I'm starting to worry that my husband might be experiencing the first stages of "failure to thrive". He's sleeping 16 hours a day and has lost about 25 lbs in the last few months. He's delighted with the weight loss and says it's because he's trying, but he isn't. If I fix a plate for him, with the amount I know he'll finish, he demands I add more, then doesn't eat it. He's always been a big eater but not anymore. This is a man who is proud of having an enlarged heart because "bigger is better". He argues that when his blood sugar falls it's great, because it will help his A1C average. His denial of his health problems is a steadfast, strong and lifelong thing.
His last Dr. appointment was good. The Dr. pushed him to better control his his blood sugar, but that was about it. He mentioned that his cholesterol medicine was working well and said his blood work looked good, for him. I mentioned his excessive sleeping and weight loss and he says it was probably just the diabetes. He didn't seem concerned at all. However, he's still losing weight.
DH has severe heart disease, non-alcoholic cirrhosis of the liver, kidney failure that fluctuates between stage 2 and 3, type 2 diabetes that has claimed several toes and mild memory problems. I suspect that he has mild to moderate depression but he absolutely will not mention that to the doctor and denies it heatedly if I try to talk to him about it. So there are any number of things to point a finger at. I'm just wondering if anyone has any experience with FTT. What I can find online isn't very definitive. I'd love to rule it out.
But whatever the problem is, it sounds like your husband is not going to make any necessary changes or pursue other possible problems. I am sorry you are in a tough spot.
Hopefully you have HIPPA releases so you can talk to his doctor, now and in the future. Do you have DPOA and MPOA. It sounds like you are going to need them.
Very best wishes as you try to deal with this!!
I struggle to keep in mind that he is an adult and that somewhere, under all that denial, he knows the consequences of his actions or rather lack of action. My goal, at this point, is to just keep the car between the ditches, for as long as I can.
Cirrhosis can contribute to this. The liver is a vital organ for so many functions- glucose metabolism in storing glucagon (usable glucose) as well as clearing toxins from the blood. I suspect his cirrhosis is causing many of his symptoms.
You can ask his doctor for a medication to increase his appetite (offhand I can’t remember the name of the med). It is prescribed for only a month or two to stimulate appetite as the medication is a steroid base which does increase appetite. But steroids may be contraindicated due to his other co-morbid conditions.
We don’t know his prognosis or how long he has had liver disease so it’s hard to assume anything.
Also from your post it sounds like he has been playing Russian roulette with his health for some time.
His body can be responding to years of abuse.
Failure to thrive can also be atttibuted to attitude as well. When someone just gives up on life due to despair or depression his/her will to live fades
and the person just doesn’t want to eat thinking it’s pointless.
Good luck to both of you!
"Remeron (mirtazapine), which belongs to a class of drugs known as tetracyclic antidepressants, can treat depression by moderating the levels of neurotransmitters in the brain. ... The drug has also been prescribed as an appetite stimulant. (One of its most common side effects is weight gain.)"
As with ANY medication, discuss with doc and even better, the pharmacist. There can be interactions with other medications/alcohol, counter-indications with some medical conditions, and of course, side-effects.
How much weight has your husband lost from one appointment to the other? And how far apart were the appointments? And is he retaining muscle mass and tone? If not that is another concern. If the 25 pound weight loss occurred between 1 appointment and another I can not see how a doctor would not be concerned about that if the appointments are 6 months apart as many seem to be.
Does he see more than 1 doctor? If so I would bring this up with another doctor and see if they accept your concerns or not. I would not let this drop keep pushing for a proper diagnosis.
Depression is probable and should not be brushed off. This might be something that you bring up to the doctor maybe without your husband present. Do you have access to the Patient Portals so that you can communicate with the doctor before the appointments?
Just a quick clarification from someone in the medical field. HIPPA law prevents a healthcare professional from talking with you about a patient without the patient's permission. However, you are free to talk with the healthcare professional about your concerns at any time. In fact, well intended and informative feedback from caring family members is welcomed by any good professional. They will take your input under consideration and may work it into their treatment plan; they just can't give you feedback in return unless the patient says it's ok to do so. Hope that helps!
You don’t have to check his sugar daily. The A1C tells the doctor better than daily readings.
There are less obvious numbers they look at too. My moms doc told me he can tell whether she’s eating enough, should say getting enough nutrients by looking at 2 different values.
Why look for trouble? Now if your husband complained, it might be different.
Not only that, insurance companies dictate treatment plans. Some times the doctors hands are tied until you’re seen for a differently labeled visit.
charlotte