Dear XXXXXXX

‘Heart enlargement problem’ in this situation is most likely from cardiomyopathy.
The haemoglobin (Hb) is low – less than 50%. Such low Hb – by itself poses additional load on the heart.

Giving iron in any form and in any amount can only raise approximately 1% everyday.
One unit of blood will raise it approximately 7% in a few hours.
Nowadays, whole blood is rarely given – only blood components – in this case, packed red cells.

Measures to prevent complications are also undertaken carefully – in this case, - they will give intravenous diuretic like furosemide before / and prolong the duration of transfusion – say six hours or more / space the next unit after a day or two / so on. Given in good hospital setting, it is generally safe.

And why Iron? It may be other deficiency like B-12, folic acid and so on.

A proper diagnosis is necessary – MCV, smear and blood levels of these components will show.

If it is iron deficiency - which is most likely - it needs more investigations – to exclude chronic bleeding from an unknown source – like stomach or intestine. If she is losing from one side, how will she improve? – it is like the motor pumping and taps open – will the tank fill?

The best option will be to get her admitted to a TERTIARY CARE MULTI-SPECIALITY hospital / get a HAEMATOLOGIST’s assessment and give transfusion - in a setting of CCU or ICU - smaller amounts at a given time - AFTER getting CARDIOLOGIST’s assessment for compensated failure.

She ought to do well.
Wishing her a speedy recovery.
Good luck

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Dear XXXXXXX

There are 3 basic approaches to treatment of Diabetes – or any disease for that matter –
1) Diet 2) Exercise 3) drugs

DIET – is the foundation. By this time, she will be aware of most restrictions.
She should take smaller feeds / more number of times
She should avoid plain sugar in any form.
Salt must be restricted – not to be added on table > reduce, if possible, avoid while cooking.
There is some salt in everything – even if we don’t directly add, we can’t escape about 2 to 3 grams in a day!

EXERCISE – out of question in her case because of heart failure, anaemia and so on

DRUGS –
There are several medicines nowadays. It is a question of adjusting the dose.
When she is in hospital, it is wiser to test the sugar frequently and get small doses of insulin, until her anaemia and heart are stabilised.
Switch back to oral medicines in hospital itself and get the sugar under control.
Buy a machine to test sugar by yourself – a responsible person at home can easily be taught to do and follow up
Sugar, a little higher than normal, may not be of great concern in her case / may be safer, than a very strict control. Very low levels (‘hypo’glycemia) could be XXXXXXX

I cannot recommend anything about Homeopathy – it is not my speciality.
But, giving more than one system of medicine may be XXXXXXX – DRUG INTERACTION is a dreaded consequence

Wishing her a speedy recovery
Good luck

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