instruction: hello doctor my father is out of coma and on regular physiotherapy however we have a major concern now with frequent drop in his sodium level every five to six days his sodium level drops to 10 120 when that happens his consciousness level goes down and stops body movement or response he is given injection sodium chloride isotopic solution with fludrocortisone one tablet per day it takes about five to six days for his sodium level to improve around 130 when he starts responding he opens his eyes and moves body parts we have seen this three to four times since last one and a half months eight days back his sodium level went down to 109 and currently it is 121 but he has not shown much of body movement yet normally he recovers within five to six days please suggest what has to be done for faster recovery what has to be done to prevent this happening again and again I have listed the medicines he is taking currently initially tolvaptan is given for 10 days currently stopped fludrocortisone 10 extra salt per day with liquid food tablet ofloxacin 200 my capsule or tablet phenytoin sodium 100 my tablet vitamin complex tablet losartan potassium 50 my tablet metoprolol 50 my and tablet pantoprazole 40 my
output: hi I am sorry to note that he is having problems with sodium levels I suggest the following serum specific gravity urine specific gravity serum and urine osmolality revert back after the investigations to a general medicine physician online