Geriatric Patient

[Guest guest]

Does anyone have experience with elderly patients that would like to

comment?

 

Pt is 84 y.o. male who was self-sufficient until 2 years ago when he

became symptomatic and was dx'd polymylagia rheumatica. 6 mos later

he developed herpes zoster located from lower right quadrant around

right side to L3 to L5 area. He has an ancient history of compression

fracture in his upper back and and a herniated L2-L3 disk (by MRI).

He has been taking prednisone for most of the last 2 years. He is

also taking nortriptyline, fossamax, celebrex, atenolol, tylenol with

codine, tylenol arthritis formula and a calcium supplement.

 

He has lost 25 lbs during this time (current weight is 122 lbs). He

experiences abdominal bloating, especially in the area of the abdomen

affected by the herpes zoster. His stools range from water to dry and

hard. He has urinary hesitancy (dx'd w/ elarged prostate).

 

He is rather emaciated with poor muscle tone. He has had extensive

subcutaneous bleeding, especially in the extremities as he bruises

very easily from simple daily activity.

 

Pulses are deep, weak and absent in the chi positions. Tongue is red

and dry with scant, dry, unrooted yellow coat.

 

He came to my office for acupuncture at the suggestion of his

personal physician and was also steered away from a pain clinic

because his doctor did not want more meds added. (Not sure how he'll

feel about herbs, so need to be diplomatic).

 

I've treated him for the first time today w/ modest reduction of

pain. In addition to the acupuncture, I want to start using herbs to

tonify the spleen (tonify and contain the blood and improve his

assimilation of gu qi) and tonify his kidney, but I am unsure about

what to expect given his condition and the drugs he is taking. I

would also like to get enough control of his pain to allow the

removal of the prednisone (which I believe will make a huge

difference!)

 

This is the oldest and weakest patient I've treated so I am in

uncharted territory for me. What are your experiences?

 

BTW, If his condition doesn't improve, he is probably headed for a

nursing home as his care is becoming burdensom to his son's family.

 

 

Michael Buyze