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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Alcohol Addiction, Pulmonary Fibrosis And Mild Sleep Apnea

My niece who is 59, just came off a vent one week ago after spending a week on the vent. For resp. Arrest. Her other dx. Are COPD, pulmonary fibrosis or interstitial lung disease, hep. C, osteoporosis,Htn.,etoh. abuse. The drinking started about 9 years ago when her daughter left for college. We think the drinking has been solved but she says she smokes a pack/day. In this time span she has been incubated a total of three times. She also has a vascular necrosis for which she has had bil. Hip replacements earlier this year. Now she says she will quit the smoking. Now her o2 level on r.a. Is 90-92 percent. Also dx. With mild sleep apnea. A sleep study done on Thursday. At he. Her o2 dropped into 80 s and was told she would need to wear her c-pap or o2 at us. The next nite they did not use either as her o2 was about 90. Last Nov, she was told to wear c-pap but never did. She also has had 3 fractures of her foot over last three years. She has not been able to work the last 18 mos. due to her health and being in/out of hospital. She is suppose to go to Emory University Hospital. For eval in their fibrosis clinic. The Drs. Are stumped as to where to go. They do not have a definitive dx. Yest. CXR showed atypical pneumonia is. Her wbc. Are 27. Today up from 25. from Fri. She is weaning off steroids-finished SoluMedrol on Thurs. and now on prednisone for two more weeks. Lu,ng bx. Done last year showed inflammation. Unsure of all of her meds. I think depression could be part of it but her Detroit. Is married and she has a 3 mo. Old baby.i believe she was also dx. With hemochromatosis which caused his death at age 43.his twin also died 3 mos. prior with hepatitis. I live in Cinti. Oh. so I do not see her all the time. What suggestions might you have? Thank you.
Mon, 24 Jun 2019
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Addiction Medicine Specialist 's  Response
Hi,

A lot of the issues like hemachromatosis (ferritin level), hepatitis (liver funcitons and hepatitis tests) are testable and can be ruled out. If someone is drinking and taking benzodiazepine or any narcotics whether or not they tell you about it, it can be quite a problem. So, a urine drug test would be the first test to do, the others, then...
On alcoholism, there are a lot of effective treatments. Counseling and AA in this context would be quite helpful. There is also naloxone antabuse and campral. The second line would be anti-depressants or anti epileptics like topamax which is helpful in some.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Matt Wachsman, Addiction Medicine Specialist
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Suggest Treatment For Alcohol Addiction, Pulmonary Fibrosis And Mild Sleep Apnea

Hi, A lot of the issues like hemachromatosis (ferritin level), hepatitis (liver funcitons and hepatitis tests) are testable and can be ruled out. If someone is drinking and taking benzodiazepine or any narcotics whether or not they tell you about it, it can be quite a problem. So, a urine drug test would be the first test to do, the others, then... On alcoholism, there are a lot of effective treatments. Counseling and AA in this context would be quite helpful. There is also naloxone antabuse and campral. The second line would be anti-depressants or anti epileptics like topamax which is helpful in some. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist