Abstract

A 71-year-old woman with extensive medical history, including type 2 diabetes mellitus, bipolar disorder, bilateral lower extremity above-knee amputations due to osteomyelitis, poor baseline mental status, and chronically bed-bound state, was brought in by family for worsening fatigue and malaise. The patient was cared for at home and fed primarily through a percutaneous gastrostomy tube. Her only reported home medication included levothyroxine 125 μg daily. Her family stated that for approximately 1 month they had been feeding her “protein shakes and powders” because her other feeds were producing excessive diarrhea.

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