Charles is a 29-year-old man who began to suffer seizures after a head trauma injury from a motorcycle accident at the age of 18. For the first 2 years after the accident, he was prescribed various anticonvulsant regimens. The combination of phenytoin (Dilantin), 300 mg daily, and phenobarbital, 120 mg daily, has proven to be the most effective therapy to control his seizures. Charles has been stabilized on this regimen for the last 11 years. Charles is a senior computer programmer for a large corporation. He is 6 feet 2 inches tall and weighs 187 lb. He admits to having an aversion for exercise and athletics. In his free time, he enjoys reading, playing computer games, and watching television. During the past year, Charles has broken his left femur and tibia on two separate occasions. He broke his femur when he missed the bottom step on the stairway in his office building. Several months later he broke his tibia when he tripped over a broken branch in his yard. Charles recently complained to his orthopedic surgeon about hip and pelvic pain of several weeks’ duration. An orthopedic examination with x-ray examination, bone scan, and DXA scan revealed that Charles is suffering from osteomalacia. A review of Charles typical diet reveals a nutritionally marginal diet that commonly includes fast foods and frozen dinners. His diet is generally deficient in fresh fruits, vegetables, and dairy products.
Nutrition Diagnostic Statement
Food-medication interaction related to inadequate calcium and vitamin D intake while taking anticonvulsant medications as evidenced by osteomalacia.
Nutrition Care Questions
1. Is osteomalacia common in young men?
2. How does Charles’ lifestyle contribute to the development of osteomalacia?
3. What vitamin or mineral deficiency may have contributed to the current state of Charles’ bones?
4. Describe the food-drug interaction that has contributed to Charles’ osteomalacia.
5. What medical nutritional therapy would you recommend for Charles?