Tag Archives: alcohol

nErD does not stand for nearest Emergency room Department

I ran across the term nErD yesterday and I wasn’t sure what it might mean. My first thought as a health professional trained in medical acronyms was that it might have something to do with the ER or Emergency Room Department. In addition to the adult ICU (Intensive Care Unit) there is also a Neonatal Intensive Care Unit (NICU) but there isn’t a neonatal emergency room department to my knowledge.

To my chagrin after a few seconds of puzzlement I noticed another reference to the term — “nerd” — and I felt like I should probably go see the movie “Revenge of the Nerds” again just as a refresher course.

Emergency Rooms have been on my mind for a while so that might explain my jumping to that idea first. At some point in the past I’ve shared this idea but I’ll reshare it because it could help provide safe and effective health care at an inexpensive price.

A patient can spend a lot of time waiting in an Emergency Department, to be seen or to be treated or for the test results to be ready or for the specialist to stop by. Some of that waiting time could be spent in a relaxing and potentially healing Epsom salt foot soak or bath.

Magnesium deficiency is estimated to be a problem for as many as 70-80% of the U.S. population. It can be an underlying factor in many chronic illnesses and chronic pain conditions and can be involved in acute substance abuse or mental health situations. A foot soak in Epsom salts can take slightly longer than a soak in an Epsom salt bath to achieve results but both can be helpful for relieving muscle cramps and some other types of pain such as migraines. Mental upset due to alcohol or other substance abuse or mental health conditions can also be soothed by soaking in Epsom salts. The amount of time to soak would vary depending on how deficient the person was in magnesium and might even be helpful as a diagnostic screening for magnesium deficiency (the mineral is largely stored within the interior of cells or within the bones so blood tests for magnesium only catch extremely severe cases of magnesium deficiency).

Excessive magnesium absorption can relax the muscles too much and may cause slowing of the heart rate and smooth muscle relaxation can also cause watery bowel movements. A hospital protocol might involve having an attendant start a patient with a non-open wound pain situation or upset mood in an Epsom salt foot soak or bath. The patient would be instructed on the early symptoms of excessive magnesium absorption and to let the attendant know if/when the first fluttery heart beats or relaxation of sphincter muscles was occurring. Typically a 20 minute Epsom salt bath is a good length of time while a forty minute bath might cause excess relaxation. Research suggested the ideal routine for a patient with difficulty absorbing magnesium from dietary sources would be approximately twenty minutes in a bath with one cup of Epsom salts every other day or three to four times per week. Taking the baths more often though can lead to symptoms of excess magnesium occurring sooner than twenty minutes, based on my personal experience with Epsom salt baths.

Alcohol and some other substances that are used excessively can cause magnesium deficiency which can cause irritability and even increase the risk for violence.

So if you or a loved one is upset or in pain that is not due to an open wound then it is possible that a trip to your bathroom for a Epsom salt bath might be soothing enough to skip a trip to the nearest Emergency room Department (you know, the nErD).

Excerpt from a previous post with more info about safely taking Epsom salt baths:

Time for an Epsom bath perhaps.

Epsom salt baths can be a well absorbed source of magnesium because skin absorption will bypass a problem of poor intestinal absorption of magnesium. Calcium tends to be preferentially absorbed by the intestines, especially when there is an imbalance in vitamin and hormone D levels and poor intestinal absorption of magnesium over time can easily lead to symptoms of magnesium deficiency. Symptoms of magnesium deficiency are usually labeled something else by the medical profession because the problem is not obvious on lab tests until it is quite severe because the body takes more magnesium from the bones as needed up until the point where osteoporosis is severe  enough to cause a shortage of stored magnesium.

Soaking in a bathtub for twenty minutes that has one cup of Epsom salt to a half full bathtub, and one teaspoon of a cooking vinegar such as apple cider vinegar to balance the alkalinity of the Epsom salt, can be a cure for a bad mood as well as various achy muscle cramps if magnesium deficiency is an underlying problem. Negative symptoms can occur if you stay in the bath too long. Excess magnesium absorption can cause loose watery stools for an entire day, not just once. Falling asleep in the bath can also lead to more life threatening symptoms of a weak, and fluttery heart rate, or even lead to coma and/or death — so twenty minutes to forty minutes is probably safe for a deficient person while someone who isn’t deficient might notice a weak slowing heart rate sooner than the twenty minute average that a person deficient in magnesium might find only as calming and soothing to  their mood and muscles. A person who was deficient but who then started taking the baths regularly might start noticing the weak heart rate sooner — get out of the tub then, even if its not been twenty minutes — shower and rinse time. Research on the therapeutic use of Epsom salt baths recommended one cup Epsom salt to the half full/full bath and use up to three to four times per week, but not daily.

I can’t find the actual research study {here it is: http://george-eby-research.com/html/absorption_of_magnesium_sulfate.pdf }  among the following posts of mine (see below) but Dr. Oz has an article on the baths also and recommends the twenty minutes a few times a week also: [http://blog.doctoroz.com/oz-experts/restoring-magnesium-levels-with-epsom-salt-baths]

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.


Kidney dialysis may be a side effect of sugarcane production in Nicaragua; a link

Chronic kidney disease has become a problem for almost half of the adult men in Chichigalpa, Nicaragua. The disease seems to the linked to the men’s work cutting sugar cane. The exact cause of the problem is unknown but it is suspected that dehydration is a factor due to the hot working conditions with limited time for breaks. Read more: [1] Chronic kidney disease might be less of a risk associated with their jobs if sugarcane workers were allowed enough time to take breaks to prevent dehydration from occurring, as dehydration itself can cause long term harm to the kidneys. [2]

As a consumer of sugarcane products I care about whether sugarcane workers are allowed their right to protect their health during their workday. As a human I care about the worker’s pain and shortened lifespans and about their families. Chronic kidney disease and kidney dialysis treatment require the patient to follow a very restrictive diet and the treatment requires the patient to stay attached to the dialysis machine for hours every few days.  Providing adequate breaks to the workers now seems like an easier strategy in the long run, to me.

There is also a question of gender representation — Why aren’t half of the women suffering from chronic kidney failure too? If the disease was caused by something in the environment it would show up in a more even distribution, men and women would be sick in equal numbers. If the disease is associated with cutting sugarcane then maybe women aren’t getting it because more men then women are working as sugarcane cutters. Likely cutting sugarcane is very physically demanding work and male skeletal structure and muscle mass on average simply is stronger and larger than female anatomy. Machines able to navigate sugarcane fields might be invented to do the job but that solution would be taking away yet more jobs from humans and a risky job, unfortunately, is better than no job for many people because, unlike corporations, people have to eat to survive.

Working in hot conditions causes a loss of fluid and electrolytes contained in sweat and overheating may further increase the amount of sweat that is produced. Evaporation of sweat can have a cooling effect on the body. Intense physical exercise in hot and humid conditions may cause losses of up to three liters of sweat which is almost equivalent to the water content of the body’s blood supply.  [3] Workers need to have enough time to drink, eat and cool down to help prevent the risk of acute dehydration and the risk of it causing lasting damage to the kidneys.

Allowing workers frequent breaks in the shade might give their bodies time to cool down and slow down the loss of nutrients caused by excessive sweating, and allow them enough time to drink water and have a salty magnesium rich snack to replace the nutrients that were lost in sweat or used by the kidneys. The water and potassium in a piece of fruit and a salty magnesium rich snack like tortilla chips would help replace the water, sodium, potassium, and magnesium that are essential for the kidneys function. [4] The kidneys have to have enough nutrients to be able to filter out the toxins that are produced daily as a normal part of physiology and any extra toxins created by a job with hard physical labor and then still have enough nutrients to filter out any additional toxins that may have been absorbed from working around the agricultural chemicals.

4/18/2017, Update: dehydration is still suspected to be involved in the increased incidence of chronic kidney disease in agricultural workers. The problem is more widespread however than just Nicaragua. Pesticides from agriculture or silica from contaminated ground water is suspected to be involved. Use of painkillers and alcohol in the evenings combined with the limited access of water during the work day is also suspected to add to the risk of chronic kidney damage occurring.  [5]

Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved.” [6]

Part of the problem is that symptoms don’t occur until fairly serious permanent damage has developed. Earlier diagnosis by use of more frequent screening of certain lab tests may help but families need to eat and someone needs to work. Young adult sons take over when their father is no longer able to work. The disabled men are a financial and physical burden for the family and the number of widows has increased in many of the areas that have been experiencing an increase in the number of adult workers with severe chronic kidney disease. A sense of futility in the men may be part of the problem too – you can’t prevent what you don’t feel you have any control over. [5]

Preventative health care can help prevent damaging chemicals from collecting in the kidneys. And having adequate magnesium and water throughout the day and evening can help the kidneys detoxify and remove the chemicals before damage develops. Having water and some salty snacks or peanuts along with alcoholic beverages in the evening can help the body detoxify and remove the toxic effect of alcohol before it has a chance to cause damage to the kidneys either.

Agricultural companies might save money on employee turnover and sick days if they provided filtered water [8] and adequate work breaks, especially during the hottest part of the day.

A video about the condition and research regarding the increased incidence in El Salvador is available with subtitles in English, Enfermedad Renal Crónica: NefroSalva Clínico (El Salvador): [7]

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. http://news.nationalgeographic.com/news/2015/01/150129-sugarcane-workers-kidney-disease-nicaragua-health-ngfood/
  2. http://www.kidneyfailureweb.com/causes-others/767.html
  3. http://www.texasheart.org/hic/topics/hsmart/hydrate.cfm
  4. http://transcendingsquare.com/?p=967
  5.  http://www.sciencemag.org/news/2016/03/mysterious-kidney-disease-goes-global
  6. Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved.” https://www.ncbi.nlm.nih.gov/pubmed/24878644
  7. Enfermedad Renal Crónica: NefroSalva Clínico (El Salvador), a video from El Salvador: https://www.youtube.com/watch?v=Tk9wcMyRG1E&feature=youtu.be
  8. 6 types of water filtering devices designed for developing nations: http://inhabitat.com/6-water-purifying-devices-for-clean-drinking-water-in-the-developing-world/