Summer Heat and Dehydration

May 6, 2024

WRITTEN BY LANA WILHELM

Rick’s stroke affected his taste and the ability to determine when he was hungry or thirsty. Everything tasted bad and he would go hours without eating or drinking unless I reminded him. This remains an ongoing and frustrating issue for both of us. I make a nutritious meal and he would take one or two bites and be done. I tried every recommended diet on the market with no luck. 

            One morning, he got out of bed a little too fast and felt dizzy. This is not uncommon; we’ve all  done this, but with a stroke survivor, this is a concern. Before I could slow him down, he lost his balance and fell to the floor. He gathered himself and refused to call the MD.  Although he wasn’t injured, I was concerned.  Later that day, he again lost his balance and felt woozy.

I immediately checked his blood pressure which was low, and a common cause of falls and dehydration.  Our physician directed us to the emergency room for evaluation.  An episode of dehydration can mimic a stroke when a person exhibits confusion and falls. A member of the stroke team evaluated Rick and ordered a CT scan to rule out any additional brain damage. Dehydration caused orthostatic blood pressure, which is a drop in blood pressure when standing, and that is what caused the fall. The body is amazing:  when blood pressure is low, essential organs need blood flow to sustain life. Subsequently, the kidneys received less blood as the body focused on sending blood to the brain.  Once rehydrated, the body returned its focus to kidney function.

            Not only did I need to monitor his care but more importantly his behavior and compliance with what he needed to do.  The following early signs of dehydration helped me to determine how well he was managing his fluids. 

Signs to watch for…

•   Change in blood pressure from sitting to standing.

• Headache or headrush

• Dry mucous membranes

• Decreased urine output or dark yellow urine. Producing lots of clear urine is a good sign of being well-hydrated.

• Loss of appetite, tiredness

• Fatigue

• Dry or flushed skin

• Chills

• Constipation. Producing lots of clear urine is a good sign of being well-hydrated.

To prevent dehydration…

• Drink plenty of fluids and eat foods high in water such as fruits and vegetables.

• For most, thirst is a great guide if you are consuming adequate daily fluid guidelines. Many times, stroke survivors may state they are hungry when they are thirsty.

• Always include fluids when eating or snacking.

• You can usually reverse mild-to-moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.

• Call your healthcare provider if you suspect dehydration. Each survivor is different, and your healthcare provider can provide recommendations on the next steps.

• Increase fluid intake if you experience the following.

  • Medical conditions such as flu, vomiting or diarrhea.

  • Hot weather.  Fluids will help lower body temperature and replace what you lose through sweating.

  • Cold weather, Fluids help to combat moisture loss from dry air, particularly at higher altitudes.

Dehydration after a stroke increases the risk of a blood clot. If Rick doesn’t drink enough fluids, his blood thickens and begins to move slowly. The concern is that the blood can back up in a narrow or blocked blood vessel.  This can then cause an additional neurological incident, such as another stroke.

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