Episode 88 S3-7
Starvation & Dehydration
The Walls of Freedom Ch 7
Dr. Joe Alton
It is hard to find reliable data on how long someone who is healthy can live without food if they have access to liquids. Ghandi went twenty one days without food with only sips of water. The Irish army soldiers in captivity would go on food strikes for twenty eight to forty six days but they had access to fluids as well. If you can maintain a body mass index of more than one half of normal you can survive a long time without food. However, once you get lower than twelve percent it is not good. This level is incompatible with life.
When you do not have access to food your body will go through five phases of starvation. First you will feel hunger. You will think about food all the time. Physically your blood glucose levels are maintained by trying to produce glucose from protein, fat and glycogen. Glycogen is stored in the liver but only for a limited time. After several weeks you will use all the glycogen you have stored your body will begin breaking down fats and proteins.
Stage two of starvation begins when your body starts eating its fat reserves. This becomes the main energy source for your body. This causes ketone production after one week and the brain would have to start using these to function. After your fat reserves are gone you enter stage three. In stage three your body begins to swell, causing a bloated abdomen, legs and ankles. In stage four your body starts eating your protein reserves which is found mostly in your muscles. You become very weak and cellular deterioration sets in. You will begin to withdraw from life, become listless, weak and your body becomes susceptible to infection due to the loss of your immune system. In the final stage of starvation your body weight become incompatible with sustaining life and you will die.
If you have a healthy heart and metabolism your body will appreciate a little extra fat. Your body wants a little extra fat to ensure that during periods where food is not abundant it can still survive easily. That is why your body has natural resistance points when you are trying to lose weight. It wants to maintain you at a level where you can survive starvation periods. Fasting will slow your metabolism and further restrict weight loss because this is your body's natural defense to starvation. Eating multiple small meals a day will speed your metabolism up because the body will understand that food is abundant and there is no need to slow the metabolism to ensure survival.
If someone has been without food for an extended period of time the worst thing they can do is sit down to a huge meal and gorge themselves. They could literally die from too much food at this point. They need to start slowly with small frequent meals. The meals should consist of easy to eat food like soup and the soup should be high in calories and especially protein to replace what the body has cannibalized. The World Health Organization Formula for feeding an individual after starvation is 1 to 1/2 grams of protein per kilogram of body weight and one hundred calories per kilogram in a day. Small chunks of meat are best. Bulky foods will cause problems: abdominal pain, diarrhea, and vomiting.
The maximum time you can go without water is three days by the rule of thumb but you may be able to last up to a week or longer, depending on the environment. If you are in a dry, hot environment you will not last as long as you would if you were in a cool environment. There have been stories of people living eight days lost at sea or buried in mudslides or earthquakes. The big question is how well hydrated were you when the ordeal began. You need to stay hydrated all the time! Most people are walking around dehydrated on a day to day basis and simply do not pay enough attention to their hydration level.
There are stages of dehydration as well. When your body hits one percent of total body water loss your thirst mechanism in your body will activate. At two percent you may develop a headache, anxiety, loss of concentration and work efficiency. At six percent you will experience loss of coordination, delirium and may become unable to function properly. At ten to twenty percent of total body water content loss your organs start to fail. You will go into a coma and eventually die.
There are clear signs that the body displays when you are becoming dehydrated. You will produce less urine and it will be a very dark yellow. Your skin will look dry. When you perform a pinch test, grabbing the skin of the forearm and releasing, it should normally snap right back but when you are dehydrated it will stay up longer because of the loss of turgor or elasticity. Your body physically gets thinner and your tongue lines and lines in your skin may get deeper and more pronounced. You will look older and more wrinkly.
Re-hydrating a person after a long period of dehydration can be tricky especially without an IV. The first thing you should do is move the individual to a shady, cool area. Give them sips of fluid but they have to be awake and alert. You don't want the water going down the wrong pipe. Big sips will cause stomach spasms and induce vomiting. Inserting an IV of saline solution is the best and most direct way to re-hydrate someone. Regular tap water will not work in an IV; you need to have sterile saline solution. You can make it yourself. Get a pan with a lid. Add one liter of water to 2 tsp salt, non-iodized salt is best, and boil for fifteen minutes. Let it cool with the lid on the pan and use it or store it in a sterile canning jar with a sterile lid. It will store for thirty days or more. Of course to use an IV you have to be prepared with an IV kit. Saline solution is a prescription so it is not available online. This also makes IV kits hard to find online. If you are interested in getting one you can request one from Dr. Bones at firstname.lastname@example.org.
In the IV bag there are options for the solution. Normal salines stays in the blood vessels for a long time and is very effective. You may also want to add dextrose to the mix if there has been a lack of food and water. Potassium is another good additive but you should only use dextrose and potassium if the patient is urinating.
Fruit is another great option for re-hydrating someone but they need to be conscious to eat it. Fruit contains a limited amount of fluid per bite so it is hard to overdue the amount but the patient will still get a large amount of fluids ingested.
Quote from The Art of War on Repairing America
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Featured Quote From Today's Chapter:
"He was her savior. For him she could come back from hell itself."