Hello doctor,
Your advice has been very valuable. I am greatly astonished at the exactness of your listing of my mother’s other symptoms that I have not narrated to you. You are one of the best physicians I have come across. She indeed has severe constipation. She has good presence of mind and she has somehow discovered the cure for constipation all by herself. She insists on eating plantain fruits every day, and I happily give her at least six fruits every day without fail. She also asks for several glasses of hot water, preparatory to her emptying of bowls. Unfortunately, she empties her bowels on alternate days only. Now that you named constipation as one of the reasons for delirium, I remember that days when she has a free and complete discharge from her bowels, her disturbances are relatively mild.
Your listing of symptoms for delirium perfectly matches my mother's. She always searches for something in the bed, under the bed, on the floor, on the shelves. She will not allow a bedsheet or pillow to remain in their place. She carries them with her as she leaves the bed. Often she picks some small unseen objects from her other palm and eats them. She picks floor mats and misplaces them. Fortunately, she sees no insects or snakes. She goes in front of the full-length mirrors, makes gestures at her reflection, and talks to it. She had never failed to recognize a family friend or acquaintance. Her memory of the remote past is excellent. She recognizes and remembers political leaders on TV. Even when she has delirium, restlessness, or agitation, she returns to normal immediately when she is accosted or addressed by someone. She sees and talks to persons who are not present. Sometimes she goes on weeping for hours for no apparent reason at all. She hates to remain quiet. She will not lie down on the bed even if she drops her head in drowsiness.
Over the years, she has also developed some small semi-spherical projections of a 1 cm radius and about 0.5 cm height on the head just above the forehead.
Could you please enlighten me on the following:
1. How is intracranial pathology done? I mean, how is the bioptic sample collected? Does it involve incision or penetration of any kind into the head? The doctor advised us to do the intracranial pathology at the RCC, hence the delay. Can it be done reliably at private laboratories? Does it require hospitalization?
2. Please give me a detailed prescription for all the necessary tests, including one for intracranial pathology.
3. Could you please prescribe some harmless medicines for constipation for continued use?
It will be very kind of you if you provide early and detailed advice.