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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for breathing difficulty and drowsiness

patient smt sumitra devi ,female ,67years old lady ,known diabetic type 2 ,non hypertensive ,H/o CAD unstable angina ,Tmt Positive , S/p CAG [17.5.10] kameneni ,LMCA +triple vessel disease ,good LV function , treated at care hospital banjara for 44 days and presently readmited at hiranandani hospital ,mumbai , for brethlessness and drowsy , kept on Bi pap support , with minimal support , sp02- 99, RR -17, HR 77, BP -134/77 , on pyridostigmine , a know case of occular myopathy , with type 2 respiratory disorder , looks to be musculat distrophy , needs further management ,looking for what can be the suitable offer to the patient , pl advice
Tue, 6 Jan 2015
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Diabetologist 's  Response
welcome to hcm,
type 2 respiratory disorder can be diagnosed by ABG( arterial blood gas analysis) . it responds well to bipap , the settings can be decided by a pulmonologist. but, her coronary artery disease needs attention too. i would suggest to get her stabilized first and get her CABG done as soon as possible.
muscular dystrophy is a subset of disease with very few treatments. physiotherapy and correct diagnosis of type of muscular dystrophy may help.
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