The old aunty and her sons were coming from the emergency department. The polyclinic was very crowded as usual. The elderly aunt was in a wheelchair, conscious, but restless and seemed troubled with meaningless movements.
From the letter in their hands, there were expressions that we should mediate for her hospitalisation in the ward. However, I had just met with the chief of the ward and there was no room. As for the clinical picture, there was a picture of low sodium and other accompanying conditions were heart rhythm disorder, hypertension, previous embolic type stroke and COPD. He was taking blood thinners as well as blood pressure, heart and lung medications. As for the cause of the recent process, it was seen that hyponatremia (low sodium) and urea values increased due to the effect of the blood pressure medications he was taking as well as the loss of fluid caused by the effect of the laxatives given consecutively for the elimination of long-lasting constipation.
We referred the patient to the emergency room of the state hospital with a cover letter. However, when his son came in the evening and stated that there was no place, we were forced to give fluid electrolyte treatment at home under the supervision of a nurse. This treatment should be done at very slow speeds so that the brain is not affected. We said that we should see the daily electrolyte and blood values by paying maximum attention to these issues.
However, three days later, when this sick aunt came to me on foot and said, “Son, what have you done to me?”, I said, “What have I done to you, aunt, look at how you were, how you have become”; When she said to me, “Son, that’s what I’m telling you, what did you do to me when I was paralysed and now I can walk and talk easily,” we realised that we were witnessing how the real picture was transformed into a marvellous situation with our simple intervention, thanks to the emergence of a long-term hyponatremic event in the emergency room after diarrhoea.
The sodium was corrected and so was the patient. Of course, we did not neglect to replace the wrong medications with the right ones.
As for our question, especially about the treatment of the elderly.
Now, what was the curve? What was the right one?
I am waiting for your comments from those you understand.
Those who make the correct comment will be announced separately.
