Quote:
Originally Posted by glenntaj
--that in some people even blood sugar readings in the prediabetic range can cause neuropathy.
But I think the much more obvious aspect here is vitamin deficiency. She had gastric bypass surgery in the past--that is absolutely associated with difficulties absorbing vitamins, especially the B-complex ones and especially B12.
And B12 deficiency (that level of 387 you mentioned was much too low, despite typical American lab ranges; in Europe and Japan the lower range limits usually start around 500-550--we just seem to take a long time to catch up to more recent clinical thinking) is not only associated with peripheral neuropathy, but with multiple systems degeneration that can include cognitive/memory issues and motor problems. In fact, in gerentological circles it is established that among elderly people with cognitive/memory issues one really ought to check their vitamin levels first before assuming dementia or Alzheimer's; B12 and other B-vitamin deficiency is quite common as people get older as the intrinsic factor needed to break out cobalamin from foodstuffs in the stomach significantly declines with age (with or without alcohol consumption).
I'd see if you can get your mother's doctors to monitor her vitamin levels regularly, and to continue her physical therapy. Hopefully she will improve over time, but neurological damage takes a long time to heal, if it can, and the recovery is often patchy and incomplete.
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I know we've seen at least a little improvement since I got her on the B12, as both her PT and OT, and my grandma, noted how much faster she was moving. It probably wasn't a huge increase, but we'll take any improvement we can get. I'll see about getting some Jarrow B Right, too, but I'm very worried about her B6 going over and causing even more issues. This particular problem seems very delicate to handle, and I'm far from qualified for it...we'd go get blood tests, but we have no way to get around right now-- we're practically stuck. And that's not even the hard part, it's her having to come to terms with the fact that the healing is going to take time. She's really really impatient with painful situations like this. And it doesn't help that her memory is still shot (which I'm suspecting to maybe be due to liver damage from alcohol causing repetitions of hyponatremia, since her sodium seemed to drop back down when she had to go back to the hospital weeks ago for low sodium again). I think it's improved a little, but there's no way she can return to her job as an accountant the way she is now, even though she's been working almost entirely from home the past year. It's probably why her doctor has kept her on a fluid restriction ever since she left the hospital, too.
Another issue we're running into is that her insurance doesn't cover frequent PT or OT visits, nor does it cover short term care for them to help her get back on her feet, and we're already strapped for money as it is. And for some reason she becomes a lot more immature and unwilling to work out when it's a relative (like me) trying to help her as opposed to PT or OT. I've been there when they visit-- they ask her to do something, and she tries with a little comment of uncertainty as her only protest, if she does protest. When I want her to work out, she tells me to wait 5 minutes and then takes another 2 minutes when I get back to sit up and reach for her walker. And then it's a struggle to get her to do some workouts that she already has done before with PT or OT.
It's just rough. And I guess it's gonna be like this until she's able to ditch the walker, which could be months. I'm not really looking forward to that...