Guest guest Posted July 26, 2010 Report Share Posted July 26, 2010 Need some reassurance that I am not missing something on this patient. 3 yrs post RNY, lost over 100#, did become alcoholic, attended treatment and is 1 yr sober. No micronutrient issues on record, still takes supplements as directed. Recently, last 6-12 months she has developed aspiration pneumonia several times. Reports waking up several times choking and then shortly thereafter develops fevers and then aspiration pneumonia, been hospitalized for it on a couple occasions. She is totally distressed due to missing work and scared of choking to death. She uses wedge pillow, has bricks under head of bed, nothing to eat/drink 3 hours prior to bed. She has had swallow study and it was normal. GI doc as well as bariatric surgeon aware of issue and doing studies. Anything else I should be advising? Anyone else have this happen with a patient? Thanks in advance. Laschkewitsch RD LDDietitianGood Samaritan Weight Management InstitutePortland, OR(503) 413-8135 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2010 Report Share Posted July 27, 2010 Does she have a diagnosis of GERD? This is the primarily cause of aspiration pneumonia in adults 50 yr+ without dysphagia. There are medications that can help. Emotional stress can make the condition worse. Cordially, Litchford PhD, RD, LDNwww.casesoftware.commdlphd@...Check out the 2010 edition of Laboratory Assessment of Nutritional Status. From: "Laschkwitsch, :LPH Weight Management Institute" <KLaschke@...> Sent: Mon, July 26, 2010 8:10:47 PMSubject: aspiration issues? Need some reassurance that I am not missing something on this patient. 3 yrs post RNY, lost over 100#, did become alcoholic, attended treatment and is 1 yr sober. No micronutrient issues on record, still takes supplements as directed. Recently, last 6-12 months she has developed aspiration pneumonia several times. Reports waking up several times choking and then shortly thereafter develops fevers and then aspiration pneumonia, been hospitalized for it on a couple occasions. She is totally distressed due to missing work and scared of choking to death. She uses wedge pillow, has bricks under head of bed, nothing to eat/drink 3 hours prior to bed. She has had swallow study and it was normal. GI doc as well as bariatric surgeon aware of issue and doing studies. Anything else I should be advising? Anyone else have this happen with a patient? Thanks in advance. Laschkewitsch RD LDDietitianGood Samaritan Weight Management InstitutePortland, OR(503) 413-8135 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2010 Report Share Posted July 27, 2010 No eating or drinking 30 minutes to 1 hour prior to laying down > From: Laschkwitsch, :LPH Weight Management Institute <KLaschke@...> > Subject: aspiration issues? > > Date: Monday, July 26, 2010, 8:10 PM > > > > > > > > > > > > > > > >  > > > > > > > > > > > > > Need some > reassurance that I am not missing something on this > patient. >  > 3 yrs post RNY, > lost over 100#, did become alcoholic, attended treatment > and is 1 yr > sober. No micronutrient issues on record, still > takes supplements as > directed. >  > Recently, last > 6-12 months she has developed aspiration pneumonia several > times. Reports > waking up several times choking and then shortly thereafter > develops fevers and > then aspiration pneumonia, been hospitalized for it on a > couple occasions. >  She is totally distressed due to missing work and > scared of choking to > death. She uses wedge pillow, has bricks under head > of bed, nothing to > eat/drink 3 hours prior to bed. She has had swallow > study and it was > normal.  GI doc as well as bariatric surgeon > aware of issue and doing > studies.  Anything else I should be > advising? Anyone else have > this happen with a patient? >  > Thanks in > advance. >  > Laschkewitsch RD LD > Dietitian > Good Samaritan Weight > Management Institute > Portland, OR > (503) 413-8135 > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 27, 2010 Report Share Posted July 27, 2010 Is this patient cutting her vitamins in half and taking them that way? I had a patient that was taking her vitamins this way and aspirated one of the ½’s and developed aspiration pneumonia. Needless to say, she is now on chewables! Quote Link to comment Share on other sites More sharing options...
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