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Suffering from diabetes, obesity, neuropathy, heart problem and reduced kidney function. Any suggestion?

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General & Family Physician
Practicing since : 1978
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My mother is 84 and suffers from diabetes, obesity, neuropathy, Parkinson type symptoms (although she has been tested and sees a neurologist who says she does not actually have Parkinson's), heart problems (afib), reduced kidney function (stage 2-3 renal failure) and a myriad of diabetes related problems. She uses a walker for short distance, but more recently has to be wheeled in a wheelchair due to her shortness of breath getting worse. The most recent problem she's dealing with is excessive mucus/phlegm in her throat, which seems to "strangle" her and she has a horrible cough, which is now causing her to sometimes vomit up the mucus. She claims her stomach feels "off" and she doesn't feel like eating sometimes when this is happening. Her doctor has thought she possibly has a hiatal hernia; and most recently has prescribed Prilosec because he thinks she is having an acid reflux problem. When we give her Mylanta, it seems to relieve the symptoms for a short duration and she may go a day or so without having the symptoms. I am not sure that this is related to acid reflux as she doesn't really complain of any burning...just a lot of mucus and that gagging cough and not feeling like eating or things not tasting good. I have heard that Parkinson's can cause excess mucus so I'm wondering if maybe that's part of it. We would like to try to find something that will give her some relief from this...if there is something that would "cut" the mucus somehow....or cause her to produce less mucus. What foods she should not eat or what she should eat to relieve it. I am wondering how long to use the Prilosec if it's not working yet (she's been on it one week)...and also if she can take the Mylanta as well as the Prilosec. I am just trying to find something that will help her. We know she is not in good health, but we want to make her as comfortable as we can.....and the mucus, phlegm, coughing, choking and not wanting to eat are causing her quality of life to be really bad. Any info you could offer would be appreciated.
Posted Mon, 6 Aug 2012 in Diabetes
Answered by Dr. Pavan Kumar Gupta 1 hour later
I understand your concern and will try to address them.
Before answering your question I need certain informations from you.
Since when she having this coughing?
Is her diabetes under control?
Does she suffer from hypertension?
What are the medications she is taking?
When does she cough more,day or night?
Does she have any fever?
Any investigations like blood counts or x-ray done?
Since she is taking PRILOSEC for a week,how are her symptoms now?

Waiting for your answer.
Above answer was peer-reviewed by
Follow-up: Suffering from diabetes, obesity, neuropathy, heart problem and reduced kidney function. Any suggestion? 18 minutes later
She has been having the coughing for quite some time, but more over the last year. Her diabetes is pretty much under control; she takes Novolog 70/30 insulin twice a day. However, as I said, she has beginning kidney failure and other complications. She does have some heart issues, the afib. She does NOT have a fever and the doctor has checked her lungs which are clear. She has periodic blood counts done and also x-rays which have been normal, other than the kidney function getting worse over time. She did have low sodium the last time it was checked and is due to be rechecked. She has been taking Prilosec for one week and symptoms seem to be the same so far. Her medications are:
Levoxyl     Thyroid     100 mcg
Diltiazem     HCL ER capsules     120 mg
Lipitor     Cholesterol     20 mg
Plavix     Blood Thinner     75 mg
Requip     Balance/Shaking     1 mg
Lasix (Furosemide)     Diaretic     20 mg
Vitamin D RX          50,000 units
Alphagan     Eyes
Cosopt     Eyes
Xalatan     Eyes
Genteal     Eyes
Answered by Dr. Pavan Kumar Gupta 2 hours later
 Chronic cough is not a disease in itself; rather it is a symptom of an underlying condition. 

Some common causes of chronic cough include asthma, allergic rhinitis, sinus problems (for example sinus infection), and esophageal reflux of stomach contents. In rare occasions, chronic cough may be the result of aspiration of foreign objects into the lungs.

Less common causes of chronic cough include allergies, tumors, sarcoidosis, congestive heart failure, or other lung diseases such as chronic obstructive disease (COPD) or emphysema.

Now since lung examination and x-ray chest are clear,this rules out most of the lung problems
However I would still want a CT chest along with CT sinuses,as post nasal drip caused by sinus infection can result in chronic cough and an eosophageogastroduodenal endoscopy ( EGD ) done to confirm the presence of GERD.
Last but not the least,DILTIAZEM also causes cough in 3% cases.
Please discuss all these with your treating doctor.
Best of luck
Above answer was peer-reviewed by
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