effective therapy to reverse amyloidosis

Other Therapies: Dimethylsulfoxide (DMSO) and colchicine have been used at times to decrease amyloid deposits. To prevent serious cardiac complications in patients with cardiac amyloidosis, antidysrhythmic agents are prescribed. Digitalis is avoided because patients are susceptible to toxicity. Vitamin K is used to treat coagulation problems, and analgesics are prescribed for pain. As the disease progresses and malabsorption develops secondary to GI involvement, parenteral nutrition is used to meet nutritional needs.

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Maintain a patent airway when the patient's tongue is involved. Prevent respiratory tract complications by gentle and adequate suctioning when necessary. Keep a tracheotomy tray at the patient's bedside in case of airway obstruction. When the patient is placed on bedrest, institute measures to prevent atrophy of the muscles, development of contractures, and formation of pressure ulcers.

Provide a pleasant environment to stimulate the patient's appetite. Give oral hygiene before and after meals and assist the patient as needed with feeding. Note that the disease puts tremendous stressors on the family and patient as they cope with a chronic disease without hope of recovery. Encourage the patient to verbalize her or his feelings. Involve loved ones in the care of the patient, and involve the patient in all discussions surrounding his or her care. Present a realistic picture of the prognosis of the illness, but do not remove the patient's hope. This illness tends to be progressive and debilitating with significant dysfunction of the involved organs. Long-term health planning is essential. Refer the patient and family to the chaplain or a clinical nurse specialist for counseling if appropriate.

• Physical findings: Adequacy of airway, degree of hydration or dehydration, presence of lesions, macroglossia, edema

• Ability to use extremities: Range of motion, weakness, gait, activity tolerance

• Nutritional status

• Changes in heart and lung sounds, presence of dysrhythmias

• Response to medications, speech therapy, counseling, surgery

• Emotional responses to disease: Degree of hope, resiliency, family support, ability to cope

• Understanding of and interest in patient teaching

MEDICATIONS. Teach the patient the purpose, dosage, schedule, precautions and potential side effects, interactions, and adverse reactions of all prescribed medications.

COMPLICATIONS. Teach the patient to examine her or his legs daily for signs of swelling. Instruct the patient to monitor urinary output for a decrease in quantity. Teach the patient to test the stool for bleeding. Advise the patient to report breathing difficulties or irregular heart beats.

FOLLOW-UP. Explain to the patient and significant others that a variety of counseling and social supports are available to help as the disease progresses. Give the patient a phone number to call if some health assistance is needed.

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