Brief Answer:
Concentrate on diet - multiple meals

Detailed Answer:
Hi,
Thanks for asking.

I am Dr. Prakash HM and I will be answering your query.

Based on your query, my opinion is as follows:

1. It appears post cancer therapy, your appetite is reduced.

2. You are on a selective diet, assuming you are suffering from a malabsorption disease.

Based on the above, if you were my patient, I would advice as follows:

A. Need to evaluate for anemia and hypothyroidism. Due to cancer therapy and previous cancer induced cachexia and loss of appetite and chemotherapy, you need to get a hemogram to evaluate anemia and also a thyroid hormone levels to rule out hypothyroidism.

B. Your diet appears to be good, however, due to age related malabsorption, absorption of nutrients will be less. You need to take multiple adequate meals with good nutrition. I would suggest at least 6-8 meals per day. Liquid diet, fiber rich diet with fruits and veggies are essential.

C. Exercises improve metabolism and also appetite. You need to do moderate exercises like walking or cycling at least for twenty minutes, morning and evening.

D. Hydration is very important. Take good amount of fluids during day time. Avoid excess fluids after sundown to avoid disturbing sleep. More fluids will come out in urine and reduce risk of infection.

E. Sleep very important. Minimum 8-9 hours at night and regular timings is necessary.

F. Spending time with family and involvement in social activities will reduce stress and this will give a good feeling.

Get the tests done. If you have a recent ones, do let me know.

If tests are normal, you need to follow the above religiously. You need to eat well. Improvement in appetite is necessary.

You have gone through a stressful period. You need to do the above to improve yourself.
Need to stay active and avoid excess rest.

Any other test reports you have, do attach if you need to know anything else.

Hope it helps.

Any further queries, happy to help again.

Dr. Prakash HM

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Brief Answer:
Go for low dose cortisone with other composition.

Detailed Answer:
Hi,
Thanks for asking again.

There are many brands in the market composed of luekotrine modifiers (montelukast), nedocromil, theophylline, monoclonal antibody therapy (if the cause is known) or ipratropium bromide. However, if Ventolin does not help, others might have reduced effect.. You can try the above with low dose cortisone. In asthma, it is very important to continue a specific treatment, which is working and not causing any side effects.

Cortisone should not cause blackout episodes. It does not cause hypotension, on the contrary it causes increased blood pressure. It causes hyperglycemia. Other compositions in cortisone based product you are using may be causing it.

If Asthma were to be the cause, you would have episodes. If it is always present, other causes needs to be evaluated. I did not have your complete medical history and medications, so I cannot at present comment about it based on your treatment alone.

Have you started improving your diet and taking more meals/day. As age progresses, multiple degenerative changes occur. Need to remain active to adjust to everything. The activity at any age should be compared with the same person of that age. Even mild exercise is good considering you are recovering.

Improve your diet, take plenty of water. If you are not overweight, take more in your diet. Step by step, increase your physical activities and slowly it will improve.
You might not be able to reach your 100% as being sporty in the past, you can reach possibly 90%, it might take 2-3 months. The need at present is regular medication, nutritional diet with multiple meals and slowly increasing activities.

Also try deep breathing exercises.

Avoid any risk of falling. While moving from sitting to standing or sleeping to standing etc (change of posture), be slow. The body will take longer to adjust to changing blood pressure and can cause fall.

Appendix in children are commonly removed to avoid any complications as it can rarely cause severe life threatening abdominal conditions.

Learn to ignore problems which are not disturbing and adjust. It can get worse with age, but I as i told you earlier, your comparison should be with a person of your age. It will improve. Healing takes longer in elderly.

Rest and activity - both should be balanced.

Hope it helps.

Any further queries, happy to help again.

Dr. Prakash HM

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