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Suggest Remedy For Profuse Sweating, Cough And Chills In A Diabetic
Question: My 75 year old husband woke up with emesis with coughing, then bowel movements x5 that were overdue, chills and sweating. He is diabetic, on insulin and oral meds, CHF with defibrillator and meds from cardiologist. Sugar blood level OK. Weak. Your thoughts? He does not have an internist. Refuses to add another MD to my dismay.
Brief Answer:
Watch full hydration, pantoprazole plus anti emetic, decrease diuretic.
Detailed Answer:
Hello , I am Dr Mody and I will be addressing your concern.
Firstly I would like to ask whether he did have a m bad meal (outside food, XXXXXXX Chinese or dairy products) in last 2 days.
Many a times the chills may happen due to the vomiting and increased bowel movements.
Tylenol is safe to give considering so many Co- morbidity, however it will not help much.
The weekend is due to loss of electrolytes and , however considering that he already suffers from CHF, supplementation a lot of fluid is not wise, at the same time we should make sure he is not dehydrated.
I would recommend.
To take pantoprazole 40 mg/ esomeprazole 40mg and emset 8mg which are both over the counter medication and will take care of nausea / vomiting.
As soon as he can tolerate orall, soft diet and oral rehydration solution is advised, or home liquids like juices, soup, coconut water is advised.
Going a little low on the diuretic he is on considering his CHF would be good.
Strictly keep a balance on his input and output, and inform if there is any fall in urine output
Keep measuring the blood pressure if you have a machine. ER call if it's on lower side persistently.
If there was any pus / blood / blackish stools than we should should consider dysentery and with an antibiotic is recommended. Ciprofloaxin / metronidazole would be a good combination .
Ideally I'd things don't settle in a day by 8 hours, Consult a physician so he can examine the patient and after necessary investigation can chalk out a treatment plan.
Let me know if any clarification needed, I would be happy to help.
Regards Dr Priyank Mody
Watch full hydration, pantoprazole plus anti emetic, decrease diuretic.
Detailed Answer:
Hello , I am Dr Mody and I will be addressing your concern.
Firstly I would like to ask whether he did have a m bad meal (outside food, XXXXXXX Chinese or dairy products) in last 2 days.
Many a times the chills may happen due to the vomiting and increased bowel movements.
Tylenol is safe to give considering so many Co- morbidity, however it will not help much.
The weekend is due to loss of electrolytes and , however considering that he already suffers from CHF, supplementation a lot of fluid is not wise, at the same time we should make sure he is not dehydrated.
I would recommend.
To take pantoprazole 40 mg/ esomeprazole 40mg and emset 8mg which are both over the counter medication and will take care of nausea / vomiting.
As soon as he can tolerate orall, soft diet and oral rehydration solution is advised, or home liquids like juices, soup, coconut water is advised.
Going a little low on the diuretic he is on considering his CHF would be good.
Strictly keep a balance on his input and output, and inform if there is any fall in urine output
Keep measuring the blood pressure if you have a machine. ER call if it's on lower side persistently.
If there was any pus / blood / blackish stools than we should should consider dysentery and with an antibiotic is recommended. Ciprofloaxin / metronidazole would be a good combination .
Ideally I'd things don't settle in a day by 8 hours, Consult a physician so he can examine the patient and after necessary investigation can chalk out a treatment plan.
Let me know if any clarification needed, I would be happy to help.
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your reply. It came after we left for ER. My husband was in septic shock. Gallbladder infection in the blood stream. Now on dialysis and drips for very low blood pressure hoping to have the gallbladder removed if he's strong enough on Monday. Amazing how rapidly it put him at risk.
Brief Answer:
SUpport of all organ system, till infection is cleared will be the plan.
Detailed Answer:
It was a good call for timely admission.
Congestive heart failure, is a low immunity state, so even a small infection can rapidly spread, the reason I suggested an antibiotic if slightest hint.
It is a good decision to support the kidneys till the infection is cleared with the help of antibiotic.
If the while blood cells counts and infection makers like CRP is on decreasing trend, than mostly he should come out if the crisis.
The blood pressure is on lower side due to sepsis, septicaemia increase the need of body oxygen which his weak heart would not be able to sustain ( hence need of medication to maintain blood pressure). So optimum support of all the vital organs, is required till the time antibiotics may take care of the infection, which I think Is being done for him.
Removal of gall bladder would be the definitive cure
Let me know if you have any doubt during the time frame till recovery , and I would be happy to help.
Wishing him the best of health and early recovery.
Regards Dr Priyank Mody
SUpport of all organ system, till infection is cleared will be the plan.
Detailed Answer:
It was a good call for timely admission.
Congestive heart failure, is a low immunity state, so even a small infection can rapidly spread, the reason I suggested an antibiotic if slightest hint.
It is a good decision to support the kidneys till the infection is cleared with the help of antibiotic.
If the while blood cells counts and infection makers like CRP is on decreasing trend, than mostly he should come out if the crisis.
The blood pressure is on lower side due to sepsis, septicaemia increase the need of body oxygen which his weak heart would not be able to sustain ( hence need of medication to maintain blood pressure). So optimum support of all the vital organs, is required till the time antibiotics may take care of the infection, which I think Is being done for him.
Removal of gall bladder would be the definitive cure
Let me know if you have any doubt during the time frame till recovery , and I would be happy to help.
Wishing him the best of health and early recovery.
Regards Dr Priyank Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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