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Saturday, March 17, 2007

 

I'm studying, I swear.

Let's talk about fluid balance, shall we?

Mr. Hypo Thalamus was watching the monitors in his office, keeping track of the temperature, the hunger level, the thirst level, and several other screens. Suddenly, there was a knock on his door. "Come in," said Hypo. The door opened and a messenger stuck his head in. "Hey, Hypo, it's Osmo Receptor. Got a note for you. It's getting kind of salty out there, I think the company has lost some fluid." "Thanks, Osmo," replied Hypo. "I'll get right on that."

Hypo Thalamus picked up the telephone and punched the button for overhead paging. "Attention, everyone, we are going to Thirst Level 1. Let's drink some water out there!". He then dialed the extension for the pituitary department down the hall. "Hi, Pituitary? I've got a message for the back office. Yeah, Posterior Pituitary. Can you have him release some ADH? You know, antidiuretic hormone? Thanks." Hypo Thalamus hung up the phone and stretched. His work was done.

Posterior Pituitary had his feet up on his desk when his secretary came in. "Hi, Posterior," she said. "I've got a message for you from Hypo Thalamus upstairs. He says you need to send out some ADH right away - I guess things are pretty salty out there." P. Pituitary swung his feet down from the desk and opened his filing cabinet. Taking out a wad of ADH, he handed it to the secretary and said, "This ought to do the trick. Go ahead and tube this down to the kidneys. Tell Hypo to call me if he needs more ADH down there. Thanks!"

The secretary dropped the ADH into the pneumatic tube system and punched in the extension for the Kidney department. When the shipment of ADH arrived at Kidney Central, the foreman passed the ADH around to all the collecting ducts and distal tubules in every nephron unit. "Listen up, everybody!" the foreman shouted. "We've got salty conditions out there and we need to keep more water in the major water treatment system. No clean water should be flowing out to the storm sewer at this time." Each nephron unit readjusted their settings to allow the distal tubules and collecting ducts to get more permeable. Soon, water started splashing through the tubules and out into the utility pipelines, diluting the bloodstream back to normal level. "Nice work, everyone!" the foreman said. "You can take it easy for a while now. Good thing this company doesn't have SIADH or we would have to be on permeable settings all the time - imagine what a hassle that would be!"

Meanwhile, the Adrenal offices upstairs from the Kidney department were monitoring their own screens. "Hmm, looks like the company is reabsorbing some water down in Kidney," said one Adrenal officer. "Yeah, we'd better remind them to retain some sodium, too, or else we're going to have hyponatremia problems," replied the other Adrenal officer. "I'll send out some aldosterone, that should do the trick." The Adrenals sent a shipment of aldosterone downstairs to the Kidney department. "Thanks!" the Kidney foreman called upstairs. "I'll get some renin sent out right away!"

The Kidney foreman shipped a batch of renin out into the utility pipeline along with the water. While floating along in the plasma, the renin ran into some angiotensinogen on it's way out of the liver. "Yo, Angi!" called out Renin. "Good to see you, man! Wanna go talk to the Adrenal department with me?" "Sure!" replied Angiotensinogen. "Just let me change into Angiotensin real quick, Adrenals never listen to me if I don't change." After swapping his Angiotensiogen team jacket for the Angiotensin II jacket, Angi headed back to the Adrenal offices. "Hey Adrenals, how's it going?" said Angi. "Kidneys sent Renin to tell me that the company is having problems with the sodium levels. Can I help you with that?"

"Thanks for letting us know!" replied the Adrenal officers. "We'll send out another batch of aldosterone to the Kidney department right away."


There, now wasn't that more fun than reading about the renin-angiotension-aldosterone mechanism???

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Comments:
This is great! You should do a whole series, and I will illustrate the books for you. Instead of anything published by Mosbys or Lippencott Williams, our books will make it onto the reading lists of future nurses everywhere at schools around the country.

Too much wishful thinking? 8-)
 
Oh my - that was great!!!! I'll never forget what I just read and I've been doing this for 28 years! : D
 
That was great!
I have a friend that just moved to Seattle and her Dr. just diagnosed her with siadh. I am concerned and am looking for a specialist for her to see in Seattle. 34 yo no other health problems. He said it was due to stress...Swollen feet/ankles occasionally with some kidney pain rarely. Can you recommend someone? jen.leeper@yahoo.com
 
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