'S EXCHANGE PATCHES! SEND A PATCH TO THE PO BOX, AND WE WILL SEND YOU A CUSTOM ELBOWS TIGHT PATCH BACK! Travis Motl PO Box 768 Seabeck, WA 98380 The Equipment Behind Elbows Tight Podcast: https://kit.co/ElbowsTightPodcast  Follow Our Social Media Pages! Instagram Podcast Page https://www.instagram.com/elbowstight/?hl=en Facebook https://www.facebook.com/ElbowsTightPodcast 00:00 Introduction and Podcast Announcement 00:24 Getting to Know Riley Rogers 02:22 The Magic of Technicality in Jiu-Jitsu 05:59 Training at an Older Age: Balancing Aggression and Playfulness 08:16 The Significance of Belts in Jiu-Jitsu 13:56 Rolling with Lower Belts and the Importance of Mindset 16:56 Teaching Jiu Jitsu: Curriculum and Individualized Instruction 22:08 Preparing for Classes and Answering Student Questions 25:21 The Challenges and Rewards of Coaching Jiu-Jitsu 25:58 The Reluctance to Become a Jiu-Jitsu Coach 27:13 Developing Teaching Skills in Jiu-Jitsu 32:17 The Use of Strength and Size in Jiu-Jitsu 34:24 Tapping Early and Controlling Submissions 51:28 Recovery Strategies for Jiu-Jitsu Practitioners 54:38 Setting Boundaries in Jiu-Jitsu 57:15 The Inspiration Behind Salt Electrolytes 01:00:39 Dehydration and the Need for Electrolytes 01:04:08 Understanding the Role of Electrolytes in the Body 01:08:54 The Creation and Packaging of Salt Electrolytes 01:18:04 The Importance of Saltiness in Electrolyte Drinks 01:20:31 The Dangers of Hyponatremia and the Importance of Learning Leverage  

In this new series, Drs. Alice Sheridan and Martina McGrath speak with guest editor Dr. Michael Emmett to discuss his editorial "Cystic Fibrosis and Hypoelectrolytemia With Metabolic Alkalosis" from nephSAP Volume 23, Number 2.

In this new series, Drs. Alice Sheridan and Martina McGrath speak with guest editor Dr. Michael Emmett to discuss his editorial "Cystic Fibrosis and Hypoelectrolytemia With Metabolic Alkalosis" from nephSAP Volume 23, Number 2.

Dr Tamara Hew-Butler is the Queen of Hyponatremia (@hyponaqueen on X). What's hyponatremia, you may be wondering? It is a condition that is far more dangerous than dehydration, and which can develop when we drink too much fluid during exercise, with potentially lethal and often tragic consequences. We have been conditioned to fear the health and performance risks of dehydration during exercise, to believe that we cannot afford to lose fluid, and that by the time we are thirsty, it's too late. But Hew Butler, a world authority on fluid requirements during exercise, is here to set the record straight, to explain how exquisitely our bodies regulate our sodium and fluid levels, and why we can and should trust our physiology instead of the marketing messages of sports drinks and water companies. This is an episode that will challenge beliefs, and set the record straight on exercise hydration.Show notesBecome a Patron and join the Discourse communityLinks to articles on the subject matter of the podcastTami is lead author on a series of consensus statements on Exercise Associated Hyponatremia. This is the most recent version of that consensusThe Men's Health article mentioned on the show, discussing overhydration and quoting TamiA review article by Tami, published in 2017, with details on the physiology, treatment and prevention of hyponatremiaA 2022 paper by Tami, on the Physiology, Psychology and pathophysiology of overhydrationA study Tami was involved in looking at soldiers doing a 40km march, showing that drinking to thirst avoided the dangers of both hyponatremia and dehydrationIn the show, we spoke about research we did at the Comrades Ultramarathon. Here is one of the papers from those studies in the medical tentTwo papers on what typically happens during ultra-endurance exercise, first in Ironman athletes, by Sharwood et alA second paper describing over 2000 endurance athletes and the changes in body weight, sodium levels and hydration statusThe first case series of hyponatremic athlete in the Comrades, going all the way back to the 1980sTami's X handle: @hyponaqueen Get bonus content on Patreon Hosted on Acast. See acast.com/privacy for more information.

Alex Larson, a prominent sports dietitian, is renowned for her expertise in optimizing athletes' performance through tailored nutritional strategies. With a background in nutrition science and a passion for sports, Larson has become a go-to figure for athletes seeking to enhance their training regimens and achieve peak physical condition. Her approach is characterized by a deep understanding of the specific nutritional needs of different sports and individual athletes, combining evidence-based research with practical, personalized advice. Larson's holistic approach not only focuses on fueling athletes for performance but also emphasizes recovery, injury prevention, and long-term health. Through her consultations, workshops, and educational outreach, Larson continues to make a significant impact in the realm of sports nutrition, helping athletes of all levels unlock their full potential.EPISODE OUTLINE:00:00 Introduction and Setting the Stage03:00 Optimizing Performance through Individualized Approaches06:17 The Role of Processed Supplements in Training10:49 Finding Affordable and Convenient Fueling Options14:17 Personal Preference in Fueling Workouts22:17 Misconceptions About Sodium25:38 Introduction to Hydration for Athletes29:38 Letting Go of the Dieting Mindset34:01 Don't Fear Weight Gain: Prioritize Fueling for Performance37:12 The Pitfalls of Quick Fixes and Extreme Diets40:27 Using Leftover Chicken in Multiple Dishes43:19 The Importance of Breakfast for Athletes43:40 Navigating Time Zones with Athletes43:46 Navigating Time Zone Challenges44:04 Strategies for Managing Time Zone Changes44:16 Coordinating with People in Different Time Zones44:27 The Benefits of Flexibility45:08 Staying Connected through Social Media45:37 CloseTRANSCRIPT:https://share.transistor.fm/s/48eec58b/transcript.txtMORE FROM ALEX:Website: https://alexlarsonnutrition.com/PODCAST INFO:Podcast Website: www.relaxedrunning.comApple Podcasts: https://podcasts.apple.com/au/podcast...Spotify: https://open.spotify.com/show/2MMfLsQ...RSS: https://feeds.transistor.fm/relaxed-r...SOCIALS:- Facebook: https://www.facebook.com/relaxedrunning- Instagram: https://www.instagram.com/relaxed_run...

Treating hyponatremia, a condition characterized by low sodium levels in the blood, can be both complicated and quite risky.. Disruptions to the delicate balance of sodium in the body can lead to a spectrum of outcomes, from an asymptomatic presentation to life-threatening seizures, coma, and death.Through the patient story of Mrs. Saltman, host Sarah Lorenzini explains the role of sodium in the body, breaking down the science of osmosis and electrolytes so nurses can better understand the causes of hyponatremia. She goes over the three levels of hyponatremia that are categorized by blood tonicity and volume status, and how each level impacts the diagnosis and management of hyponatremia. Sarah also dives into the nuances of treating hyponatremia, including the risks of rapid sodium correction, the importance of knowing a patient's baseline, the underlying cause of their condition, and more.This episode will provide nurses with the knowledge needed to recognize the signs of hyponatremia and navigate the risks of treatment. Tune in now!Topics discussed in this episode:Introduction to Mrs. Saltman's caseThe pathophysiology of hyponatremiaCauses of hyponatremiaTypes of hyponatremia: hypertonic, hypotonic, and isotonicHyponatremia treatment strategies and their risksMentioned in this episode:Rapid Response and Rescue Intro CourseCONNECT

HOST: Andy Herber, P.A.-C. GUEST: Mira T. Keddis, M.D. Join our host, Andy J. Herber, P.A.-C., as he explores Hyponatremia and Hypernatremia; common findings in both the inpatient and outpatient settings. Sodium disorders are associated with an increased morbidity and mortality for patients. Guest, Mira T. Keddis, M.D. , renown Mayo Clinic Nephrologist, joins the podcast to provide guidance on understanding evaluations and management of sodium abnormalities. Mayo Clinic Talks: Lab Medicine Edition | Mayo Clinic School of Continuous Professional Development Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

People have asked us many times what we think of CrossFit, so it's about time we just laid it all out. In this episode we work our way through CrossFit's various philosophies, protocols, and teachings and highlight where we agree and where we don't. In general, the first half of the conversation is more critical while the second half is more positive. If you want to dive in on your own, we framed this conversation around the CrossFit Level 1 Training Guide, which you can download for free. They describe it as "the most comprehensive CrossFit training resource available" and "foundational to the CrossFit methodology" so it's arguably the best primary source for understanding the CrossFit system. We talk about all the classics in here: - Defining "fitness" and CrossFit's "fitness in 100 words"- What "functional fitness" means- Kipping- Nutrition (including Paleo and Zone)- Olympic Lifting- Uncle Rhabdo and Pukey the Clown And so much more... In one section we mentioned a series of articles on hydration. The Hyponatremia of Exercise is a 12 part series by Tim Noakes. Here's a link to part one which links to all the subsequent parts. Skip to part 4 if you want to see where the Army (and specifically USARIEM) got involved, but it comes back up throughout the series.

Welcome to Part 2 of our collaboration with #NephMadness! This week we sit down with Dr. Jeff Kott (Nephrologist and Critical Care Fellow) from the NephMadness Exec to discuss the latest and greatest in hyponatremia correction rates.  Support the show

We partnered up with the NephMadness team to release two special episodes on hyponatremia. In this one we take you through a new(er) approach to hyponatremia and its workup. Stay tuned later this week for our Ask a Fellow episode where we cover the latest and greatest controversy on rates of correction! Written by: Dr. Caitlyn Vlasschaert (Internal Medicine Resident) Reviewed by: Dr. Jeffrey Kott (Nephrologist & ICU Fellow) and Dr. Laiya Carayannopoulos (Intensivist & Internist) Support the show

Sit back and grab some salty treats as you enjoy the mindful musings of master nephrologist Dr. Joel Topf (X: @Kidney_Boy) who joins Nick & Cyrus to chat about hyponatremia in critical illness - a very common condition. Here we discuss diagnosis and management of hyponatremia with special attention to those in the intensive care unit. Of course, no discussion is complete without plenty of time dedicated to osmotic demyelination syndrome (aka: central pontine myelinolysis) which gets plenty of face-time during this episode. Give it a listen and leave feeling confident in your ability to diagnose and manage a very prevalent condition in our patient population! Hosted on Acast. See acast.com/privacy for more information.

Show notes at pharmacyjoe.com/episode894. In this episode, I’ll discuss how correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely. The post 894: Correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode894. In this episode, I’ll discuss how correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely. The post 894: Correction of hypokalemia in a hyponatremic patient makes inadvertent overcorrection of hyponatremia more likely appeared first on Pharmacy Joe.

Hyponatremia is a side effect of most diuretics but the incidence from thiazides is unknown. Join host, Geoff Wall, as he evaluates a new study from Denmark evaluating hyponatremia and thiazides. The GameChangerThiazide diuretics are considered first-line therapy but electrolyte side effects are underevaluated. A new study suggests hyponatremia is significantly more common than previously reported, especially in the elderly. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceAndersson NW, Wohlfahrt J, Feenstra B, et al. Cumulative Incidence of Thiazide-Induced Hyponatremia: A Population-Based Cohort Study. Ann Intern Med. 2023 Dec 19. doi: 10.7326/M23-1989. Epub ahead of print. PMID: 38109740.https://www.acpjournals.org/doi/abs/10.7326/M23-1989?journalCode=aim Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss the use of thiazides in hypertension and their adverse effects 2. Assess the strengths and weaknesses of the Andersson et al study0.05 CEU/0.5 HrUAN: 0107-0000-24-032-H01-PInitial release date: 1/15/2024Expiration date: 1/15/2025Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Renowned pediatric nephrologist, Michelle Starr, returns to the podcast to help unravel and simplify the approach to pediatric hyponatremia, providing valuable insights into diagnosis and treatment strategies. Tune in to elevate your salt game to the next level!

ReferencesJC mentioned that the diagnostic accuracy of 24 hour urine collection increases with more collections! Metabolic evaluation of patients with recurrent idiopathic calcium nephrolithiasisWe didn't refer to a particular study on sodium intake and the 24 hour urine but this meta-analysis Comparison of 24‐hour urine and 24‐hour diet recall for estimating dietary sodium intake in populations: A systematic review and meta‐analysis - PMC 24‐hour diet recall underestimated population mean sodium intake.Anna looking up ace i and urinary sodium Effects of ACE inhibition on proximal tubule sodium transport | American Journal of Physiology-Renal PhysiologyThe original FENa paper by Espinel: The FeNa Test: Use in the Differential Diagnosis of Acute Renal Failure | JAMA | JAMA NetworkSchreir's replication and expansion of Espinel's data: Urinary diagnostic indices in acute renal failure: a prospective studyHere's a report from our own JC on the Diagnostic Utility of Serial Microscopic Examination of the Urinary Sediment in Acute Kidney Injury | American Society of NephrologyJC shared his journey regarding FENa and refers to his recent paper Concomitant Identification of Muddy Brown Granular Casts and Low Fractional Excretion of Urinary Sodium in AKIAnd Melanie's accompanying editorial Mind the Cast: FENa versus Microscopy in AKI : Kidney360 (with a great image from Samir Parikh)JC referenced this study from Schrier on FENa with a larger series: Urinary diagnostic indices in acute renal failure: a prospective study​​Nonoliguric Acute Renal Failure Associated with a Low Fractional Excretion of Sodium | Annals of Internal MedicineUrine sodium concentration to predict fluid responsiveness in oliguric ICU patients: a prospective multicenter observational study | Critical Care | Full TextA classic favorite: Acute renal success. The unexpected logic of oliguria in acute renal failure Marathon runners had granular casts in their urine without renal failure. Kidney Injury and Repair Biomarkers in Marathon RunnersCute piece from Rick Sterns on urine electrolytes! Managing electrolyte disorders: order a basic urine metabolic panelThe Urine Anion Gap: Common Misconceptions | American Society of NephrologyThe urine anion gap in context CJASNExcellent review from Halperin on urine chemistries (including some consideration of the TTKG): Use of Urine Electrolytes and Urine Osmolality in the Clinical Diagnosis of Fluid, Electrolytes, and Acid-Base Disorders - Kidney International ReportsRenal tubular acidosis (RTA): Recognize The Ammonium defect and pHorget the urine pH | SpringerLinkOutlineChapter 13- New part: Part 3, Physiologic approach to acid-base and electrolyte disorders - Do you remember the previous two parts? - Renal physiology - Regulation of water and electrolyte balance- Chapter 13: Meaning and application of urine chemistries - Measurement of urinary electrolyte concentrations, osmolality and pH helps diagnose some conditions - There are no fixed normal values - Kidney varies rate of excretion to match intake and endogenous production - Example: urine Na of 125/day can be normal if patient euvolemic on a normal diet, and wildly inappropriate in a patient who is volume depleted. - Urine chemistries are: - Useful - Simple - Widely available - Usually a random sample is adequate - 24-hour samples give additional context - Gives example of urinary potassium, with extra renal loss of K, urine K should be < 25, but if the patient has concurrent volume deficiency and urine output is only 500 mL, then urine K concentration can appropriately be as high as 40 mEq/L - Table 13-1 - Seems incomplete, see my notes on page 406 - What is Gravity ARF?- Sodium Excretion - Kidney varies Na to maintain effective circulating volume (I'd say volume homeostasis) - Urine Na affected by RAAS and ANP - Na concentration can be used to determine volume status - Urine Na < 20 is hypovolemia - Says it is especially helpful in determining the etiology of hyponatremia - Calls out SIADH and volume depletion - Used 40 mEq/L for SIADH - Also useful in AKI - Where differential is pre-renal vs ATN - In addition to urine Na (and FENa) look at urine osmolality - Again uses 40 mEq/l - Mentions FENa and urine osmolality - Urine Na can estimate dietary sodium intake - Suggests doing this during treatment of hypertension to assure dietary compliance - 24 hour urine Na is accurate with diuretics as long as the dose is stable and the drugs are chronic - Diuretics increase Na resorption in other segments of the tubule that are not affected by the diuretic - Points to increased AT2 induced proximal Na resorption and aldosterone induced DCT resoprtion - In HTN shoot for less than 100 mEq/Day - Urine Na useful in stones - Urine uric acid and urine Ca can cause stones and their handling is dependent on sodium - Low sodium diet can mask elevated excretion of these stone forming metabolites - 24-hour Na > 75 and should be enough sodium to avoid this pitfall - Pitfalls - Low urine sodium in bilateral renal artery stenosis or acute GN - High urine sodium with diuretics, aldo deficiency, advanced CKD - Altered water handling can also disrupt this - DI with 10 liters of urine and urine sodium excretion of 100 mEq is 10 mEq/L but in this case there is no volume deficiency - Opposite also important, a lot of water resorption can mask volume deficiency by jacking up the urine sodium - Advises you to use the FENa - THE FENA - < 1% dry - >2-3% ATN - It will fail with chronic effective volume depletion - Heart failure, cirrhosis, and burns - Suggests that tubular function will be preserved in those situations - Also with contrast, rhabdo, pigment nephropathy - Limitations - Dependent on the amount of Na filtered - Goes through the math of a normal person with GFR of 125/min and Na of 150 has filtered sodium of 27,000/day so if they eat 125-250 mEq their FENa will be 600-800 - Urine osm < plasma osm in face of hypernatremia indicates renal water loss due to lack of or resistance to ADH - In ATN urine OSM < 400 - In pre-renal disease it could be over 500 - Specific but not sensitive due to people with CKD who are unable to concentrate urine- Specific gravity - Plasma is 8-10% igher than plasma so specific gravity is 1.008 to 1.010 - Every 30-35 mOsm/L raises urine Osm of 0.001 - so 1.010 is 300-350 mOsm/L H2O - Glucose raises urine specific gravity more than osmolality - Same with contrast - Carbenicillin- pH - Normally varies with systemic acid-base status - PH should fall before 5.3 (usually below 5.0) with systemic metabolic acidosis - Above 5.3 in adults and 5.6 in children indicate RTA - PH goal 6.0-6.5 - Separate individual RTAs through FR of HCO3 at various serum HCO3 levels - Also can monitor urine pH to look for success in treating metabolic alkalosis - Look for pH > 7 - In treatment of uric acid stone disease - Want to shift eq: H + urate – uric acid to the left because urate is more soluble - PH goal 6.0-6.5

Aneurysmal Subarachnoid Hemorrhage (aSAH) Part II Special Guest: Casey May, PharmD, BCCCP, FNCS 04:24 – Guideline overview 09:15 – Blood pressure management 22:03 – Nimodipine 31:15 – Antifibrinolytics 36:58 – Hyponatremia and adjunctive treatments 46:20 – Seizure prophylaxis 49:10 -- Cerebral vasospasm/DCI treatment 52:46 -- Gaps in guidelines, future trials, ideas for future studies 60:25 – Take-home points  Reference List: https://pharmacytodose.files.wordpress.com/2023/08/asah-part-ii-references.pdf PharmacyToDose.Com  @PharmacyToDose  PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Drinking too much water can cause serious health problems! Find out why.

Dr. Douglas Casa has been the CEO of the Korey Stringer Institute since it was founded in 2010 and has been a professor of Kinesiology at the University of Connecticut since 1999. The mission of the KSI (ksi.uconn.edu) is to provide research, education, advocacy, and consultation, to maximize performance, optimize safety, and prevent sudden death of athletes, warfighters, and laborers.Dr. Casa has written several books and authored many papers on maximizing performance and safety while training or working in the heat. He has treated hundreds of cases of heat stroke with zero fatalities and has served on the International Olympic Committee's Adverse Weather Impact Expert Group, where he helps to ensure the safety of athletes competing in extreme heat during summer Olympic games.In this episode, we talk with Dr. Casa about his work at KSI, the science of heat stroke and how to manage it, how our bodies adapt to extreme heat, and how factors like saunas, hydration, and electrolytes affect our bodies in the heat. Timestamps:00:00:25 Intro00:02:01 Origins of KSI00:03:19 What Brought You to KSI00:04:42 What Does KSI do00:06:09 The Science of Heat Stroke00:09:34 The Consequences of Excessive Core Temp00:11:09 How to Recognize the Signs of EHS00:13:52 How to Treat EHS 00:19:19 Common Misconceptions00:22:20 What Conditions Create the Greatest Risk00:28:41 Objective Environmental Factors 00:30:23 Performance Clothing00:32:49 What Can an Athlete Do to Acclimate to Extreme Heat00:35:11 How do You Know Your Core Temp00:36:41 Type of Thermometers Recommended 00:37:19 Plasma Volume Expansion00:40:03 Train For Heat Adaptations at Home00:42:49 Sauna Guidelines00:43:22 Infrared Saunas 00:44:12 Manage Hydration00:47:36 Hyponatremia and Electrolyte Balance00:52:45 What do You Recommend For Hours Long Stressful Events00:55:02 Hydration Recommendations00:56:27 Are You More Likely to Get HS if You've Had it Before00:58:20 How do You Sign up For The Course00:59:20 Average Range of Cost to Work With KSI1:00:19 Outro

For five years I've been struggling with dehydration and finally found that it's due to a lack of sodium. It's not that I haven't taken electrolytes in the past, it's just that I haven't taken nearly enough. Listen in to hear how I finally conquered this long on going problem. Hopefully this can help out others who have dealt with the same issues.

The following episode covers the basics of hyponatremia. This episode is a bit longer than most but the prevalence of hyponatremia in critical care warrants a slightly longer conversation.  For further reading on hyponatremia: https://emcrit.org/ibcc/hyponatremia/  

Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Freely Filtered. He is also host of the podcast Channel Your Enthusiasm, a deep dive monthly recap of the nephrology textbook Clinical Physiology of Acid Base and Electrolyte Disorders by Dr. Burton Rose (who, incidentally, is the creator of the original UpToDate). Dr. Topf wrote his own book on fluids, electrolytes and acid-base homeostasis.  He's the co-editor for the fourth edition of Nephrology Secrets and the first edition of The Handbook of Critical Care Nephrology. Dr. Topf joined us to talk about a new paper he co-authored on osmotic demyelination syndrome and hyponatremia. I'm also joined by Dr. Mita Hoppenfeld, hospitalist at the University of Utah, to talk about a new DOAC vs warfarin trial in On-X aortic valves, whether it's better to avoid hypertension or hypotension around time of surgery, and the diagnostic accuracy of CT abdomen scans without contrast. Check it out! Osmotic Demyelination and HyponatremiaApixaban vs Warfarin for On-X Aortic ValvePerioperative Blood Pressure Strategies Diagnostic Accuracy of CT Abdomen Without ContrastMusic from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R

Episode 9! In this episode we step a little out of our comfort zone to talk about a couple of analyses which caught our interest recently: 1) "Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock" published  by Bosch et al March 2023 in JAMA Internal Medicine2) "Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia" published by MacMillan et al March 2023 in NEJM EvidenceFludrocortisone: https://pubmed.ncbi.nlm.nih.gov/36972033/COIITSS: https://pubmed.ncbi.nlm.nih.gov/20103758/ODM: https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200215ODM Editorial: https://evidence.nejm.org/doi/full/10.1056/EVIDe2300014If you enjoy the podcast please share on social media or by word of mouth! Thank you!Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

We tackle the knotty dilemma of diagnosing and treating hyponatremia, with Dr. Paul Adams, a dual-trained nephrologist and intensivist at the University of Kentucky. Find us on Patreon here! Buy your merch here! Takeaway lessons Resources

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing... The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on Emergency Medicine Cases.

Dr. Alexis "AC" Gomez, a second year fellow at the combined MGH, Brigham and Women's, and Boston Children's nephrology program, discusses her approach to hyponatremia with host Dr. Joyce Zhou. She shares the pathophysiology behind her diagnostic framework for hyponatremia and her systematic approach, and discusses pearls such as how to use ddAVP clamps in treating this disorder. Run the List podcast on AccessMedicine: https://accessmedicine.mhmedical.com/multimedia.aspx#1460

The SLS team tackles the case of a young woman presenting with a prolonged, inflammatory pulmonary syndrome is found to have pulmonary granulomas, headaches and hyponatremia. Join them as they apply CPSolvers schemas to real life Patient care to facilitate the diagnostic reasoning process.   Download CPSolvers App here Patreon website

In this episode Emma is joined by Emily Cole, a senior XC / track and field student-athlete at Duke. After a scary experience with Hyponatremia - a medical condition caused by drinking too much water - Emily became passionate about teaching athletes the importance of nutrition and is soon releasing her book, The Players' Plate. She has also built a strong social media following on TikTok and Instagram where she shares her story and everyday life as a student-athlete at Duke. Throughout this convo, Emily talks about her experience with Hyponatremia, how she began to redefine what healthy nutrition was and what would work best for her, why content creators in the running world are important, how social media has changed her life, more. Follow Emily on Instagram: @emilycoleYou can find Emma on Instagram at @emmaabrahamson and on her YouTube Channel. Follow Convos Over Cold Brew Podcast on Instagram at @convosovercoldbrewpod.Click here to shop Convos Over Cold Brew merchandise!Offers:-Inside Tracker | Go to insidetracker.com/emma or use code EMMA20 for 20% off the top selling Ultimate Plan Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

What are the 3 types of solutes you can use in hyponatremia? What are each of their drawbacks? How do loop diuretics work help in hyponatremia? What can you use to tell you on day 1 that fluid restriction alone will not work?Show notes, Transcript and References:  https://www.coreimpodcast.com/2022/08/03/hyponatremia-man…5-pearls-segment/Sponsor: https://go.amboss.com/CoreIM-E4Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps:01:20 Intro04:46 Pearl 113:13 Pearl 224:03 Pearl 332:49 Pearl 437:05 Pearl 5

Digital Education Conference 2022 in Oct 7 & 8 2022: https://cmecatalog.hms.harvard.edu/digital-educationWhat does each diagnostic test tell you? How do you interpret urine osmolality, urine sodium, or urine urea? What studies can be used to better assess response to treatment? How can uric acid be utilized as a diagnostic tool? What is the interplay between ADH and UOsm?Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-imTags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology