Introduction
  Evaluation
  Short of breath
  Too tired
  The dwindles
  Weight loss
  Healing
  Chemotherapy
  Mom to be
  Very sociable
 
   Thanks To
   Quiz
 
 
 
 Mark W. Braun, MD
 braunm@indiana.edu

 
   Nutrition and Diagnosis-Related Care

 

 
 

There are a number of ways to help. Here are just a few.
  • Encourage patients to eat what they like, aiming for a high-calorie/high-protein diet.
  • Avoid high-fat foods.
  • Don't wait for weight loss to start nutritional supplementation.
  • Maintain hydration and promptly treat fevers, infections and diarrhea.
    • 9-12 (8 oz) cups of water per day.
  • Vitamin supplementation 2X daily recommendation for water soluble vitamins.
  • With diarrhea, use frequent small meals and avoid extremes in temperature and fat content.
  • Be attuned to the possibility that depression can serious complicate matters and lead to reduced food intake.

So what became of Mr. Abrahms? Remember his SGA score?

  • His oral Candidiasis quickly responded to therapy and he is able to eat pain-free.
  • His triple drug anti-retroviral regimen has begun to work and his CD4 count is rising.
    • His lipids will be monitored and he will likely need treatment for hyperlipdemia.
  • A consultation visit with the dietitian went well, and she recommended:
    • Vitamin and caloric supplementation until his weight comes back to normal.
    • Adjust his daily protein intake to 2-2.5 g/kg
      • Threonine and methionine are limiting amino acids for protein synthesis in AIDS patients.
    • Maintain his caloric intake at 35-45 kcal/kg
    • Be prepared to increase daily calories by 1.5X during times of infection.
    • He will be seen again in 6 weeks for a follow-up visit.
  • He has agreed to see a psychiatrist who can help with his depression.

Mr. Abrahms says he now has a positive outlook and is hoping he can go back to work.

Ready for a step back in time?

 
                                  Main Index | Slide Table of Contents | Case Studies Table of Contents