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What Causes Lethargy And Severe Vomiting After Travelling In An Elderly Person?
Question: We returned from a 12 day excursion (first 7 days on a cruise ship, last 5 on land) to Alaska. My husband has been sleeping since our return with few periods of wakefulness in between. Today he has slept all day and is now vomiting. He is 72 years old, has high blood pressure and diabetes, neither of which is controlled. He has not eaten since last night at which time he had a hamburger, but I think that is all he ate all day long. Although I think he is sleeping, it may just be lethargy, too. Do I need to take him to the emergency room?
Brief Answer:
I think you should take him to the ER
Detailed Answer:
I read your question carefully and I understand your concern.
Given his age and risk factors such as high blood pressure and diabetes he is someone at risk for issues such as stroke. While more typically presenting with weakness of the limbs on one side, there are stroke types, mainly affecting posterior areas of the brain, which can manifest with vomiting and lowered level of consciousness.
So I believe in this setting you should take him to the emergency room for evaluation on that regard.
Regarding other possibilities apart from stroke, given the diabetes diagnosis a metabolic abnormality such as very high or low blood glucose, electrolyte alterations must also be considered through blood tests in the ER.
Let me know if I can further assist you.
I think you should take him to the ER
Detailed Answer:
I read your question carefully and I understand your concern.
Given his age and risk factors such as high blood pressure and diabetes he is someone at risk for issues such as stroke. While more typically presenting with weakness of the limbs on one side, there are stroke types, mainly affecting posterior areas of the brain, which can manifest with vomiting and lowered level of consciousness.
So I believe in this setting you should take him to the emergency room for evaluation on that regard.
Regarding other possibilities apart from stroke, given the diabetes diagnosis a metabolic abnormality such as very high or low blood glucose, electrolyte alterations must also be considered through blood tests in the ER.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you . That was how I was leaning. It will, however, be difficult to get him to go.
Brief Answer:
Read below.
Detailed Answer:
You're welcome. I imagine if he's somnolent it would be difficult to take him there. But in that case you shouldn't risk it alone but call an ambulance. The paramedics would also be able to measure his vitals and glucose level, will be able to start treatment right away in case of extreme glucose levels.
Also if he's not alert and has been vomiting, attention should be paid to protecting his airways from aspiration so that is another reason to call them.
I remain at your disposal for other questions.
Read below.
Detailed Answer:
You're welcome. I imagine if he's somnolent it would be difficult to take him there. But in that case you shouldn't risk it alone but call an ambulance. The paramedics would also be able to measure his vitals and glucose level, will be able to start treatment right away in case of extreme glucose levels.
Also if he's not alert and has been vomiting, attention should be paid to protecting his airways from aspiration so that is another reason to call them.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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