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Advice on uncontrolled diabetes, BP, kidney problem - Online Doctor Chats

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

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   Hi My father is having low pulse of 42 and high BP (170-74). Please suggest. He is in remote location and unable to consult any cardiologist there.
Doctor :   hi
Doctor :   Dr. XXXXXXXX here
User :   he is also having high sugar
User :   hi sir
Doctor :   since when he is having the problem?
User :   Hi My father is having low pulse of 42 and high BP (170-74). Please suggest. He is in remote location and unable to consult any cardiologist there.
User :   since 1 week
Doctor :   what were his recent blood sugar and BP levels?
User :   he was in ICU for 3 days
User :   259 Sugar
Doctor :   is he on regular medications?
User :   174/74 - BP
User :   yes
Doctor :   his sugar and BP both needs to be properly controlled
Doctor :   if he is still in ICU, then wait till he becomes stable
User :   he was in ICU
Doctor :   and shift to a higher institution, preferably a multispeciality hospital
User :   his pulse is fluctuating between 40 - 70
Doctor :   such that he gets combined medical appraoch from
Doctor :   cardiologist and endocrinologist
User :   is high BP can lower the pulse?
User :   and is pulse of 42 is risky?
Doctor :   usually high BP wil not lower the pulse
User :   and high sugar?
Doctor :   high sugar can sometimes cause low pulse
User :   ok
Doctor :   he needs special care
User :   but as he is in remote location ... it will take another 10-12 hours to shift him to metro place
User :   is pulse of 42 can cause any problems?
Doctor :   see if he can be shifted to nearby city where multispeciality care can be given
User :   sir is pulse of 42 is a problem while shifting?
Doctor :   yes low pulse will cause problems as blood oxygenation levels might come down
Doctor :   and lead to complications
User :   ok any medicine so that there is no problem while shifting?
Doctor :   what medications is he currently taking?
User :   nitrolong
User :   gluconorm
User :   ponact
Doctor :   the treating doctor will not let you shift him, unless he is stable, and if shifting, they will give medications to continue until he is reached higher institution
User :   thanks
User :   can i consult for my father also?
User :   he is having kidnet problems
User :   kidney
Doctor :   ok. please proceed
User :   my father is having high bp and sugar enen though he controlled them a lot and its stable within limits .. he is facing kidney problems
User :   his creatinine is 9.7
User :   blood urea - 191
User :   and Hb - 8.1
User :   ESR - 68
Doctor :   ok
User :   is there any medicine to lower doen the creatinine
User :   and urea?
Doctor :   due to uncontrolled BP and sugar, damge to kidney, and liver and heart would have already been there
Doctor :   if teh damage done is irreversible, it cannot be undone
Doctor :   and he would require dialysis support
User :   what will be the frequency of dialysis?
User :   he was not having motions when it increased to this level
Doctor :   it would depend on his general condition and blood test values
User :   any idea if this can be reversible
User :   ?
Doctor :   creatinine is 9.7 and blood urea - 191 are quite high

Doctor :   have you taken a nephrologist consultation/
Doctor :   was abdominal ultrasound done?
User :   yes
Doctor :   if yes what did it show?
User :   it was showing poor cmd
User :   prostate grade II
Doctor :   then it means that already a lot of damage is don eto the kidney, and most probably the changes are irreversible
User :   chronc renal parenchymal disease - bilateral with multiple renal ctsts kidneys
User :   but is the no medicine in world which can lower down the urea?
Doctor :   as I said, medications are given based on teh examination and investigation fondings
User :   and i heard that there is a machine which can fit under person kidney which does automatic dialysis?
Doctor :   +findings
Doctor :   your father needs special care
User :   we are consulting nephorologist
Doctor :   where is he located at present? how far is the nearest city? and which city is the closest?
User :   he is in new delhi
User :   india
Doctor :   you can get him to AIIMS?
Doctor :   or to Fortis group of hospitals?
User :   ok
User :   but any simpler way to to dialysis?
Doctor :   and continue further treatment there
User :   and new technology
User :   ?
Doctor :   taking second opinion from a nephrologist would help. I am a general practitioner
User :   ok sir ...
User :   cant i chat with nephorologist here?
Doctor :   no, they are available as specialist consultation. I will provide the link to contact them
Doctor :
Doctor :   follow this link to consult with a nephrologist
User :   ok
Doctor :
Doctor :   follow this link to consult with a diabetologist
User :   but they are not available online?
Doctor :
Doctor :   follow this link to consult with cardiologist
Doctor :   no they are not available online, their consultation is available on request.
User :   ok sir
User :   thanks a lot
Doctor :   is there anything else i can help you with?
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