One person suffers from 5 diseases and cannot stop 15 medicines a day
How to treat the "one body with multiple diseases" for the elderly
"I'm on the stage again." After participating in the elderly dance competition, 74-year-old Ms. Wu sent a photo to Zhang Ping, director of the Gerontology Center of Beijing Jishuitan Hospital.
In the photo, Ms. Wu looks very energetic in a bright dance dress.
Who could have imagined that this was an old man who had suffered from high blood pressure and diabetes for more than 20 years, and suffered from pain due to a waist fracture for five or six years, and once wanted to give up life.
This year, Jishuitan Hospital established a Geriatrics Center to provide medical services to elderly patients with "one body and multiple diseases".
The elderly who rekindle hopes for life here like Ms. Wu are not alone.
Operation
Relieve the dilemma of "rotten wood cannot be carved"
As bones age and body functions decline, the impact of fractures on the elderly is often fatal.
Especially for hip fractures, once bedridden, elderly people with multiple illnesses can easily cause multiple complications.
In the past, the treatment of hip fractures in the elderly was called "carving on dead wood" by doctors, which shows how difficult it is.
Through multidisciplinary joint diagnosis and treatment, this problem has been solved to a large extent.
Not long ago, Ms. Li, who was over eighty years old, tripped over a pet dog at home, her hip was painful and unable to move, and her family was sent to the Geriatrics Center of Jishuitan Hospital.
Experts are very cautious in treating such elderly patients. "Many basic diseases will have an adverse effect on surgery and rehabilitation. Geriatricians must conduct preoperative evaluation and examination."
Upon examination, Ms. Li suffers from basic diseases such as hypertension and diabetes.
"High blood pressure makes it easy to be dangerous during anesthesia; high blood sugar is also prone to lung infections and non-healing wounds. In the past, specialist doctors often recommended conservative treatment for elderly patients. Although it is tricky, it is out of consideration for the quality of life of the elderly. After the joint consultation of the Department of Geriatrics and Orthopedics, it was decided to perform the operation." Zhang Ping said.
Before the operation, Ms. Li was admitted to the ward of the Geriatrics Center. Through symptomatic treatment and professional care, her body maintained its best condition and passed the preoperative evaluation.
The orthopedic team performed the operation smoothly for the patient without serious postoperative complications.
drug
Conduct a multi-drug evaluation
"Director Zhang, look, I always have subcutaneous purple spots in the past two days." Mr. Liu walked into Zhang Ping's office and rolled up his sleeves as soon as he sat down.
After careful questioning, Zhang Ping locked the "suspicion" on drugs for the elderly to treat chronic diseases.
Mr. Liu counted his medications.
Promoting blood circulation and removing blood stasis, treating coronary heart disease, treating diabetes, treating hypertension, treating prostate hypertrophy... Count it down, Mr. Liu actually takes 15 kinds of drugs every day!
Among these drugs, Zhang Ping found that the components of the drugs prescribed by two different departments were duplicated.
Two doses of one medicine were obviously overdose, so Mr. Liu developed symptoms of subcutaneous hemorrhage.
The elderly often need multiple medications due to their multiple diseases.
"In the past, elderly patients went to specialist outpatient clinics from house to house, and doctors in various departments prescribe drugs in their own fields, and it was often difficult to take into account the problem of multiple drugs." Zhang Ping said that the Geriatrics Center follows a holistic approach to the management of multiple drugs and avoids duplication. The harm caused by medication to the body.
The Geriatrics Center recommends that when elderly patients suffer from more than 3 diseases and take more than 5 drugs a day, they should go to the geriatrics department for regular medical treatment for multiple drug evaluation and management.
prevention
"Stuck" at the signs of advanced age disability
Walking into the ward of the Geriatrics Center, the head nurse Wang Cong is leading an elderly man in his 70s to perform oral exercises.
The old man was admitted to the hospital because of aspiration while eating, causing lung infection. The situation was once critical.
After treatment, the patient's condition improved and stabilized.
Wang Cong “prescribes prescriptions” for the family members who care for the elderly. “You choke when you eat, eat less every time, and eat dry. If you can’t eat enough, you buy some food thickeners to make the liquid food thick and easy to swallow. In addition, we must create a good dining environment."
Wang Cong said that how to "stuck" the signs of elderly disability through correct treatment and health knowledge is of extremely important significance to patients, families and society.
He reminded that early prevention and treatment of signs should be made. Once severe dysfunction is caused, it is often difficult to reverse.
remind
Don't pay too much attention to the condition
"My blood pressure has risen again. I was so anxious that I didn't fall asleep all night." This is the fifth time that Ms. Huang has come to Zhang Ping's clinic in a month.
I saw that she took out the health monitoring record book. The day before, she memorized the results of 12 blood pressure measurements for herself.
When the blood pressure is lower, she is worried, and when the blood pressure is higher, she is anxious. Anxiety leads to insomnia. Insomnia, blood pressure will fluctuate again, forming a vicious circle.
"Monitoring twice a week is enough. I think you are in a good state now." Through positive guidance and psychological hints, Ms. Huang's condition stabilized.
Zhang Ping said that there are not a few elderly patients who pay too much attention to their illness and physical condition. "In fact, this is completely unnecessary." Zhang Ping said.
In addition, Zhang Ping suggested that elderly people with "one body and multiple diseases" should maintain good work and life habits; master necessary health knowledge, and refrain from credulous and excessive health promotion.
In addition, she called on the family and society to give more attention and care to the elderly. “For the health of the elderly, hospital support is only one aspect, and more important is the long-term functional maintenance after returning to society and the family.”
Our reporter Sun Leqi
Correspondent Jin Xiaofang