Thirsty for help

Rx for Readers welcomes queries from readers: I can’t seem to get enough water when it’s hot. What’s wrong?

By JUDY SIEGEL-ITZKOVICH
The Golan Heights Way (photo credit: www.goisrael.com)
The Golan Heights Way
(photo credit: www.goisrael.com)
I made aliya several decades ago from the east coast of the US, where I was born and raised. I always liked cold weather and hated the heat, and that is partly the reason we wound up in Jerusalem (as opposed to Tel Aviv or Haifa). Though the heat is somewhat less debilitating for me to deal with now than when we first arrived (first because of learning to avoid the sun to the extent possible, and second because of air conditioning), I still have a hard time. At night – whether or not the air conditioner is running – I typically wake up numerous times to drink. On the hotter nights, I am completely parched and simply cannot get enough water. I do not have a problem with my blood sugar.
Is there anything you can suggest? – L.R., Jerusalem
Dr. Karen Djemal, family physician and medical director of TEREM’s Family Care Clinic on Jerusalem’s Hagdud Ha’ivri Street, replies: Even though you do not have problems with blood sugar, it is important to verify this with appropriate blood tests, as diabetes can produce excessive thirst. In addition, if you have noticed that you are passing more urine as well as needing to drink more than usual, other blood and urine tests can help determine electrolyte and other metabolic disorders.
So this would be a reason to consult your family doctor.
It is important to distinguish between excessive thirst and the need to drink to alleviate the discomfort of a dry mouth. Your description of being “completely parched” suggests the discomfort of a dry mouth.
There may be several reasons for this:
• Dry air-conditioned or centrally heated environments. Humidifiers can help.
• Blocked nasal passages from nasal polyps, sinus infections or chronic rhinitis will necessitate mouth breathing, which will cause uncomfortable dryness during the night. These conditions, once identified by your family doctor or ear-nose-and-throat specialist, can easily be treated.
• Cumulative mild daytime dehydration causes a dry mouth at night. This can be helped by maintaining good hydration. It also helps to avoid sugary drinks and other “oral irritants” such as coffee, alcohol and nicotine, along with acidic drinks like carbonated beverages and juices.
• Some drugs cause or aggravate dryness in the mouth. The most common culprits are over-the-counter decongestants and antihistamines used as cold and sleep remedies. Prescribed drugs that commonly cause a dry mouth are anti-hypertensives such as diuretics and beta-blockers, certain antidepressant and anxiolytic (anti-panic or anti-anxiety) medications and drugs used for treating neuropathic pain control and overactive bladders.
Sometimes a dry mouth is aggravated by a coexistent Candida infection. This needs to be recognized and diagnosed in order for the simple treatment to be given.
In some situations, “dry mouth” is a symptom of a multisystem inflammatory disorder characterized by reduced salivary secretions in the mouth and reduced tear secretions in the eyes, as well as other extra-glandular features.
This condition is called Sjogren’s syndrome.
It can occur in a primary form not associated with other diseases or in a secondary form associated with rheumatoid arthritis and systemic lupus erythematosus. The diagnosis and comprehensive treatment of patients with Sjogren’s is usually undertaken by rheumatologists. In these cases, mouth dryness may be harder to treat, requiring artificial saliva, salivary stimulants and special dental care.
Hanukka doughnuts are my downfall. I’m a 38-year-old man, somewhat overweight and absolutely addicted to them. I start eating them already after the High Holy Days when they appear in bake shops and supermarkets.
I don’t overdo eating any other desserts – only the fried, filled balls of dough. Now that Hanukka is not far, and I will surely be invited to many holiday parties, I suppose I will gain even more weight. Is there any advice that can help me cope? – S.T., Beit Shemesh
Sarah Stern and Leah Frankel at the dietitians unit at Hillel Yaffe Medical Center in Hadera comment: Many people find a pile of doughnuts full of jam or other fillings and covered with powdered sugar or other toppings very tempting. The fact that most people eat them after the doughnuts are fried in oil means that the amount of calories consumed during the eight days of the holiday is considerable.
Try to choose the time and place for eating them – for example, right after candle-lighting – and decide in advance the maximum number you will eat. Use your self-discipline and determination. Tell yourself you won’t nosh on any doughnut that is not absolutely fresh, and don’t nibble on those left over from the previous day.
If you have the possibility of eating a baked doughnut instead of a fried one, choose the substitute. Bake your own or make fried ones with yogurt without yeast.
Give up something fattening that you would have eaten in an ordinary meal so the calories will balance out. This helps you control what you put in your mouth.
When you’re invited to a party or a dinner during the festival, don’t arrive hungry. Have a small meal before. This will boost your willpower and enable you to choose on what you will waste your allocated calories.
Most important, exercise throughout the week so your physical activity will burn calories.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538- 9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.