Shelbie Lockhart Clinic Presentation Summer 2016 Vitamin B12 Deficiency Shelbie Lockhart Clinic Presentation Summer 2016

Client (Rita) Information 15 year old female Severe Stuttering Cognitive Deficits: sequencing events, following complex directions, problem solving etc. Incontinent Wheelchair bound Depression (upon admit) Memory Loss 3 years prior she was walking, running, and speaking typically Some questions about cognition level prior to hospital admit

What is B12 A vitamin that aids in keeping nerves and blood cells healthy and helps to make DNA. A lack of this can cause people to become tired and weak. Deficiencies are slowly progressing; symptoms may take years to affect people Diagnosed through blood test or bone marrow biopsy

Causes Thinning of stomach lining Pernicious Anemia Surgery removing part of stomach or small intestine Chron’s Disease, Celiac Disease, Bacterial Growth, Parasite Heavy Drinking Immune System Disorders (lupus) Long-term use of acid reducing drugs Insufficient Diet Pernicious Anemia: makes it hard for body to absorb b12 Stomach acids help break down b12 Diet: vegetarians and vegans must be sure to supplement foods to get enough b12 – Grandmother reported that Rita does not each much meat Deficiencies are slowly progressing; symptoms may take years to affect people

Symptoms Weakness, tiredness, or lightheadedness Shortness of breath Pale skin Smooth tongue Constipation, diarrhea, loss of appetite Numbness or tingling Problems walking Mental problems Mental Problems: depression, memory loss, behavioral changes Rita: presented with diarrhea, loss of appetite, inability to walk, tired, and cold

Treatment B12 injections Diet Change Multivitamin containing B12 **Any nerve damage caused by deficiency could be permanent

What about Rita? Medical: Speech Therapy: Receiving B12 injections Hopeful that feeling will return to legs Speech Therapy: Sequenced Daily Tasks Working Memory Activities Problem Solving Fluency Techniques Will receive outpatient therapy to address stuttering and cognitive deficits When we first started seeing her she was shut off and quiet…depressed She was discharged a july 8th and was happy and initiating conversation

References Vitamin B12. (2013, November 1). Retrieved July 15, 2016. Nazario, B., MD (Ed.). (2015, July 23). Vitamin B12 Deficiency. Retrieved July 7, 2016. New Orleans Children’s Hospital Inpatient Clinic Staffing. Summer 2016