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Should tracheotomy be done after recovery from infections in Parkinsons patient?

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Internal Medicine Specialist
Practicing since : 2009
Answered : 3014 Questions
My father has been diagnosed with Parkinsons since 2008. In the last 3 months his condition has worsened signigicantly. As of August he could walk perfectly and could speak clearly. Today he is intensive care unit at hospital suffering from asperation phneumonia. He cant talk and cant move and he even appears to be in a comatose state at times. The doctors decided to intubate him yesterday because his oxygen levels became very low. They stuck a tube of oxygen directly in his mouth. This has become sadening due to the rapid decline in his health. He is on antibiotics to fight the phneumonia and a urinary tract infection. Also he is getting a MRI and a spinal Tap today. (My question is could this MRI and Spinal Tap be benenefical to the neurologists or doctors? Or at this stage should it not matter.) They believe he may have had a seizure this monday however a EEG came back negative. he has never had seizures before. Also now that my father is being intubated will he continue to need assistance breathing they say they have a fear he will not be able to protect the airway. The issue i am having is that my father has had so many infections lately and had not been fed in 5 days. he is extremely weak so i am wondering if i should allow his body more time to recover before we make decisions such as a tracheotomy.
Posted Thu, 26 Dec 2013 in Brain and Spine
Answered by Dr. Anshul Varshney 1 hour later
Brief Answer: They might help, consider tracheostomy Detailed Answer: Dear Friend I am sorry to hear about his health deterioration. See in parkinsonism , secondary infections are very common as he is having like aspiration pneumonia and UTI. MRI Brain helps to rule out any structural abnormality , that might be missed in belief of his sufferings from parkinson's disease. Seizure may occur as a result of metabolic causes like electrolyte imbalance and sepsis. However , it's not very uncommon to see seizure in these patients. Spinal fluid examination will also help to rule out causes like meningitis. Putting him on ventilator will help him in maintaining his oxygen and will protect his airway. But he will be at risk of Ventillator associated pneumonias. I suppose , if your doctor's feel he may require ventillatory support for long , tracheostomy should be considered. He must be started on parenteral nutrition. If not discuss with your doctor's I hope i am able to solve your query , if you have any further query , ask me. I wish him speedy recovery.
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