"Water Toxicity" or "Hyponatremia". Drinking too much water can kill you!
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marymickaela wrote: »Oh My Goodness, I didn't even look at this until this morning and didn't realize how many people knew about this problem. So much happened last week it would have taken a novel to tell you. I know as looking back I don't know how a few friends even wallowed thru my emails.
OK, here was my warped reasoning. Physical, July 28th. Was at dr's office Monday, 31st about bad reaction to pneumonia vaccine given at physical (not the sodium), saw NPrac. My dr's nurse calls me back in before I get to leave to discuss low sodium, says my dr. (off that day) called and thinks it was due a my Trileptal med. But when I say "well I did start drinking all this water on the 20th." .Nurse say that's it, you're flushing all the sodium from your body" and proceeds to give me instructions. It was only later Monday I get the 2nd call back that when my dr. found out about the water I was told I had "water toxicity" and could start having seizures at any min.
I hadn't been to the Dr. since March, which was the last time labs were done. It was purely coincidence I just happened to have 2 specialists appt also last week (Neurologist and Psych). See Neurologist for my RLS, but see his PA Tuesday (next day) and she totally downplays entire seriousness, dismissing my Internist's concerns, but says "let's repeat labs". Get a call Wed early AM "ah, you're sodium's still really low, maybe you should go to ER." I proceed to tell her off and she profusely apologizes. Put call in to my Internist. Should I go to ER?
Meanwhile my d is an ICU nurse and has put her cap on. Badgering me "you're drinking how much?" I'm getting non-stop lectures from her that I'm still drinking too much although I reassure her Internist said I'm to drink Gatorade (too much sugar so G2), Propel, or Pedialyte. When I mean lecturing, she's is on me 24/7 she's so worried and says "if you were in the hospital you'd be on IV's with nothing by mouth." Internist's nurse finally calls me back later Wed to say although sodium's still seriously low I'm to follow dr's instruction and ignore my d.
Get in to Kidney spec Thurs (8/3) who explains what happened re:increasing my water combined with med causing my kidneys to start flushing sodium/retain water and gives me the 1.5L instructions. Also says my d was giving me correct advice and my Internist was wrong saying Gatorade is basically water with very little sodium. Of course my d loved that. Takes labs.
Last Friday had my 3mo psych dr appt and he's the one prescribing the Trileptal. Immediately says "it was the Trileptal." Has had it happened to a few other patients, one to the point she was passing out. Cuts dose in half. However, after that 1st initial talk, where my Internist's nurse mentions it might be the Trileptal, I had started to cut my daily dose by 1/4 and so when my labs came back early 8/4 with sodium 136 psych and I were convinced it was due to Trileptal and NOT WATER.
Which leads to my current situation. Last Sunday, 8/6 eyesight dramatically improves. However, how am I to know if it was just the Trileptal, just the water, or both? Most recent labs came back this past Monday 8/7, sodium was now 134 so had dropped slightly below normal. Kidney spec's on vacation and nobody in office will tell me if it's ok to increase my water. My Internist has now turned the sodium problem over to him. Her nurse msgs me my dr did look over my labs and felt sodium was fine, but also won't give me permission to increase water either, must ask kidney spec, who's on vacation.
I never stopped using salt while detoxing off the sugar. I no longer follow the Sugar Smart Diet as I stopped it when this sodium crisis happened. However, luckily for me I had been off sugar products of any kind long enough that I now have zero desire for anything with sugar and that includes: pasta, pizza, bread, and of course any free sugar. I do eat some type of rice and steel cut oatmeal, and I eat a very healthy diet, including lots of fruits, but that's healthy sugar and ok. Have never limited my salt even before sodium crisis. I have continued to lose weight (down 10lbs) which of course inspires me to continue with my healthy eating. I did cut back the water yesterday, drinking only 2 (30oz) YETI's, my coffee, and a Lacroix, so am hoping eyesight improves again. It was seriously bad yesterday after drinking so much water on Thursday. Internist doesn't think eyesight improving is related to sodium and I have call into my Retina Spec. but haven't heard back, but how can it be pure coincidence after months of blurriness?
I reconnected with a best friend after losing touch for over 20yrs in the spring. She's been cheerleading me on my journey to detoxing off all sugar. Of course she was also encouraging me to keep drinking that water. But who knew. I'm now leading a MFP member on and Paying it Forward. She's on Day 4 and we text daily, even posting progress pics. She thanks me for my help, but I tell her that she's helping me just as much as I continue to eat healthy. I look back at how seriously poor my eating habits were and I won't even go there in this post.
Sorry this got so long, but I just wanted to explain my thinking. I didn't feel I was being reckless, but damn that water just tastes so good, esp. out of my 30oz YETI cup, which I think I'm being buried with. I've been so over the moon happy after getting sodium levels stable I just can't contain my happiness.
Thanks for all the great responses and insight. I knew people on MFP would be knowledgeable. So smart.
I *have* read the entire thread, but the bolded above from your previous post jumped out at me.
Firstly, why are you on Trileptal, which is an anti-seizure medication? Do you have seizures? Yes, it can also be used in conjunction with other psych drugs as a mood elevator, but that's not intended as a primary use. Are you on other pysch meds with the Trileptal as an add-on?
Secondly, you state that your psych doctor cut your dose in half, but then it appears that - on your own and without medical advice - you decide to further reduce it to 1/4?
Am I following this correctly?
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We're heading into town to the Farmer's Market to buy fresh green beans and see what other good healthy foods I can find. Hope they're not out of the free range eggs. They go fast.
I also eat tons of fresh blueberries everyday. Lots of eggs, non-fat Greek yogurt mixed with all natural chunky peanut butter, grilled chicken bacon ranch salad from McD's for lunch yesterday and loving my "Instant Pot". :Husband made us this great stew last night using hamburger, tomatoes, zucchini from our garden, and other wonderful veggies. I had that over a bowl of basmati rice and was stuffed.
Honestly, once I got the sugar cravings out of my system I can look at a brownie and have zero desire for it or anything sugary. I'm lovin it! I stopped logging after the sodium crisis, but the weight's still coming off since I got off the junk food and non-stop emotional/stress eating. Trust me, with all the stress I went thru last week it would have been so easy to fall back into my older pattern of stress eating, but I didn't. Very proud of myself. Please don't "rain on my parade!"2 -
marymickaela wrote: »We're heading into town to the Farmer's Market to buy fresh green beans and see what other good healthy foods I can find. Hope they're not out of the free range eggs. They go fast.
I also eat tons of fresh blueberries everyday. Lots of eggs, non-fat Greek yogurt mixed with all natural chunky peanut butter, grilled chicken bacon ranch salad from McD's for lunch yesterday and loving my "Instant Pot". :Husband made us this great stew last night using hamburger, tomatoes, zucchini from our garden, and other wonderful veggies. I had that over a bowl of basmati rice and was stuffed.
Honestly, once I got the sugar cravings out of my system I can look at a brownie and have zero desire for it or anything sugary. I'm lovin it! I stopped logging after the sodium crisis, but the weight's still coming off since I got off the junk food and non-stop emotional/stress eating. Trust me, with all the stress I went thru last week it would have been so easy to fall back into my older pattern of stress eating, but I didn't. Very proud of myself. Please don't "rain on my parade!"
Don't see anyone raining on your parade. Everything I've read on this thread has been about people taking time out of *their* day to try and help you as well as doing their best to sort out what's a *very* confusing situation.10 -
Just watch this. Even 8 glasses of water a day as gospel is woo: https://www.youtube.com/watch?v=OWASUMMQjj82
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K I looked up a G2 nutrition label.
https://www.gatorade.com/products/g-series/low-calorie-thirst-quencher
160 mg sodium, 7g sugar
Compared to a gastrolyte sachet.
https://gastrolyte.com.au/products/orange-flavour-electrolyte-powder-sachets/
470 mg sodium chloride, 4g sugar
Both will work.0 -
I work in health care. Every doctor that prescribes Trileptal should discuss possible side effects of the medications with their patients, especially possible hyponatremia, and should also be monitoring sodium levels on a regular basis. Of course you had no idea it could do that, because you were not given proper education about the medication.4
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Don't see anyone raining on your parade. Everything I've read on this thread has been about people taking time out of *their* day to try and help you as well as doing their best to sort out what's a *very* confusing situation. [/quote]
I am truly grateful for all of you taking time to respond. Was just trying to be light hearted about what's been a very stressful last week. Also, just watched "Funny Girl" my all time favorite movie of all time. So please don't think I don't appreciate all this insight. I do, and thank you!!! I also was heading to Mexico last week trying to make light due to all the stress so apologized later for people thinking I was truly losing but I was.
Mary
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orangegato wrote: »I work in health care. Every doctor that prescribes Trileptal should discuss possible side effects of the medications with their patients, especially possible hyponatremia, and should also be monitoring sodium levels on a regular basis. Of course you had no idea it could do that, because you were not given proper education about the medication.
Totally agree! Someone dropped the ball for sure.
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K I looked up a G2 nutrition label.
https://www.gatorade.com/products/g-series/low-calorie-thirst-quencher
160 mg sodium, 7g sugar
Compared to a gastrolyte sachet.
https://gastrolyte.com.au/products/orange-flavour-electrolyte-powder-sachets/
470 mg sodium chloride, 4g sugar
Both will work.
Txs! Will definitely check this out!1 -
I want to reintegrate how much I TRULY APPRECIATE ALL OF YOU for taking the time to respond so insightfully to my post. Yes, I know I need to follow dr's instructions, but also feel they aren't always available to ask so it's people like you, esp. the people who have gone thru similar experiences who help me. Saying to drink Tequilla with salt? Well that was just my stupid brother trying to be funny. However, my cousin saying "eat pickles and watermelon" was her being very serious. Oh and a good friend saying she got extremely healthy focusing on her gut and probiotics. It just went on and on, which is why my ICU nurse d wrote the post telling everybody to "stop, this is serious!" I loved her for that. I love all 3 of my d's and my middle 1 with 4 kids was leaving them and heading to Mexico with me after I promised her her own Cabana Boy. LOL!!2
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[/quote]
I *have* read the entire thread, but the bolded above from your previous post jumped out at me.
Firstly, why are you on Trileptal, which is an anti-seizure medication? Do you have seizures? Yes, it can also be used in conjunction with other psych drugs as a mood elevator, but that's not intended as a primary use. Are you on other pysch meds with the Trileptal as an add-on?
Secondly, you state that your psych doctor cut your dose in half, but then it appears that - on your own and without medical advice - you decide to further reduce it to 1/4?
Am I following this correctly?
[/quote]
Let me clarify. I am on Trileptal as a mood stabilizer for what my psych doc feels is a form of Bipolar. I hesitate to use that word as it scares a lot of people. Many just use the word "Mood Disorder" which is ok too. So please don't judge me too harshly that "oh she's just mentally ill." So not classic, but some form. It has been a great med and for the most part I've been stable. I cut the dose by 1/4th on my own, but the psych doc cut it by another 1/4th, thus 1/2 the dose now. However, after getting the news my sodium was back to normal I think I'm been having some form of mania or hypomania the past week. I've just been so damn happy and I can't help it. I want to shout it from the roof tops. I love my therapist of 2 yrs and I see for her for EMDR for PTSD. For 2 years she has raged about the BP dx saying so many want to label people with PTSD with a BP dx when that's not the problem.
Well I see her once a week. I saw her two days ago and rattled on and on and on about the past week, how happy I was, on and on and on, saying I really don't think I need therapy anymore. For the very 1st time in 2yrs I heard her use the word "mania". I stopped but didn't say anything as I was so stunned. I definitely will bring it up next week. However, my H and I discussed it in depth last night as he said I'm definitely manic. Whether it't due to cutting the Trileptal or the stress that triggered it, not sure. Only got 3 hrs sleep last night. I honestly don't want to ruin my happiness, but as one specialist pointed out to me several years ago "what goes up, must come down." Meaning if you go into mania, the opposite is going into a depression. Haven't been in a serious depression for many many years, but it wasn't pretty when I was in it. I don't want that to happen. So I'm getting ready to rest for awhile and try to stay calm. I can't focus or accomplish and have so much to do it really bothers me.
I don't want this to turn into a mental illlness thread, but wanted to honestly answer your question. I see my psych doc in 2 weeks and if still this way will probably get another med added or I may even call him sooner if not feeling stable. The problem when you're feeling happy you don't think it's a problem so why would I want anybody to ruin it. I've worked so hard to get off of so many meds it will be a hard pill to swallow. So going to try to use some self care to come down.
Thanks for taking the time to respond.3 -
Just make sure your psychiatrist is aware that you cut the Trileptal dose on your own as well, so there is no confusion about how much they think you are taking. Good idea to call him sooner than the appointment if you are still manic. Maybe he can see you sooner.3
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marymickaela wrote: »jgnatca wrote: »
Or maybe not add some self prescribed item to the mix and listen to medical professionals.
Well last week I had 4 medical specialists all giving me different advice so how do I handle that?
Internist-"stop all free water and only drink Gatorade or start having seizure."
Neurologist-"Oh, you're fine".
ICU Nuse d who sees the worst of the worse-"mom, stop drinking so many fluids".
Internist-"Don't listen to ICU nurse d regarding limiting fluids, drink as much as you want as long as it contains electrolytes and eat lots of salty foods like potato chips, in fact salt all food".
ICU Nurse d-"you should follow your dr's instructions."
Kidney Specialist "Limit fluids of any kind, drink 1.5L of free water and eat normal well balanced diet and d was right and Internist was wrong."
Psych doc-"it's the Trileptal, not the water."
So which medical professional do I listen to?
Has nurse D seen all your medical records? If not IMO, she should not be advising you.0 -
OP, if you are manic or hypomanic right now, you should not be making any major or changes regarding your health.
Follow the advice to limit your water intake to avoid hyponatremia.7 -
marymickaela wrote: »After re-reading some of your responses I have to say this. I have over 830 days of non-stop logging on MFP. However, due to past bad experiences posting on Community and getting some really rude remarks, such as "I have no sympathy......." Well, this is why I stay away. But is also why I wanted to give you the full picture of my reasoning. After re-reading responses I do think there was some good advice and insight. I should have slowly increased my water intake, going from drinking very little water, Diet Pepsi's, Sprite, LaCroix to the 100+oz of water was not smart. However, I did have my girlfriend cheerleading me on that this was wonderful. How was I to know? I had never of heard of anything like this.
Please don't judge me. I thought I was getting healthy, but as I am learning more and more realize I also need to be smart. I see kidney specialist the 17th and will follow his orders until I get his permission to increase water or at least not go wild drinking 120+oz.
Thank you! This is what I wanted to hear and maybe a little tough love talk was good too. Sometimes I need a kick in the You Know What?
I'm not going to judge you for any of that. But I know I read this exact same post elsewhere on MFP recently. So I'm either going to judge you for multiple posts of the same novel, or because you plagiarized someone else.4 -
collectingblues wrote: »marymickaela wrote: »After re-reading some of your responses I have to say this. I have over 830 days of non-stop logging on MFP. However, due to past bad experiences posting on Community and getting some really rude remarks, such as "I have no sympathy......." Well, this is why I stay away. But is also why I wanted to give you the full picture of my reasoning. After re-reading responses I do think there was some good advice and insight. I should have slowly increased my water intake, going from drinking very little water, Diet Pepsi's, Sprite, LaCroix to the 100+oz of water was not smart. However, I did have my girlfriend cheerleading me on that this was wonderful. How was I to know? I had never of heard of anything like this.
Please don't judge me. I thought I was getting healthy, but as I am learning more and more realize I also need to be smart. I see kidney specialist the 17th and will follow his orders until I get his permission to increase water or at least not go wild drinking 120+oz.
Thank you! This is what I wanted to hear and maybe a little tough love talk was good too. Sometimes I need a kick in the You Know What?
I'm not going to judge you for any of that. But I know I read this exact same post elsewhere on MFP recently. So I'm either going to judge you for multiple posts of the same novel, or because you plagiarized someone else.
this is her second post on the topic - so that's probably why you think you've seen it before3 -
TooaBurn, I totally agree. Have been trying to rest and can't shut my mind off. May give my psych dr a call, but hate to call him on weekend, but don't want to get worse either. Just so tired right now.
Orangegato, yes psych doc knew exactly what I was doing, as I filled him in ahead of time, knowing you usually only get 15min for psych appts as that's for meds. You're supposed to be seeing a therapist for the other issues. However, he's great and has many times spent a good half hour with me and did last week too. All my docs are totally informed.
My actual Neurologist got involved last week. He started sending me messages. 1st he wanted me to get a brain MRI to see if I had any swelling and he wrote again apologizing for his PA's insensitivity and said he had talked to her. She's very young. His nurse called me a 3rd time saying when dr heard my sodium was stable I didn't need MRI and was I still with the practice? Well, I do love my dr, but not wild about his PA who I have to see, but not that often. I said it was such a learning experience for everyone, including my doctors.
Kidney spec also wanted me to get chest x-ray to rule out cancer, but when sodium came back normal again said I didn't need it. So much happened that I couldn't write, but I have kept my entire care team up to speed. Probablh a little too much as I have a feeling my Internist was getting sick of my daily message to her. However I did get a nice message from my Internist thanking me for keeping them "in the loop and what a great historian I was and asking if my kidney spec would be following up with sodium problem." Said they were there for me if I needed them.
So, I do feel I'm in good hands now. Lucky for me having a nurse for a d really paid off. The nephrologist (kidney dr) my Internist referred me too never has returned my call, although they took a message and said an Intake person would call me back. My d asked the name and said "she's good, but this other kidney doc is amazing! He's young, but the smartest doc any of the ICU nurses have ever met." Called and they got me in the next day. She was right in singing his praises. He was like Sherlock Holmes trying to solve a case.
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deannalfisher wrote: »collectingblues wrote: »marymickaela wrote: »After re-reading some of your responses I have to say this. I have over 830 days of non-stop logging on MFP. However, due to past bad experiences posting on Community and getting some really rude remarks, such as "I have no sympathy......." Well, this is why I stay away. But is also why I wanted to give you the full picture of my reasoning. After re-reading responses I do think there was some good advice and insight. I should have slowly increased my water intake, going from drinking very little water, Diet Pepsi's, Sprite, LaCroix to the 100+oz of water was not smart. However, I did have my girlfriend cheerleading me on that this was wonderful. How was I to know? I had never of heard of anything like this.
Please don't judge me. I thought I was getting healthy, but as I am learning more and more realize I also need to be smart. I see kidney specialist the 17th and will follow his orders until I get his permission to increase water or at least not go wild drinking 120+oz.
Thank you! This is what I wanted to hear and maybe a little tough love talk was good too. Sometimes I need a kick in the You Know What?
I'm not going to judge you for any of that. But I know I read this exact same post elsewhere on MFP recently. So I'm either going to judge you for multiple posts of the same novel, or because you plagiarized someone else.
this is her second post on the topic - so that's probably why you think you've seen it before
Ah, OK. So it's "I'm going to use a community forum as my blog" thing.
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orangegato wrote: »Just make sure your psychiatrist is aware that you cut the Trileptal dose on your own as well, so there is no confusion about how much they think you are taking. Good idea to call him sooner than the appointment if you are still manic. Maybe he can see you sooner.
This. ^^
Bi-polar manic phase would explain a lot.
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I have treatments three times a week to remove excess water, which often also causes my sodium levels to drop and thus cause low blood pressure. When that happens I usually just mix in 1/8 tsp sea salt into 4 oz water. That gives about 400mg sodium per serving with none of the sugar.1
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@marymickaela you should not feel bad about calling on call docs over the weekend or calling your internist daily. It's their job. You have to be selfish and advocate for your health. Sounds like you should probably call and need an adjustment of meds.1
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marymickaela wrote: »orangegato wrote: »You started the same thread on August 1st ("Warning to Others...."), but didn't mention Trileptal then. Why didn't you just continue that thread?
Trileptal is notorious for causing hyponatremia, but as you said there is controversy over if your low sodium was from BOTH consuming EXCESSIVE amounts of water AND from Trileptal. Probably both. Nothing is ever really black and white, all or nothing.
You should be getting routine and regular blood tests to monitor your sodium forever.
I didn't mention the Trileptal because I have a tendency to be long winded, perhaps people wouldn't read this, and felt I wanted to give people a snapshot of what happened last week. However, after reading the responses, felt I needed to give you a more precise account. I've been taking Trileptal for several years, no problem. I was at no time told this might cause a problem. My psych did say at my appt he normally has his patients get regular blood work unless he knows they're under another Dr's care, which he assumed I was. Well, I do see quilt a few Drs due to various health problems, but never for this.
I am also on a lot of other meds. I have no thyroid due to cancer at age 26 so see "Endocrinologist" he tests thyroid. RLS - See "Neurologist". 2 yrs ago started having hematuria in urine. See "Urologist", and of course my Internist for everything else, esp. High Blood Pressure which I finally agreed to start meds in March. Thinking back. When I started feeling so tired and lethargic in May I had many things I blamed it on so started back on Shaklee Protein & Vitamins after reconnecting with best friend. June, still not feeling good. Well, maybe I need to start eating better. So July, start new Sugar Smart Diet and the 20th increase my water. Hindsight is wonderful, but I had no reason to suspect the "Trileptal".
I am just thankful for that already scheduled physical on the 28th, which found the low sodium. As I tell my family and friends "I try not to think of the "what if's"." or it scares the crap out of me. I would have continued drinking large amts of water, sodium would have continued to drop. I'm driving, pass out, killing myself and others." Those are my "what if's" I try and not think about.
The bolded also jumped out at me. Was it the long-lost friend who got you on Shaklee, or was this just a coincidence?2 -
If you are cycling and currently manic your condition is not controlled, you absolutely should stop posting here and speak to your psychiatrist as soon as possible. I know you're high and happy and feel great about the world but you also know it's because of the mania. Good luck to you.11
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Something you have to keep in mind is that when we post replies here, we're not just talking to the OP, but to who knows how many beginners lurking on the thread.
So when someone seems to be recommending or doing something that's actually dangerous, we have to call it out - not just for the sake of the OP, but also the invisible audience, who are learning from what's posted here. Sometimes we call out dangerous behaviour in pretty sharp terms. I'm sorry if that causes hurt feelings, but better hurt feelings than serious harm to health.
Persisting in high water intake, even after you've already had symptoms of harm from it and doctor's advice not to do it, is dangerous behaviour. And frankly, the fad of drinking more water than necessary has taken such firm hold that people can easily get the idea that doctor's advice should be ignored here. It should not.
I hope you feel better soon and that the thread has been more helpful than upsetting for you. All the best.12 -
Point taken. I haven't posted on Community for years so am not at all familiar with what's what. I didn't think I was posting a repeat post as I felt I was replying in more detail to my initial post, which confused many people.
I will stop talking about this as I'm so tired and need to rest. I can only call my psych doc if it's a true emergency and I think I can manage this until he's back in the office.
I do find it upsetting to read responses using the word "OP" amd writing responses as if I'm not here. My name is Mary. Thank you all for taking the time to respond and give me some great advice and insight.
Mary
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marymickaela wrote: »I do find it upsetting to read responses using the word "OP" amd writing responses as if I'm not here. My name is Mary. Thank you all for taking the time to respond and give me some great advice and insight.
Mary
That's just forum convention. It's really not personal. It makes it easier to follow the conversation, because in the middle of the conversation it can be easy to forget which of the people involved actually started it. Besides, I was taking in generalities, about any thread and any OP, not just your thread or you as OP.
No offence is meant, on my part anyway. My best advice for reading conversations online is that 'tones' and hostility are usually not really there - and it makes everything much more peaceful if you give everyone the benefit of the doubt and assume they meant something neutrally, even if you hear it as having a tone. In many cases if someone comes over as abrupt, they're just trying to be clear and avoid confusion. That's the case with me. I wouldn't be here if I didn't care about helping people.6 -
Mary--
I hope this does not sound condescending. A little translation: OP means "original poster," or the author of the thread.
Your given name is Mary, and while in person it would be very rude to address you otherwise, online it's customary not to out of respect. Because we're all strangers and don't personally know you some people might be hesitant to address you by first name. Be safe.6 -
Mary - I'm posting this because I too am on lower dose seizure meds for a mood disorder. You recognize you're in a manic phase right now (maybe the first one you've experienced at this intensity?) I strongly urge you to get in touch with your therapist sooner rather than later, since your psyc won't see you except if it's an "emergency", and you're not in a space to recognize this level of mania is something your psyc would want to know about right away. Speaking from experience, I understand that the manic feeling is exhilarating and the desire to put off coming down is strong, but you are very much at risk of making impulse decisions you will regret later, and if you crash without support it can be life-threatening. Coming down from the mania with medical support doesn't have to be the end of your happy mood, and re-entering reality is not the equivalent of suddenly becoming depressed or unhappy. I'm offering this advice gently in hopes you will speak with your husband and ask him to pick up the phone for you if you find that too hard.15
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