User talk:Bluesky2013

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Thanks for responding.

I have removed the second paragraph (under hypomagnesemia talk) so we can focus on the first.

Let me respond to your points:

First there is nothing in the first paragraph (or the second either) that talks about the frequency of occurrence of hypomagnesemia in elderly patients. I don't know what the frequency is. I have seen it only one time. When I discussed it with the head nurse at the facility, she said it was fairly common but she did not have any statistics. I have searched for statistics on-line and I can only find statistics on annual deaths from all types of heart failure. This includes chronic heart failure which is totally different.

You would like me to provide a reference. I have not found anything that summarizes the impact of hypomagnesemia exactly as I have done here. If I could, I would not need to write this paragraph. However, all this paragraph does is restate clearly and concisely what happens, there is nothing new in it. Let me step through it line by line

Hypomagnesemia is a potentially life threatening problem if not handled promptly and properly.

It is common knowledge that muscles do not work if they do not have enough electrolytes. This includes the heart. If the heart stops the person dies. So the reference for this is any textbook on human physiology.

The patient will exhibit tremors and tetany at the beginning but this may not be visible if they are bedridden and only receiving casual monitoring.

The reference for this is your article. It is well known that a patient will experience tremors and tetany in the early stages of hypomagnesemia.

As the deficiency becomes more severe, they will appear to fall into a coma and become unresponsive.

The reference for this is also your article. It does not use the word coma but that is the best word to describe what I saw. The words it does use are close enough.

Very soon after this, the heart will lose power in the left ventricle.

This might not be so obvious. But there are only 2 ways the heart can fail due to electrolyte imbalance. Either the entire organ shuts down or a part of it shuts down. If the entire organ shuts down (ie it stops beating), the patient will die from lack of oxygen. Some cases of death from hypomagnesemia may occur this way. I only saw one case. In that case, the person's lungs filled with fluid and he could not breath. So I need to expain how this occurs as part of this writeup. The second way the heart can fail is if only a part of it fails. There are 2 main parts: the left ventricle and the right ventricle. The other ventricles are subordinate. The left ventricle has to push blood out into the entire body. This requires a lot of energy. The right ventricle only has to push blood into the lungs. If there is a shortage of electrolytes, the ventricle that needs the most energy is going to fail first most of the time. That is the left ventricle. I don't have a reference for this but it looks like common sense to me. I will try to find a reference.

This will cause a pressure difference across the lungs.

The patient is at a point where the right ventricle is still pumping at a reasonable level but the left ventricle is weakened because of insufficient electrolytes. Fluid (ie blood) is incompressible. The amount of fluid pushed into the lungs must exactly equal the amount of fluid being pulled out of them. If this is not the case, there is a pressure difference. The reference for this is any fluid dynamics textbook.

Fluid will burst into the lungs and the patient will not be able to breath.

The pressure must be relieved somehow unless the container is strong enough to contain it. The lungs are very delicate and not able to withstand any significant internal pressure so they burst. The reference for this is any fluid dymanics textbook.

The damage from this is irreversible and death will follow shortly after.

Once the lungs are blown out, the patient cannot intake sufficient oxygen. They are going to die from lack of oxygen and/or loss of blood. That this damage is irreversible I think is obvious.

The cause of death for these patients is almost always listed as heart failure.

I cannot find any statistics on death from hypomagnesemia. So if people are dying from it, the cause of death on their death certificates is not hypomagnesemia. Since the top level cause in these cases is heart failure, the death certificate is going to list heart failure as the cause of death.

But a closer review of the patient's history would reveal that this is not the root cause - the root cause is hypomagnesemia.

My purpose in writing this paragraph is to indicate that death from hypomagnesemia is possible. And if it occurs, how it would look to an observer. I think this paragraph accomplishes this. I am willing to make changes if the above discussion does not provide sufficient explaination of each point.

Bluesky2013 (talk) 16:36, 18 October 2013 (UTC)bluesky2013[reply]

This discussion belongs on Talk:Hypomagnesemia because the contributors to that article will respond there. They aren't watching this page. :-) Krakatoa Katie 19:00, 18 October 2013 (UTC)[reply]