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Obese, have severe leg pain. MRI revealed clogged area and scheduled for surgery. Suggest?

Nov 2013
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Practicing since : 1994
Answered : 5294 Questions
His weight is 286. Not very active since retirement. Sleeps a lot during day time and early evening. Stays up til approx. 12 a.m. then goes to bed and gets up between 3 a.m. and 5 a.m. His chewing looks like a chipmunk.
At meal time no matter where we are he piles his plate full as is there will not be another meal. Confronting him about this only makes him angry.
Posted Thu, 17 Oct 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
My replies are below

Detailed Answer:

Thank you for posting your query.

Clearly, there are issues that need to be tackled to ensure his better health and better future.

I can see three problems, which may be linked to each other.

First is the overeating and obesity. For this, a consultation with a barbaric physician or surgeon may be helpful. This would involve reducing his weight to normal levels. Also, counseling sessions with a psychologist may be required to make him stop overeating.

Second, he has pinched nerves in the back, which is causing leg pains. As he is planned for surgery, we hope he would become pain free after the surgery. However, he would need to follow up the exercises and physiotherapy regime, as advised by the physiotherapist after the surgery.

Third, he could be having obstructive sleep apnea (OSA) making him sleepy and tired. If he has snoring, then, it may be better to get a sleep study (polysomnography) done to exclude OSA. If he has OSA, then a CPAP machine would improve his night sleep and make him feel better and fresh during daytime.

Best wishes,
Dr Sudhir XXXXXXX MD DM (neurology) XXXXXXX consultant neurologist
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