1

votes

Please hack my sister

Answered on September 12, 2014
Created July 22, 2012 at 12:15 AM

My sister is 28 years old, 4'11" and 88 lbs. That's the lowest weight she's ever been and her doctors say she has lost weight. She's normally been around 95-99 lbs. She does not have an eating disorder, she's not on a diet, she doesn't even exercise regularly. However, what she eats is horrible: tons of junk food, microwavable dinners, she only eats conventional meat/SPAM/etc, lots of baked goods/sweets, etc. She has high cholesterol, she's on birth control but still gets her period regularly, she told me her TSH is fine, and that her doctors say that her MCV is low and she needs to eat more protein. But I don't know what could have caused this unintentional weight loss. I'm very concerned about her and I'll take into consideration anything you guys have to say.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 23, 2012
at 12:32 AM

"missing cancer is generally considered poor form....." that is a good point.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 23, 2012
at 12:30 AM

Understandable April, and in the end it is up to her. I do hope for both of you that she gets things straightened out and gets well soon!

Medium avatar

(10663)

on July 22, 2012
at 08:15 PM

Yes, unfortunately she's a very picky eater and not open to trying new things.

Medium avatar

(10663)

on July 22, 2012
at 08:14 PM

Thanks, @Shari. I hope we find out what, if anything, is wrong soon.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 22, 2012
at 07:11 PM

Oh yeah. Typically that's picked up by 2-3 years of age. That's why I said I watch too much House. Simple genetic screenings that pops up late in life...

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 22, 2012
at 03:36 PM

April I can hear your love for your sister in your post. She's lucky to have you in her corner. I am sure if she keep pushing for answers she will find them. It sounds like her medical team has barely scratched the surface. That's a lot of weight to lose unintentionally or without explanation. If her doc(s) is dismissive she needs to get one who is not. I hope she gets some answers soon. For both of you.

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 22, 2012
at 03:31 PM

I agree that adding some stuff to her diet instead of trying to get her to change completely is the way to go. And yes if she has no interest in helping herself there really isn't much to do. Hard to accept I know.

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 22, 2012
at 03:29 PM

That is an extremely low weight for that height. Even her usual weight of 95-99 is a bit low.

Medium avatar

(10663)

on July 22, 2012
at 02:55 AM

No, she's a registered nurse who works 3 days a week. She loves what she does. There's no family issues, boyfriend issues, etc. that I know of.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:36 AM

I was attempting to give you an at home intervention that has little to no negative side effect and a possibility of resulting in improvement to her condition. However, everyone is liable for their own decisions as to what the will or will not do.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:34 AM

Or further medical work up.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:30 AM

vitamin deficiency seems pretty plausible.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:27 AM

She wont taste the liver....you can hide 3 oz in there easily. Seriously...I can feed this to my finacky 3 year old, I'm sure your sister can handle it if she has ANY interest in her health. If not, there is nothing left to do nutritionally. She will need psychiatric care.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:27 AM

It's been a minute since I spent time on the hematology/oncology floors, but I think thal major would have been noticed by 28. I could be wrong though. I've been wrong before. It'll probably happen again.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:27 AM

Colon cancer in a 28 yr old is kind of a zebra, but I've seen it before in young people w/negative family history. as much as I hate differentials- I seem to remember wanting to consider the most likely as well as the crap you really don't want to miss. missing cancer is generally considered poor form. Occult bleeding doesn't cause much visible change in stool. that's why it's occult. melena is a bit less subtle. and stinky.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:22 AM

Colon cancer in a 28 yr old is kind of a zebra, but I've seen young people with no family history of colon cancer. I would also point out that in your differential, you want to consider the most likely as well as the crap you really don't want to miss. and occult bleeding doesn't cause much visible change in stool. that's why it's occult. melena is a bit less subtle. and stinky. It's been a minute since I spent time on the hematology/oncology floors, but I think thal major would have been noticed by 28. I could be wrong though. It's happened before. It'll probably happen again.

Medium avatar

(10663)

on July 22, 2012
at 02:13 AM

@TME, why would she need a colonscopy?

Medium avatar

(10663)

on July 22, 2012
at 02:12 AM

IMO, that is a pretty low weight, even for that height. She was skinny enough to begin with so I don't know why her body would just lose the weight like that.

Medium avatar

(10663)

on July 22, 2012
at 02:01 AM

She absolutely hates liver. I recommended taking B vitamins and to supplement with whey protein since she doesn't eat meat often.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:37 AM

Well I guess your making the most dismal of assessments. There is a saying....don't think zebras when you got horses running aroung.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:35 AM

And if I'm following CD asks "occult bleeding" about the colon....well your gonna see that change in the stool. No need for he colonoscopy there.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:33 AM

My rec will do the trick then ;)

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 22, 2012
at 01:30 AM

TME, are you thinking occult bleeding? That's interesting, I was thinking Thalassemia Major (but I think I watched too much House). Given her diet it's probably a lack of B-12 and folate

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:23 AM

Obviously online its all a guess....and lets face it....she doesn't have and eating disorder as far as you know. Don't rule it out unless you accompany her 24/7

3b0b95dfc6dc5c18e535945f4aab0866

(2392)

on July 22, 2012
at 01:10 AM

I do have to ask, a 4'11 female, is 88lb really too low of a weight? I would consider it low end of the scale and one wouldn't want to go lower...

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6 Answers

7
3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 22, 2012
at 12:27 AM

April, My only suggestion is to ensure that she is working WITH her doctors. If they are not providing her with the type of care she deserves, then she needs to find a new ones. However, it would be extremely inappropriate to provide any type of advice for you and/or your sister in this situation. There are far to many unknowns. I am really sorry to hear about her situation, and I hope she gets this sorted out quickly!

3
5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 01:19 AM

Microcytic anemia and unintentional weight loss- she's young, but has she had a colonoscopy?

Disclaimer: without examining someone or knowing their complete medical history it would be impossible to figure out what's really going on. If you're unhappy with her physicians, getting a second opinion is always reasonable.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:30 AM

vitamin deficiency seems pretty plausible.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 22, 2012
at 07:11 PM

Oh yeah. Typically that's picked up by 2-3 years of age. That's why I said I watch too much House. Simple genetic screenings that pops up late in life...

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:37 AM

Well I guess your making the most dismal of assessments. There is a saying....don't think zebras when you got horses running aroung.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:27 AM

Colon cancer in a 28 yr old is kind of a zebra, but I've seen it before in young people w/negative family history. as much as I hate differentials- I seem to remember wanting to consider the most likely as well as the crap you really don't want to miss. missing cancer is generally considered poor form. Occult bleeding doesn't cause much visible change in stool. that's why it's occult. melena is a bit less subtle. and stinky.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:35 AM

And if I'm following CD asks "occult bleeding" about the colon....well your gonna see that change in the stool. No need for he colonoscopy there.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:23 AM

Obviously online its all a guess....and lets face it....she doesn't have and eating disorder as far as you know. Don't rule it out unless you accompany her 24/7

Medium avatar

(10663)

on July 22, 2012
at 02:13 AM

@TME, why would she need a colonscopy?

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 22, 2012
at 01:30 AM

TME, are you thinking occult bleeding? That's interesting, I was thinking Thalassemia Major (but I think I watched too much House). Given her diet it's probably a lack of B-12 and folate

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 23, 2012
at 12:32 AM

"missing cancer is generally considered poor form....." that is a good point.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:33 AM

My rec will do the trick then ;)

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:22 AM

Colon cancer in a 28 yr old is kind of a zebra, but I've seen young people with no family history of colon cancer. I would also point out that in your differential, you want to consider the most likely as well as the crap you really don't want to miss. and occult bleeding doesn't cause much visible change in stool. that's why it's occult. melena is a bit less subtle. and stinky. It's been a minute since I spent time on the hematology/oncology floors, but I think thal major would have been noticed by 28. I could be wrong though. It's happened before. It'll probably happen again.

5bc9ad5738ad8417d1e735b6ead201ca

(160)

on July 22, 2012
at 02:27 AM

It's been a minute since I spent time on the hematology/oncology floors, but I think thal major would have been noticed by 28. I could be wrong though. I've been wrong before. It'll probably happen again.

1
3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 01:26 AM

Feed the girl a liver, fruit and yogurt smoothie every day and see if that helps. Easier to add healthy things than take crap away....and if she is underweight anyway, why not? See if that helps. Otherwise I'll defer to the fact that we know way too little about the case nor do we have the access to physically examine your sister to make any more specific recommendation.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:36 AM

I was attempting to give you an at home intervention that has little to no negative side effect and a possibility of resulting in improvement to her condition. However, everyone is liable for their own decisions as to what the will or will not do.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:34 AM

Or further medical work up.

Medium avatar

(10663)

on July 22, 2012
at 08:15 PM

Yes, unfortunately she's a very picky eater and not open to trying new things.

Medium avatar

(10663)

on July 22, 2012
at 02:01 AM

She absolutely hates liver. I recommended taking B vitamins and to supplement with whey protein since she doesn't eat meat often.

98bf2ca7f8778c79cd3f6c962011cfdc

(24286)

on July 22, 2012
at 03:31 PM

I agree that adding some stuff to her diet instead of trying to get her to change completely is the way to go. And yes if she has no interest in helping herself there really isn't much to do. Hard to accept I know.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 23, 2012
at 12:30 AM

Understandable April, and in the end it is up to her. I do hope for both of you that she gets things straightened out and gets well soon!

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 22, 2012
at 02:27 AM

She wont taste the liver....you can hide 3 oz in there easily. Seriously...I can feed this to my finacky 3 year old, I'm sure your sister can handle it if she has ANY interest in her health. If not, there is nothing left to do nutritionally. She will need psychiatric care.

0
46d2d71df39b4a6336df6d8307b25d87

(278)

on July 22, 2012
at 03:36 AM

I'd also add that she should get tested for infection. Unintentional weight loss is a symptom of some viral infections (I'm thinking HIV in particular, which may or may not be a job hazard depending on what kind of nurse she is) and of many parasitic infections. Probably not the case, but worth looking at, I think.

0
45ace03a0eff1219943d746cfb1c4197

(3661)

on July 22, 2012
at 02:41 AM

In my teens, I weighed 86 pounds and was 5'1". I was skinny for sure but not ill.

If your sister is willing, and she very well may not be, I'd suggest real food that she really, really likes. You eat more when it tastes good, plain and simple. Without knowing her tastes, I can't suggest specifics. It's just that she has to love it or it doesn't work. Keep it natural, keep it real food, and don't skimp on fat or flavor.

0
1407bd6152d9fdbc239250385159fea1

on July 22, 2012
at 12:28 AM

Though many people often gain weight while under stress, some manage to lose it. Is your sister under a fair amount of mental stress?

Medium avatar

(10663)

on July 22, 2012
at 02:55 AM

No, she's a registered nurse who works 3 days a week. She loves what she does. There's no family issues, boyfriend issues, etc. that I know of.

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