Suggest Treatment For Cholesterol, BP And Depression

Posted on Mon, 12 Oct 2015

Question: Dad is 94 and a great case study. He still remembers what went on back "in the old country". Walks with a cane and has a few issues. Has a small stroke a few years ago which left him with the cane for balance. Only in the past 10 years has he begun taking medication. Cholesterol, blood pressure, anti depressant,Folic acid, foxomax and Vesicare. He drinks 2 cups of decaf a day and about 3 16oz bottles of water, mostly with his medication. Doctor says to cut the water because he is low in sodium. I do not think he is drinking too much and am concerned of him getting a UTI if he is not having enough fluid. Would you suggest Gatorade or adding salty foods to the diet instead of limiting the fluid? Thank you for being available.

Answered by Dr. Praveen K Nath (1 hour later)

Brief Answer:
LOW SODIUM - GIVE SALT WITH WATER INTAKE

Detailed Answer:
Dear sir,

At the outsent I wish your dad a speedy and complete recovery. I have gone through his medical history in detail and understand he is on regular medication for hypertension, anti depressants and high cholesterol. If he has low sodium then I think it is right to evaluate the cause of low sodium. Perhaps his physician or nephrologist will be able to do that. Until then

1. He should increase his sodium salt intake, BUT in measured amount. I would prefer adding extra amount of salt with his doctor's permission instead of gatorade.

2. He can continue with increase water intake only if his heart / kidneys are ok. Without details about his heart and kidney I am not sure why he is asked to limit fluid intake. Perhaps you may want to discuss about it too while you visit his doctor again.

3. It is important to keep a regular watch on serum sodium and renal function tests at this age.

4. Mild increase in blood pressure due to increased salt intake may be managed with mild increase in anti hypertensive medication .

5. I did not find serious risks of UTI from the history provided. Morever UTI can be treated with antibiotics SOS

Hope this answers your querry
Feel free to contact me any time

Dr XXXXXXX k XXXXXXX
Director
Deptt. of neurosurgery

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Praveen K Nath (12 hours later)

His cardiologist says his heart is amazing and he does not show signs of renal failure according to the doctor. That is why I was shocked to hear the doctor said to reduce his fluid intake. Unfortunately dad will go to the extra length of now saying no when offered fruit because he is concerned of the fluid intake.
Dad has had about 3 UTI's over the past couple of years. Could this be attributed maybe to his lack of wanting to change his diaper that he wears because of occasional leakage or urgency to get to the toilet and not enough time. I was thinking of having him put in a pad which is easier to swap out during the day.
We will add some salty items to his diet. The only reason the doctor said to decrease his water intake was due to his low sodium. I am trying to get Dad and my brother on board to switch to a geriatric doctor. This is not easy as they both do not like change.

Answered by Dr. Praveen K Nath (13 hours later)

Brief Answer:
low sodium give calculated salt intake

Detailed Answer:
Dear sir
Hello
Wishing a complete recovery to your dad .
It,s good that his CARDIAC and RENAL functions are ok.
He can very well have more water along with calculated intake of salt .
Calculated means we need to monitor INTAKE/OUTPUT CHART and REGULAR SERUM SODIUM levels check up .
For UTI you can add some urinary antibiotic SOS .
You can very well manage with DIAPERS .
Geriatric doctor is always preferrable

Thanx
Hope this answers your querry
Feel free to contact me for any further querry

Dr XXXXXXX k XXXXXXX

Note: Get a consultation booked to know more about aging related medical issues. Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina