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March 11, 2001

Community Resources, Complications

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Question from Houston, Texas, USA:

My 75 year old father is has had diabetes for 30 years and until recently his weight has been well under control. However, in the past six months he has rapidly gained weight, falls asleep while eating, or at church, etc., and is now complaining of not being able to walk due to the pain in his hips, and is even having a hard time breathing. He seems to choke easily now while eating. His doctors are not explaining this, just give him diuretics or more exploratory medicine. He is now like a child, we can’t leave him alone or let him drive due to his getting lost. What other measures can I explore before I get him to change doctors?

Answer:

From: DTeam Staff

It is difficult to say what is happening with your father without seeing him, but here are some thoughts that come to mind:

He may have congestive heart failure, a condition that may result in fluid accumulation in the lungs and also in the legs and sometimes the abdomen, and can cause fairly rapid weight gain and trouble breathing. It is treated with diuretics and heart medications.
He may have hypothyroidism. This can cause fluid retention, fatigue, sleepiness, forgetfulness, and many other symptoms. It is tested for by checking thyroid hormone levels in the blood, and is treated easily with thyroid hormone pills.
His kidneys may be failing, resulting in fluid retention. This may treated with diuretics in the early stages.
His mental status changes may be related to another underlying condition, or be something separate like Alzheimer’s disease or stroke.

I would recommend that he have a thorough evaluation, including physical exam, blood tests, probably a chest x-ray, possibly some tests on his heart like electrocardiogram or echocardiogram, and possibly an evaluation by a neurologist for his mental changes and choking. I would also recommend that you go with him so you can talk with his doctor(s) and get all your questions answered.

ML

[Editor’s comment: Bring along a copy of this question and answer with you when you visit with the doctor, and definitely call ahead of time to explain your concerns to the doctor or nurse. If he truly has lost the ability to drive without getting lost, as you state, a neurologic evaluation seems essential, and I’d definitely suggest you contact the doc and be sure that the doc knows of this! Hopefully, the physician has checked out the possibilities mentioned above, and can give your father and you some answers.

Of course, your father has to give his permission for you to be present, but I assume that that will not be a problem. (If your father does refuse to allow you to participate in his health care, things could become more difficult, but it’s still worth notifying the doc of your dad’s confusion.)

WWQ]