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What Do My Lab Test Reports Indicate?
Posted on
Fri, 21 Apr 2017
Fri, 21 Apr 2017
Answered on
Fri, 12 May 2017
Last reviewed on
Question : My dad xxxxxxxxxxxxxx a good Samaritan man, was a healthy, athletic strong man and always fun to be around. He started dealing with diabetics when he became around 50 years old and he started taking insulin around 60 years old, In 2013-2014 when he was turned in to 64 one day his sugar was high and we decided to take him to ER, Doctors did some exams and took him to CAT scan and MRI they believed that there are some twisted artery so they recommended Quadruple bypass heart surgery to prevent him from possible heart attack, surgery was proceeded. He was prescribed with more than 12 different medications hydralazine, lisinopril, Aspirin, Coumadin, amiodarone, Potassium, Lasix, Miralax, amlodipine, Tegretol, Insulin, Pravastatin, Ativan...etc. the Medications were not very friendly with my dad he struggled with them I guess he didn't like when he was getting dizzy or sleepy after 1 year of taking those Medication one day he fell down from his little garden he put together and broke his Hip, we had to take him back to surgery for the hip replacement, 2 weeks after surgery while he was still in the therapy rehabilitation he fell again, and broke the same hip! Doctors took him back to the surgery and proceeded a second surgery and the surgery lasted around 8 hours, when he came out he was talking strange sometimes he couldn't even finish the sentence and he was having a huge memory delay in the 1970s and my mom was told by the doctors that he should be fine after 3-6 months, the prescriptions added up to 17 medications. hydralazine, lisinopril, Aspirin, Coumadin, amiodarone, Potassium, Lasix, Miralax, amlodipine, Tegretol, Insulin, Pravastatin, Ativan, Haldol, Seroquel, Risperidone ...etc. Right now he is confused, my mom has to clean him because he doesn't think straight he also has a difficulty with speaking, he cannot walk and aggressive it’s been almost 2 years like that, we have taken him to several doctors every doctor we visited subtract and add a different set of Medications, at some point we had multiple medications with different names, Currently my dad is under treatment in a enforced psychotics rehabilitation for some kind of aggressive behavior and they told us that he may be dangerous being around my mom! I asked the psychiatrist who's seeing the patients in that facility, what is the treatment process? he said they have increased the Seroquel dosage by 3X and he said my dad is good when he is a sleep but when he is awake he would get aggressive again, and now he said he will focus on Risperidone for two more weeks and he will continue increasing the dosage until he can see some result.
My humble request from the Almighty God is help and cure my dad by connecting him with one of you great Doctors.
My humble request from the Almighty God is help and cure my dad by connecting him with one of you great Doctors.
Brief Answer:
More information is needed.
Detailed Answer:
I read your question carefully and I understand your concern about your father. I will provide my honest opinion but not every neurological condition can be reversed and of course recommendations here should be discussed with the doctors taking care of him.
It is difficult to get a complete picture of what has happened as there are some unclear points.
Apart from prescribing drugs, what was the doctor's opinion on the cause of this mental deterioration? Psychiatric conditions do not appear at that age out of the blue, usually there is an underlying neurological cause. Did they think it was in the setting of dementia, stroke or some other cause?
What imaging tests has he had when his mental status started to change, you mention CT and MRI but not their findings and they were done before the worsening anyway it seems. Without knowing the cause it is hard to make any recommendations on whether it is possible to do something about it.
That list of drugs you mention is really impressive (not in a good way). Do you mean that he took all of them at the same time or at different periods. Were Aspirin and Coumadin taken together? Those are both blood thinners and are not usually used together, that would increase the risk of hemorrhages, including brain bleeds.
What about Tegretol, Ativan, Haldol, Seroquel, Risperidone? Those drugs all act on the central nervous system. Their use may justify the confusion and inability to take care of himself, it doesn't seem plausible for them all to be used together.
Please let me know something more on those points, so that we can later discuss on possible steps.
More information is needed.
Detailed Answer:
I read your question carefully and I understand your concern about your father. I will provide my honest opinion but not every neurological condition can be reversed and of course recommendations here should be discussed with the doctors taking care of him.
It is difficult to get a complete picture of what has happened as there are some unclear points.
Apart from prescribing drugs, what was the doctor's opinion on the cause of this mental deterioration? Psychiatric conditions do not appear at that age out of the blue, usually there is an underlying neurological cause. Did they think it was in the setting of dementia, stroke or some other cause?
What imaging tests has he had when his mental status started to change, you mention CT and MRI but not their findings and they were done before the worsening anyway it seems. Without knowing the cause it is hard to make any recommendations on whether it is possible to do something about it.
That list of drugs you mention is really impressive (not in a good way). Do you mean that he took all of them at the same time or at different periods. Were Aspirin and Coumadin taken together? Those are both blood thinners and are not usually used together, that would increase the risk of hemorrhages, including brain bleeds.
What about Tegretol, Ativan, Haldol, Seroquel, Risperidone? Those drugs all act on the central nervous system. Their use may justify the confusion and inability to take care of himself, it doesn't seem plausible for them all to be used together.
Please let me know something more on those points, so that we can later discuss on possible steps.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response!
Yes all the medications I listed are currently on his chart I requested it last week and that's what they gave me, and this is despite the medication which was discarded prior to his last visit to the hospital which was two months ago. And yes I forgot to mention the results from MRI and CT scan we have performed those exams more than 3 to 4 times...every one of them came out negative and none of them show any kind of brain deterioration-or damage in any way, of causes this is all based on the feedback we are getting from the Doctors but because my dad's behavioral have been progressively aggressive and showing agitation therefore the Doctors continuously providing higher dosage of medications.
. Yes I totally agree with you and we believe that some of the medications contradicting each other and damaging his brain rather than curing him, I can request a copy of the images from the exam I you would like to see.
Yes all the medications I listed are currently on his chart I requested it last week and that's what they gave me, and this is despite the medication which was discarded prior to his last visit to the hospital which was two months ago. And yes I forgot to mention the results from MRI and CT scan we have performed those exams more than 3 to 4 times...every one of them came out negative and none of them show any kind of brain deterioration-or damage in any way, of causes this is all based on the feedback we are getting from the Doctors but because my dad's behavioral have been progressively aggressive and showing agitation therefore the Doctors continuously providing higher dosage of medications.
. Yes I totally agree with you and we believe that some of the medications contradicting each other and damaging his brain rather than curing him, I can request a copy of the images from the exam I you would like to see.
Brief Answer:
Read below
Detailed Answer:
Thank you for the additionl information.
The number of medication's he's under then is really huge. I do not agree with using 3 antipsychotics at the same time. I can understand that at times patients are difficult to control, but I would use the one and raise its dosage as needed, they are too many.
Tegretol is an antiepileptic, you do not mention seizures, so not sure why it's being used. Even if he's had seizures one would prefer something else, with less side effects and interactions. Tegretol alters metabolism of other drugs so not that suitable when patient is on many medictions.
The same for the use of both Aspirin and Coumadin, especially since you do not mention any stroke on imaging. Their use together while not responsible for the psychiatric changes puts him on a high risk for hemorrhage after an occasional hit. I really question that.
There are details which I am not aware of as an outsider, my colleagues may have very good reasons for their course of management, but they should sit down with you and at least try to explain better what the diagnosis is, for the moment it is unclear why his mental condition has deteriorated, you seem to have been left in the dark.
It might be difficult for you to upload all the images (an MRI alone may contain hundreds of images) but perhaps you could upload a copy of the written reports.
Read below
Detailed Answer:
Thank you for the additionl information.
The number of medication's he's under then is really huge. I do not agree with using 3 antipsychotics at the same time. I can understand that at times patients are difficult to control, but I would use the one and raise its dosage as needed, they are too many.
Tegretol is an antiepileptic, you do not mention seizures, so not sure why it's being used. Even if he's had seizures one would prefer something else, with less side effects and interactions. Tegretol alters metabolism of other drugs so not that suitable when patient is on many medictions.
The same for the use of both Aspirin and Coumadin, especially since you do not mention any stroke on imaging. Their use together while not responsible for the psychiatric changes puts him on a high risk for hemorrhage after an occasional hit. I really question that.
There are details which I am not aware of as an outsider, my colleagues may have very good reasons for their course of management, but they should sit down with you and at least try to explain better what the diagnosis is, for the moment it is unclear why his mental condition has deteriorated, you seem to have been left in the dark.
It might be difficult for you to upload all the images (an MRI alone may contain hundreds of images) but perhaps you could upload a copy of the written reports.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor is there any neurologist in XXXXXXX XXXXXXX XXXXXXX XXXXXXX please advise for evaluation visit? please advise
Brief Answer:
Read below
Detailed Answer:
Hello again!
Your question is a little difficult for me. This site enrols doctors from all over the world and I happen to live and exercise in Europe. So not that well acquainted with the US medical system, my knowledge would come from the internet.
I can recommend based on US hospital rankings two medical centers in XXXXXXX TX, which are Baylor University Medical Center and UT Southwestern Medical Center in XXXXXXX two of the highest ranked in XXXXXXX If it is names you need I could mention Dr XXXXXXX Black or Dr XXXXXXX Bachoo (the first affiliated with Baylor while the second with Southwestern.
Let me know if I can further assist you.
Read below
Detailed Answer:
Hello again!
Your question is a little difficult for me. This site enrols doctors from all over the world and I happen to live and exercise in Europe. So not that well acquainted with the US medical system, my knowledge would come from the internet.
I can recommend based on US hospital rankings two medical centers in XXXXXXX TX, which are Baylor University Medical Center and UT Southwestern Medical Center in XXXXXXX two of the highest ranked in XXXXXXX If it is names you need I could mention Dr XXXXXXX Black or Dr XXXXXXX Bachoo (the first affiliated with Baylor while the second with Southwestern.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One last thing if you could the facility right now asking for that report analysis based on what you have provided me and they want to know if they can compare to what they have. They said they would like to see the report based on your medication analysis to those medications and that way they can go from there
Brief Answer:
Read below
Detailed Answer:
I have read and reread your question several times but I am not sure what you're asking of me. Do you mean the facility would like to see a report from me? If that is what you mean I would say that is a little difficult with the limited information I have at my disposal thus far.
I mean going back to that list of medications there are blood pressure medications on which I can't comment not knowing any blood pressure values, diuretics and electrolytes without me knowing anything about blood test results, an antiseizure medication without any history of seizure being mentioned and without an EEG report, two blood thinners without any info on presence of heart arrhythmia or valve issues (where coumadin is needed), a statin without info on cholesterol values and to close several sedatives without any info on the type of psychiatric symptoms and interview (and no imaging reports or blood tests).
For the moment all I know is that your father has had a deterioration of his mental status, without any detail on any diagnostic test. So hard to make any confident recommendations based on that.
I would recommend removing Attivan, Haloperidol and substituting Tegretol with another antiepileptic (depending on seizure type - if necessary at all). Also I would reconsider the use of both Coumadin and Aspirin, if there is no heart arrhythmia or valve issues continue with Aspirin only, if there is a rhythm abnormality like atrial fibrillation then Coumadin or even better one of the new oral anticoagulants like Apixaban which have less interactions with other medications.
Read below
Detailed Answer:
I have read and reread your question several times but I am not sure what you're asking of me. Do you mean the facility would like to see a report from me? If that is what you mean I would say that is a little difficult with the limited information I have at my disposal thus far.
I mean going back to that list of medications there are blood pressure medications on which I can't comment not knowing any blood pressure values, diuretics and electrolytes without me knowing anything about blood test results, an antiseizure medication without any history of seizure being mentioned and without an EEG report, two blood thinners without any info on presence of heart arrhythmia or valve issues (where coumadin is needed), a statin without info on cholesterol values and to close several sedatives without any info on the type of psychiatric symptoms and interview (and no imaging reports or blood tests).
For the moment all I know is that your father has had a deterioration of his mental status, without any detail on any diagnostic test. So hard to make any confident recommendations based on that.
I would recommend removing Attivan, Haloperidol and substituting Tegretol with another antiepileptic (depending on seizure type - if necessary at all). Also I would reconsider the use of both Coumadin and Aspirin, if there is no heart arrhythmia or valve issues continue with Aspirin only, if there is a rhythm abnormality like atrial fibrillation then Coumadin or even better one of the new oral anticoagulants like Apixaban which have less interactions with other medications.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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