After I found out that the metabolic acidosis was the problem with my Dad I talked to his surgeon. He immediately said, yes that is what he has. When my Dad saw a kidney specialist, he said my Dad would have to take the sodium bicarbonate for life. A member of this board who I corresponded with said her Dad's doctor told him he had to take it for 3 months and at that time the neobladder starts acting like a "real" bladder. It seems every doctor says something different. When I spoke to my Dad's surgeon's nurse/assistant... she said she had never heard of it.... in ten years! My Dad had no underlying condition... well bladder cancer... but every bladder cancer - neobladder patient has this.
I will try to remember the story....
The Neobladder is made out of a piece of intestine. Urine can seep thru into the body. This causes the body to become acidic and therefore metabolic acidosis occurs.
Maybe some people are just not that acidic.... their bodies handle it better?
This is what I found and read that triggered a disturbance in my Dad's body due to the surgery and not due to his not drinking enough water...
www.nci.edu.eg/Journal/june%202004/CAN_2.PDF
Conclusion Our experience suggests that neobladders composed of sigmoid or ileum are good bladder substitutes and comparable to each other interms of adequate capacity with a low-pressure system. Surgeon preference, ease of construction and length of mesentery are among the factors that must be considered when choosing between them. However, sigmoid neobladders are easy to use, avoid small intestinal resection, reaches the pelvic cavity easily, and protects from met-abolic acidosis in patients with borderline renalfunction. It is noteworthy that with ileal neo-bladders, on the other hand, the patient requires medical supervision to prevent the occurrence of symptomatic electrolyte disturbance.
From our experiences, every doctor seems to have a different story about this. Maybe it's too early for exacts?
From another site and information:
Electrolyte Imbalance
What are electrolytes?
There are many chemicals in your blood stream that regulate important functions of our bodies. These chemicals are called electrolytes. When dissolved in water, electrolytes separate into positively and negatively charged ions. Your body's nerve reactions and muscle function are dependent upon the proper exchange of these electrolyte ions outside and inside cells.
Examples of electrolytes are calcium, magnesium, potassium, and sodium. Electrolyte Imbalance can cause a variety of symptoms.
My Dad had blood tests, ER visits and no one caught this!! The high potassium was causing dehydration which makes you nauseus and therefore not wanting to eat or drink. High potassium can be deadly and almost caused a heart attack in my Dad.
Here is another site and report that states that metabolic acidosis is a complication.
jjco.oxfordjournals.org/cgi/content/full/35/7/391
And yet another quote from a site:
Metabolic disturbances may result from the interaction of urine with the absorptive surface of the bowel used for the procedure -
www.emedicine.com/med/topic3083.htm#target1
It depends what part of the bowel is used.
I really hope this helps. I can keep looking through all of my saved articles I have found and read about this and post them if it is desired.
Karen E.