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Nyesthenia Help
by johnthebaptist, Feb 04, 2008 10:58AM
I am a PA wor works with a 83 FP who has MG, CLL, type II DM, early renal failure and COPD. He a;so had had a PE in the recent past. He is being treated with Mestinon. Lately, his CO2 levels have been rising to the point he has episodes of confusion, and is sleeping longer periods of time. He is no longer in practice and none of our local doctors have any experience with MG. He is on a CPAP device at hs, supplemental O2. I have instructed his wife not to increas the O2 to greater than 1L. The CO2 is continuing to rise but he refuses hospitalization and wants to be treated at home. Blood gases show his pH to be well compensated. I am reluctant to start an IV and give sodium bicarb slowly. Any suggestions? Thanks. Rev. John Ashbaugh PA
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