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Behavioral changes after TIA, low sodium levels, side effects of TIA medication - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Stroke
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
User :   hello
Doctor :   please proceed with the query
Doctor :   good morning
User :   my query is regarding the side effect of some medicines
Doctor :   ok
User :   my dad had TIA on jan 6th
Doctor :   ok
User :   right side
Doctor :   ok
User :   due to which he got admitted in hospital
User :   he has BP and Diabeties
Doctor :   ok
User :   now dr proscribed below mediciens
Doctor :   ok
User :   Telma 40 mg
User :   Amlog 5 mg
Doctor :   ok
User :   deplatt
Doctor :   ok
User :   and echosprin 150 mg
Doctor :   fine
User :   *ecosprin
Doctor :   ok
User :   also ciprolex 5mg
Doctor :   how old is your dad?
User :   he is 67
Doctor :   ok
User :   now his blood sodium is low
User :   its 118
Doctor :   ok
User :   last week he had some issues with behaviour
Doctor :   ok
Doctor :   is he ok now ?
User :   he was doing some tasks repeatedly
User :   and was not stoppable
Doctor :   fully conscious?
User :   he is fine now
Doctor :   ok
User :   dr advised to stop the ciprolex
Doctor :   is he on iv fluids?
User :   and initially they were giinbg telma h 40 mg
User :   no
Doctor :   ok
User :   he is taking sodamint from last 3 days
User :   3 tabs 3 times per day
Doctor :   ok that is good
User :   he is fine now
User :   but he looks lil stressed
Doctor :   ok
User :   and talking very less
Doctor :   when did you last check sodium
User :   3 days back
Doctor :   ok
User :   electrolite test
Doctor :   is he in the hospital
User :   no he is at home now
Doctor :   ok
User :   my question is can we stop telma
Doctor :   ok
User :   as he is already taking amlong
Doctor :   ok
Doctor :   let me explain it to you
User :   ok
Doctor :   drugs for diabetes or high blood pressure
Doctor :   generally act as a combination
User :   he is not taking anytab for diabeties
User :   it is under good control by diet
Doctor :   since single drugs will not be effective in most of the people
User :   ok
Doctor :   as far as high bp is concerened
Doctor :   it needs a combination medicine
User :   ok
Doctor :   we have a protocol which all doctors follow
User :   ok
Doctor :   single drugs usually do not help in elderly
User :   i read lot of side effoect for Telma
User :   so worried lil bit
Doctor :   every drug has side effects
Doctor :   so do not worry
User :   but this is effecting ihs behaviuor
Doctor :   if the doctro has asked to continue telma
Doctor :   it is very important
User :   he bahaves very strange
Doctor :   to control his blood pressure
User :   ok
Doctor :   when sodium comes low
Doctor :   behaviour changes happen
User :   will the low sodium cause confussion and do the same things again and again with out their notice ?
User :   ok
Doctor :   yes
Doctor :   it can
User :   he used to do chanting all the time
Doctor :   but since you know the cause that it is due to low sodium
User :   form 2 days he is fine
User :   after giving the sodamint
Doctor :   we can supplement the sodium and avoid the changes
User :   now if we ask him about that
User :   he dont remember what he was doing
User :   dr was not sure
User :   they had a doubt and as the blood sodium was low
User :   they thought it may be one of the cause
Doctor :   i would suggest you to repeat the electrolytes
User :   ok
User :   dr asked me to come tomorrow
Doctor :   we can never predict the cause
Doctor :   for electrolyte imbalance most of the times
User :   and get the electrolite test done tomorrow also
Doctor :   it is common in elderly
User :   ho ok
Doctor :   get it done tomorrow then
User :   sure
Doctor :   it is good that he responds when on supplements
User :   he had blood cholesterol
Doctor :   this will happen for few days and then it will be balanced
Doctor :   do not worry
Doctor :   just be cautious
User :   now in the lipid profile it came to normal
Doctor :   and never stop any BP medicine just like that
User :   it is less than 200 now
User :   ok , sure will not do like that
User :   due to stroke , he had some issues with memory
Doctor :   ok
User :   he forgets most of the things happend in pastt 2-3 days
Doctor :   yes TIA causes memory issues, with time , it will come to normal
User :   will it improve?
User :   ok super
User :   what all i can do to help him in improving it
Doctor :   he needs to contiue medicines on time
User :   ok
Doctor :   good diabetic control and good blood pressure control is helpful
User :   which medicine ampong the prescribed address this memory thing
User :   ok i will take care of that
Doctor :   memory thing is not with medicines here
User :   ho ok
Doctor :   when he completely recoers from stroke , with time , the memory will improve
User :   ok
User :   he dont have any issues with left part of the body
User :   he had 4/5 power in left when he had stroke
Doctor :   ok ,
User :   now he looks fine
Doctor :   TIA there will be bleeding in the veseels
Doctor :   this forms some clots
User :   no
Doctor :   these clots take time to resolve
User :   CT scan shows no bleeding
Doctor :   when they resolveslowly the memory improves
Doctor :   this is the general pattern in TIA
User :   MRI showns a small infarction
Doctor :   ischemia means block in blood supply
User :   ok
Doctor :   so with time it resolves
User :   so nothing to worry, right..
Doctor :   other wise we have to think of other causes
User :   by time this should improve and he will be norma;
Doctor :   as i said sodium and other electrolyte to may be the reason
User :   ok fine
User :   he had low potasium (3.38)
Doctor :   ok
Doctor :   this may need supplements
Doctor :   3. 5 is also fine
User :   yes
User :   they have giving some potassium tinic
Doctor :   its little on the lower side
Doctor :   yes , contue the same
Doctor :   do not stop
User :   10ml with diluting in water at bed times
User :   ok
User :   another thing i observed is
User :   he was watching TV continuesly after stroke
User :   last week he was watching TV till 1 am
User :   he was watching TV frm morning
Doctor :   ok
User :   and at the end he became so restless that, he started pressing some or the other buttons
User :   and when i asked him to switch off the TV he was not ready
User :   he was tellin gsome nice programm is coming..
User :   will sleep after that
User :   but infact he was watching some channel..(non kannada)
User :   which he cant understnad only
User :   and nothing interesting was coming there
Doctor :   ok
User :   some tele add was coming
User :   so now i told him that TV is not working
User :   and from last 3 days i am not switching on TV
User :   and made him to read papers and sleep
User :   is that fine
User :   or shall i allow him to watc hTV
Doctor :   yes
Doctor :   there is no need for you to stop him from watching tv
Doctor :   let him watch
User :   i didi it once and this repeated behaviour thing triggred
User :   he will start that strange behaviour of chantting.. moving hands here and there..
User :   touching gods photos .. things like that
Doctor :   i would not associate it with tv at all
User :   ok
Doctor :   as he has recovered from TIA
User :   so all due to low sodium then
Doctor :   he wil have psychological changes
Doctor :   most of stroke patients suffer from deprression
User :   ok
User :   ok he dont have that
User :   my mom keeps him busy with her old time jokes
User :   and he will laugh like any thing for that
User :   :)
User :   but one change
Doctor :   ok
Doctor :   do not worry
Doctor :   continue the medicines
User :   he was a kind of person who likes to be always busy with some or the other thing
Doctor :   i see doctor had put him on antideprassants
User :   and he used to be out all the time
User :   now he is not at all willing to go out
Doctor :   it is aging which has to be blamed
Doctor :   you or may can not change that
User :   he prefers to stay at home
User :   ok
User :   ciprolex was antidepressant
User :   they asked to stop it now
Doctor :   yes
Doctor :   why did they stop it?
User :   it was one of the cause for low sodium
User :   and also he became more expressive
Doctor :   ok
User :   and used to hug, kiss ..
Doctor :   justified
Doctor :   follow the doctors suggestions
User :   ok
Doctor :   and do not worry
User :   thanks a lot
Doctor :   do not worry
Doctor :   he will be fine
Doctor :   pleasure here
User :   it all started as i wanted him to under go angiogram
Doctor :   ok
User :   that test shown normal
Doctor :   my dad also is a heart patient
Doctor :   i have gone through the same
Doctor :   do not worry
User :   but after discharging from hospital..(the next day)
Doctor :   just follow the doctors advice
User :   evening
User :   he had this stroke
User :   ok fine
User :   how is ur dad now?
Doctor :   stroke is common in people with diabetes and high blood pressure
Doctor :   he is fine
User :   nice to know..
User :   hope fully my dad also recoveres fast
User :   his only worry is to find one gal for me
User :   when his sodium was low..
Doctor :   ok
User :   he used to call me and do some thing with his hand and used to say now you will get a good gal
User :   :(
Doctor :   i understan d
User :   i felt like crying
Doctor :   do not worry
Doctor :   take care of him
Doctor :   did i answer all your questions
User :   thanks a lot for your time and sugessions
User :   take care and have a nice day
User :   yes
Doctor :   take care
User :   it cleared my basic doubts
Doctor :   pleasure here
Doctor :   thanks for consulting me

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