Elderly mother not responding to any treatments

[paintryder]

My mother health plummeted in December, from walking with a cane, and driving herself around to wheelchair useage, unable to stay awake, severe anemia, complete loss of appetite, muscle weakness, especially in lower body, she is virtually unable to function now.  The Dr has run a battery of bloodwork, Thyroid had several level changes but now is within normal range, she is getting intravenous iron but it is not changing her condition at all.  She is type 2 diabetic, but her blood levels are staying within normal although she is too weak to eat three meals a day.  She has no interest in anything and we are referring her to endocrinology as well as hematology.  Her GI series is also normal.  Do you have any ideas for where we should look next.  She went from a fully functioning level with the beginnings of age related dimentia to completely non functioning now.  We are very afraid she is going to lay there and die if we cannot find something to help her.

[Dr. Kokil Mathur]

Hi
Thanks for keeping me posted!
Liver and kidney function should be properly assessed. UTI can cause a number of symptoms including the ones your mother has. Get a urine culture sensitivity and a kidney function test to begin with. This can slowly affect the filtering capacity of the kidney and cause uremic encephalopathy. You can read more about this on: http://emedicine.medscape.com/article/1135651-overview
• “Uremic encephalopathy (UE) is a consequence of renal failure (RF).
• Symptoms begin insidiously and are often noticed not by the patients but by their family members or caregivers.
• In many cases, impairment of the nervous system provides the first indication of metabolic derangements.
• Symptoms may progress slowly or rapidly.
• Changes in sensorium include loss of memory, impaired concentration, depression, delusions, lethargy, irritability, fatigue, insomnia, psychosis, stupor, catatonia, and coma.
• Patients may complain of slurred speech, pruritus, muscle twitches, or restless legs.”
If kidney function is normal and UTI is treated and still the symptoms persist then you need to look into liver functions.
Do consult an urologist. Please let me know if there is any thing else and do keep me posted. Take care!

[paintryder]

Thank you for your help, she had a full scope (nothing found), GI series (again nothing found), cat scan of the brain, tons of blood work which shows severe anemia that does not respond to either oral or intravenous iron. There was an elevated white blood cell count which the doctor said must be an infection in her stomach so he elevated her prilosec.   She also has had several tranfusions that did nothing to change her symptoms.  
A few weeks ago she was diagnosed with a UTI.  Funny that you should mention that, would that cause alot of these symptoms if it was untreated for so long?  Thanks for anything you can suggest.

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!

I am sorry to hear about your mother and understand your need to help her out.Can you provide some more details of her symptoms?

Dementia can result in a number of symptoms. However there are two things that must bbe looked into—one is Alzheimer’s and other is stroke. You can read more about this on http://www.nlm.nih.gov/medlineplus/dementia.html
The cause of anemia should be looked into. One possibility is poor diet over a long period. Get her stool examined for occult blood. Another possibility is subclinical UTI.
Hope this helps. It is difficult to comment beyond this at this stage.  Please let me know if there is any thing else and do keep me posted. Take care!