## Friday, July 20, 2012

### Semipermeable Membranes - Significant?

Semipermeable Membranes and Fluid Compartments

The water moves back and forth between a cell, the space surrounding a cell and a small member of the blood circulatory system called a capillary.

The cell's interior water is intracellular water and occupies the Intracellular Fluid Compartment of the body. When the water leaves the cell through its semipermeable cell membrane it enters the Interstitial Fluid Compartment of the Extracellular Fluid Compartment that occupies the space between the cell and the circulatory system. When it enters the capillary of the circulatory system through its single cell layer semipermeable membrane it is now in the Extracellular Fluid Compartment. Remember,, the Extracellular Fluid Compartment is made up of the interstitial fluid compartment and the circulatory system.

Your Digestive System breaks down fluids and food into items that easily (sometimes) pass through the selectively permeable membrane with or without help.

Water is like a stream with all these breakdown products floating in it. This is pretty simplistic but you get the idea.

The reason water flows is the ability of the body to move particles (solute particles)  to the side of a selectively  permeable membrane where the body needs the water to flow. The cells of the body need the breakdown products of digestion. This is the way the breakdown products make it to the circulatory system for distribution to all the cells in the body.

This is the ultimate purpose of glucose. Food for the manufacture of insulin in the pancreas. These strips test for glucose in the blood.

Now were getting to Act Two. The whole process above is reversed to supply those products of digestion to the destination cells.

Since were talking to interested diabetics the destination products, for us, is going to the Pancreas.

## Thursday, July 19, 2012

### Fluids - Extracellular - Interstitial - Intracellular

Fluid and Electrolytic Balance

Water is a solvent, not a solute molecule or particle. Water does not have a "concentration" if it is a body solvent. Things dissolved in water, in living things form a solution.

Fluid is compartmentalized. The basic structure consists of Extracellular Fluid (Outside the Cell) and Intracellular Fluid (Inside the Cell).

The Extracellular Fluid Compartment consists of all the fluid outside the cells. One compartment is the Blood (contained in blood vessels) and the other compartment of the Extracellular Fluid Compartment is the Interstitial Fluid. It is the fluid that exists between the blood vessels and the cells.

The body controls the changes that occurs in the  fluids (what's dissolved in the water that makes up the fluid) to shift fluid from one compartment to another compartment when needed.

This is Fluid Balance.

When fluid flows from one compartment to another it does this in response to the differing concentrations of solutes dissolved, in the water, of each compartment.

Before we proceed, we need to understand a workable definition of Osmosis. Remember this definition.

Osmosis is the diffusion of water through a selectively permeable cell membrane from an area of low solute concentration to an area of high solute concentration.

Since a cell membrane is constantly changing, and is selectively permeable, the body breaks down large molecules in the fluid into small, electronically charged particles called ions. Some of these are simple like the positively (+) charged Hydrogen Ion and some are complex like the negatively charged ( - ) Bicarbonate Ion discussed in a post earlier about Buffer Systems.

A good way to look at electrolytes is replacement drinks for athletes after a workout. Heres one product below.

These particles are collectively referred to as Electrolytes

The body need to shift these essential electrolytes from compartment to compartment to help balance the concentration of electrolytes throughout the body.

## Tuesday, July 17, 2012

### Respiration Buffering of Acidosis - Bicarbonate

Buffering of an Acid - Bicarbonate Buffering System

There are three systems involved in preventing wide swings in blood pH. Respiration, Circulatory and Renal systems.

A goal in Homeostasis is the prevention of wide swings in chemical imbalance. The free hydrogen ion (H +) is a prime candidate to keep within the pH range of 7.38 and 7.42.

It is important to recognize the ability to have a two way system. This enables the bicarbonate buffering system to act on an acidosis one way and an alkalosis on the other way.

One factor to remember is living cells always produce carbon dioxide as a by product. Therefore there is a constant  source of carbon dioxide being formed.

The Respiratory System can control the amount of free hydrogen ion (H +) by either breathing rapidly or very slowly.

Here is the equation:

If carbon dioxide is allowed to build up in the blood by increasing its concentration from lower than normal respiration rate the equation above moves to the right.

The water (H2O) combines with the excess carbon dioxide to form undissociated carbonic acid (H2CO3) that immediately breaks down (dissociates) into free hydrogen ion (H+) and a bicarbonate ion (HCO3-). The increase in the concentration of free hydrogen ion (H+) lowers the pH (becomes more acidic).

If the acidity of the blood approaches a pH of 7.38 the reversible formula above begins to move to the left.

The excess of free hydrogen ion (H+) combines with the bicarbonate ion (HCO3-) to form carbonic acid (H2CO3) that immediately breaks down into water (H2O) and carbon dioxide (CO2).

This happens because the Respiratory System is breathing at a faster rate than normal and "blows off" the excess carbon dioxide (CO2).

This temporarily takes free hydrogen ion (H+) out of circulation and the pH moves to a more alkaline pH of 7.42.

In a nutshell this is the Bicarbonate Buffering System.

This process continues without your knowledge as a state of equilibrium is maintained that keeps the pH in the range of 7.38 to 7.42.

### Just what is Acidosis and Alkalosis?

Acidosis and Alkalosis

First, in the  human body, an acid is the presence of a free hydrogen ion (H+) in the fluids found in the body. This is an important point.

If the hydrogen ion is chemically combined with some other chemical it is not affecting the pH of the body, at that time.

The normal pH of the human body is 7.42. This is an average pH. The range for pH extends from a pH of zero to a pH of 14. Any pH value near 1 is extremely Acidic (lots of free hydrogen ions). Any pH value near 14 is very Basic (very few free hydrogen ions).

The normal pH value of the human body is slightly Basic. When you look at pH what is the significance of the number 7.42? How do we interpret them?

The definition of pH is meaningless when it come to what is happening to the patient. If the pH falls from a value of 7.42 to 7.41 the increase in the number of free hydrogen ions is 10% (percent).

If it drops to 7.32 the increase in the number of free hydrogen ions is 100% (percent).

Yes, it has doubled. A patient who has a drop of one tenth of a pH value is in a serious Acidosis. Think trends are important? Using an old Minnesota phrase, "You Betcha!"

Going the other way, if the pH rises to 7.52 the number of free hydrogen ions has declined 100% (percent). The patient is in a serious Alkalosis.

Did we really need a formal definition of pH to understand what its values tell us.?

Remember, with electrolytes, time of decision is critical.

### The Purpose of our Body Systems

The Enzyme - Protected by our Body Systems

To understand life and our ability to live the purpose of the enzyme is very important. It is an organic enzyme that makes it possible for all our chemical reactions to occur at body temperature.

Our planet is a miracle. Temperate climate, wonderful atmosphere and, of course, water.

Estimates on the age of Earth focus on 4.5 billion years. How could this hot, molten ball of mass change from a hostile environment to the Earth of today?

Biological life consists of four essential elements: Hydrogen, oxygen, carbon and nitrogen in the chemical form of carbon dioxide (CO2), Water(H2O) and Nitrogen Gas (NO2) and Oxygen (O2) in todays atmosphere. Scientists think the atmosphere on our early planet consisted originally of three gases: Methane (CH4), Ammonia (NH3) and Water (H2O).

To follow my story note the three compounds above contain the elements C (Carbon), O (Oxygen), H (Hydrogen) and N (Nitrogen) the essential elements of biological life as we know it today. One set hostile to life and the other set compatible to life.

Some biodegradable products contain enzymes. Heres one:

We couldn't breathe methane and ammonia today without dying. What happened? The Earth changed from a hostile environment through a very slow process, that made sense.

The planet had to cool. That took a lot of time. When the Earth reached a temperate climate a miracle of sorts happened in the seas that comprise  4/5 of the planets changing surface.

Something appeared that reproduced and gave off a waste gas called carbon dioxide (CO2). This gas slowly built up in our oceans  until another miracle happened.

Then a form of creature started that used the oxygen (O2) and gave off carbon dioxide (CO2) as a byproduct.

We are the ultimate creature of this entire process. If you didn't notice, this set the stage for "The Balance of Nature" between plants and animals that exist today.

What made all of this possible? Thats right, an enzyme. A biological enzyme. All of this is biological chemistry that deals with the biology of life.

Our Body Systems have one purpose - make a perfect environment in each and every cell that comprises your body. This biological enzyme catalyzes the chemical reactions necessary for life. Energy!

Energy is necessary for life!

Diabetes disrupts this perfect environment inside our cells. Normally, our body systems can do this without us being conscious of the events.

When we can't do this alone, the medical profession steps in to help. Diabetes is just one disease.

## Monday, July 16, 2012

### Non-Ketotic Hyperosmolar Coma in Diabetics

Non-Ketotic Hyperosmolar Coma in Diabetics

This coma is associated with nursing home patients but can occur in all ages. The principal symptom is lethargy that progresses to behavior that mimics one with less than  normal mental capacity. Vomiting is not, ordinarily, associated with this type of coma.

Extreme hyperglycemia is accompanied by dehydration when the person doesn't drink enough fluids. This coma occurs most often in people who develop Type II diabetes and they have an impaired ability to recognize when they are thirsty. They need to drink and, instead, slip into a state of dehydration from lack of fluids.

I have replaced many a battery for other devices. Duracell is a good brand I use for other purposes.

When the person exhibits mental confusion that is not characteristic, the physician may order a chemical screen. The screen, with this type of coma, may show extreme hyperglycemia ( 1800 mg/dl - 100 mM) and dehydration.

Treatment consists of insulin and gradual rehydration with intravenous fluids.

## Sunday, July 15, 2012

### Diabetic Ketoacidosis Coma

Diabetic Ketoacidosis Coma

This coma begins innocently when you have flushing and rapid breathing and dehydration. A coma is near or begins when you have visible sweating and vomiting, your face appears gray from diminished perfusion, shallow breathing and rapid heart rate.   Symptoms differ from person to person. Don't wait until all the symptoms appear to seek help or advise others, if you can, to seek help for you.

If these symptoms continue and worsen, without treatment, they could cause unconsciousness. That is the result of hyperglycemia, dehydration, shock and exhaustion.

Coma happens after worsening vomiting and hyperventilation. If you are diabetic, the diagnosis of ketoacidosis is made from your appearance and continuous vomiting over a span of one to two days. Blood chemistry confirms ketoacidosis by the presence of hyperglycemia and severe metabolic acidosis

Treatment consists of isotonic fluids administered orally, if awake, or intravenously if you are still in a coma, to stabilize your blood circulation. Simultaneously you continue with the iV with saline that contains potassium and other electrolytes to reverse the ketoacidosis. The physician or emergency staff will keep an eye on you for further complications.