My mother in law 56 years, 76 kg weight, height 5 ft3 inch, known diabetic for 10 years, hypothyroidism taking thyroxine 100 mg daily ,taking insulin, undergone angiography and single artery standing 1 year back, taking all required medication and regular follow up, takes an anti anxiety medication called depolv 37 (mixture of imiprime plus 2 more drugs].recently did a nuclear myocardial perfusion study, which came out normal. Yet she constantly complaint of pain in upper left chest area and breathless on getting up stairs and on getting up from toilet. No physical activity as she feels exhausted after few rounds of slow walk. Feels drowsy all day and remain lie down on bed day long and gets less sleep in night. Consulted all the relevant doctors, who gave same impression of all normal state and advised her proper diet and physical work out. She has weak mental strength so gets panicked easily. So I request for suggestions to get her back to normal state. Please help.
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From the medical history you have given, it appears that apart from hypothyroidism, your mother-in-law has metabolic issues and likely to have raised inflammatory markers. This is overlapped with menopausal symptoms that explains some of her newer symptoms particularly the ones related to her moods. Such a clinical situation is quite common amongst middle-aged women. I would approach such a case in a systemmatic manner and optimize the metabolic and hormonal imbalances in a comprehensive manner.
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Please get an Echo, hemoglobin, TSH levels and Chest x-ray AP view if not done or your MIL. Echo will tell us the condition of her heart and about any valve leakage, hemoglobin to rule out anaemia which can be a cause of this breathlessness and chest x-ray to rule out any lung issues. If these tests are normal then we will have rules out major causes leading to this problem. The anti-anxiety medicine could be a cause of her drowsiness, weakness etc so please stop it unless she has some underlying psychiatric condition for which she is receiving this treatment. A mild anti-anxiety can be given to her to control her anxiety. Also you can talk to her treating cardiologist to do a check angio once just to re-assure her that there is no problem in her stents.
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