Newbie looking for holistic support (long)

Playtriple

81 year old mother, diagnosed w/cognitive impairment 4 or 5 years ago.  Brought her home 4 weeks ago for a myriad of reasons.  

Primary question today is holistic/nutritional advice.  I will certainly research & get approval from her NP or Neurologist prior to any changes or recommendations.  (Don’t like her Neurologist, love her NP.)

1. She contracted Covid in MC on 1-15-2021, 2 days prior to scheduled 1st shot. Fought & kicked Covid’s butt after 20 days.  1 oxygen machine away from ventilator & a request for her DNR is how close she came.  Went to rehabilitation for almost 60 freaking days.  I pulled her out & brought her home due to her not eating and so many other reasons.  (She left MC pre-Covid  using a walker & came home in a wheelchair.  1 week after coming to my house, she was back to using her walker & started eating for me.). We are now 4 weeks at my home & she is regressing on her eating.). She  has type 2 diabetes & is on  Metformine, Glipizide, Atorvastatin, Donepezil,  Dulixetine, Lisinopril, Memantine & Quetiapine, which I detest.  She also has kidney issues so has been taken off D3 & Neuropathy in her feet.  Dr Norm Shealy has a protocol online I’m interested in, just curious if anyone has tried it or any other holistic protocol.  I realize there is no cure but if symptoms can be alleviated w/o incurring more side effect from meds I’m all in,  (She has lost 30+ ponds since her visit w/ NP in October, probably all since her Covid battle.  Came game w/ severe protein malnutrition. dx)

2. Other issues on my plate, figure out which stage she is in.  Change Neurologist.  

3.  Finish fight w/Medicare Advantage plan-UHC,  Medicare & CVS & whoever else I need to on behalf of my mom.  MC, Bethesda affiliate scheduled & apparently counted her as present for her Covid  shot 2 days after she was hospitalized w/ Covid.  CVS billed & was paid for both her shots by Medicare.  CVS won’t fix the issue  & I need to get her shots when she is eligible  in 2 weeks,  so I filed a Medicare fraud report.  UHC-Medicare Advantage plan denied her PT, OT & ST after just 15 days in rehab.  Went through Livanta for 2 appeals & lost.  1 more to go. I still can’t understand how they think an 81 year old can fight & beat Covid for 20 days but Medicare will deny services after 15 days because no improvement.

4. On FMLA for now to care for her then will  rehire w/35 years.  And I’m sure will be asking for advice, suggestions or just a good vent as this disease changes my mother.  I appreciate anything you all have to offer.  Forgot to mention I have written my government representatives about most of these issues but I’m in Missouri so I didn’t get any assistance.  Not that I expect to have much time in the future but am curious if there are groups to help us fight for the representation our loved ones deserve.

Teresag56

My mom is 92 and in moderate stage of Alzheimer's.  She is in great physical health. She takes no meds. I took her to a nutritional holistic practice. He suggested she eat a a more alkaline diet...he gave her some supplements...he did recommend lots of deep breathing to get more oxygen to the brain. My mom can hardly do it though...she want breathe in deep enough. Good luck on your hourney

Sjodry

PlayTriple,

The only “holistic”, out-of-the-box treatment I did for my mom, was to take her for Hyperbaric Oxygen treatments. I wanted to see if it would work as I had read about it being used with dementia patients and people with concussions, etc.

Once we navigated how to get an 86 y/o woman into a blown up, capsule device and down to her back for the hour treatment, we were golden. I was concerned that mom might become claustrophobic or worse..try to get out in the middle of the treatments, but she was great. I had my son put 200-300 of my mom’s favorite era songs on an MP3 player. We began adding the music to her treatments..she loved it. She would routinely sing loud enough for the other nearby therapy patients to hear her or be moving her hands to the music when I would take a peek at her during treatments.

She had;had six treatments when Covid hit and the cognitive changes in her were impressive! My aunt gushed, “I have my sister back!”. Yes, we could see an undeniable improvement with these hyperbaric oxygen treatments. Sadly, mom fell and re-broke a hip and I knew she could never navigate the blow-up capsule again. The medical facility had to cease the Hyperbaric oxygen treatments because of Covid..so it is questionable whether you could find such treatments now while we are still in a pandemic.

Hope you find others! Good for you for trying!

Sandy

windyshores

I looked up all of those meds, each one. 

I would look at getting those meds down as a first priority.

Many affect kidneys. I don't understand why no D3 but those other meds continue. Did you know Quetiapine (Seroquel) raises blood sugars? Not good for type 2 diabetes.

Many of us made the choice not to use meds for dementia due to side effects and questionable benefits. I would research and get second opinions.

Does your mother have bipolar disorder, depression, schizophrenia? She is on a few psych. meds. Did the facility put her on these to keep her behavior manageable?

Even the statin can be looked at.  

Diet can certainly help with type 2 diabetes and as a replacement for statin, and for health in general. But that is a LOT of medications.

If you can start with a cleaner slate I think it would help. Be assertive.  One thing also: be careful with withdrawal. For instance for antidepressants, some people take months to get off without undue effects from withdrawal.

Maybe see a functional medicine doctor for help.

May flowers

When we moved my FIL in with us, we worked with his neurologist and family doctor and got to get off his cholesterol meds, Gabapentin, Tamulosin  (prostrate med), and BP meds. We have monitored all the conditions he was taking them for (including blood work) and is having no issues. In fact, coming off the meds solved some of his other issues which was a nice surprise. 

He is only taking Namzaric (not sure it is even working), and low dose of Zoloft to help with skin picking (not working). He will likely come off those two at some point. He continues to take a multivitamin and eye vitamin.

We added Fish Oil, vitamin D3 and melatonin.  

We had him on CBD oil which did reduce his skin picking. The neurologist is fine with him taking it. But she won’t prescribe it so he won’t be able to take it at the MC, unfortunately. 

windyshores

I think you can end up in a cycle where medications cause a side effect that is then treated with another side effect.  That is why sometimes it is good to start from scratch as much as possible. A geriatric psychiatrist could look at the depression meds and anti-psychotic.  Your mom is young but if her dementia has already progressed, some tell us that the dementia meds (she is on two I think) aren't worth the side effects. Especially concerned for her kidneys.

It might be possible to get off blood pressure meds. statin, and even diabetes meds but I think that could come after the psychiatric and dementia meds.

Her appetite may improve with some med changes-?  Do you test her blood sugar frequently? Higher blood sugars tend to actually make you hungrier, so that's not it, but still, her overall well-being might be improved along with tight control of blood sugars. Her diabetes doc should have a nutritionist on board.

Lane Simonian

Direct inhalation aromatheraapy may help.  Your mother could smell some of the more stimulating essential oils (such as rosemary clove, and bay laurel) in the morning and some of more relaxing ones at night (lavender, rose, and orange, for instance) at night for a few seconds under each nostril.  The only drawback is that some of the more stimulating oils can increase anxiety and blood pressure in some people.

Wishing better days ahead for you and your mother.

ButterflyWings

Welcome Playtriple, 

You seem to have a good handle on things, and appear to be getting a lot done.

I wish you and your mom well. A thought about the weight loss: my DH lost 20 lbs. pretty quickly, due to appetite suppression caused by Aricept and later Donepezil. I'm thinking there may have been some agitation, increased anxiety or aggression too. That med class didn't seem to be adding much value but was definitely causing harm so Dr. and I agreed to drop it. Hubby regained his appetite immediately and the weight in just a few weeks. 

Eating well again made everything better (though the "everything" with Alzheimer's is a lot...none really good...and only going in one direction). Since his memory is going to decline anyway, the meds that "may" help cognition, but cause any sort of issue at all, are off our list.  Not worth it. 

Seroquel, on the other hand, makes it possible to get him through the day without alarming levels of delusions and hallucinations, and equally alarming reactions to those. (Weaponing up to protect against imaginary intruders, exit-seeking, combative and verbally abusive behavior, and highly stressful constant motion rummaging activities, etc.) For us, quetiapine/seroquel has been a real sanity saver (mine). Good luck to you.

windyshores

A discussion of risk/benefit with Seroquel being given to a person with type 2 diabetes would be helpful. There may be other meds that don't affect blood sugar. If sleep is the issue, there are definitely other meds.

Alternatively, if Seroquel really is needed, then frequent testing may show whether, say, insulin is needed to counteract the effect on blood sugars, and that introduces a whole new set of dangers. High blood sugars are dangerous, but lows even more so in the short term.  Maybe for this particular person with these specific diabetes meds, Seroquel is okay but it also might be possible to reduce or get off meds without that medication and with dietary changes.  Not enough information to really suggest anything other than to consider these issues.

Diabetes affects kidneys, and kidney issues are already there. So that is another concern with many of these meds. Including Seroquel.

Playtriple

Thank you all for your responses. She‘s not on blood pressure meds, never been diagnosed with mental issues.  She lost a husband in 2013 & my sister in 2016, who had been diagnosed with schizophrenia some 30 years.  I know her NP put her on something for depression back then but I thought once I started taking her to her appointments in 2018 or so she was taken off it.  I’ve wondered about some of them several times.  She did start getting anxious & a little demanding/hateful/insistent  in the summer of 2020 after I hadn’t been able to visit her in AL.  Emergency move to MC in the fall because they found her wondering in the courtyard in the wee hours.

Pretty sure most of her weight loss was due to fighting Covid in January.  No way to really know since I’m not aware MC ever weighing her.  Due to Covid I had been working 12-15 hours a day 7 days a week since March of 2020, so the emergency move & my workload didn’t give me much of an opportunity to chat with MC much.

Also I have an email someone wants to friend me but I can’t figure out where this request is.

windyshores

She IS on blood pressure medication:

"Lisinopril is used to treat high blood pressure." from the drug site.

Here are 4 meds used to affect the brain. Again, Seroquel may raise blood sugars. We were offered dementia meds but declined due to uncertainty of effectiveness and side effects. Maybe others can advise. Is she on Duloxetine for nerve pain or depression/anxiety? Are some of these meds interacting or causing side effects? Are some of them redundant? I took my mother off some anxiety meds that were increasing her dementia despite, I have no idea if that is a risk with any of these. Does you mom have an Alzheimer's diagnosis? Anyway just from Dr. Google"

Duloxetine is used to treat depression and anxiety. In addition, duloxetine is used to help relieve nerve pain (peripheral neuropathy) in people with diabetes or ongoing pain due to medical conditions such as arthritis, chronic back pain, or fibromyalgia (a condition that causes widespread pain).

Quetiapine (Seroquel) is used to treat certain mental/mood conditions (such as schizophrenia, bipolar disorder, sudden episodes of mania or depression associated with bipolar disorder).

Donepezil (Aricept) is used to help improve mental function in people with Alzheimer's disease. Donepezil does not work the same in all people. Some people taking donepezil have improved mental function, while others may have unchanged or even worsening mental function. Donepezil is not a cure for Alzheimer's disease. 

Memantine reduces the actions of chemicals in the brain that may contribute to the symptoms of Alzheimer's disease. It is used to treat moderate to severe dementia of the Alzheimer type.

Lipitor has side effects that have driven some of my friends to go off: limb pain, muscle spasm, UTI's, arthralgia, diarrhea, stroke...but it also has its important uses for some.

Metformine and Glipizide are often used in combo. Is there any chance diet could reduce the need?

It just seems like a lot of meds with the potential for side effects or interactions but I am not a pharmacist and you know best since we don't know that much about why some of these were prescribed. I have found I had to be fairly assertive sometimes to get my mother's meds reduced or stopped.

You must be pretty amazing to be working so much during COVID, dealing with a mother who had COVID and has dementia. Hats off!

M1

You are correct that lisinopril is used for high blood pressure, but it's much more than that. It is a class of drug called ACE inhibitors that protect the heart and kidneys, especially in diabetics. It is recommended that all diabetics take an ACE inhibitor, aspirin, and a statin, if tolerated, because the evidence (long-term studies) shows that they do better, with lower risk of vascular complications. I fully support a practical approach, especially in a 91 year old, but there are many reasons she was put on these.....I wouldn't recommend stopping them without careful consideration.

windyshores

Just to clarify I was not suggesting stopping the Lisinopril. I was just responding to the original  poster's statement that the mom was not on a blood pressure med. (I have a family member with diabetes for 26 years now who does not take a med like that actually.)

For the rest of the meds, I just suggested considering them in terms of side effects and interactions- and which ones are needed at this point. Including effects on blood sugar and on kidneys.

To me, a holistic approach begins with looking at the effects of medications first.

The original poster also stated there were no mental health issues so why the psych. meds? Did the facility medicate grief? Were there behavior management motives?

Playtriple

Windyshores I appreciate your and everyone’s responses.  You have made me realize I still have more inquiries to make to determine when & why she was put on different meds, especially the lisinopril & duloxetine.  I think she was put on lisinopril for her Diabetes but need to verify.  Thank you again.

windyshores

And the Seroquel!

Glad my post didn't offend    I've been where you are.   Good luck!

The duloxetine may be for nerve pain for diabetes, if neuropathy is an issue.