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Neurology (Expert Forum)
SHY DRAGER SYNDROME
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SHY DRAGER SYNDROME
by BAVETE, Jan 02, 1999 12:00AM
I AM A CAREGIVER FOR A 68 TEAR OLD WOMAN WITH SHY DRAGER SYNDROME. SHE SUFFERS FROM CHRONIC CONSTIPATION AS ONE SYMPTOM. SHE IS UNABLE TO WALK AND HAS A CATHETER DUE TO IMMOBILITY AND URINARY INCONTINENCE. SHE USES METAMUCIL DAILY AND EATS A FEW PRUNES DAILY BUT REMAINS CONSTIPATED. OUT OF SHEER DESPERATION HER HUSBAND GIVES HER HARSH LAXATIVES (DULCOLAX). THESE WORK SUDDENLY AND DRAIN HER LITERALLY AND FIGURITIVELY. THEY DEHYDRATE HER AND CAUSE SEVERE CRAMPS AND SHE CAN'T ALWAYS GET TO THE RESTROOM IN TIME DUE TO THE NEED FOR ASSISTANCE CAUSING GREAT EMBARRASSMENT TO HER. WHAT CAN SHE DO TO STAY SOMEWHAT REGULAR AND WHAT CAN SHE USE FOR RELIEF INSTEAD OF HARSH CHEMICAL LAXATIVES? CURRENTLY SHE TAKES THE FOLLOWING MEDS: FLORINEF 0.1MG 2XDAILY, CARBI/L-DOPA 25/100 1/2TAB EVERY 2 AND 1/2 TO 3 HOURS, NITROFURANTOIN 50MG 1XDAILY, POTASSIUM-CHLORIDE 10MEQ 2 CAPSULES DAILY, OYST-CALCIUM 500MG 1XDAILY, SINEMET CR 25/100 1@BEDTIME, ALPRAZOLAM .25MG UP TO 2XDAILY, PROPAGEST 25MG 1/2TAB 2XDAILY. HER DOCTORS HAVE TOLD HER TO AVOID HERBAL REMEDIES AND VITAMINS AND MINERALS NOT PRESCRIBED BECAUSE OF MED INTERFERANCE. THANK YOU SO MUCH.
Dear Bavette:
Sorry to hear about your patient. Constipation is a problem in Shy-Drager syndrome patients. I would try and increase the bulk in the foods she eats. Increase the whole grains, veggies, and fruits. Try pear juice (contains more of the ruffage stuff than prune juice). If these fail, then try to titrate the ducolox to a level that helps her go to the bathroom without having explosive diarrhea. Let us know how she does.
Sincerely,
CCF Neuro[P] MD
