Brief Answer:
need more details..

Detailed Answer:
Hello XXXXXXX XXXX , Welcome to HCM.

I've gone through your query and understand your concern for your mother.

Well 1.5 Ltr of water consumption per day is considered normal in an otherwise healthy individual. Now that being said, I'd like you to please take a moment and go through the following questions and answer them for me so that I can guide you in a better way :

Why was the Creatinine done in the first place ?

Any other reports available ? As along with Creatinine there will be complete metabolic profile, So please upload them so that I can have a detailed look at them(if you can't upload you can e-mail them to YYYY@YYYY and keep the Subject as ATTN : Dr Arnab Banerjee, I'll get them)..

Is she having any past medical history ? Specifically any kidney/urinary/heart condition ?

Any particular medications is she on due to any particular reason (I understand that she may be under treatment of the cardiologist you've mentioned) ?

It's always a good sign that the electrolytes are within normal range..

Please get back to me all these details..
Awaiting for your reply..

Regards

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Brief Answer:
Continue all medications as already advised .. detailed answer as follows..

Detailed Answer:
Hello XXXXXXX XXXXX, Welcome back to HCM,

Appreciate all the details shared by you, yes I've gone through all of the reports.

Well let me assure you at first that almost all the reports are reasonably alright for your mother.

Now her urine routine microscopy is fine along with a fair pumping capacity of the heart , however this Echo cardiography is showing date of 26th Dec'16 which is obviously a printing mistake on the discharge summary(I guess it was done on the date of admission only which was 26/02/16).

At this point I'd advice you not to go by values of the Creatinine , which is already started showing downtrend from 2.4 to 1.9 now. So it's a sign of improvement only.

The condition actually showed acute kidney failure so with timely intervention and appropriate management it should subside over a period of time.

I'd advice you to strictly follow the discharge advice given by the Cardiologist.

The Acute Renal failure is due to combination of several factors , like loose motion resulting in dehydration; compromised cardiac chamber pressures resulting in leakage in cardio-pulmonary valves thus affecting the whole body's regulation.

Now since the PPM was done in 2008 , and considering it's a standard device only which generally requires a check up in every 10 years, I'd strongly advice you to go for her Pacemaker interrogation right away not to wait for another 2 years (if not done already).

Yes She should continue drinking drinking water up to 1.5 Ltr per day (but not more than that) for the time being. Also since she's been put on to Diuretics (Lasilactone) , it's important to keep an eye on the urine output(just an approximation of say around 600-700 ml per day will do just fine for the time being).

I'd also advice you make sure that she follows all the standard precautions like taking no extra salt in diet , avoid salty/junk food and regular walking of 30-40 min while some one supervising over , and daily exercise of the feet and legs specially and all other routine care and advises(avoidance of any strenuous activities etc.) which you must be knowing already.

Now comes the most important part, which is routine and regular follow-ups to the Cardiologist or to the hospital where ever you feel like.

Ideally it's better to repeat The Renal function test along with the electrolytes after another 7 days and see how is she doing. But if she develops any further breathing difficulty immediately within a month or two then a Coronary Angiography might also be needed to be done .

So that's it for now, please get back to me if there's any doubts.

Feel free to discuss any time and do let me know how stays later on.

For future reference you can always get in touch with me , below is my direct follow-up link through which you can contact me anytime anywhere , I'll be happy to help - http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041



Take care
Regards

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