Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 69-year-old mother constantly makes cooing sounds like a pigeon throughout the day. She says she has not passed urine and stools for the last two days. From two years, she has not been keeping good health. Two years ago, she started complaining of stomach pain. We got her admitted to the hospital twice. Current medications list is attached. We got her an endoscopy, colonoscopy, a positron emission tomography (PET) scan, and a computed tomography (CT) scan of chest and abdomen done. Doctors say there is no major problem. No malignancy. However, she has lost a lot of weight almost 33.07 lb. She does not want to eat. Please advise
Hello,
Welcome to icliniq.com. I have gone through the attachments (attachment removed to protect patient identity). Her symptoms could be related to a psychiatric disorder called dementia with psychotic signs. For this reason, I would suggest increasing the dose of Quetiapine to 50 mg daily. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. You should discuss with her psychiatrist about this. Regarding her stomach complaints and loss of weight, I would recommend performing some tests: A chest X-ray. An abdominal ultrasound. CEA (carcinoembryonic antigen), CA (cancer antigen) 19.9 levels. Thyroid hormone levels. Stool analysis
Patient's Query
Thank you doctor,
However, I would like to inform you that we have very recently done a chest, abdomen and a pelvic scan. I have also attached thyroid and other blood reports. I would request you to review the same.
Hello,
Welcome back to icliniq.com. I have gone through the attachments (attachment removed to protect patient identity). I reviewed carefully her uploaded tests and would explain that it is necessary performing a fibrogastroscopy (if she has not performed it yet) to examine her stomach better considering the thickening in the CT (computed tomography) scan report. Her thyroid hormone levels are fine but she has dyslipidemia and it is necessary to continue taking a statin to lower her cholesterol levels. She has also high HbA1c (glycated hemoglobin) levels which are indicative of diabetes. You should consult about this with her doctor. She has high sedimentation rate which is indicative of inflammation. Coming to this point her hallucinations and the negativity the fact that she does not want to eat could be the cause of theloss of weight. Anyway, increasing the dose of Quetiapine could help improve her appetite and gain some weight. Consult your specialist doctor, discuss with him or her and with their consent take the medicine.
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Neurology
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