To ask for an urgent second opinion ? Unwell 90 year old

[AnOnne]

My mum is 90, with a number of health issues (type 2 diabetes, under active thyroid, kidney disease, heart failure, obesity and more.) She has been on mounaro for her diabetes for over a year and has lost 6 stone and was generally feeling a lot better for it. Recently she has started suffering hot flushes, dizziness, agitation and generally feeling wrong/unwell. Her weight loss has suddenly accelerated to 6lbs a week which seems a bit alarming. I think it started to scare her (she is a long time GP avoider) since she checked her BP herself Thursday and noticed that her heart rate was in the 30s. She made a GP appointment, which was yesterday. The GP was apparently dismissive, disinterested and had little to say. He booked her bloods and an ECG for 10 days time, and when pushed by my 90 year old mum agreed that maybe she could reduce her thyroxine dose in the meantime. AIBU to ask to see another GP Monday? Surely there shoud be a bit more urgency when a 90 year old has a HR in the 30s? (He did take her HR which was 45 in clinic.) Any advice would be really welcome.

That’s what I thought but it seems it’s ok 🙁

The two things that come to mind are that with that weight loss she may well need her heart failure drug doses reducing (I needed that for a lesser loss) but also that a heart rate that low may be heart block, so definitely needs an ECG.

As it's for her diabetes it definitely won't be a private prescription. Everyone seems to have forgotten than Mounjaro is first and foremost a diabetes medication, with an additional effect of weight loss.

Was coming on to say this - it’s a diabetes medication!! Lots of mmy diabetic friends are on it for this reason. 🤦🏽‍♀️

Agreed. That's definitely a possibility if her HR really is this low.

At 90 years old all her organs are 90 years old too.
This may be hard to hear but as an ex nurse it doesn’t sound good.Another opinion may increase your mums anxiety especially as she’s avoided drs her whole life.
Much as we would like to make things better we can’t.Being present with her and doing calming things may be the very best you can do.
wishing you both all the very best at a difficult time.

Pharmacy first is a mess
A lot of pharmacists didn't want it as they are so overwhelmed already in the community, however the dept of health didn't give them a choice.
So on paper it looks like Pharmacy first / 111 etc are reducing a&e attendances ...

I think this is the exact problem and frankly GPS are awful at adjusting meds. Definitely get a 2nd opinion, this is the sort of thing happens all the time and lands people in hospital

Likely her HF meds need adjusted at the very least

I assume you mean your mum has a heartbeat of 30 beats per minute? And that she takes Levothyroxine for an under active thytoid? Please do not lower the dose if this is the case, as this could reduce her BPM further.
Id seek a second opinion, so possibly take your mum to A&E, if only just to get the ball rolling and the relevant tests done quicker.

I’m a GP. I would bring her to A&E straight away. They’ll do an ecg and review. She could have heart block or similar with HR in 30s plus dizziness etc.

Given the information here this presentation is so inappropriate for a walk-in centre

She’s not on ‘weight loss jabs’, she’s on diabetes medication because she is diabetic.

Personally I would try to get a GP appointment asap but I wouldn’t go to A&E. Hospitalisation at that age can start a very rapid cognitive and physical decline, unfortunately. My otherwise pretty fit and healthy 90yo granny had a fall on ice and broke her collarbone and had to go into hospital. When she came out, she was nothing like how she was when she went in. It was the start of a very rapid decline.

Unless there’s an emergent situation, I would attempt to get help at home/local GP surgery where possible.

My dad is 94 and prescribed munjaro for his diabetes. Made him feel so ill just wasn’t strong enough to take it.

Haven't they just!!!! Bizarre........

I quite quickly developed both of these conditions. DH rang 111 who sent an ambulance to take me to hospital where I had a pacemaker inserted the next day.,
Follow Musicaltheatremum and rainingsnoring’s advice.

I have an under active thyroid, and lost 14 stones (not via MJ)I had to have my thyroxine dose halved (over about a year) so at the least this needs checked

As a very long term user of levothyroxine myself, if she’s lost 6 stone she’s possibly over medicated and has gone hyper. I lost 9 stone and my levothyroxine was reduced by 150mcg. I put on 4 stone and had to have my dose increased 50mcg

worth pushing for bloods to check

hope you get it sorted xx

If the levothyroxine dose is too high due to the weight loss, surely the heart rate would be increasing, rather than declining though.

She has lost 6lbs, not gained

Is that an informed medical opinion or just a wild overreaction based on what you know of mounjaro from the media and nothing of any substance?

Read it properly gained six pounds a perfect example of why asking for medical advice on forums is a bad idea!

Take your own advice. "Her weight loss has suddenly accelerated to 6lbs a week". Weight loss. She has lost 6lbs per week.

ECG is useless. Echocardiogram picks up more. The best thing for gaining weight is Rice Pudding with cream and sugar. Most tests are ordered to Fob you off for a few days, be honest, these days.

Well this sounds medically well informed and convincing.

@AnOnne hope things are ok.