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80 years old with Parkinson's disease. How to get a good health?

Answered by
Dr. Sudhir Kumar


Practicing since :1994

Answered : 5617 Questions

Posted on Thu, 27 Dec 2012 in Brain and Spine
Question: Sir, my mother is 80 years old, bed ridden now with parkinson's decease, now on "rhyles tube". We are feeding her liquids like Tea, Milkwith Pulmocare powderand Bcomplex, Rice water,Fruit juice, again Tea, Milk with Mecalvit, then Veg soup. I know we are loosing her she has lost her muscles and and almost everday she is loosing her muscles. Thrice we have given her blood and four times the XXXXXXX protien" (now I dont remembe the name which does cost about 6000 indian rupees). Now please can you tell me name of some tonic or medicine where in I can improve or at least keep her muscles for a longer period Please
Answered by Dr. Sudhir Kumar 11 hours later

Thank you for posting your query.

First of all, I wish to appreciate you and your family's efforts in taking such an excellent care of your mother.

It is unfortunate that our options are limited when we think of Ryle's (naso-gastric) tube feeding.

One can give feeds at regular intervals (usually every two hours) via the Ryle's tube.

Regarding providing protein content, milk is the best and most easy to give. Other food items which can be included in the tube feeds for providing proteins are- cottage cheese, soyabeans, pulses (dhals), etc. If someone is non-vegetarian, then eggs (raw) and meat (mashed or in soup form) can also be given.

For calories, sugar is the best.

Other option we consider in some people is a feeding gastrostomy. In this minor surgery, a "hole" is made in the stomach, and various types of foods can then be given through that. A gastroenterologist can give you more details about that.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Sudhir Kumar 8 hours later
Thanks a lot Doctor
Both my sister and my Brother in law are also Doctors ,since they are specialized on other subjects we are showing my mom to our family physician, Every two to three hours we are feeding her with fluids ( milk twice daily about totaling about 500ml, and all other fluids totaling about 1000 ml, The out put is also correct = more thnt 1500ml /day) The problem with giving pulses egg or non veg soups is that my mom cant digest it and the next day only she will have loose motion. Sinceshe is on catheter also it will be risky and and need to be cleaned at most care or else chances of infection is there. We have taken lot of care, for cleanliness since she never had any infections though the the first catheter was inserted about 18 months ago! ( We are changing the catheter every fifteen days.Again she had bed sours also which needs dressing everyday and is being done carefully, and its reducing now. Though she is sleeping on water bed we need to change her position every three to four hours, which is being done) So cant you suggest any Tonic Medicine ? ( apart from B-protien, B-complex, Pulmocare powder,Mecalvit) I will be grateful to you Doctor if you can suggest any, Regarding feeding gastrostomy, I dont think its possible looking her condition now, any how I will discuss that with my sister and family doctor too, but meanwhile if you can suggest something?
Thanks again XXXXXXX
Answered by Dr. Sudhir Kumar 6 hours later
Thank you for getting back with more details.

I again congratulate you and your family for giving her the best possible care (your mother is privileged to have all of you around)!

Among the things that you are doing, amount of milk can be increased, as it is a good source of protein (3%). Rest of the things seem fine.

Regarding other supplements, we tend to use Resource and Ensure protein quite a bit in our patients on Ryle's tube feeding.

To provide her with other vitamins, something like zincovit syrup may be useful.

I hope it is helpful. Please get back if you have any more questions.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Sudhir Kumar 15 hours later
Thanks a lot Doctor
We are already giving her about 500ml of milk, and don't you think that increasing the quantity may lead to Daria? Any how we will try that , and regarding Zincovit syrup , that also we will try, Thanks a lot doctor , God bless you , Good luck and do take care bye XXXXXXX
Answered by Dr. Sudhir Kumar 5 minutes later
Thank you for getting back.

You can increase the quantity of milk slowly. For example, give 200 ml extra to start with. If she tolerates it without diarrhoea, then you can increase the amount of milk.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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