Dr. David Coradin

Starting with having him go to his PCP. Traditional love and empathy will help. Along with mirtazapine May help some. Ultimately his depression is most likely bereavement so helping him cope is the first response.

My first concern would be what they call a "rolling pill tremor". Not so much a stroke as potentially a movement disorder such as Parkinsons. A cerebellar stroke, a part of the brain that coordinates movement, could possibly also lead to tremors. Seek a primary care doctor or neurologist.

Make sure your a-fib is acting up when you exercise. I would recommend you use a heart rate monitor to see what happens with your heart rate with exercise. Also could be considered a type of Angina, and your cardiologist may suggest either a stress echo or MUGA scan or other diagnostic tests. Before considering alternatives I would strongly suggest that if there has been a sudden change in your overall functional capacity you visit your cardiologist and discuss this further. Other alternatives could be low testosterone, high levels of paraproteins leading to slower blood flow and hence fatigue, a change in your pulmonary capacity.

With excellent care, and as best a lifestyle as possible the life expectancy can be 5-10 or more years. This is with preservation of the current level of function. With further decline in function it can be much shorter closer to 1-3 years. Mainstay of treatment will be diuretics to empower the kidneys to filter urine, potassium if it becomes low from the diuretic, bicarbonate in the form of citrate (also can use green veggie juicing but watch out for high potassium), appropriate salt intake which is less than 2 grams or less in some cases, low potassium diet, water/fluid intake restriction to avoid overloading the body which can be 1 liter to 2 liters, as much of an active lifestyle as possible, close monitoring of body weight, close monitoring of kidney function and electrolyte levels. With the right regimen you can last long. The hard part is helping our loved one make the changes needed in their lifestyle due to the stubbornness and them not listening to anyone. In the end they should be listened to in regards to how they want to live their life, and how they would like to take care of themselves, with their own will in the center of everything. We cannot force our parents to live how we think is best, they have a right to know what they should do and decide how they would like to be cared for and for themselves.

I have personally seen patients dealing with this problem along with their loved ones that were the ones that brough the concern up to me. First of all, sorry to hear, second I know this is extremely difficult due to the lack of cooperation. I would make an appointment with a geriatric psychiatrist or a kind hearted primary care geriatrician. After the appointment is set I would reach out to the office to inform them of the situation with your mother so that they can participate in the plan of getting her to come in for a visit. I would simply tell your mother that its time for a check up and your doctor wants to see you, that they called and since it is a new year they have new things to discuss with you to keep you out of the hospital (or use whatever you know would motivate her to go in). Sometimes we feel as family we are misleading our loved one, but this is completely correct and justifiable as they do not understand the nature of their condition. If they are completely and utterly resistant to go in, then try to set a telehealth appointment initially to at least get it started, even if the encounter is mostly with you and the doctor and not your mother due to her state. She may have developed a medication side effect if she is on certain meds, or a true mental issue related to a psychiatric problem or even in some cases as consequence to certain medical conditions. Of course dementia can have many presentations and forms and this may also be the cause. The most important thing to start is getting some good primary geriatric care to assist. I know its hard, but search and due your due diligence. If all else fails and you fear she is at risk to harm herself or others you can consider a "baker act" through your local police department if that is a law in your state. I know this sounds drastic but there are certain situations where this is justified, and honestly its better to go overboard than to risk irreversible harm if that is the case. All that we do we should do out of love for our family member, though we may worry about what our family member will feel emotionally in the moment. I have yet to see a case where the family resents the act of love to the point that it causes separation. Rather after getting appropriate care the loved ones always show gratefulness. You know her best, so do not depend on the opinions of others, sometimes not even other siblings truly understand because they are at a distance emotionally, mentally, or physically and in effect can be blind to certain important changes or dangerous ones in our loved ones.

Sorry to hear. These are very dangerous and can be life threatening. If this is your first, and hopefully only episode, the treatment if fully thinning out your blood so that the blood clot does not keep growing and affecting your ability to oxygenate your blood or put undue stress on the right side of your heart. With time your body will activate its ability to resolve the blood clot on its own. We do not treat only the clot that already occured, but in reality we treat the cause and the interim high risk for another clot from forming where the first one did. Most pulmonary emboli originate from the deep venous circulation of the lower extremities. So treatment is recommended for a minimum of 3 months or up to 6 months on a first even if it was provoked by something. Provoked means, if you did something or didn't do something which can be pin pointed as the reason why the clot occurred in the first place. If the clot is unprovoked then eventually more blood tests will be required to determine the cause, and a lifelong course of blood thinners may be recommended. Stay consistent with your treatment and follow up with your doctor.

Sorry about what you are going through.
It is likely that you developed this low testosterone progressively over years time. Testicle shrinkage is a side effect of testosterone being replaced.
What your doctor has done makes sense. Not unusual to see, the question of why you have become testosterone deficient may not be able to be answered as in most cases. But if you have a strong question you should see an Endocrinology specialist. The rosuvastatin may be overkill without giving your body first time to show if the replacement of testosterone will increase your cholesterol. If your cholesterol was already borderline then that would be a different story. Tamoxifen is being used because of the higher dosage of testosterone and frequency to prevent the natural production of high levels of estrogen coming from the normal metabolism of the testosterone you are injection, and hence prevent breasts from forming and other undesired estrogen effects. To stop the testicles from shrinking you can ask your doctor about HCG injections. When you are deficient in testosterone based on 2 clinical exams, then replacement is ussually life long. Though you do not HAVE TO replace testosterone to live a healthy life, doing so can improve some of the symptoms of it, especially if Erectile dysfunction is the cause of it. There are injections, but there are pills and even daily gels that can be applied if that makes it easier which you can have your doctor send to a compounding pharmacy locally or even in another city if you do not have any near. You can even just ask for the prescription and send it yourself. I would wait till you find the regimen that works to get your levels to at least 500 ng/dL. Also continue your routine blood work and ensure your Prostate Specific Antigen (psa) is being monitored regularly. If you have personal coronary artery disease history, or personal or familial prostate cancer history this should be evaluated thoroughly by your doctor.

Sinus infections can be viral or bacterial. Also severe allergies can feel as infections in some cases. Many times sinus infections are from a virus, this can lead to clear discharge or thin mucous with sometimes very severe congestion and sinus pressure. Yellow-green thick discharge with fever, chills, increased heart rate, and headache could be considered more likely bacterial. If you have black discharge, which could happen in someone with uncontrolled diabetes, then other causes could be considered. In the case of a viral sinusitis no antibiotic is recommended, and rather symptom management. In the case of bacterial sinusitis the gold standard depends on your region and resistance patterns to antibiotics. Generally the standard treatment consists of an augmented amoxicillin called amoxicillin-clavulanic acid. The amount of mg depends on your age and kidney function. If you are allergic to penicillin another option is Levofloxacin, though this has a black box warning and can cause serious side effects even when used as intended. Adjunctive treatment I frequently recommend are sinus rinses, steroids in nasal spray form or if too congested in oral form, and other over the counter sprays or oral remedies containing decongestant and mucous dissolvers. Most infections last about a week to 10 days for full recovery. Sometimes a viral sinusitis, after improving, suddenly worsens which is considered a "double-worsening" which is classic for the onset of a bacterial sinusitis right after a viral one which can happen in some cases.

Absolutely can, though some multivitamins can be harsh on the stomach, many are just fine. I strongly propose a multivitamin should be used especially since we are very poor in our nutrition in general. It is just a matter of finding the right one for each individual, especially taking into account medications that each one takes and their associations with certain deficiencies & interactions in some cases.