Metabolic Encephalopathy / psychogenic polydipsia

[nurseT]

I had an inmate who was in for a battery charge. 24 yr old male.He had a history of self mutilation and had a small fresh cut on his forearm at intake. He denied ever seeking treatment for his condition and denied any psych meds. He was very slow to respond verbally and had the mentality of a 5 yr old. so I requested he be maintained in holding with another inmate of similar qualities. On the evening of day 2 he had a tonic clonic seizure and became combative. He was sent to the ER. The nurse there said his sodium was really low and he was putting out a boat load of urine. The doctor Dx'd the encephaly and psychogenic polydipsia. I watched 2 days worth of video of him and his bunky. this kid drank 1 to 2 cups of water every 5 to 10 minutes. He had 43cups in the first 5 hrs of video that I watched. I also noticed him checking his pulse in the video. His girlfriend and mother cane to the jail to pay his bond. The girlfriend says " I knew he would do that, He said he could get out of jail if he did that". I was shocked. I know this is rare. Anyone seen this up close?

[indigo girl]

I had an inmate who was in for a battery charge. 24 yr old male.He had a history of self mutilation and had a small fresh cut on his forearm at intake. He denied ever seeking treatment for his condition and denied any psych meds. He was very slow to respond verbally and had the mentality of a 5 yr old. so I requested he be maintained in holding with another inmate of similar qualities. On the evening of day 2 he had a tonic clonic seizure and became combative. He was sent to the ER. The nurse there said his sodium was really low and he was putting out a boat load of urine. The doctor Dx'd the encephaly and psychogenic polydipsia. I watched 2 days worth of video of him and his bunky. this kid drank 1 to 2 cups of water every 5 to 10 minutes. He had 43cups in the first 5 hrs of video that I watched. I also noticed him checking his pulse in the video. His girlfriend and mother cane to the jail to pay his bond. The girlfriend says " I knew he would do that, He said he could get out of jail if he did that". I was shocked. I know this is rare. Anyone seen this up close?

I can't answer your clinical question because I know nothing about this condition. I do think that if he knew enough to tell his girlfriend that his behavior could get him out of jail, then perhaps his mentality is more than that of a five year old.

[HOOSIERNW]

I can't answer your clinical question because I know nothing about this condition. I do think that if he knew enough to tell his girlfriend that his behavior could get him out of jail, then perhaps his mentality is more than that of a five year old.

Many inmates will do ANYTHING to work the system to get what they want, when they want it.......They are very focused and excellent actors.....

Now we have to figure out what the real medical problem is that they problably have hidden........It's never a dull moment in corrections....

[juvynurse]

I can't answer your clinical question because I know nothing about this condition. I do think that if he knew enough to tell his girlfriend that his behavior could get him out of jail, then perhaps his mentality is more than that of a five year old.

Agreed.

[BSNinTX]

I've seen it, but in a different way. We had an inmate who had postural hypotension because of dehydration. We instructed him to increase his fluid intake, which he did...to the point that he gave himself diabetes insipidus. He wasn't trying, but it happened.

I had an inmate who was in for a battery charge. 24 yr old male.He had a history of self mutilation and had a small fresh cut on his forearm at intake. He denied ever seeking treatment for his condition and denied any psych meds. He was very slow to respond verbally and had the mentality of a 5 yr old. so I requested he be maintained in holding with another inmate of similar qualities. On the evening of day 2 he had a tonic clonic seizure and became combative. He was sent to the ER. The nurse there said his sodium was really low and he was putting out a boat load of urine. The doctor Dx'd the encephaly and psychogenic polydipsia. I watched 2 days worth of video of him and his bunky. this kid drank 1 to 2 cups of water every 5 to 10 minutes. He had 43cups in the first 5 hrs of video that I watched. I also noticed him checking his pulse in the video. His girlfriend and mother cane to the jail to pay his bond. The girlfriend says " I knew he would do that, He said he could get out of jail if he did that". I was shocked. I know this is rare. Anyone seen this up close?

[VegRN]

We had an inmate once who had psychogenic polydipsia.

He was a brain injured from a car accident and had major problems regulating his emotions. Would go from being nice to anger to crying like a baby in a short time

Anyway had a long history of this. Once, his Na went down to 113, serious emergency.

Water in his room ended up being turned off, toilet almost had to be turned off. Needs to be carefully monitored

I agree with the above poster though. If the inmate had the ability to tell people he knew how he could "get out of prison", he had more than the capacity of a 5 year old.