Dr. Rajesh Gulati
Family Physician
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,
I am a guardian and caregiver for my 92-year-old mother. She is altogether in fair to good shape. She is oriented, and has excellent mental acuity but has notable short-term memory issues. She walks with the use of a walker but would be challenged to walk beyond (very roughly) 50 meters. She has been complaining for the last few months of weakness in the morning and has attempted to increase blood pressure in the morning with salty snacks (effectiveness not clear) and increased movement (mostly resisted). She recently suspected a urinary tract infection but the main symptom was decreased urine output. Laboratory tests were ordered (urine sample plus blood draw) but due to administrative error, the urine test was not performed. Laboratory results can be found listed under 12/18 in the attached health summary.
Anemia is a known problem for her and is supported by recent laboratory work (at least as a layman, that is my interpretation). Would that by itself explain the low energy in the mornings and what can be done? Does this feel like diabetes? And if so, how serious are the risks and what are the next steps? Is there anything else that pops out to you from these results and records? Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern. These are expected symptoms at this age, she is doing much better than her peer groups. She should take multivitamins, vitamin D, vitamin B12, and vitamin C supplements. She should do daily light exercises as per her comfort and capacity. I would suggest you repeat the urine culture test to rule out the current infection.
I hope this helps you.
Thank you.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
Could you please explain why the vitamin D, B12, and C supplements are required? I am sure you are right, but would like to understand the reasoning. Also, could you comment directly on diabetes and anemia? I will get her urine culture done.
Thank you.
Hello,
Welcome back to icliniq.com.
Vitamin D and B12 deficiencies are very common in this age group and are the most common reasons for weakness. If you want, you can check these levels before starting. Vitamin C supplements are very good for muscles and checking its level is not needed. I could not get iron levels, if these are low she should get iron injections done. Oral supplements are very slow to work. Also, I could not get the HbA1c (hemoglobin A1c) level. If its level is more than 7, she should take oral sugar medications.
I hope this helps you.
Thank you.
Regards.
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