Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
151 Doctors are Online

Diabetic neuropathy,treatment,on tegretol - Online Doctor Chats

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

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
Doctor :   Hello
Doctor :   ok
Doctor :   Please proceed further
User :   Hello. I need some medical advice. My mother is 54 years old and has been smoking for 30 years now. Is over-weight is 163 cm tall and weighs about 85 kg
User :   She suffers from Depression, Anxiety, Asthma, high colesterol, high blood pressure and type 2 diabetes
Doctor :   ok, I understand
User :   She is medicated for Depression & Anxiety, she takes Lerigan Forte, Sobril 10 mg, Stesolid 10 mg, Zoloft 200 mg, Blood pressure Amlodipin Accord 5 mg
User :   Insuline injections Insulatard 60 units in the morning and 60 units in the evening
Doctor :   ok
User :   Her recent illness is that she has this tingling sensation in her hands
Doctor :   ok
User :   stabbing, severe pain, sometimes they go numb and can't feel a thing. Cannot hold objects for a long time and often they fall out of her hands because they feel weak
Doctor :   I understand her problem
User :   loses movement in her legs and she falls underneath her knees and has dark patches on them, her knees
User :   often wakes in the middle of the night becuase of the pain which she has been having for 10 days now
Doctor :   I understand
Doctor :   How is her physical activity otherwise?
User :   some kind of nerve pain and muscle
User :   she has always been very active, even when she is over-weight. Very energetic
Doctor :   That is good to hear
User :   cannot stand still or just sit around and do nothing. In is not in her personality
User :   she doest workout or anything like that
User :   but she does things around the house
User :   etc
User :   what do you think Dr?
Doctor :   Your mother is quite young, she is 54 years old, right?
Doctor :   ok
Doctor :   It seems to me like she is on quite a lot of medications
User :   correct
Doctor :   And she is having a bit of health issues also
Doctor :   Yes, I do agree and it is required for her
Doctor :   yes, sure
User :   she is indeed but they were given to her by professionals
User :   not something she wants to take but must for different reasons
Doctor :   May I know her last readings of Blood sugar and Blood pressure?
Doctor :   ok
User :   shes not the kind of person that ├é┬┤complains and is sick physically. Its very seldom when she does go sick, fly or virus something like that
User :   her blood sugar is regulated. Its around 7-9
Doctor :   Do you mean to say Glycosylated Hb as 7 to 9?
User :   her blood pressure fluctuates
User :   she was given a few days ago Amlodipin in the e.r
User :   not sure
User :   what you mean
Doctor :   What are these values 7 to 9, are these her blood sugar levels?
User :   I check it for her and it reads sometimes 7 sometimes 9 or 11
Doctor :   ok
Doctor :   ok
User :   correct
Doctor :   Yes, I would suggest definitely
User :   has terrible migrains also
User :   so what you reckon Dr.?
Doctor :   Her problems seems to be more of a nervous weakness due to the medications as well as due to Diabetes
User :   suggest what?
Doctor :   She is having generalized weakness in her muscles
Doctor :   It happens sometimes due to more CNS medications also
User :   shes has
Doctor :   ok
User :   shes only had diabetes for 2-3 years
Doctor :   But still Diabetes can have effects on the nerves faster
Doctor :   Drugs used in Central nervous system
User :   CNS medications?
Doctor :   It is unlikely to be degerative in nature considering her age
User :   is it degenerating that could worsen?
Doctor :   I suggest you to get her blood glucose levels tested in the lab
Doctor :   Also do get your mothers' blood pressure checked
Doctor :   ok
User :   The thing is that I took her to a hospital in the emergency room. They took some blood tests and the Dr. on call said that it is not spinal
Doctor :   As far as I see it, your mothers' health concern is not an emergency
Doctor :   It actually needs detailed clinical examination by a neurologist in the OPD
User :   no bad cirulation cuz she has warm hands. According to him, the cardoologist, he thinks it might be Diabetic Neurophaty
Doctor :   That is fine, she can continue on it
User :   he has given her a referal to a Neurologist but given her Tegretol Retard 200 mg
Doctor :   Her nervous system examination has to be done in a detailed manner
Doctor :   Also get her blood sugar tested in the lab
Doctor :   Most likely, it seems like Diabetic neuropathy
Doctor :   Is she on any nuerotropins?
Doctor :   ok
User :   she only takes what he gave her
Doctor :   OPD is out patient department
User :   the regerol retard 200 mg
User :   what is OPD
Doctor :   You can discuss with your doctor about adding neurobion forte to her current medications
User :   so I'll need to explain it for them or what?
User :   so what do I need to say to the neurologist
Doctor :   She will be fine do not worry
User :   ok
User :   yes but I dont want some wishy-washy neurologist to give her "half ass" examination if you pardon my french
Doctor :   Please do get her thoroughly examined by her neurologist
User :   what do I have to say and do to make sure that he or she does her job right?
User :   yes
Doctor :   Just ask the doctor to include a neurotropin in the medications
User :   ok. Well my mother says that she does feel better becuse of the new drug Tegretol
User :   but I still want her checked out. Will she have to take these drugs all her life or will it pass with time this affliction
Doctor :   She will have to continue on these medications
User :   ok
Doctor :   yes, it is lifetime
User :   ?
User :   always
User :   and as long as she takes them, the condition will not worsen or degenerate?
Doctor :   Degeneration starts only after 70 years, she is too young for it now
User :   nothing to be worried about???
Doctor :   Yes, she will be fine
User :   that sounds assuring
Doctor :   Continue her medications, Also she can go in for physiotherapy
User :   great. Another question that doesnt involve this
Doctor :   Yes, sure go ahead
User :   I have this recurring pain in my shoulder blades. It hurts like hell and I've had inflammation before
Doctor :   I understand.
Doctor :   Is it on both shoulders or one of them?
User :   They get all swollen and stiff.
User :   I try with Ipren cream and tablets. Its changes, once its on the left and then on the right
Doctor :   ok
Doctor :   It should be a sprain in the shoulder blades due to stress
User :   the pains goes away for a few hours but to releif the pain I have to take 8 tablets a day to be pain-free
User :   then my stomach hurts from the medicine
User :   physical terapy I cannot manage now becuase of the pain
Doctor :   Why don't you try some ice packs locally
Doctor :   also some shoulder exercises should help
User :   on the area that hurts
User :   ?
User :   ok
Doctor :   Please do get an X-ray done
User :   but why does it come back, it is clinical stress?
User :   will it show? I mean, I think the x-ray will show only if its damaged or injured right?
Doctor :   X-ray will show changes in the joint due to wear and tear
Doctor :   Also it shows any fracture
User :   I'm not questioning your expertise or anything Dr.
Doctor :   It also says about the calcium status of the bone grossly
User :   I see
User :   what else should I do
User :   ?
Doctor :   You do not need anything much other than an X-ray
Doctor :   Do take simple analgesics for the pain
Doctor :   May I know your age please?
User :   analgesics. Ofcourse 34 years old female
Doctor :   ok
Doctor :   Most likely it seems to be of muscular origin
Doctor :   I feel you should be fine with some rest and pain killers
User :   i see.
Doctor :   You need not worry about calcium deficiency as you are still young
User :   but its recurring. It comes and goes but it hurts like a sonavvabitch! Pardon for writing that
Doctor :   I understand the pain
Doctor :   Do not strain your shoulders much
Doctor :   Yes sure, they can
Doctor :   You can go to a massuese
User :   do you think a massuese or chiroproctur can help me?
User :   ok
Doctor :   It would be better than a chiropractor
Doctor :   yes
User :   really?
Doctor :   You just need some relaxation of the shoulder muscles
Doctor :   Exactly
Doctor :   Also see an orthopedician with the X-ray
User :   so get a x-ray, go to a messuse, do not strain the shoulder blades, put ice on it
User :   can my house doctor do an x-ray or will I need to go to the hospital for that?
User :   what is that?
Doctor :   An orthopedician is a doctor who specializes in diseases of the bones
Doctor :   For sometime now
User :   but will I have to medicate the pain for it to stop comming back again? I see, ok
Doctor :   Inflammation starts in the joint as the stress on the joint increases
User :   how does the inflammation start?
User :   is it something cause by me???
Doctor :   When you use your shoulders more than they can actually handle, there is strain in the joint cavity, various cytokines are released into the joint causing pain and inflammation
User :   whats the best medication for the pain and inflammation do you think?
Doctor :   Ice packs locally are very very good
Doctor :   Are you understanding what I am saying to you?
Doctor :   You can ask me again if you do not follow
User :   i see
User :   every word
Doctor :   Thank you
Doctor :   Please proceed
User :   Thank you for being so kind but I understand you 100% Dr.
Doctor :   Heat actually worsens the inflammtion
User :   I asked a nurse about it and she said that heat does wonders, like being in a sauna, taking a hot shower
Doctor :   I do not suggest heat therapy for inflammations
User :   etc, is that true?
Doctor :   So, as more and more cytokines are released, the joint gets swollen
User :   I'm always suspicious about Swedish doctors and nurses and I was right in doing so. (smiles)
User :   so no heat
Doctor :   Fluid is secreted into the joint cavity and hence swelling and pain in the joint
Doctor :   Please do not apply heat
User :   ok
Doctor :   I do not recommend it
User :   i wont then
Doctor :   Nice to see you smile
User :   and what medicins do you reccomend for the pain
Doctor :   You can take simple analgesics like Paracetamol, it should suffice
Doctor :   Thank you too
Doctor :   Is there anything else I may help you with?
User :   thank you...
Doctor :   Not really, do not take very hot showers
User :   should i stay away from hot showers?
User :   seriously?
Doctor :   Better would be lukewarm water
Doctor :   Thank you for consulting me
Doctor :   You too have a great day
User :   i see. Ok Dr. thank you so much for your time and your valuble advice. Have a great day and take care
Doctor :   Wishing you and your mom a very healthy life
User :   thank you kindly
Doctor :   Bye for now
Question is related to
© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor