Signs of Dehydration

• Dry mouth
• Decreased urination and/or darker urine or both
• Dizziness or feeling light-headed
• Weakness or fainting
• Weight loss

Treating Dehydration

• Drink a variety of fluids; 8-10 glasses a day.
• Water should only be a part of the 8-10 glasses a day (water does not replace lost minerals)
• Drink slowly and small quantities often
• Gatorade or other "sports" drinks
• Clear soup, broth
• Sodas: let stand until fizz has decreased
• Juices
• Avoid alcohol and caffeinated beverages; they are dehydrating
• Add salt to food and eat salty things (ex. potato chips, etc.)

• Get plenty of sleep (may require medication)
• Plan rest periods during the day
• Space necessary activities throughout the day rather than all at once
• If able, continue mild-to-moderate exercise
• Fatigue is not dangerous and exercising moderately will not cause a setback and may be helpful
• Maintain a well balanced diet

• Sip clear liquids frequently (ginger ale, clear juices, sport drinks, broth, popsicles)
• Eat small meals of bland, easily digested foods
• Eat small quantities every 2 hours for 2 or 3 days

BRAT Diet:
B-Bananas
R-Rice
A-Apple Sauce
T-Toast 

When these are well tolerated you may add chicken, scrambled eggs, crackers, white bread, pasta without sauce, canned or cooked fruits without skins, baked potato, pancakes

• As long as nausea persists, take anti-nausea medicines regularly-1/2 hour prior to meals or as directed by your physician. Examples:
  (generic names in parentheses): Compazine (Prochlorperazine), Reglan (Metoclopramide), Kytril (Granisetron), Zofran (Ondansetron)
• If unable to eat or drink fluids and if losing weight or faint when standing, call the office

• Rinse mouth gently before and after meals with salt or baking soda + water (1 tsp. to 1 quart warm water)
• Use very soft toothbrush or sponge toothette and avoid harsh mouthwashes
• Drink plenty of fluids (avoid citrus juices)
• Eat small frequent meals of non-spicy foods (popsicles, frozen yogurt, ice cream are soothing)
• Keep lips lubricated
• Ask the doctor to recheck sores when you are in the office
• Call the office if new, severe sores appear

• Drink 2-3 quarts of fluid per day (sports drinks, juices, salty broth are best)
• Avoid high fiber foods, rich, spicy foods and dairy products
• Take anti-diarrheal medicines (such as Imodium, Lomotil, Pepto Bismol) after each loose stool
• If skin around anus is raw, try to keep it dry. Do not apply creams or ointments unless specifically instructed to do so
• If diarrhea is uncontrolled or persists for over 24 hours, please call the office

• Take "as needed" pain medications at the first sign of pain to obtain more immediate relief
• If pain medication is required routinely, take it on a regular schedule as prescribed by an M.D.
• Keep a pain journal of frequency, intensity of pain and whether it is relieved by medication; bring this record to your office visits. Record pain from 1-10 (1= mild, 10 = unbearably severe)
• If taking narcotic pain medication, start a laxative program to avoid constipation (see section on "CONSTIPATION")
• Anticipate prescription refills so you do not run out of pain medication, especially over weekends and holidays. Check your supply each Thursday, as you need a written (not phoned) prescription for narcotic pain medicines

• Eat high fiber foods (bran, whole grain cereal + bread, fresh raw fruits and vegetables, prunes)
• Increase fluid intake (fresh fruit juices + hot liquids are helpful in the morning)
• Increase activity as tolerated
• Use stool softeners twice a day along with plenty of fluid
• Initially take laxative at bedtime (examples: Milk of Magnesia, Ducolax or Senokot tablets) Then if no success: Repeat laxative several times during the day until constipation is relieved (example: If no stool in two days with bedtime doses of MOM, take MOM 4 x a day until you have a stool. Then increase laxative dose to 2 x a day to prevent further constipation)
• If no results, use Ducolax suppository or Fleet enema
• Since strong pain medicines always cause constipation, it is often wise to start laxatives early

LOW RED BLOOD CELL COUNT, LOW HEMAtoCRIT, hemoglobin or "anemia," (Hemoglobin less than 10) or (HEMatoCRIT LESS THAN 30)

• Call office if short of breath, chest pain or light headed
• Continue moderate exercise if able

LOW WHITE BLOOD CELL COUNT (Neutropenia) (Neutrophils less than 1,000)

• Take your temperature if you feel ill, such as chills, fevers, new breathing trouble, new pains, etc. If the fever is over 101 degrees, call the doctor, day or night
• Avoid contact with people with colds, flu, infections, coughs. If contact is made, wash hands after meeting them
• Wash fruits and vegetables well before eating
• Wash hands often with warm water and soap

LOW PLATELET COUNT (Thrombocytopenia) (Platelets less than 50,000)

• Use electric razor rather than razorblade
• Use soft toothbrush or sponge toothette to decrease irritation to gums
• Use stool softeners and laxatives to prevent straining and rectal bleeding
• Avoid aspirin, ibuprofen, naproxen and other anti-arthritic medicines unless approved by your M.D.
• Check with doctor before taking "over the counter" medicines

• Temperature of 101 degrees or greater and/or shaking chills (Call day or night)
• Problems with urination: burning, frequency, decreased amounts, very dark in color
• Cough producing dark yellow, green or blood-tinged sputum
• Uncontrolled headaches lasting over 24 hours
• Severe sore throat
• Sore or white patches in your mouth
• Swelling, redness, drainage, or worsening pain in leg or arm
• New or increased shortness of breath
• Feeling dizzy or faint upon standing
• Sudden weight loss or gain (example: 5 lbs. in one week)
• Uncontrolled diarrhea for over 24 hours
• Uncontrolled nausea, vomiting or inability to take fluids for over 24 hours
• Constipation without relief for 2-3 days
• Uncontrolled pain or new pain
• Unusual or uncontrolled bleeding
• Feeling disorientated, confused, or unable to sleep
• Any new symptom causing you distress
• New numbness in legs

IT IS BEST TO CALL EARLY IN THE DAY TO REPORT SYMPTOMS, SO THAT WE CAN SOLVE THE PROBLEM BEFORE THE OFFICE CLOSES. DO NOT "WAIT AND SEE HOW IT GOES" INTO THE EVENING. 

ON EVENINGS, WEEKENDS AND HOLIDAYS, THERE IS ALWAYS A DOCTOR ON CALL 24 HOURS FOR EMERGENCIES

Seattle PSCC: (206) 365-8252
Edmonds PSCC: (425) 775-1677