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Diabetic, Having Weakness, Mucus In Bronchial Tubes, Disc Bulge. Done With Spine And RBS Test. Treatment?

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Posted on Thu, 16 May 2013
Question: I'm 72. Ht 165cm Wt 56kg. I'm controlled Diabetic for the last 8 yrs. RBS was 380 when tested first time in 1999. Then got it under control by medication, food & exercise.
Present problems:
1. I've no inherent strength even to walk. My steps do not fall where I propose. Have burning sensation on feet (especially on soles),numbness or muscle locking in some parts.
2. Formation of extra mucus in bronchial tubes (especially in the junction Larynx & Pharynx. It's coming through nasal cavities too.
3. I feel total weakness in my backbone; unable to stand for more than 15 minutes.
The recent scanning report is like this:
Screening C spine images show normal cord signal, posterior disc bulge at C3/4 mildly indenting the cord, disc space narrowing and diffuse posterior disc osteophyte at C5/6 and C6/7 indenting the cord and causing moderate bilateral foramen narrowing. IMPRESSION: Diffuse generalised involutional changes with no specific lobar predilection. No major territory vascular infarct, mass lession or surface collection.
Submitted for advice. Thanks.
XXXXXX
doctor
Answered by Dr. Achuo Ascensius (4 hours later)
HelloXXXXXX
thanks for the query.

The underlying issue on your present situation is related to affection of nerves and you have two problems that could result to nervous irritation or affection; diabetes and the narrowing of the spinal canal.

Diabetes is a metabolic disease and it causes microvascular complications that cause the numbness due to affection of nerves leading to weakness as well. High glucose levels as well will lead to weakness and dehydration that will further aggravate the weakness. Complications of diabetes could result even when one thinks he has his diabetes well controlled. Glycated hemoglobin is an essential tool for evaluating blood sugar control and it will be necessary you get tested for it. If its high that will imply your blood sugar level is not actually under control.
Spinal canal narrowing typically presents with discomfort during standing, weakness and numbness and could as well explain most of the symptoms you present with apart from the increase mucus which could be due to an infection of the respiratory tract.
So what you should do is:
-first of all ensure your sugar levels are under controlled and check your glycated hemoglobin level
-Get some vitamin B complexes tablets to help the nerves
-If glycated Hemoglobin and sugar level are normal then its certainly the narrowing of the spinal canal that is responsible for your symptoms together with a probable infection of your respiratory tract. In the case of spinal canal narrowing, you will need a consult with a neurosurgeon. Some steroids and pain killers would help relieve the symptoms but could not be a basis for permanent treatment.

Hope this answers your query. If you have further query i will be ready to help.
Best regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Achuo Ascensius (18 hours later)
Dear Doctor Ascensius,

Thank you very much for the valuable opinion after your minute observations. One thing I forgot to tell you while submitting my history. Actually, its after the consultation of a local neurologist I managed the information about my scanning report.

Here goes the history: I'm under his treatment for the last 3 months. Before the scanning report he advised me folwng Medcns:
Tab Syndopa 110mg: 1/2 - 1/2 - 1/2
" Liofen 10mg : 1 - 0 - 1
D 500 Cal : 1 - 0 - 0 (Varying Dosage was given every month)
Inj Re nerve 1 amp : IM/month ATD

Iin the begning above injection was given every day for one week. Then weekly once for one month and now bieng given monthly.

Here goes the scaning report of brain:
" (Technique - T1 & T2 - Axial; Flair -Coronal; T2 - Sagittal)
Observation:
There are diffuse generalized involutional changes with no specific lobar predilection.

The ventricles appear dilated expected for the degree of surrounding involutional change.

There are moderate periventricular white matter small vessel ischemic change.

No major territory vascular infarct, mass lesion or surface collection. No diffusion restriction.

The cerebellum, pons, midbrain and medulla appear unremarkable.

The pituitary gland and infundibulum appear normal.

The optic nerves and chiasm appear normal. The orbits show no abnormality.
Intracranial vessels show expected flow void."

No medicine advised for mucus accumulation in bronchial tubes. Could you pls advise something for that. The phlem is colorless during day time and white in the morning cough. No bad smell.

The valuable above is submitted for for your advise. Thanks.

XXXXXX

doctor
Answered by Dr. Achuo Ascensius (45 minutes later)
Hello XXXXXX
thanks once more for the query.

The abnormalities of your scan (generalized involution and ventricular dilation) appear to be senile rather than to be caused by an on going structural abnormality. With age, certain chemicals in the brain may run out or better still their metabolism may be defective as it is the case in parkinson for which you are taking syndopa and liofen. Calcium in needed for the bones and the injection is meant to improve on nerve function which are affected by diabetes and other nerves irritants.

The effects of syndopa could be more felt in elderly people resulting in more drowsiness, dizziness, or lightheadedness. More so, it can alter blood sugar levels thus carefulo blood sugar level follow up is needed.

For the mucus, you could take carbocystein 5% to help in release of the mucus but more importantly mobilization or frequent change in position is important in control of bronchial secretions.

Hope this answers your query. If you do not have further query you could close the discussion and rate the answer.
Best regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Achuo Ascensius (25 hours later)
Hello Doctor,

Thanks for prompt advice. With the hope of your Reviews, if needed.

XXXXXX
doctor
Answered by Dr. Achuo Ascensius (36 hours later)
Hello XXXXXX
it will always be a pleasure to respond to your query whenever you do have one. You could close the discussion and rate the answers. Your review shall be highly welcome.

Best regards
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Achuo Ascensius

General & Family Physician

Practicing since :2012

Answered : 1040 Questions

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Diabetic, Having Weakness, Mucus In Bronchial Tubes, Disc Bulge. Done With Spine And RBS Test. Treatment?

HelloXXXXXX
thanks for the query.

The underlying issue on your present situation is related to affection of nerves and you have two problems that could result to nervous irritation or affection; diabetes and the narrowing of the spinal canal.

Diabetes is a metabolic disease and it causes microvascular complications that cause the numbness due to affection of nerves leading to weakness as well. High glucose levels as well will lead to weakness and dehydration that will further aggravate the weakness. Complications of diabetes could result even when one thinks he has his diabetes well controlled. Glycated hemoglobin is an essential tool for evaluating blood sugar control and it will be necessary you get tested for it. If its high that will imply your blood sugar level is not actually under control.
Spinal canal narrowing typically presents with discomfort during standing, weakness and numbness and could as well explain most of the symptoms you present with apart from the increase mucus which could be due to an infection of the respiratory tract.
So what you should do is:
-first of all ensure your sugar levels are under controlled and check your glycated hemoglobin level
-Get some vitamin B complexes tablets to help the nerves
-If glycated Hemoglobin and sugar level are normal then its certainly the narrowing of the spinal canal that is responsible for your symptoms together with a probable infection of your respiratory tract. In the case of spinal canal narrowing, you will need a consult with a neurosurgeon. Some steroids and pain killers would help relieve the symptoms but could not be a basis for permanent treatment.

Hope this answers your query. If you have further query i will be ready to help.
Best regards.