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or sometimes in the middle of the night  but there are no obvious symptoms My dad is 91 with moderate dementia. I have been living with him for a little over a year after he fractured his second hip in 7 years. Up to that point he was able to live alone with just a little help from me on a daily basis. After his last hip replacement, his mental capacity has declined substantially even though he has been able to walk with a walker since the surgery. Lately he has been saying he is sooooo sick. Sometimes he says he feels bad all over. Other times, he says he is having trouble breathing though he is showing no signs of distress and no symptoms. I check his vitals and everything is good. I took him to see his doctor and his lungs and heart sounded wonderful but he had had some post nasal drainage and been lower than usual energy-wise. The doctor gave him a course of antibiotics in case he was developing an infection. Initially I thought he was improving and thought we'd found the answer, but he has started the same thing again. He told me if he'd felt any worse he'd have me take him to the ER. Normally he never wants to admit he's sick. I'm going to call his doctor Monday and see what she'd like to do. This feeling he has comes and goes. Seems to happen on first getting up. It reminds me of other times he would get up and say, Why can't I walk right? My legs have chains on them. I can't move. And then after a while he'd be fine. I get the feeling that when he wakes up he is expecting to feel like he did 30 or 40 years ago and not like a 91 year old.Instead of having awareness of the progression of aging, does he wake up and can't figure out why he walks or breathes like a 91 year old? Does anyone have a similar experience with a family member?

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I have a lot of acid reflux problems and famotidine does squat for me. Ranitidine or a PPI may be better if that turns out to be the trouble. A lot of heart trouble is treatable, maybe not curable, medically, even at age 91...hoping for the best!
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What about dehydration? I know for me that would make me feel under the weather after awhile. It's not easy to keep elders hydrated because they feel the more they drink the more they need to make a mad dash to the bathroom.
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I want to second VStefans idea of an echocardiogram. A couple of years ago, my husband went to the doctor because of a vague pain in the back of his neck, and feeling just generally "not well" for a couple of weeks. The doc (thank God) sent DH to a cardiologist, more because DH's father died at age 40 from cardiac problems than anything else. They discovered a rather large Aortic Aneurysm and eventually a leaking aortic valve. all was repaired surgically. Now, your dad may not be a candidate for surgery at 91, but there ARE cardiac issues which make you feel ill that don't get picked up by a general office visit.
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To be frank, I feel like crap when I wake up. I have back issues, nerve damage in my leg and now a foot problem - so from laying in bed I wake up really stiff and achy. I must be a sight, limping all hunched over as fast as I can go - trying to beat my aging bladder to the bathroom! But also I feel nauseous. I discovered how to help that and as I read the replies wondered if anyone else knew the symptoms and what helps. Sure enough - wise and knowledgeable pamstrgma hit it! Low blood sugar! So after the bathroom - a victory lap to the fridge and I have a small glass of OJ - then coffee with cream and sugar and the blecky feeling subsides. It's certainly an easy thing to try to see if it helps your dad - I hope it can be that easy for you. Wouldn't that be a refreshing change?!!
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It could be so many things. The first thing I thought of was that his inner ear was a little out of whack first thing in the morning. As his blood pressure and sense of position corrected, he felt better. The inner ear can cause problems in older people, making them feel nauseated or dizzy.

My mother feels bad each morning when she wakes up. It has been going on for years now and no one has located a specific cause. It is probably a combination of psychological and physical things. She gets to feeling better as the day wears on. It could be that many older people have the same morning sickness.
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A saltine cracker and banana by the bedside-I agree with the low blood sugar ideas. Drink more water, Dad.
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Both Prilosec, and now Pepcid Complete (Famotidine) caused me real weakness issues, more difficulty walking. The pepcid complete has a big No No for me, and that is a neurotoxin which is ASPARTAME!!
Aspartame is a sweetener,, a neurotoxin- Can make you feel sick, imo.

Try something different. Won't hurt.
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I like vstefans' approach, that it is worth investigating and if there is anything that would make him more comfortable it is worth search for. And Pam's idea that if a glass of juice or milk makes him feel better within 15 minutes it might be low blood sugar sounds reasonable. Does he snack before bedtime?

This may not be relevant at all, but sometimes I wake up with a vague and general sense of anxiety. I don't know what I am anxious about but I have a heavy feeling of dread. I think if I were a bit confused or having trouble with words I would describe myself as "sick" or "not feeling good." I have learned that this feeling does not last long and now I just go about my day without trying to figure it out. I wonder if it help if you reminded your dad, "I'm sorry you are feeling this bad. At least we know when this happens it clears up within an hour. While we wait for your body to feel OK, would you like to sit near the window by the bird feeder?" That is, remind him that he has experienced this before and he'll feel better soon.
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Could he have sleep apnea?
A little bit of OTC pain medication can't hurt, at his age he almost certainly has pain of one kind or another.
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And weight is good.
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I will try that juice idea and see if that helps.
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Dad's had blood tests recently and everything came back ok. He is also on famotidine and his appetite is good. The doctor said last time if he's not doing better that a chest xray would be good to do just to rule out other problems. The only specific complaint is he is having difficulty breathing. Otherwise he just says I feel bad all over. He sees his doctors regularly. He doesn't sleep well though. We've tried a variety of things for that including meds but he doesn't tolerate them.
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When he feels lousy, could he possibly have low sugar? Borrow a glucose meter and do a few checks. Or give him a glass of orange juice and if that perks him up, it's a sign his sugar is dropping overnight.
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PS - is he losing weight at all??
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It can be difficult trying to get to the bottom of this kind of thing. Is he able to express how he is sick? Is there a pain? Nausea? Is he just feeling bad because he sleeps poorly? Has it affected his appetite?
He might be having problems with low hemoglobin, did the doctor do any blood tests?
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Well, one possibility is gastroesophageal reflux, it can definitely cause those vague symptoms rather than obvious heartburn. And not all cardiac disease can be picked up just by listening. I know he is 91 with dementia, but if something might make him feel better or at least less uncomfortable, it is worth a little non-invasive investigation like an EKG, chest x-ray and maybe an echocardiogram, and just trying something else empirically like a little ranitidine if you and the doc decide it really might be GI. Hope you have a good geriatric person to help you sort it out, and stay out of the ER if you can!!
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