My mother was admitted to neighbouring hospital after falling due to slippage on floor. She is 72 years old and type 2 diabetic with controlled diabetes 150/200 with glimestar 1 mg 2 pills per day for last 15 years. It was observed on MRI that a compression fracture on back bone and two small cracks on pelvic bone. During traction and physiotherapy she exhibited severe shortness of breath and doctor carried out sonography and found some abnormality of the sort enlargement of heart. Upon pulmonary angiography bilateral pulmonary embolism was observed. Suddenly the other treatments stopped and some blood thinning medication under critical observations for 5 days conducted. Later she was brought to ward and two days was in observations and discharged suggesting if possible to walk 10-20 steps and increase slowly wearing proper belt. Initially she was only able to stand with support and walk only 2-3 steps with great difficulty. Normal diabetes medicine and daily 1 tablet of warfarin was prescribed. The major problem after discharge observed was her reluctance to swallow sufficient food and water. With great difficulty only juices, milk with energy drink, dal rice smashed was accepted only in limited quantities with reason of tasteless in mouth and vomiting sensations. All the food given was not swallowed to full extent, instead kept in mouth and she use slowly split the same after some time. Standing on her feet was also not possible and she was reluctant even to her moving on bed itself for frequent change of position. Sugar level increased to 200/300 and the tablet increased to 2 mg. Meanwhile blood was observed in urine and upon test Warfarin was stopped for 10 days. Within next 2-3 days, urine turned to white and upon /urine test /infection was detected and antibiotics prescribed. But the very next day the infection became severe as she was observed very uneasy. Upon hospitalization once again, she is kept in intensive care with antibiotic treatment and signs of improvement observed but the problem of tasteless in mouth is concern. At present the food is being fed through pipe in nose. We are very much worried about the future as without proper food, there is no scope of survival. Can you please help how to come out of such dreadful situation?
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Hi Any patient in the ICU needs few important things to recover faster. 1. Good nutrition: Though she is on feeding tube, you can give her high calorie drinks through the tube and not just milk or kanji. A good dietician will help you in calculating the right calorie intake for her. 2. Good Physiotherapy: Atleast 30min of physiotherapy a day will keep them active and prevent bed sores with frequent change of posture. 3. Good care with medications as prescribed and lots of love. Keep the patient engaged and do not leave them alone especially when they are at home with all these ailments. Encourage them to eat small feeds but at frequent intervals. Too many oral medications leave a bad taste in the mouth which will slowly improve with time as the medications will be reduced. If there is an ongoing infection and a risk of repeated infections, insulin would be best. By this we can avoid unnecessary fluctuations in her blood sugar as she is not eating well and also prevent any further infections. Once she is better we can switch her over to oral tablets for diabetes.
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Please go to insulin treatment .also blood thinners should be taken. Please take help of some good neurophysician and diabetologist. Any guide you want I can help you.
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