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Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 8751
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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My 89yrs old mum (Dementia)has been sent to hospital 4 times

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My 89yrs old mum (Dementia)has been sent to hospital 4 times since xmas. Having been diagnosed with urine infection, chest infection, each time after various examinations x rays she has been sent home the same day. A week last Friday we discovered she had a prolapse. Last Friday she was examined and taken to hospital for the prolapse when checking her bloods she was then diagnosed with a clot in her leg. She is scheduled for a scan tomorrow. On visiting her yesterday I found her tummy to be twice the size from a few days earlier. She is in extreme discomfort, (her breath smells like a sewer) finding it so difficult to move at all, with the dementia it is so difficult to get a true answer re her conditions. They say when she has scan she will be treated accordingly returned to nursing home and doctor will have to re refer her for the prolapse. What questions should I be asking to ensure she is getting the best treatment?
Hello and thanks for your question. I'm Dr. Hasan and I'll try to help you. I am really sorry to hear about her problem. She has two major problems right now. One is the prolapse and other is big tummy. Prolapse will be managed later because big tummy and her blood clot are major problems to be addressed. Big tummy is most likely due to the fact that she is retaining fluids in her body. There can be three major causes for that; Her heart, liver or kidneys. Bad breath can be related to kidney failure. So you should be asking your doctor that what exactly is the cause for that big tummy and for that she should have the following investigations.

1. EKG.
2. ECHO (heart ultrasound)
3. Abdominal ultrasound
4. CT scan of abdomen including liver
5. Blood complete examination
6. Liver function tests
7. Kidney function tests
8. PT/APTT and INR
9. Urine R/E
10. Blood sugar and electrolyte levels
11. Xray Chest

If there is fluid retention, are they going to remove it with ultrasound guidance through abdomen or by giving water pills or injection.

Will she be on those water pills for ever or for short term.

Regarding blood clot, you should be asking your doctor about her INR value because that is something which needs to be monitored.

Lastly ask about her co morbid conditions. Make sure that she is being seen by an internal medicine specialist and later on according to the cause, she will need gastroenterologist, cardiologist or a nephrologist.

For pain management, narcotic pain killers are best for her provided other parameters allow because pain killers like ibuprofen and naproxen are not good for her as she must be on treatment for blood clot and this puts her at more risk of bleeding.

I hope i have given you an overview. I wish her good luck and that she gets well soon. My goal is to provide you with excellent service – if you feel you have received anything less, please reply back as I am happy to address follow-up questions. Kindly rate me when you are done. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.
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