Navigating My Mother’s Health Decline
I’m reaching out for guidance on how to engage with my mother’s primary care physician (PCP) and what information to seek out. My mother is on a managed care plan, yet her symptoms continue to deteriorate, rendering her nearly unable to consume food. **Current Challenges:** My mom has recently experienced a significant increase in numbness in both her arms and legs, along with severe pain in the muscles of her inner thighs. She is plagued by persistent coughing spells and has lost her appetite drastically, averaging fewer than 600 calories daily. Notably, she struggles even with rice, which sometimes leads to vomiting. Additionally, her water intake has significantly decreased. Despite regular visits to her PCP, she feels dismissed, as her recent blood tests showed no concerning issues, and she was advised to return home. This lack of nourishment has resulted in a weight loss of over 20 pounds in less than three months, dropping from a starting weight of 120 pounds. Movement is now limited for her; she can barely walk from one end of the living room to the other due to weakness and continuous coughing episodes throughout the day. **Medications:** Currently, she is prescribed sodium chloride tablets to address a previous sodium deficiency, Zoloft at a 25mg dosage to assist with sleep, and Gabapentin at 100mg for the numbness in her extremities. She also has a medication for bowel issues, though I can’t recall its name, which she takes only when she has not had a bowel movement for three days. **Duration of Symptoms:** These health concerns have persisted since May 15, 2025, spanning approximately four months. **Upcoming Specialist Appointment:** Next week, she has an appointment with a pulmonologist to go over the results of a PET scan related to a nodule found in her right lung. **Background Information:** In May, my mother was diagnosed with SIADH. She fainted twice post-hospital discharge, likely due to her low sodium levels. The incidents occurred on June 19 and again in August. Both times resulted in hospital visits, yet fortunately, CT scans revealed no fractures or significant head trauma. Prior to May 2025, her health issues were limited to knee pain. In early May, she sought medical attention due to a sizable abscess located at the back of her neck, just beneath her hairline. After failing to improve, it was drained at the hospital. Following this procedure, she was prescribed sulfamethoxazole for antibiotics and wound care. However, a week later, she had a reaction and was treated with banophen for the rash, along with Keflex and methylprednisolone. A day later, she drove herself back to the hospital due to neurological distress, experiencing nerve pain that prevented her from finding comfort. After leaving against medical advice, she appeared disoriented the following morning and was subsequently readmitted for more than a week. During that time, doctors noted elevated troponin levels, indicating possible cardiac issues, alongside low sodium and high blood pressure. Upon my insistence regarding her numbness and dietary struggles, they conducted several imaging tests, but no clear diagnosis was established. Only a nephrologist addressed her low sodium concerns. Ultimately, after being treated for SIADH with tolvaptan, which she could not tolerate due to severe nausea causing further fainting episodes, she was switched to sodium chloride pills after a subsequent hospitalization in August. A concerning nodule (2.1 cm) was discovered in her upper right lung lobe during that stay, leading to a referral for a PET scan. The results hinted at possible neoplastic changes, but we await the pulmonologist's review next week for clarification on whether this indicates cancer or a benign growth. Since her hospital discharge following the second fainting episode, her ability to eat has rapidly declined, with her being unable to tolerate even simple foods like bananas and rice. She relies on Ensure for nutrition, as she does retain some hunger yet continues to struggle with sleep due to persistent pain and numbness in her limbs.
Answers (1)
9/11/2025, 9:21:11 AM
OpenHealth AI
I'm sorry to hear about your mother's health challenges; it sounds incredibly stressful for both of you. Given the complexity of her symptoms and her declining health, it’s essential to approach her care with a clear strategy when engaging with her primary care physician (PCP) and any specialists.
Key Points:
- Persistent Symptoms: Your mother is experiencing significant health issues, including severe numbness, pain, persistent coughing, and drastic weight loss.
- Nutrition Crisis: The low calorie intake (averaging fewer than 600 calories daily) is alarming and needs immediate attention.
- Upcoming Appointments: The appointment with the pulmonologist is crucial for understanding the potential impact of the lung nodule on her overall health.
Explanation:
Your mother’s combination of symptoms—numbness in extremities, muscle pain, severe coughing, and loss of appetite—raise concerns. These conditions suggest a potential neurological issue, respiratory problems, or medication side effects, particularly given her history with SIADH and the recent changes in her care plan. Her weight loss and inadequate nutrient intake are also concerning and need prioritization.
Next Steps:
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Gather Information:
- Before the upcoming pulmonologist appointment, prepare a list of all her symptoms, including the severity and duration. Document any side effects from her medications, and note how these have affected her daily life.
- Collect and organize medical records that detail her health history and recent test results. This will help the pulmonologist provide a comprehensive assessment.
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Communicate with Her PCP:
- Schedule a dedicated meeting with her PCP if possible to discuss her ongoing nutritional struggles and weight loss. Clearly express your concerns about her low caloric intake and ask about potential causes and solutions.
- Inquire about the appropriateness of current medications and whether alternative treatments or additional therapies could improve her symptoms.
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Consider Nutritional Support:
- Since she’s currently having difficulty eating, explore high-calorie nutritional supplements like Ensure or consider discussing with her doctor the need for a referral to a dietitian who specializes in managing complex dietary needs. This can help tailor her intake for better nutrition while managing her symptoms.
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Monitor Symptoms:
- Keep a daily log of her symptoms, appetite, and any side effects from her current medications. This data can be vital for her PCP and specialists to adjust treatment effectively.
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Follow-Up on Specialist Appointments:
- Ensure to address any findings from the PET scan with the pulmonologist, especially given the potential implications of the lung nodule. Ask the doctor to clarify whether further diagnostic tests or immediate interventions are required based on the results.
In these situations, constant communication between you, your mother, and her healthcare team is critical for addressing her needs effectively. It can also help to inquire about support services, such as counseling or community health resources, that might offer additional assistance through these challenging times. Remember, your mother's comfort and quality of life are paramount; don't hesitate to advocate strongly for her needs.
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