Lithium and Dialysis, Part IV

Author: Natalia Beiser

Note: These are my experiences of having taken Lithium Carbonate and undergoing dialysis.  Not everyone taking Lithium Carbonate, nor partaking in dialysis will run into these issues.


I have Diabetes Insipitus (DI), which some people taking Lithium develop as a side effect.  Diabetes Insipitus is a disease in which the secretion of or response of the pituitary hormone vasopressin is impaired, resulting in the production of very large quantities of dilute urine, often with dehydration and insatiable thirst.


Prior to my psychiatrist starting a medication trial for treating Diabetes Insipitus, it was documented that I was drinking four gallons of fluid a day, which was obviously disruptive to my life and in regulating the Lithium dose.


After successfully starting treatment for Diabetes Insipitus, I was able to decrease my fluid volume to approximately six quarts a day.  However, I was told before going on dialysis that I would need to decrease my fluid to one quart a day.


I was scared.  How does one go from drinking six quarts of water a day to one quart?  It was one of the main reasons why I wanted to not go on dialysis.  When one has insatiable thirst, the threat of having one’s fluid taken away is a huge deal.


Medical staff would lecture me about when I went on dialysis, I would have to change my fluid intake.  I tried explaining that this was something that I cannot change and they would not listen, did not understand, or did not care.  I was very scared and determined to give up.


Finally, I decided to discuss this with my nephrologist (kidney doctor).  In spite of the verbalizations of his staff, he was very supportive.  He said that I may have to spend an extra day on the dialysis machine because of my fluid intake.  However, he said that the dialysis machine may be able to work out the problem and try not to worry about it.  We would see how the situation would work itself out when dialysis came, which started approximately two weeks later.


I am very glad that I finally had this talk with my doctor.  Discussing my fears gave me a sense of peace, because he did not threaten to take my fluids away like other medical professionals did.


When I started dialysis, I found that the Diabetes Insipitus substantially dissipated.  I am no longer as thirsty; I am down to drinking approximately two quarts of water a day now.  Also, I sleep better because I no longer have to get up in the middle of the night multiple times to urinate.  This helps decrease bipolar symptoms by getting a more restful night’s sleep.


The moral of this story:  Talk to your physician about your fears.  If your physician will not listen or does not have solutions, do your best to locate someone who will.  I am sure glad now that I talked to my nephrologist, or I may have opted to die before trying dialysis.


Read the rest of Natalia’s Lithium and Dialysis Journey here: Part I, Part II, Part III

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