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My mother is 73. She currently takes the following. calcium…

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My mother is 73. She...
My mother is 73. She currently takes the following. calcium 600 mg. w/ D. Asprin 81 mg. Citrucel 2x's daily. Lopid 600 mg , Lovastatin 40 mg, Ferrous Sulfate 325 mg, Estradial 0.5 mg,Levoxyl .0112 mg. Also has a aortic Enuyresum plus asthma. She expierences vomitting 2-3 x's wkly. Weakness, loss of appetite. She want to sleep all the time. She refuses to accept that something is wrong. I know there is. Her Dr. says blood work says everything is fine. Where do we start looking for a solution???
Submitted: 8 years ago.Category: Medical
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Answered in 13 minutes by:
6/9/2010
Doctor: Dr. Arun Phophalia, Doctor replied 8 years ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 39,100
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

Greetings.

I fully agree to your concern. Vomiting, weakness and loss of appetite need further evaluation. The blood test may not reveal any abnormalities. Your need to proceed in following way;

1) She needs certain initial medical imaging; chest x-ray, ultrasound of the abdomen, and later on CT scan of the abdomen and/or brain.

2) A referral to internal medicine specialist who would review the medicines. Her medicines can be responsible for the symptoms (these can be the adverse effects/side effects of the medicine). She also needs a referral to the gastroenterologist for upper gastrointestinal endoscopy.

These would certainly be able to clinch the cause for her problem/symptoms.

Please feel free for your follow up questions.

Dr. Arun

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Customer reply replied 8 years ago
Her Dr. is a Internal Specialist. He is the one who ordered this medicaine and says there is nothing wrong. Due to Insurance he has to refer her to other dr's. He sees no need. Sorry to say this information was not very useful. We already thought the exact same thing you just told us
Doctor: Dr. Arun Phophalia, Doctor replied 8 years ago

Hello,

She needs a second opinion from another internal specialist. For her symptoms; there are only two possibilities;

1) She has some pathological process going in the body; in this case she would need further investigation. There is no other way we can detect the cause if there are no physical examination clues. Medical imaging will give guideline for the further work up. But she can have blood work like creatinine kinase which shows muscle problems due to medications, which I feel would may not have been done.

2) Medications; Ferrous Sulphate, citrusel and Estradiol can cause vomiting. Weakness can be caused by Lovastatin. There is a small bias for not considering the side effects as causative symptoms by the prescribing physician, so this is the reason for the suggestion of a second opinion.

Following are the main causes of vomiting and increased sleep in her age group;

A. Central nervous system

1) Space occupying lesion in brain (Mass lesion)

2) Labyrinthitis

3) Ménière's disease

4) Pseudotumor cerebri

B. Gastrointestinal symptoms;

1) Gastroparesis

2) Irritable bowel syndrome

3) Non ulcer dyspepsia

4) Peptic ulcer disease

5) Cholecystitis/cholangitis (gall bladder problems)

6) Hepatitis (liver inflammation)

C. Hormonal

1) Thyroid disorders; she is on the medications. But is it adequately controlled or she needs an endocrinologist opinion. The endocrinologist may also advice, if she needs estradiol.

2) Diabetes

3) Adrenal disorders

D. Psychiatry disorders

1) Anxiety

2) Depression

3) Conversion disorders

E. Infections.

All of these causes should be ruled out, one by one. till one is zeroed down.

It is pleasure and privilege assisting you.

Dr. Arun

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