Hi Docs. Just looking for some guidance to point us in the right direction. I understand your limitations on medical advice. She would be very unlikely to agree to a consultation, but I can try encouraging it if you think it would be especially helpful.
This past weekend Mum complained of loss of appetite and unintended weight loss. She is a little unclear on the exact timeline, but she has dropped from 50kg to 48k over the past 2-4 weeks. She would have been around 75kg 3 years ago. She welcome the weight loss at first, but it has clearly gone too far (BMI 28 to 18)
I understand this is all extremely concerning.
She says she knows she needs to eat more, but that she doesnāt enjoy some of the foods she used to. I asked for a typical day. Breakfast was a banana. No lunch. Meat and veg for dinner. Some kind of dessert every 2nd day or so.
My first impulse was to try to work with her and help her find some foods she likes, or can at least eat, especially with more protein, but I suspect that is too simplistic and optimistic. It echoes the ājust eat lessā treatment of obesity with an equally wishful ājust eat moreā treatment of the opposite. If that had a good chance of working, it already would have.
She claims she recently saw her doctor (unrelated to this) and her doctor was uninterested in the weight loss. I know she has had some justifiably negative experiences with some doctors in the past, but Iām not confident her account of this was entirely reliable.
Where should we go from here? Iām thinking she needs to properly consult with a doctor specifically for this asap. Iām guessing that some kind of appetite stimulant might help, but wouldnāt dream of suggesting anything given possible interactions with the long list of medications she is already on, or the impact side effects might have on her other conditions.
History:
Her first MI 1999 at 54 years old.
Smoked 40/day from age 14 to 54. Cut down to 6/day after MI. Never fully quit. Maybe around 6-9/day now.
COPD. Fairly constant productive cough.
1-3 episodes of diverticulitis/year
In the last few years she has had stent repair of coronary artery, and for abdominal aortic aneurysm that was found ~12 years ago
She tripped and fell 10/2023, landed on shoulder.
Aside from gardening and walking her dog, sheās never had an interest in exercise and I donāt push it. She is less able to garden now (still does some) and no longer has a dog. However, she will often ask how to get stronger. Thanks to BBM I have usually framed it in terms of what activity would she like to be able to do now that she used to do, but no longer can (or would like to do more easily). This has helped. She started regular hands free sit-to stand exercises since her fall. Initially twice daily, then every second, then 3x week. Made an obvious difference in walking more confidently and with greater stability, especially on stairs.