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Knee pain,tonsilitis - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Osteoporosis
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1768 Questions
Doctor :   hi
Doctor :  
how can i help you?
Doctor :   It seems you have moved out of the chat window. Please log in back if you have medical queries.
Doctor :   hi
Doctor :  
are you back?
User :   yes doctor
Doctor :  
please proceed with your health query
User :   Doctor, my mother is having serious problem with knee
Doctor :  
ok
Doctor :  
could you please explain your mother's symptoms?
User :   She is 74 years old. She is having extreme pain in the knees. Can't walk properly. I need medical advice for her going forward
Doctor :  
ok i will help you in this
Doctor :  
was any x-rays done for her?
Doctor :  
was any Ct/MRI scan for knees were done?
Doctor :  
is she taking any medication now?
User :   Yes. X-ray was done. However Ct/MRI scan scan was not done
Doctor :  
ok
Doctor :  
what did the x-ray report come as? how long back was this x-ray done?
User :   She is having physiotherapy every alternate day
Doctor :   is she able to fold and extend her knees well? to the full extent?
Doctor :  
ok
Doctor :  
is the physiotherapy helping?
Doctor :  
what modalities is she taking in the physiotherapy?
Doctor :   what did the x-ray report come as? how long back was this x-ray done?
User :   X-ray was done a year before. X-ray report suggested that bones are deformed
Doctor :   ok
Doctor :   then a MRI should hav ebeen done to see if only bones are deformed or is there damage to cartilage also
Doctor :  
what medications is she taking now?
User :   Catilage are damaged, as per x-ray
User :   She is not taking any medication, except Voveran 50 daily
Doctor :  
the knee joint has three parts comprising it, the bones, the ligaments and the cartilage and the soft tissue around it, so any problems in any of these or a combination results in pain
Doctor :   ok Voveran 50 is for pain
Doctor :  
i recommend you to take a MRI scan of both the knees
Doctor :  
It seems you have moved out of the chat window. Please log in back if you have medical queries.
Doctor :   hi
Doctor :  
are you back?
User :   yes doctor, I am here
Doctor :  
Dear User. Please close this browser and log in from another browser if you are facing difficulties in the chat
User :   It's fine now
Doctor :  
ok
Doctor :  
i recommend you to take a MRI scan of both the knees
Doctor :  
it will show the structures inside the knee joint too
Doctor :  
like the menisci, the ligaments within the knee joint which are not seen in the x-ray
User :   OK Doctor. However Doctor has advised knee surgery the last time we visited max hospital
Doctor :  
knee surgery for what reason?
Doctor :  
what diagnosis did the doctor in Max hospital give?
User :   Knee surgery was recommended by Dr. Abhijit Dey of Max, on account of the following reasons: knee joint toally defunct, osteoporosis
Doctor :   ok
Doctor :  
i respect the diagnosis made by him. But i still recommend that you do a MRI scan for her. Then decide on the surgery
Doctor :  
osteoporosis in women is treated with calcium supplimentation and non-hormonal bisphosphonate drugs
User :   What should I look for in the MRI scan. Also, I stay in XXXXXXXX Park, New Delhi. Can you recommend a good visit for this nearby?
Doctor :   ok
Doctor :  
please confirm your contact details
User :   G 1390, XXXXXXXX Park, New Delhi - 0000, MObile No: 0000
Doctor :  
one of our executive will guide you where you can take the MRI scan and the alternate orthopedician too for a second opinion after the MRI
User :   For osteoporosis , Is there any medication that you would like to prescribe?
Doctor :  
in the meanwhile start your mother on the Calcium Sandoz tablets one in the morning and one at night
Doctor :  
and tell her to continue taking Voveran 50 mg, one tablet two times a day
User :   OK Doctor
Doctor :  
to control her pain
Doctor :  
diet changes also helps
User :   Modalities of physiotherapy are: Ultrasonic & IFT
Doctor :  
tell her to take milk and milk products like yogurt once day
Doctor :   avoid brinjal, tomatoes
User :   OK.
Doctor :  
take broccoli, carrots, sesame seeds
Doctor :  
taking flax seeds also helps
User :   What are flax seeds called in Hindi?
Doctor :   physiotherapy modalities too can be changed to
Doctor :  
wax bath, ultrasonic massage and IFT
User :   OK. I will note it.
Doctor :  
Flaxseed is commonly known as Alsi (Gujrati, Hindi Punjabi)
Doctor :   Is there any thing else I can help you with?
Doctor :   please get back to me with the reports in case of any doubts
User :   She is also having palpitation, whenever she walks
User :   She is also not in a position to carry out her exercise
Doctor :  
Please fill the feedback form while i answer your next query, and say done when done.
Doctor :   ok
Doctor :  
i will help you in this too
Doctor :  
she will have palpitation and difficulty in doing the exercises due to old age
Doctor :  
for her palpitations, get her Complete blood count checked
Doctor :  
and for the lack of exercise which could be due to the stiffness in the joints, wax bath in physiotherapy will help
User :   She is also having pain in her legs, whenever she walks
User :   She is over 70 kgs
Doctor :  
continue the medications for pain and the calcium
User :   What is wax bath
Doctor :  
what is her approximate height?
Doctor :  
wax bath is amodality in physiotherapy
Doctor :  
in which
User :   5'2"
Doctor :  
they use molten warm wax to cover the affected area
Doctor :  
to restore function and increase motion and releive pain
Doctor :  
as per her height, her ideal weight should be between 54 - 57 kgs
User :   Will homoeopathy help
User :   How can she reduce her weight. She can't do any physical exercise
Doctor :  
her BMI is 28
Doctor :  
which shows she is overweight
Doctor :  
she can reduce her weight by diet changes and exercises
User :   She applies Volini gel locally
Doctor :  
i am not sure about homeopathy as i practice allopathic medicine
Doctor :   yes Volini gel can be uesed locaaly
User :   What should be the diet chart
Doctor :  
ask her to do warm compressed before and after applying the gel
Doctor :  
such that it works more effectively
User :   ok
Doctor :  
you can ask for a personalized diet chart for her, giving her preferences by visiting
Doctor :   WWW.WWWW.WW Doctor :   the diet chart has to be followed strictly for 12 weeks
User :   Physiotherapist comes at home. Is wax therapy possible at home?
Doctor :  
the weight changes will take time, it will not happen overnight or in a week, so she and you will require to have lots of patience
Doctor :   you need to check with the physiotherapist if he can get the required things to home and give her
Doctor :  
the wax bath therapy
User :   ok
Doctor :  
Is there any thing else I can help you with?
User :   she is having gastric problems too. We are confused whether it is related to heart or gas
Doctor :   what symptoms does she have?
Doctor :  
Please fill the feedback form while answer your next query, and say done when done.
User :   pain in the chest, on her back. She feels giddy. She is also having spondalitis.
Doctor :   ok
Doctor :  
her pain symptoms wil be taken care of by the Voveran 50 that she is taking, increase it to two times a day. morning and evening
User :   ok
Doctor :   does she have rapid heart rate? difficulty in breathing?
User :   Yes
Doctor :  
does she have nausea, stomach discomfort, belching, flatulence, heartburn?
User :   Heartburn - Yes. Others - No
Doctor :  
ok
Doctor :  
i will recommend you to do an ECG test th enext time she is having the chest and back pain to rule out/confirm heart related problems
Doctor :  
and give her Syp Digene, one table spoon, two to three times a day before food
User :   While being operated for umbellical hernea during March 2008, she was dianosed with pulmonary embolisis and was in serious condition in the ICU. So, tell me how to go in for the knee surgery when Doctor has already told that there will be a risk
Doctor :  
the pulmonary embolism is cured right?
User :   Yes
Doctor :  
and the knee surgery can be thought upon after the MRI result
Doctor :  
if the result confirms only degenerative changes, medical approach should be tried first with the disease modifying agents, and when these fail y=then surgery should be looked upon
Doctor :  
the osteoporosis can be treated with oral drugs
User :   Doctor, I just checked that MRI has been done. Subject of the report says: The deep venous system of bilateral lower limbs shows normal 2D and wall characteristics. No evidence of any thrmbosis seen.
Doctor :  
the report sound more like a lower limb doppler report and not MRI report
Doctor :  
are you sure that MRI was done?
User :   OK. Sorry. It might not be MRI report
Doctor :   as the MRI report wil comment on al the compartments of the joint

Doctor :  
the bone, joint space structures and the soft tissues
Doctor :   and the images taken also will be more comprising of sections through th joint at 2-5 mm distance
User :   On 24th Apr 2009, she had discomfort, palpitation and pain in the heart and was taken to a cardiologist. ECG came with the note "within normal limits"
Doctor :  
ok
Doctor :  
almost 6 months are over after this, so you should do a repeat ECG and a ECHOCARDIOGRAM if she is still having the chest pain and palpitations symptoms
Doctor :   and compare with th eolder ECG report
Doctor :  
to see the changes
Doctor :  
so i suggest you get a complete blood test, ESR, CRP, RA factor, ECG, ECHOCARDIOGRAM and MRI of knee joint done and get back to me with the reports
User :   Will Glucosamine help? We tried taking Amway product, but it did not help at all?
Doctor :  
do not try self medications without evidence of the condition causing the symptoms
Doctor :  
it is dangerous to do that
User :   OK Doctor
Doctor :  
I am sorry, i do not have much knowlegde of AMWAY products and their contents as it does not come under allopathic medicine.
Doctor :   if you wish me to go through the reports, you can mail a scanned copy of them to me

User :   What's your name doctor?
Doctor :  

Doctor :  
Is there any thing else I can help you with?
User :   OK Doctor. I will send all the scanned copy of the report.
Doctor :   sure you can send them along with all the other reports of the tests that i have suggested
User :   I have a 8 yr old daughter. She is having off and on cough & cold
Doctor :   do you also need a appointment for your mother for MRI scan and another orthopedician in your area of location?
Doctor :  
ok
Doctor :  
since when she is having the symptoms?
User :   Yes Doctor
Doctor :  
ok
User :   Since she was 2 and halh years old
Doctor :   ok
Doctor :  
i will answer your query regarding your daughter
User :   OK

Doctor :   now coming to the query regarding your daughter
Doctor :  
what are the symptoms she is having?
Doctor :  
does she have running nose? sore throat?
Doctor :  
dose she have this all the time or in response to the environmental changes?
User :   My daughter is having cough and cold problem on a monthly basis sometimes accompanied by fever. It starts with Sore throat, running nose
Doctor :  
ok
Doctor :  
dos she get swallowing trouble also along with these?
Doctor :  
is there wheeze present?
User :   Most of the time because of season changes, but otherwise also.
User :   Yes. She gets swallowing trouble also
Doctor :  
has she been examined anytime for this?
User :   No Wheezing
Doctor :  
what medications she usually takes?
User :   Yes. We go to an ENT and she takes Cetzine syrup along with Polybion and crocine when she is having fever
Doctor :   ok
Doctor :  
did the ENT surgeon mention anytime that your daughter is having tonsilitis ? or did he mention that she is having allergic rhinitis? or perennial rhinitis?
Doctor :  
or adenoiditis?
Doctor :  
these are the various probable possible causes for the symptoms you mentioned
User :   Normally she has inflammed toncils.
Doctor :  
the permanent cure for tonsillitis and adenoiditis is surgery
Doctor :  
in which these glands will be removed
Doctor :  
its a one day procedure with good success rates
Doctor :  
and no recurrence if done by good experienced surgeons
User :   Doctor we are all afraid of Surgery. Are there any other treatment possible?
Doctor :  
no, only surgery is permanent cure. other than that there is only symptomatic treatment with medicines
Doctor :  
surgery is not to feared
Doctor :  
the success rates at-re very high
Doctor :  
and also your daughter is suffering almost every month as you said
User :   But still I am very afraid for surgery for my daughter
Doctor :  
surgery is recommended for people having recurrent tonsilitis consisting of more than 5 episodes per year
Doctor :   well, i can only recommend what is correct, i cannot force you to follow what i say
User :   OK Doctor
Doctor :  
since your daughter is suffering so much, and there is a permanent cure available for it, so i recommended it
User :   OK Doctor. THank You.
Doctor :  
it is upto you to decide whether to follow that or continue only symptomatic medications
Doctor :  
Is there any thing else I can help you with?
Doctor :   Can you please share your mobile number and e-mail id so that we may update our records. This information will be useful to us in case we need to send you additional information through mail or sms.
Doctor :   regarding the appointment for your mother,
Doctor :  
one of our executive will get in contact with you within 24 hours to help you out

Doctor :  
either by sending you mail, or by contacting you over the phone
User :   OK
Doctor :  
Sure XXXXXXXX
User :   Ok. THanks Doctor. Thank You very much.
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries. Please refer your friends to our service.
User :   Ok. Bye.
Doctor :   Please fill the feedback form once again, and say done when done.
Doctor :  
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Doctor :  
Thanks for consulting HealthcareMagic. Bye for now.
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