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How Can GERD With Excessive Burping Be Treated?
Question: My father's medical record:
1978: Removal of stones form the gall bladder
2000: Total prostate gland removal because of appearance of cancer
2008: Invasive surgery to fixed asymptomatic abdominal aorta aneyrism
2011: MRI BRAIN scan revealed 2-3 deteriorate cells due to age. He took aricept 5mil for some months.Due to vivid dreams and other symptoms the neurologist diagnosed Lewy body dementia. However my father was fully functional and independent. He walked every day. he was able to drive, and he was 100% sane in conversation, and fully functional.
2013:July 2013 my father had a big shock after losing most of his money in bank bankruptcy.He fell down and broke his left hip. He was operated with total sedation (not epidural).
When he came out of the surgery room he was in complete confusion for many months and since then he has mobility problems like parkisonian shuffle and stiff joints. He was sen by a neurologist who said that the post surgery cognitive decline was probably due to worsening of Lewy body dementia.Was it the sedation that cause this damage??????????
Since then my father is taking the following medications:
Seroquel 25
Cretanil 1mg
Aricept 10
Clonotril 0.5 twice a day
2016: In May 2016 my father fell and broke his other hip flexor. He was operated with epidural sedation this time. Since then he has not recovered. He cannot walk,he has very low understanding of his suroundings, does not eat and apparently he is very aggressive. Very often he punches/hits caregivers something that he did not do before 2016. He has also GERD AND RECENTLY HE HAS BeeN BURBING A LOT ACCOMPANIED WITH PHLEGMS.
I would appreciate if you could advise us on how to help my father improve!
Regards XXXX
1978: Removal of stones form the gall bladder
2000: Total prostate gland removal because of appearance of cancer
2008: Invasive surgery to fixed asymptomatic abdominal aorta aneyrism
2011: MRI BRAIN scan revealed 2-3 deteriorate cells due to age. He took aricept 5mil for some months.Due to vivid dreams and other symptoms the neurologist diagnosed Lewy body dementia. However my father was fully functional and independent. He walked every day. he was able to drive, and he was 100% sane in conversation, and fully functional.
2013:July 2013 my father had a big shock after losing most of his money in bank bankruptcy.He fell down and broke his left hip. He was operated with total sedation (not epidural).
When he came out of the surgery room he was in complete confusion for many months and since then he has mobility problems like parkisonian shuffle and stiff joints. He was sen by a neurologist who said that the post surgery cognitive decline was probably due to worsening of Lewy body dementia.Was it the sedation that cause this damage??????????
Since then my father is taking the following medications:
Seroquel 25
Cretanil 1mg
Aricept 10
Clonotril 0.5 twice a day
2016: In May 2016 my father fell and broke his other hip flexor. He was operated with epidural sedation this time. Since then he has not recovered. He cannot walk,he has very low understanding of his suroundings, does not eat and apparently he is very aggressive. Very often he punches/hits caregivers something that he did not do before 2016. He has also GERD AND RECENTLY HE HAS BeeN BURBING A LOT ACCOMPANIED WITH PHLEGMS.
I would appreciate if you could advise us on how to help my father improve!
Regards XXXX
Brief Answer:
Dementia most likely but would advise imaging.
Detailed Answer:
I read your question carefully and I understand your concern. I also reviewed the reports that you kindly sent.
Judging from that account I would say that the most probable cause for his current condition is dementia. It is true that in the 2011 MRI there are only mild changes but 6 years have passed since then and dementia whether Lewy body, Alzheimer's or other types is a progressive condition. It is very common for patients to experience deterioration of symptoms after surgery for other conditions, even when not related to the brain. Hip surgery in particular has very commonly been related with delirium and worsening of dementia (partly due to anesthetics, but also due blood loss, stress and change of surrounding environment etc), and further rehabilitation and mobility is much more affected.
However while I think that is the most probable cause I still think another imaging exam would have been advised given the quick deterioration. That is because such a sudden worsening may also be in the setting of a stroke, not only dementia. So I think brain imaging should be scheduled. Not saying that it will reverse things, but at least make some clarity and if there was a stroke to take preventive medication to avoid future ones.
If imaging is normal to the current medication I would try to add memantine which is used in addition to Aricept for moderate or severe cases of dementia (more effective for Alzheimer's, but used in other types as well). As I said dementia is a progressive condition, memantine is not a cure, but may bring some mild temporary benefit.
I remain at your disposal for other questions.
Dementia most likely but would advise imaging.
Detailed Answer:
I read your question carefully and I understand your concern. I also reviewed the reports that you kindly sent.
Judging from that account I would say that the most probable cause for his current condition is dementia. It is true that in the 2011 MRI there are only mild changes but 6 years have passed since then and dementia whether Lewy body, Alzheimer's or other types is a progressive condition. It is very common for patients to experience deterioration of symptoms after surgery for other conditions, even when not related to the brain. Hip surgery in particular has very commonly been related with delirium and worsening of dementia (partly due to anesthetics, but also due blood loss, stress and change of surrounding environment etc), and further rehabilitation and mobility is much more affected.
However while I think that is the most probable cause I still think another imaging exam would have been advised given the quick deterioration. That is because such a sudden worsening may also be in the setting of a stroke, not only dementia. So I think brain imaging should be scheduled. Not saying that it will reverse things, but at least make some clarity and if there was a stroke to take preventive medication to avoid future ones.
If imaging is normal to the current medication I would try to add memantine which is used in addition to Aricept for moderate or severe cases of dementia (more effective for Alzheimer's, but used in other types as well). As I said dementia is a progressive condition, memantine is not a cure, but may bring some mild temporary benefit.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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