Lasting health concerns with FIL... suggestions on direction?

[jeromedawg]

Hey all,

So my FIL (78) has been complaining of light-headedness and dizziness for the past several months. Two things happened at the same time when all of this started: 1) my in-laws moved into a new place in a 55+ community and 2) they got into a car accident literally the day after they moved here :( - I'm thinking these are residual after-effects of the accident (their car was totaled from it and impact was in the front of the car so they got jolted). Since moving in though, they've had several friends come over and criticize how their unit has popcorn ceilings, planting the seed that asbestos is going to kill them if it hasn't already. I'm pretty sure the ceilings are sealed. This is an older unit (build in probably the 50s or 60s? So I'm sure there's asbestos in there somewhere, but hard to believe that it's causing the issues he is having.

My wife took him and my MIL to urgent care soon after the accident and they were cleared. His [new] PCP had him do a CT scan and that came back clear too and told him nothing appears to be wrong with him. He had him see an ophthalmologist and has him scheduled to see an ENT as well. My wife isn't a fan of his PCP (and his Healthgrades ratings are relatively poor) - he is somewhat impatient and rushes them through the visits when they've seen him. I've been nudging my wife to find him a new PCP but it's apparently troublesome with HMO via Medicare (United Healthcare Chronic Complete) and the timeline before seeing a new doc is a month or more after switching, so getting more immediate care is tough. On top of that, it seems the specialists he gets referred to are often booked out really far (more than a month out). The last appointment/check-up they had (a few weeks ago IIRC) with their PCP, he complained to the doctor of the same light-headedness/dizziness and weakness in the legs (especially afternoons, where he just feels extremely tired and not able to do much physically), and the doctor told him he just needs to get around and exercise more... he said for his age he seems to be in good health and some of these things are just signs of aging, etc and that he's fine. To me, it kind of sounds like he's writing off real concerns that my in-laws and wife are having, especially after that accident.

Anyway, the asbestos thing really threw a wrench in things (especially because now my wife is all concerned and wants to do testing). My FIL now wants to do testing and pay whatever it costs to abate or resolve, thinking that *this* is the cause of all his problems. I think they're going down a rabbit hole with that one and first things first they should be focusing on medical. I'm not quite sure what direction they should take though - should we look into options of changing coverage to something more comprehensive (non-HMO where we can choose specialists for him without going through a PCP?)? Or should we try to just find another more highly regarded PCP in the area?

[GilesMM]

Asbestos is harmless unless you are actively mining it and breathing it into your lungs for decades. Then you eventually may get problems.


If others in the same community are not having the same issues then it is likely not air or water.


Maybe the accident shook up his brain and it will take months to fully recover. Not sure what specialists can do. They did a full battery of blood tests?

[Dollar Slice]

Low B12 is very common in the elderly and can cause vertigo/fatigue/lightheadedness (and a bunch of other weird symptoms that often come across as neurological/dementia/age-related in the elderly - ETA link). Make sure that is checked if it hasn't been. You can even get it checked yourself for a not-too-high fee at Quest if his doctor is too much of a PITA.

Both of my parents have had low B12 show up recently, they're in their 70s as well.

[Paper Chaser]

B12 is a great suggestion. I'd also ask what FIL's diet/hydration level look like. What is he eating/drinking, and how much?

https://www.mayoclinic.org/drugs-supplements-vitamin-b12/art-20363663

[lhamo]

What are his eating habits like -- both in terms of amount/frequency and how well-balanced his diet is?

I have had low blood sugar/pressure issues my whole life.  My mom had such severe hypoglycemia when she was pregnant with me that she hallucinated.  If I don't eat something with protein in it regularly I end up very lightheaded and sometimes pass out if I get up suddenly or have to stand for long periods of time.

MIght not be an issue in his case, but worth asking him about it.  Sometimes a major change in life circumstances leads to different eating habits.

Agree with others that the possible asbestos is likely a total red herring.

[ixtap]

My father gets debilitating weakness if he doesn't watch his diet. He has been tested for a variety of diseases with no results. But if he follows an elimination diet, he tends to get better. Unfortunately, he won't take the time to do the reintroduction phase to find actual triggers.

[Catbert]

Asbestos is harmless unless you are actively mining it and breathing it into your lungs for decades. Then you eventually may get problems.


If others in the same community are not having the same issues then it is likely not air or water.


Maybe the accident shook up his brain and it will take months to fully recover. Not sure what specialists can do. They did a full battery of blood tests?

Yep, definitely not asbestos.  He doesn't have the right symptoms or the right timeline.  Years (decades?) not days.

[wenchsenior]

I agree with others: the first thing I'd look at is any obvious vitamin deficiencies, particularly iron and B12.

The second thing I'd look at is possible hypoglycemia, which is an early symptom of insulin resistance (the metabolic issue that can eventually progress to diabetes). If he has eating habits where he eats 1) a lot of sugar; 2) a lot of processed carbs; 3) carbs 'alone' without sufficient protein, fat, and fiber in the same meal or snack; 4) goes for more than 4 or 5 hours without eating anything; or 5) all of the above, then hypoglycemia should certainly be looked into. (:has had IR for 25 years at least, and tons of experience with hypo episodes:).

[Rob_bob]

Asbestos would be a cancer issue but not in a short period of time.

Since they are concerned about it if the ceiling is well painted and you don't see the popcorn broken off and anything dusty/fibrous falling off the ceiling it is okay.  I had to keep an eye on asbestos when I was working.

[snic]

If the in-laws are obsessed with asbestos and are not listening to you when you say that's not the problem, then why not just test a bit of the popcorn ceiling and show them the negative result? I just say a thread over on the diychatroom.com forums on the topic of asbestos testing and apparently you can get it done for about $25.

Once that's out of the way you can shift them towards thinking about the more likely causes.

[oldladystache]

If they are living where I think they are living, it is asbestos. But it isn't a problem as long as you don't mess with it. Getting rid of it is a huge project.

[Sibley]

Asbestos is just the boogieman. They're getting old, just moved, had an accident at the same time - they're not feeling great, are unsettled, and feeling some mortality so they just latched onto something and labeled it as the scary thing because it feels better to have a bogeyman than to not. Which happened to be asbestos. It's irrational yet at the same time quite predictable.

Your wife isn't helping by jumping on fear-bandwagon, so please tell her to do some research and then cut it out. They're old enough that asbestos exposure doesn't matter, they'll be dead before the asbestos can cause a problem.

Agreed on the diet check, are they eating enough? Eating frequently enough? Are their pants suddenly too big, ie losing weight? Getting enough protein?

[Catbert]

If the in-laws are obsessed with asbestos and are not listening to you when you say that's not the problem, then why not just test a bit of the popcorn ceiling and show them the negative result? I just say a thread over on the diychatroom.com forums on the topic of asbestos testing and apparently you can get it done for about $25.

Once that's out of the way you can shift them towards thinking about the more likely causes.

Testing is not going to help.  A popcorn ceiling of that vintage is almost guaranteed to contain asbestos.

[Metalcat]

If the in-laws are obsessed with asbestos and are not listening to you when you say that's not the problem, then why not just test a bit of the popcorn ceiling and show them the negative result? I just say a thread over on the diychatroom.com forums on the topic of asbestos testing and apparently you can get it done for about $25.

Once that's out of the way you can shift them towards thinking about the more likely causes.

Testing is not going to help.  A popcorn ceiling of that vintage is almost guaranteed to contain asbestos.

*Looks up at asbestos ceiling, looks out at least paint on balcony*...yep

[cchrissyy]

strong agree with Sibley

i thought i remembered he also has mild issues with memory/thinking/mood?
i'd ask for a referral for evaluation for the common scary degenerative conditions of aging.
not humoring the idea that the condo or car accident are anything other than coincidental.

[jeromedawg]

strong agree with Sibley

i thought i remembered he also has mild issues with memory/thinking/mood?
i'd ask for a referral for evaluation for the common scary degenerative conditions of aging.
not humoring the idea that the condo or car accident are anything other than coincidental.

I think they'll need to find a geriatric doctor soon... fortunately, the area they're in now should have a decent selection I would think.

[cchrissyy]

having been through this, my suggestion is to find out what major medical center has the big memory and aging programs. i'm not in socal but for example in my area it's UCSF and Stanford.  since your wife is managing their care she can message the primary doctor for a referral. i would do that step quickly because there could be a longer wait until the evaluation appointments actually happen.  good luck!


edit to add- if the location is not convenient that's ok. you want the best evaluation which you can later transfer to a closer doctor that they know and recommended, or perhaps you stay at the big medical center but some visits are on zoom.

[jeromedawg]

having been through this, my suggestion is to find out what major medical center has the big memory and aging programs. i'm not in socal but for example in my area it's UCSF and Stanford.  since your wife is managing their care she can message the primary doctor for a referral. i would do that step quickly because there could be a longer wait until the evaluation appointments actually happen.  good luck!


edit to add- if the location is not convenient that's ok. you want the best evaluation which you can later transfer to a closer doctor that they know and recommended, or perhaps you stay at the big medical center but some visits are on zoom.

Thanks! I recall you giving some advice for my parents on this. On that note: my mom is reaching out to UCSF for help with my dad as he has been having some 'episodes' lately. I think he has improved a fair amount since I last posted about this, and they seem to have gotten a bit of a handle on balancing out the meds but he still has his moments.

In any case, I'll have to look into places that specialize in all that - I'm really not familiar at all. I guess I can ask on the local FB group for recommendations too...