Hypertonic saline test for the investigation of diabetes insipidus

[Pino]

Today i had an appointment in the clinic again, they told me to do the hypertonic saline test in the next weeks, i already had the water deprivation test done.

I think the results are already clearly, but perhaps they want to do some more money on this "rare" disease.

I will have to do an overnight stay again, they will push 4000ml of saline in my blood in three hours, i will be not allowed to stand up, and when this is done i have to drink 4000ml water in 30 minutes. Hell yeah, my bladder will be very happy.

No idea how i shall solve this. Perhaps i will ask for Foley catheter, no diaper will be able to hold this amount, i would have to change myself several times lying in the bed, i have never done this before. Alternatively i could use one way catheters and a bed-bag. Has anybody done this before?

 

[CheshireCat]

WOW! Now that is a stress test. I've never done that test, and I don't think I could manage pounding that much water in 30 minutes.
Are you sure you're not confused and they actually plan on waterboarding you??!?
I hope you manage well and will get answers.
(I would ask for a Foley for the night)

 

[Edgewater]

WOW! Now that is a stress test. I've never done that test, and I don't think I could manage pounding that much water in 30 minutes.
Are you sure you're not confused and they actually plan on waterboarding you??!?
I hope you manage well and will get answers.
(I would ask for a Foley for the night)

Yaaa, Waterboarding is correct!!
Regarding the 4000ml saline push. Keep that area warm, by taking the part of the tube in your hand and/or along your body to warm the saline prior prior to entering you blood stream. It will help greatly in keeping the site from becoming very painful.
FYI: Ask what they are going to do to keep your electrolytes from depleting.
Never had this kind of test before, but had a wound infection during COVID and was likewise left in one of those isolated sections of the Hospital. They were near constantly running something into me near fresh from the cooler.

 

[EcoIncon]

@Pino sorry you have to go through this. Sounds awful. I'd personally do a condom catheter if I knew I were going to pee that much but Foley's are murder for me so maybe that'll work better for you. I can't imagine anyone in the world that could hold this much fluid though. I'd assume they have some form of approach for getting rid of the fluid worked out???

 

[Pino]

@Pino sorry you have to go through this. Sounds awful. I'd personally do a condom catheter if I knew I were going to pee that much but Foley's are murder for me so maybe that'll work better for you. I can't imagine anyone in the world that could hold this much fluid though. I'd assume they have some form of approach for getting rid of the fluid worked out???

I think most people just get "bottles", but my neurogenic bladder will not open when lying on my back. It opens when lying on my stomach though, i think this my be due to my spinal cord damages, like the foraminal stenois. Noboday knows really.
The condom catheter is not really an option for me.

 

[Pino]

Yaaa, Waterboarding is correct!!
Regarding the 4000ml saline push. Keep that area warm, by taking the part of the tube in your hand and/or along your body to warm the saline prior prior to entering you blood stream. It will help greatly in keeping the site from becoming very painful.
FYI: Ask what they are going to do to keep your electrolytes from depleting.
Never had this kind of test before, but had a wound infection during COVID and was likewise left in one of those isolated sections of the Hospital. They were near constantly running something into me near fresh from the cooler.

It is a high saline IC (about 3% ?), they need to control sodium and kalium every 30 minutes, it will rise a lot and can get dangerous.
I will keep the warming in mind.

 

[rothpirate]

This test seems crazy if you already did the water dep test. I only did a six hour deprivation test and the endo got enough data to diagnose me.

 

[Pino]

This test seems crazy if you already did the water dep test. I only did a six hour deprivation test and the endo got enough data to diagnose me.

Yeah, i think so either, the water deprivation test was an overnight stay at the hospital starting 22:00 in the evening (10 p.m.) and getting really started at 06:00 a.m. and lasted until 17:00 (05:00 p.m.) - 8 hours plus 11 hours. The results were O.K., not much room left for speculating.
But i have got no tumor, what is the main reason for diabetes insipidus centralis, perhaps they want to get "really" sure it is not psychosomatic.
Officially they want to differ between centralis and nephrogene - but i can not see much indication for the second one, it looks very obviously like a moderate to severe centralis.

 

[rothpirate]

My mri was clean. My endocrinologist said that partial and idiopathic is the most common diagnosis. I concentrated quite a bit the night before, to the point I thought maybe I was getting better. Last night I peed over 2l and blew out. My pituitary fully took the night off after working pretty hard the night before. Same diet and drinking patterns as the day before. I cant take desmopressin because of fluctuations like that, I would have gotten very sick with desmopressin the night before, last night it would have been a life saver. I can sleep pretty well though because my bladder is shot, as long as I don’t leak I rest pretty well.

 

[Inconinmiss]

Pino, That test sounds like torture! If I were in your place, I might refuse to allow it.

 

[Pino]

Pino, That test sounds like torture! If I were in your place, I might refuse to allow it.

The information i get are a little different, i do get no information from the this clinic directly and look for other (German) clinics doing the same and having information on their website. Some do only 2000ml with 0,9% saline in four hours, this would be no problem for me i think, some use a catheter from the start to get the samples easy. I will ask on the telephone, but the person i speak to most know nothing for sure.
I thought this would be a three hour test ambulant, the overnight stay surprised me as well.

 

[Pino]

My mri was clean. My endocrinologist said that partial and idiopathic is the most common diagnosis. I concentrated quite a bit the night before, to the point I thought maybe I was getting better. Last night I peed over 2l and blew out. My pituitary fully took the night off after working pretty hard the night before. Same diet and drinking patterns as the day before. I cant take desmopressin because of fluctuations like that, I would have gotten very sick with desmopressin the night before, last night it would have been a life saver. I can sleep pretty well though because my bladder is shot, as long as I don’t leak I rest pretty well.

Mine is different from day to day either, between 4400ml and 7000ml a day at the moment, some nights only one time waking up, up to four times on other nights, some days my urine looks yellow most time, some days it is like clear like water. I will have to wait.

 

[rothpirate]

Sounds like partial di, which can make you feel like it’s all in your head some days. If they prescribe desmopressin, start with a half dose no matter what they say, make sure you break through before another dose and stay away from NSAID’s Or you can get very sick when medicated.

 

[Pino]

Just got the information that the test can not be done soon, because they are lacking a "BGA" - blodd-gas-analysis-device - to do it.
I will have to wait until May. Damm it.

 

[furry121]

My mri was clean. My endocrinologist said that partial and idiopathic is the most common diagnosis. I concentrated quite a bit the night before, to the point I thought maybe I was getting better. Last night I peed over 2l and blew out. My pituitary fully took the night off after working pretty hard the night before. Same diet and drinking patterns as the day before. I cant take desmopressin because of fluctuations like that, I would have gotten very sick with desmopressin the night before, last night it would have been a life saver. I can sleep pretty well though because my bladder is shot, as long as I don’t leak I rest pretty well.

A thick high capacity diaper could work for u.

 

[furry121]

The information i get are a little different, i do get no information from the this clinic directly and look for other (German) clinics doing the same and having information on their website. Some do only 2000ml with 0,9% saline in four hours, this would be no problem for me i think, some use a catheter from the start to get the samples easy. I will ask on the telephone, but the person i speak to most know nothing for sure.
I thought this would be a three hour test ambulant, the overnight stay surprised me as well.

Why don't they just take blood they can see if u have diabetes that way

 

[Pino]

Why don't they just take blood they can see if u have diabetes that way

I think you mixed up Diabetes Mellitus with Diabetes Insipidus, the name sounds close, but these are completely different diseases.
It is not about blood sugar, but about ADH hormones and kidney response.

My blood sugar is completely normal, the "long term" reading is at "105" - Diabetes Melllitus is always the first thought when i tell doctors about my problems and symptoms and i have got a lot of overlaps, including Polyneuropathy. My weight seems to be to high all the time, but i have got a high muscle part, my body fat is in a range from 20% to 30% at weighting 110 to 120kg at 184cm (6.4?), the BMI is way to high.
This results in dismissing my symptoms many times.

My wife said i do look like "Shrek".