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Suggest Treatment For Numbness And Pain In Hands Of A Type 2 Diabetic Patient
Question: Hello,
I have type 2 Diabetes, diagnosed about 2 years ago, I have a BMI of about 39 and I have a lot of Belly Fat and am in the initial stages of going through Bariatric Surgery. Hypertensive, CKD stage 3, Diastolic Heart failure with normal Systolic EF, lipid disorders, including very high Trigylcerides and low HDL. I basically have classic metabolic syndrome. I also have a diffuse Fatty Liver (liver biopsy showed grade 2 scarring) and Obstructive sleep apnea. I am only 49 years of age with all this. I am on only Insulin for my diabetes now due to my Stage 3 Kidney disease, on 5 drugs to control my hypertension and ankle swelling including Avapro 300mg, Carvedilol, Epleperone, Lasix and Clonidine, on sertraline, also on Lovaza, Crestor, ASA 325 QD, Lantus 75 units Bid and Novo log fast acting insulin pen 45 units before a meal. I have had ultrasounds of my kidneys, I have just had a XXXXXXX of my left kidney to rule out stenosis. Basically everyone has been looking for a reason why within the last 6 months my BP spiked very high, thus the 5 drugs needed. Currently my BP is controlled finally and very good, my diabetes is not at 8.6 A1C and my Trigs are crazy high at 1600 even on Lovaza and Tricor, although last look was about 550. By the way, I have had hypertension, dyslipidemia, obstructive sleep apnea for years even when I was in good shape. I also have gained a lot of weight over the last several years, especially belly fat. I take a lot of Vitamin B12, B6 and Vitamin C daily to try to help with cortisol, although Cushings has been ruled out. There is probably not a blood test I have not been given. The strange thing about my kidney disease and my spike in BP is that I was hospitalized in October 2013 for Type 2 Diabetes with an AIC of 14.1. Apparently I was in renal failure and had been doing nothing but being thirsty, drinking fruit juices to stave off the thirst and peeing all the time. Finally I took myself to the ER and was kept overnight. My kidney function came back to normal by XXXXXXX 2014 and then in November dropped from a SC of 1.05 up to around 1.7 and my GFR came back in the Stage 3 CKD range. It's been there ever since varying between around 42 and 50. I have also had a stress Echo, ABI Dopplar tests, MRI of Carotids and MRI and MRA of head (was having major headaches for months) I am also under excellent care of a Cardiologist, Transplant Nephrologist (I'm not on the list, but that is just his Speciality, and an Endocrinologist. I have a poor FP, but it's convenient and my specialists really take care of all my serious stuff. I am also pretty fatigued and it was noticed that my vitamin D is low, so I am on a once a week prescription supplement. I also have very low testosterone and I was on Androgel, but no longer. That is my long history. Now my hands have been getting arthritic and increasing numb over the last couple of weeks. I've looked at Peripheral Nephropathy on line, Gout, Rheumatoid Arthritis, Psoriatic Arthritis, Carpal tunnel syndrome and Med Symptoms on line gives me like 20 possibilities with these being at the top of the list. It has been getting worse and I have been getting more and more nervous and it is now really bothering me, with my finger joints being in pain, my fingers and joints a bit numb and tingly and it is going up my arm a bit. My right hand in some places almost feels hot if that makes any sense. It is also on both sides. I am not sure what specialist to see. I also do use a computer frequently, but have never been a secretary or anything. I'm actually been in the Pharmaceutical sales business for 24 years, so at least I found great Specialists to treat me that way, except for my GP.
Thanks and sorry for the long intro with history, but I hope it helps. My true acute problem is really this pain and numbness in my hands, I am not sure what specialist to see. I almost went to the ER.
Regards, XXXXXXX
I have type 2 Diabetes, diagnosed about 2 years ago, I have a BMI of about 39 and I have a lot of Belly Fat and am in the initial stages of going through Bariatric Surgery. Hypertensive, CKD stage 3, Diastolic Heart failure with normal Systolic EF, lipid disorders, including very high Trigylcerides and low HDL. I basically have classic metabolic syndrome. I also have a diffuse Fatty Liver (liver biopsy showed grade 2 scarring) and Obstructive sleep apnea. I am only 49 years of age with all this. I am on only Insulin for my diabetes now due to my Stage 3 Kidney disease, on 5 drugs to control my hypertension and ankle swelling including Avapro 300mg, Carvedilol, Epleperone, Lasix and Clonidine, on sertraline, also on Lovaza, Crestor, ASA 325 QD, Lantus 75 units Bid and Novo log fast acting insulin pen 45 units before a meal. I have had ultrasounds of my kidneys, I have just had a XXXXXXX of my left kidney to rule out stenosis. Basically everyone has been looking for a reason why within the last 6 months my BP spiked very high, thus the 5 drugs needed. Currently my BP is controlled finally and very good, my diabetes is not at 8.6 A1C and my Trigs are crazy high at 1600 even on Lovaza and Tricor, although last look was about 550. By the way, I have had hypertension, dyslipidemia, obstructive sleep apnea for years even when I was in good shape. I also have gained a lot of weight over the last several years, especially belly fat. I take a lot of Vitamin B12, B6 and Vitamin C daily to try to help with cortisol, although Cushings has been ruled out. There is probably not a blood test I have not been given. The strange thing about my kidney disease and my spike in BP is that I was hospitalized in October 2013 for Type 2 Diabetes with an AIC of 14.1. Apparently I was in renal failure and had been doing nothing but being thirsty, drinking fruit juices to stave off the thirst and peeing all the time. Finally I took myself to the ER and was kept overnight. My kidney function came back to normal by XXXXXXX 2014 and then in November dropped from a SC of 1.05 up to around 1.7 and my GFR came back in the Stage 3 CKD range. It's been there ever since varying between around 42 and 50. I have also had a stress Echo, ABI Dopplar tests, MRI of Carotids and MRI and MRA of head (was having major headaches for months) I am also under excellent care of a Cardiologist, Transplant Nephrologist (I'm not on the list, but that is just his Speciality, and an Endocrinologist. I have a poor FP, but it's convenient and my specialists really take care of all my serious stuff. I am also pretty fatigued and it was noticed that my vitamin D is low, so I am on a once a week prescription supplement. I also have very low testosterone and I was on Androgel, but no longer. That is my long history. Now my hands have been getting arthritic and increasing numb over the last couple of weeks. I've looked at Peripheral Nephropathy on line, Gout, Rheumatoid Arthritis, Psoriatic Arthritis, Carpal tunnel syndrome and Med Symptoms on line gives me like 20 possibilities with these being at the top of the list. It has been getting worse and I have been getting more and more nervous and it is now really bothering me, with my finger joints being in pain, my fingers and joints a bit numb and tingly and it is going up my arm a bit. My right hand in some places almost feels hot if that makes any sense. It is also on both sides. I am not sure what specialist to see. I also do use a computer frequently, but have never been a secretary or anything. I'm actually been in the Pharmaceutical sales business for 24 years, so at least I found great Specialists to treat me that way, except for my GP.
Thanks and sorry for the long intro with history, but I hope it helps. My true acute problem is really this pain and numbness in my hands, I am not sure what specialist to see. I almost went to the ER.
Regards, XXXXXXX
Brief Answer:
Replace Zoloft with Effexor XR.
Detailed Answer:
Dear XXXXXXX
1. I appreciate your meticulousness, throroughness and the amount of effort that
you put in to write this query.
2. I carefully went through your extensive report, the all in one combo that you
uploaded.
3. I sincerely accept that you are indeed, ill. I empathize with you. You probably
know what it's like to be as ill, if people were a fraction as ill, they most probably would not have put it across as you have done so.
4. Doctors appreciate such behaviour.
============================================
What's happening to you right now, and what to practically do about it.
============================================
1. As you know, this is called diabetic neuropathy. I would not tell this to anyone else, but you being in pharma, as it is, are more than familiar with such terms. You
also mentioned knowing super specialists (I read you query quite carefully). You
know these are the pinpoint symptoms.
What do you do now? More medication? No. Not at all.
See, XXXX, Kindly stop zoloft and start effexor xr. That's the best solution.
That will fix the problem with hardly any issues. In fact you can even stop
clonidine and perhaps even 2 other drugs, using this "switch".
I want your learned opinion as regards this. You can think and reason.
Finally, it's you who have to take Effexor XR pills instead of Zoloft.
Tell me what you think. Feel free with details and explanations.
It was only because your query was so detailed that a perfect drug could be given
to you. Else??
In Confidence,
Dr. Neel Kudchadkar
Replace Zoloft with Effexor XR.
Detailed Answer:
Dear XXXXXXX
1. I appreciate your meticulousness, throroughness and the amount of effort that
you put in to write this query.
2. I carefully went through your extensive report, the all in one combo that you
uploaded.
3. I sincerely accept that you are indeed, ill. I empathize with you. You probably
know what it's like to be as ill, if people were a fraction as ill, they most probably would not have put it across as you have done so.
4. Doctors appreciate such behaviour.
============================================
What's happening to you right now, and what to practically do about it.
============================================
1. As you know, this is called diabetic neuropathy. I would not tell this to anyone else, but you being in pharma, as it is, are more than familiar with such terms. You
also mentioned knowing super specialists (I read you query quite carefully). You
know these are the pinpoint symptoms.
What do you do now? More medication? No. Not at all.
See, XXXX, Kindly stop zoloft and start effexor xr. That's the best solution.
That will fix the problem with hardly any issues. In fact you can even stop
clonidine and perhaps even 2 other drugs, using this "switch".
I want your learned opinion as regards this. You can think and reason.
Finally, it's you who have to take Effexor XR pills instead of Zoloft.
Tell me what you think. Feel free with details and explanations.
It was only because your query was so detailed that a perfect drug could be given
to you. Else??
In Confidence,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Dr Kudchadkar,
Thanks for your answer although it is not one I really expected because my feet feel fine, although a little achy with my obesity. I'm a larger framed guy and somewhat muscular at 5'10 and 273. I am hoping that the gastric bypass I am heading towards will clear my diabetes or much lesson it.
As far as Zoloft, well I also have Xanax as PRN
And i have been on anxiety drugs and depression for years. Zoloft has really worked well for me. Is your logic for Effexor XR just less weight gain?
I was on Zoloft and Welbutrin and stopped Welbutrin. As far as this numbness and pain in my finger joints what are drugs to help me? I had shingled and was on a nerve blocker(forget the name). Worked very well. I've been with Bristol Myers Squibb for a long time. Launched Metformin in XXXXXXX when it was released here. Great drug! Wish i was still able to be on it.I remember now! Drug that helped me with Shingles pain was Neurontin
Thanks, XXXXXXX
Thanks for your answer although it is not one I really expected because my feet feel fine, although a little achy with my obesity. I'm a larger framed guy and somewhat muscular at 5'10 and 273. I am hoping that the gastric bypass I am heading towards will clear my diabetes or much lesson it.
As far as Zoloft, well I also have Xanax as PRN
And i have been on anxiety drugs and depression for years. Zoloft has really worked well for me. Is your logic for Effexor XR just less weight gain?
I was on Zoloft and Welbutrin and stopped Welbutrin. As far as this numbness and pain in my finger joints what are drugs to help me? I had shingled and was on a nerve blocker(forget the name). Worked very well. I've been with Bristol Myers Squibb for a long time. Launched Metformin in XXXXXXX when it was released here. Great drug! Wish i was still able to be on it.I remember now! Drug that helped me with Shingles pain was Neurontin
Thanks, XXXXXXX
Brief Answer:
Effexor will also stop your neuropathic problems too.
Detailed Answer:
Dear XXXXXXX
Effexor was prescribed because unlike Zoloft, which is an SSRI drug, it is an SNRE drug. Both drugs are totally different. Effexor is used for neuropathy too.
Effexor has the effect of Zoloft plus the relief of your neuropathy problems.
Thanks,
Dr. Neel Kudchadkar
Effexor will also stop your neuropathic problems too.
Detailed Answer:
Dear XXXXXXX
Effexor was prescribed because unlike Zoloft, which is an SSRI drug, it is an SNRE drug. Both drugs are totally different. Effexor is used for neuropathy too.
Effexor has the effect of Zoloft plus the relief of your neuropathy problems.
Thanks,
Dr. Neel Kudchadkar
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you. I did not know that
XXXXXXX
XXXXXXX
Brief Answer:
Thanks.
Detailed Answer:
Dear XXXX,
Have a nice day.
Dr. Neel Kudchadkar
Thanks.
Detailed Answer:
Dear XXXX,
Have a nice day.
Dr. Neel Kudchadkar
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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