"Second Lt. Michael Parros died after being treated for hyponatremia." Anyone have any experience with over hydration?

COL Sam Russell — Fri, 29 Jul 2016 05:34:44 -0400

"A 21 year-old soldier and West Point graduate died Wednesday on his first day of U.S. Army Ranger school after becoming ill and taken to a hospital.

"Second Lt. Michael Parros died after being treated for hyponatremia at a hospital near Fort Benning on the Georgia-Alabama border, according to Army officials. Hyponatremia is a condition where the level of sodium in the blood is too low and the level of water in the body is too high.

"Parros fell ill on Monday, less than a month after reporting to Fort Benning on June 27 and served with the 199th Infantry Brigade, according to officials. In may, Parros graduated from the United States Military Academy.

"'This is a tragic loss,' Lt. Co. Matthew Weber said in a statement. 'While 2nd Lt. Parros was only with us for a short time, he showed so much potential and was the epitome of the kind of soldier you want to serve with. We are truly saddened to lose a member of our Army family.'

"Parros was a quarterback for state champion Concord’s De La Salle High School football team and then later played football, hockey and soccer while at West Point, while also being a member of the Cultural Affairs club, Army officials said."

http://www.armytimes.com/story/military/2016/07/28/west-point-grad-dies-after-hospitalization-during-ranger-school/87660358/

West Point grad dies after hospitalization during Ranger School

2nd Lt. Michael R. Parros was being treated for a condition that can stem from drinking too much water during athletic activity.

Response by SSG Trust Palmer made Jul 29 at 2016 6:13 AM

SSG Trust Palmer — Fri, 29 Jul 2016 06:13:17 -0400

Praying for his family and friends.

Response by 1SG Private RallyPoint Member made Jul 29 at 2016 6:14 AM

1SG Private RallyPoint Member — Fri, 29 Jul 2016 06:14:00 -0400

I never had a personal experience with it my years of service. I have heard of cases where this has happened to others although rare.

Response by SGT David A. 'Cowboy' Groth made Jul 29 at 2016 6:15 AM

SGT David A. 'Cowboy' Groth — Fri, 29 Jul 2016 06:15:57 -0400

Too much water, needed to add more salt to his diet. Went thru a bout of over hydration a few years ago, sick for 3 days. Rest in Peace brother.

Response by LTC David Brown made Jul 29 at 2016 7:14 AM

LTC David Brown — Fri, 29 Jul 2016 07:14:43 -0400

Prayers for family

Response by Col Rebecca Lorraine made Jul 29 at 2016 7:57 AM

Col Rebecca Lorraine — Fri, 29 Jul 2016 07:57:08 -0400

Very sad loss. Although, hyponatremia or low sodium is very dangerous, it is often an issue with heat, excessive loss of salt through perspiration, and not having electrolyte replacement. If someone has low sodium, they can have seizures, cardiac arrhythmia and mental confusion and loss of consciousness. IV solutions provide electrolytes like sodium, so I am amazed that he actually died in this day and age. Especially one who is an athlete. There may be more to the story but it is a reminder to all how fragile and precious life is.

Response by CPT Private RallyPoint Member made Jul 29 at 2016 8:20 AM

CPT Private RallyPoint Member — Fri, 29 Jul 2016 08:20:13 -0400

I have seen a guy go down for this a long long time ago when I was at Bragg. It was right before a Ruck March. It is pretty rare. With experience you learn how your body functions. Sometimes you may need more or less water. When I was in mountains in the winter I think I drank about 1 qt a day. That is just about nothing but it didn't bother me much and I am sure the cold help to prevent me from sweating at all. In such a place it is difficult to track this when you have so many students doing so many activities.

Response by Sgt Chris Lima made Jul 29 at 2016 9:06 AM

Sgt Chris Lima — Fri, 29 Jul 2016 09:06:09 -0400

We were warned about it at Parris Island. Oversaturation of the cells or something like that... Had a fat kid fall out of a hike and he came back from medical saying that's what it was. I'm pretty sure he was just fat.

Response by SSG Private RallyPoint Member made Jul 29 at 2016 10:14 AM

SSG Private RallyPoint Member — Fri, 29 Jul 2016 10:14:10 -0400

I have dealt with it before. Not a serious case as this one. Whenever it is hot out, and someone says they aren't feeling well, the first thing I ask is "How much water have you had to drink?" Or if I see a Soldier that is sweating profusely. Grab a Gatorade for them and have them drink it. I think people (and leaders) often forget that sometimes you need more than water. The more sweat that is released from the body, the sooner you have to consume electrolytes. Rest in Peace to this man and prayers to his family and friends.

Response by SN Greg Wright made Jul 29 at 2016 12:36 PM

SN Greg Wright — Fri, 29 Jul 2016 12:36:58 -0400

Fair winds and following seas, Soldier.

Response by SFC J Fullerton made Jul 29 at 2016 12:48 PM

SFC J Fullerton — Fri, 29 Jul 2016 12:48:16 -0400

Yes. An applicant at MEPS got sick and puked on the floor shortly after arriving to MEPS early in the morning for the physical. Turns out the recruiter was having him guzzle gallons of water for the previous few hours in an attempt to flush him out so his piss would be so diluted he could pass the urinalysis.

Response by LTC Private RallyPoint Member made Jul 29 at 2016 1:04 PM

LTC Private RallyPoint Member — Fri, 29 Jul 2016 13:04:33 -0400

Sir, This exact thing happened to me while I was at Pre-Ranger a few years back. Luckily for me it was caught and I was medically released for Heat cramps as it caused my legs to lock up on the five-mile run.

Response by LTC Stephen C. made Jul 29 at 2016 4:09 PM

LTC Stephen C. — Fri, 29 Jul 2016 16:09:21 -0400

COL Sam Russell, I was lucky. A similar situation occurred to me while in Egypt in 1987. I knew (or thought) I was dehydrated and kept drinking water like there was no tomorrow. A sergeant first class (to whom I'm forever grateful) asked me what was wrong. After I described my situation briefly, he pulled out a salt pack from his pocket, flipped it down to me, and said, "Put some of this on your tongue. You'll be OK." I did and I was. Again, I was lucky, because someone just happened to walk by that recognized my symptoms and knew what to do about them.

Rest in Peace, 2LT Michael Parros.

Response by LTC Stephen F. made Jul 29 at 2016 5:21 PM

LTC Stephen F. — Fri, 29 Jul 2016 17:21:37 -0400

That is very sad news that 2nd Lt. Parros USMA class of 2016 died after falling ill on his first day at ranger School COL Sam Russell.
I had not heard of hyponatremia which is a condition caused by a lack of sodium in the blood. Our culture spends so much time and effort telling us to reduce sodium from our diet. It is sad when we learn that somebody died from complications associated with not having enough sodium.
Prayers for Michael R. Parros family and friends who I am sure are devastated by the news.
Thanks for mentioning me LTC Stephen C.

Response by Capt Seid Waddell made Jul 29 at 2016 11:16 PM

Capt Seid Waddell — Fri, 29 Jul 2016 23:16:34 -0400

Tragic loss of a dedicated soldier.

Response by SPC Elijah J. Henry, MBA made Jul 31 at 2016 6:13 PM

SPC Elijah J. Henry, MBA — Sun, 31 Jul 2016 18:13:52 -0400

Somehow, I have avoided this. When the forced hydration got beyond ridiculous, I'd start chugging faster than I could swallow, meaning an awful lot of water overflowed and ran down my uniform. I didn't even care if that meant I was sticky with cerasport and MRE drink mixes for the rest of the FTX...

Response by SSG Bobby Gilbert made Jul 31 at 2016 9:15 PM

SSG Bobby Gilbert — Sun, 31 Jul 2016 21:15:21 -0400

A case of hyponatremia was the reason we ended forced hydration. After the regular call of Drink Water by the NCO and return acknowledgement of Beat the Heat! Any one that had a drip of water hit their head from an upended canteen had to refill it and chug away. I was informed of this during a corrective action.

Response by SGT Matt Voll made Aug 2 at 2016 6:56 AM

SGT Matt Voll — Tue, 02 Aug 2016 06:56:34 -0400

Hyponatremia or low sodium is a tally more common than you might think. It often will occur with people who have psych issues (scizophrenia) who ingest too much water. This is dilution al Hyponatremia and we place these people on fluid restriction.

In this case, the soldier would have sweat so much (I graduated Ranger school in the summer and you never stop sweating) that you lose all your sodium. This is a case where it has to be replenished. The problem is that if you replete it too fast you can cause brain swelling and a process called central Pontiac myeleinosis. Sodium loss is common in athletes who are outside in the summer. I remember the RI's giving us salt tabs and rehydration packets to prevent this.

Any way you cut it, very sad story and goes to show our military are in harms way both abroad and at home. That the sacrifice is real whatever your capacity may be.

Doc Voll
RLTW

Response by PO1 Kevin Dougherty made Aug 2 at 2016 8:39 AM

PO1 Kevin Dougherty — Tue, 02 Aug 2016 08:39:33 -0400

I have volunteered as an EMT at Ironman events, and it was actually something we saw fairly often. Usually it happened when an athlete was sweating quite a bit on an extremely hot day. It's actually not so much a question of too much water, but of not enough electrolyte replacement. Most of us old farts can remember being given salt tablets on a very hot day if we were laboring or exercising outside. Nowadays an electrolyte replacement drink e.g. Gatorade is usually used. Hypernatremia can also be an issue, so depending on your level of fitness, rate of perspiration, etc. you may want to dilute it 50/50 or alternate with plain water. Usually only the elite class athletes were exercising at a level where they needed it full strength. Again, there are no hard and fast rules other than lab tests to monitor the levels, so you need to know your body, and respond accordingly.

Response by CPL Gerard Hulbert made Aug 2 at 2016 8:57 AM

CPL Gerard Hulbert — Tue, 02 Aug 2016 08:57:00 -0400

I served at Ft Polk in LA where many days were 90/90. 90 degrees and 90% humidity. We were always told to have one canteen of sugar water, one canteen of salt water and one canteen of just water then to alternate between when thirsty. Hyponatremia has many of the same symptoms as dehydration so many times they think they need more water. I am now a marathon coach and we tell runners to only drink water when thirsty not at any set time or distance. Several higher level schools taught to suck it up but found that they were losing soldiers due to dehydration and then swung too far the other way causing over-hydration which is just as bad and harder to treat.

Response by CAPT Hiram Patterson made Aug 2 at 2016 9:22 AM

CAPT Hiram Patterson — Tue, 02 Aug 2016 09:22:00 -0400

Drinking too much water dilutes the blood volume and causes electrolyte imbalances. IV's on top of that may exacerbate the problem. We used to give salt tablets in the military because we thought it would replace salt (sodium) lost due to excessive sweating. It didn't work.

Response by MAJ Byron Oyler made Aug 2 at 2016 9:49 AM

MAJ Byron Oyler — Tue, 02 Aug 2016 09:49:54 -0400

Yes it happens , "drink water" being the command and problem. Loss of sodium can alter your mental status to point of needing articficial berating machine or to point of death. Probably happens a lot more than we realize just not to the degree of needing medical support.

Response by LTC Roderic Hewlett made Aug 2 at 2016 10:30 AM

LTC Roderic Hewlett — Tue, 02 Aug 2016 10:30:17 -0400

Yes, I bicycle long distances, known as randonneuring, that ranges from 100k to 600k rides on a single event - all self-supported and of course we ride up to 40 hours at a time. So, food (complex carb, simple sugar, and protein) management is essential - frequent intake over extended periods to fuel the ride. Equally important is hydration management - a balance of electrolytes and water in the blood, tissue, and digestive system - otherwise, bad news. Most individuals only think of hydration as water intake, but for the body to absorb and maintain the right balance of water in the tissues - it must have electrolytes. You've got to balance both to maintain proper hydration. Most athletes do not complete in ultra-events long enough to suffer from food and water management problems, but extended activity without balanced intake and output management of energy, protein, and water/electrolytes can result in serious problems including, unfortunately, death. I have become an advocate for advanced education - it took me a little while of trial and error (some very bad bonks and illness bouts) to hone in my diet (ischemia is also a problem on the back side of food management for ultra athletic events). I believe the Military should invest in this education for its service members - they do by nature of their training need depth of understanding in this important area. Obviously, heat and cold management are essential too. Medication, age, and conditioning all play roles as well.

Response by SSgt Rick Glime made Aug 2 at 2016 10:47 AM

SSgt Rick Glime — Tue, 02 Aug 2016 10:47:41 -0400

When I was in Iraq during Desert Storm, we had the exact same thing happen. I worked in an Air transportable hospital and a very young man was brought to us, not very responsive, we drew his blood and discovered he had almost no sodium whatsoever. We continued sodium chloride IV's but the kid never recovered. He was with us for about 7 or 8 hours, he became very combative, he reminded me of someone very intoxicated. We shipped him to Incirlik where he later passed away. The thing is, his leadership kept pounding the "More fluids, drink lots of water" but for some reason, the kid wasn't eating so there's no telling how long this had been going on.

Response by TSgt Jim McGill made Aug 2 at 2016 11:28 AM

TSgt Jim McGill — Tue, 02 Aug 2016 11:28:28 -0400

Only dealing with idiots who took molly

Response by TSgt Jim McGill made Aug 2 at 2016 11:31 AM

TSgt Jim McGill — Tue, 02 Aug 2016 11:31:14 -0400

And a lot of the problem os these healtj nuts on these no salt or low salt dieslts which is actually bad for you

Response by MSgt Joe Marcom made Aug 2 at 2016 11:40 AM

MSgt Joe Marcom — Tue, 02 Aug 2016 11:40:15 -0400

An electrolyte imbalance affects both your heart and your kidneys; there are recorded cases of suicide by over-hydration. When I was a field medic, we monitored training exercises carefully, and pushed fluid+'lytes (usually Gatorade) on those showing symptoms of distress. We also had IV fluids ready for any instance where there was no nearby hospital.

Response by SPC Christopher Perrien made Aug 2 at 2016 11:45 AM

SPC Christopher Perrien — Tue, 02 Aug 2016 11:45:25 -0400

Humans need salt to live. Too much water and not enough salt especially combined with lots of perspiration. Boom , this happens. Almost the same in effect, yet opposite of heatstroke, which is too much salt, not enough water. At to what the lieutenant died of, this is why "Gatorade" works as a thirst quencher than only water and also prevents this syndrome from occurring.. However, salt water with too much salt , causes the same effect as Heatstroke.

One other thing, in cases of diarrhea caused by anything, a sodium and water replacement such as gatorade is a good idea also. As severe diarrhea can cause an electrolyte imbalance from loss of water same as heatstroke and cause a heart-attack , and kill. I lost a family member to that.

Response by CMSgt Steve Pennington made Aug 2 at 2016 1:32 PM

CMSgt Steve Pennington — Tue, 02 Aug 2016 13:32:01 -0400

I had a minor situation of the same issue some time ago and it was attributed to 4 days of flying in aircraft and dehydration cause by the cabin air. It was a wake up call for me. I am curious why the military stopped issuing salt tablets. We ate them by the handful in Vietnam and other hot climates, and then our medics stopped stocking the tablets. I agree that the low sodium diet could contribute to an imbalance in body chemistry.

Response by MAJ Private RallyPoint Member made Aug 2 at 2016 2:25 PM

MAJ Private RallyPoint Member — Tue, 02 Aug 2016 14:25:19 -0400

There is a fine line between ensuring your Soldiers are adequately hydrated and pushing them to a point of over-hydration. A chain-of-command that knows everyone in it may be relieved in the event of a heat injury has that much more incentive to be over-enthusiastic in the hydration push. It does not help that this condition is not discussed (at least in my experience) when the heat injury training is presented. There are a lot of people who don't even know that over-hydration is possible, much less the symptoms to look for.

Response by CPL Richard Brower made Aug 2 at 2016 2:41 PM

CPL Richard Brower — Tue, 02 Aug 2016 14:41:16 -0400

I was a paratrooper from '91-94. We spent an August in death valley at NTC where daytime temperatures routinely hit 120. We were forced to hydrate to counter this pressure.

After leaving the service, I continued pursuing physically exhausting activities (multi day alpine climbs, multi day mtn biking, etc). I went to work for REI and came across a company called Hammer Nutrition. They were all the rage amongst endurance athletes so I placed an order for some of their products. They sent a pamphlet they prepared that raised my awareness to the issue of over hydration. I believe I recall a statement in the pamphlet that stated more people dying of over hydration than under. The issue is that you're sweating out all your electrolytes (salts - our black boots were white at the bottom from dried sweat/salt). You then take on a lot of water which further dilutes the ratio of electrolytes to water. Soon, you don't have enough electrolytes to retain your water long enough to let it do its job.

It was a small pamphlet that I believe should be fact checked and if accurate should make its way into Army doctrine.

I just recalled this story to a client a couple days ago as his daughter experienced the condition. He rushed her to the hospital for quick fix but really thanked me for the information and said he thought it should be common knowledge. I agree.

I'll share a couple other lessons I've learned in case you've made it this far... The learned that the pain in my back during that month in NTC wasn't from the 100lb ruck sack but from my kidneys dealing with my dehydration. Consider this next time you're exerting yourself and feel back pain. Also, operating in the dry & cold environments can dehydrate you like extremely hot environments... That mist of air that follows each exhale is moisture leaving your body.

Response by MSG Chuck Pewsey made Aug 2 at 2016 3:28 PM

MSG Chuck Pewsey — Tue, 02 Aug 2016 15:28:28 -0400

When I was in basic (1967) there were salt pills in a dispenser in every mess hall but I understand the powers that be decided too much salt was bad and they were removed some years later. I'd heard the condition called water intoxication. It came to light when the Army adopted Israeli Army's "force drink" policy on road marches. (At given intervals, everybody stopped and drank.) It turned out a 100-pound soldier couldn't safely drink as much as a 200 pounder.

Response by MCPO Nick Baggett made Aug 2 at 2016 5:30 PM

MCPO Nick Baggett — Tue, 02 Aug 2016 17:30:14 -0400

When I taught survival techniques for most of my career, I taught all of my students and Platoon members during my time in the Desert and Jungles, to put one tablespoon of salt and sugar it a gallon of water and mix it thoroughly and that will protect against heat cramps, and from over hydration. When in the field we used the packets in our MRE'S. I have been on bases where others who were training hard in the heat who had not adequately acclimatized suffered from Heat Stroke and hyponatremia, so it is a valid cause of death. We need to make sure that people understand the symptoms and treatments such as the Colonel stated about the salt. Good post to get the word out. I am sorry about the loss of Second Lt. Michael Parros. My prayers go out to his family.

Response by PO2 Angela Easterling-Maust made Aug 2 at 2016 6:40 PM

PO2 Angela Easterling-Maust — Tue, 02 Aug 2016 18:40:53 -0400

I'm so sorry to hear this young man died from such a treatable, recognizable and preventable condition. Such a senseless loss... I pray for his family and friends at this time.

Response by SPC Kevin Busto made Aug 2 at 2016 7:56 PM

SPC Kevin Busto — Tue, 02 Aug 2016 19:56:13 -0400

Yes, saw it happen. The blood system can only expand so much. Blood cells become engorged with fluid and will explode. Once that happens, you are done, capute, game over!

Response by MSG Don Burt made Aug 2 at 2016 8:27 PM

MSG Don Burt — Tue, 02 Aug 2016 20:27:34 -0400

Strange as it seems, I've had a family member over hydrate and caused the liver to enlarge...go figure..."everyone" tells or hears, drink plenty of water, well seems that knowledge of listening to your own body kinda fell by the wayside.

Response by CWO3 Private RallyPoint Member made Aug 3 at 2016 12:36 AM

CWO3 Private RallyPoint Member — Wed, 03 Aug 2016 00:36:52 -0400

Very sad this has happened. I know that his condition can happen to anyone or an athlete. When you lose sodium and only drink water it won't fix your problem. This is one of many things that I have learned during my desert and jungle training in my younger years while in the Marine Corps. I hope for the best for the LT'S family and love ones. I also think that the U.S. Army Ranger School should review their respective safety, health, and comfort order's. Just my opinion and thoughts.
Semper Fidelis,
James

Response by Cpl Jeff Ruffing made Aug 3 at 2016 7:33 AM

Cpl Jeff Ruffing — Wed, 03 Aug 2016 07:33:49 -0400

In 1979 when I went thru boot, we had to drink a canteen of salt water at day. It was two packets of salt, in a canteen, the rest were regular water. My drills made sure we were watered. I had Nam vets as drills. Very experienced. Now, out in the fleet, a different story. We had more cases of chuckleheads NOT drinking water, never saw a person get in trouble drinking too much.

Response by SSG Raymond Minze made Aug 3 at 2016 11:12 AM

SSG Raymond Minze — Wed, 03 Aug 2016 11:12:50 -0400

As a young soldier, barely post Viet Nam era, you could still find bottles of salt tablets by the water fountain in the barracks. We were discouraged from using them because the tablets swallowed whole tended to cause ulcers. Soldiers had the bad habit of taking them whole instead of breaking them up or chewing them before swallowing the salt; we were told instead to add a little more salt to our food.

As to the condition of over hydration, as an NCO I learn to monitor my soldiers fluid intake and watch for signs of heat injuries. Many times in the field when stationed at Fort Stewart I observed soldiers not maintaining a proper sodium intake. One of the good indicators are the symptoms of heat cramps.

Response by SGT Matthew Schenkenfelder made Aug 3 at 2016 1:28 PM

SGT Matthew Schenkenfelder — Wed, 03 Aug 2016 13:28:36 -0400

I don't know about now, but it was actually quite common at MCRD Parties Island in the summer. I went there from July 1 to Sept 27 2002. That was a hot year. Recruits were dropping like flies. Most of them from dehydration, but some from hyponatremia.

Response by MSG John Cotellese made Aug 3 at 2016 1:47 PM

MSG John Cotellese — Wed, 03 Aug 2016 13:47:59 -0400

What ever happened to the salt pills the Army made us take in VN. It was hot and humid except at 6pm when it rained...

Response by Capt Private RallyPoint Member made Aug 4 at 2016 12:06 PM

Capt Private RallyPoint Member — Thu, 04 Aug 2016 12:06:06 -0400

Hyponatremia is the most common electrolyte abnormality in the United States, occurring in 3.2–6.1 million persons per year. It is estimated that 75% of patients with hyponatremia require hospitalization.
Educate about the signs and symptoms of hyponatremia and emphasize the importance of contacting the treating clinician or seeking immediate medical attention if signs and symptoms develop
Educate about strategies for maintaining good hydration (e.g., consume sports drinks containing electrolytes in place of plain water prior to, during, and following physical exertion or exercise)

Response by SFC John Trujillo made Aug 7 at 2016 2:37 PM

SFC John Trujillo — Sun, 07 Aug 2016 14:37:45 -0400

DOD medical personnel used to be eligible for a course called Operational Emergency Medicine that did detailed education on the recognition and treatment of hyponatremia until political forces shut it down. Before that, you would occasionally get a hyponatremia patient due to someone over hydrating to beat a piss test. A graduate of West Point and Infantry Platoon leader should have known how to hydrate properly. The first day of Ranger School, especially now, is not that difficult. If he was already over hydrated and the medical personnel pushed fluids on him without monitoring him properly, then you can thank the lowering of standards for this soldiers death. A couple of quick, simple lab tests could have verified the correct diagnosis. Heck, even determining his urine output should have been a clue.