An introduction to sodium and water

A number of years ago, I was invited to write a chapter introducing sodium and water for a new medical text book under the Scientific American brand. I remember being disappointed that I didn’t get hypo- or hypernatremia and being stymied for awhile before I figured out how I wanted to the topic. Ultimately, I had a great time writing the chapter and, at least at the time. I was quite proud of the work. The textbook was somehow abandoned somewhere between inviting the chapter authors and publication. The publisher pivoted to some online component that was supposed to rise out of the ashes of the text book and they asked me to do additional work. I never did that work and they never asked a second time, so I don’t know if that ever came to fruition.

Anyways, this chapter has been sitting in the bowels of my Google Drive for years.

I hadn’t thought about this until recording chapter seven of Channel Your Enthusiasm podcast where we are reading through Burton Rose’s classic Clinical Physiology of Acid Base and Electrolyte Disorders. In Chapter 7, Rose discussed using simple math to predict the changes in intracellular and extracellular fluid volume following various fluid and solute challenges. This is exactly what I did in my Scientific American chapter. I found the exercise to be a profound moment of understanding.

Here is a link to the Google Doc:

And a PDF of the same:

Robot price war hits the Fluid and Electrolyte Companion

I remember this story entertaining story from 2011 (or maybe it was is a more recent version of the same events, it’s hard for me to believe I remember anything from 2011):

(CNN) -- Lots of normal people would pay $23 for a book.
But $23.7 million (plus $3.99 shipping) for a scientific book about flies!?
This unthinkable sticker price for "The Making of a Fly" on Amazon.com was spotted on April 18 by Michael Eisen, an evolutionary biologist and blogger.
The market-blind book listing was not the result of uncontrollable demand for Peter Lawrence's "classic work in developmental biology," Eisen writes.
Instead, it appears it was sparked by a robot price war.

Well, take a look at the listing of The Fluid and Electrolyte Companion at Amazon.com today:

Come and step right up and purchase your very own copy of the Fluid and Electrolyte Companion! A bargain at $1,227.31. Don’t cheap out and but a used copy at only $834.75, go all the way and get a new one. Don’t delay there is only one left!

Or you could just download the PDF for free. Your choice.

This means we’re going to need to do another printing. Doesn’t it?

Pica or a novel fluid management strategy?

One of my favorite patient is a chronic fluid abuser. Today on rounds I noted that she had been doing better with this. She proudly showed me her new way of coping…rocks.

She is sucking on rocks rather than drinking. It takes all types.

Acid-Base Chapters (Chapters 10-16) from Fluids

Chapter 10: Introduction to Acid-Base

Chapter 11: Introduction to Metabolic Acidosis
Chapter 12: Non-Anion Gap
Chapter 13: Anion Gap Metabolic Acidosis
Chapter 14: Metabolic Alkalosis
Chapter 15: Respiratory Acidosis
Chapter 16: Respiratory Alkalosis