Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

178 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

70 years old having TB, recurrent headaches and loss of appetite. Which specialist should I consult?

Answered by
Dr. Anantharamakrishnan


Practicing since :1966

Answered : 4506 Questions

Posted on Fri, 21 Dec 2012 in Cancer
Question: my father in-law (70 yrs) has been diagnosed with TB and has recurrent headaches since a month. His illness is also about 45 days old where his temperature would be between 99 deg to 101 degrees every evening. He was regularly taking saridon when the doctor prescribed him Flunarin. There was a loss of appetite and loss of weight and energy. There was no relief and just a week back he was prescribed Liv 52, Nurokind Plus (10mg), Flowkind F and Nimprex -P (3 times a day). He felt better yesterday after taking the medicines for about 6 days but today evening he again felt very nauseated at dinner time and did not eat anything and resorted back to eating Saridon for his severe headache. I must point out that he's a diabetic and his eyes are awaiting an operation for Glucoma (right eye) and major time cataract (left eye and demanding immediate attention). Our doctor has asked us to wait for the operation for now until he fully recovers from TB. We are totally clueless and disillusioned as to what shall we do and whom to consult. Please help.....
Answered by Dr. Anantharamakrishnan 10 hours later
Hi friend,
Welcome to Health Care Magic

     Nimprex-P contains Nimesulide + paracetamol > Nimesulide is a NSAID) which has been restricted in several countries. / Saridon is propyphenazone, paracetamol and caffeine > propyphenazone is also an NSAID (old) and has been restricted in several countries. / It is wiser to switch over to safer pain relievers. Your specialist in XXXXXXX Medicine will help.
Nurokind is mecobalamin (Vit B12) – OK.
Flokind-F is finasteride + tamsulosin – it is meant for prostate and has nothing to do with pain or tuberculosis.
     Most surgeries are delayed until anti-tuberculous regime is effectively controlling it– for fear of systemic and local spread from the operation. If the surgery is not an emergency, one can wait. If urgent, it can be done a few days after starting the treatment
     Persistent fever and headache in the setting of tuberculosis may mean intra-cranial involvement - say meninges and/or brain. He MUST CONSULT A NEUROLOGIST. He may need MRI/ MRA or even Lumbar Puncture – for favour of further assessment and assistance. Neurologists are also specialised in pain management, especially headache. Take your father and he will be benefited.

Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Anantharamakrishnan 3 hours later
Dear Doctor,

Thank you for the reply. Sorry, in my previous query I forgot to mention that a report of Ultrasound of Lower abdomen shows the enlargement of Prostate which measures 50x30x32 mm with weight of 29gms and of homogenous echotexture of parenchyma and the conclusion of Prostatomegaly Grade 1. So that explains Flokind-F.

We had already got his CT Scan done on November 3, '12 and the report is as thus: No evidence suggestive of any focal parenchymal disease or any space occupying lesion is identified. Is an MRI/MRA or Lumbar Puncture is advised still? He was prescribed Tab Aamlin/ Amitane 10mg, Tab Neval Chrono/ Valparin Chrono 300mg by our Neurologist Dr. XXXXXXX K. XXXXXXX (D.M. Neuro) for a month earlier. He took these medicines for a week's time but discontinued as there was no sign of relief from headache. I also agree that this possibly could have been a wrong move.

Can you kindly prescribe/ suggest a safer pain reliever for his headache and a sugar free appetiser?

His Anti Mycobacterium Antibody Profile is:
Mycobacterium (A60 Antigen Complex) IgM IMNDEX: 0.711
So for that he's already taking FORECOX 2tabs in the morning empty stomach.

In addition to this he's taking Amlopress AT, Monosprin 30, Aztor, Gluconorm SR 1gm, Gluconorm SR for his heart, BP(Good control) and diabetes (very regulated) since last 15years.

Can you also suggest a good Neurologist in Lucknow?

I look forward to your reply and enlightenment at the earliest.

Thank you.
Answered by Dr. Anantharamakrishnan 2 hours later

It is good that intra-cranial tuberculosis involvement had been reasonably excluded. No need for MRI. A lumbar puncture may still be indicated if the headache continues.

     Cox-2 inhibitors like celecoxib are generally safe. It is better to start with a small dose and to step up later, if necessary. It is preferable not to reach the maximum doses in view of his age.
     Raising the pain threshold with drugs like gabapentin may also help – again starting with small 100 mg dose and stepping up is better.
     Also anti-depressants are useful – not simply for depression, they also modify pain perception. In general all these should be used sparingly and with caution – they all have side effects and the minimum should be used.

     May be it is time for operation of his glaucoma and that could be the only thing that can ensure relief? Consult your ophthalmologist agaun.

     Tubeculosis, Diabetes and Hypertension are being treated well. If his sugar and pressure are controlled well / if he had been taking these drugs since long, the problem is not from these drugs and there is no need to change.

     It looks like your neurologist is good and the prescription is proper. You need perseverance and compliance. Others may also do same or similar. I have no opinion about Lucknow. If you are looking for a second opinion, Professor of Neurology in the local Medical College will be a good idea.

All the best

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,  
Drug/Medication ,   ,   ,   ,   ,   ,   ,   ,  
Lab Tests ,  

Recent questions on  Gabapentin

doctor1 MD

I ve got shingles on left arm for four weeks now and still have burning pain, numbness and itching. I couldn t sleep well even I ve taken the Gabapentin 100 mg for two days by taking 1 capsule orally once daily and increase by 1 capsule daily. How can I stop the pain, numbness and itching ?

doctor1 MD

Hello. I m trying to stop using my Fentanyl patch. The pain mgmt gave me 10 mg methadone q 12 h hour withdrawals. Uh....I can t and don t want this methadone. It seems to make me worse. So, when the horrible sickness/anxiety hit the last two times, instead of methadone I took half of a hydrocodoneand.25 MG s of my za ax. What I want to know is if I can take my meloxicam and gabapentin while the methadone is still in my system? Thank you.

doctor1 MD

I have been told I have neuropathy in my feet from the RA which is quite painful at times. I take Plaquenil for the RA and Gabapentin for the neuropathy. However, my greatest problem is my left knee. I developed a cyst behind it and it has been drained once so far. I am finding more and more that the pain and swelling in the knee is getting worse. If I sit for more than a half hour at a time, the knee starts to lock. I wear a brace when it is very painful and stiff. Is there anything else I can do?

doctor1 MD

hi i have fibromyalgia,cfs/me,arthritus,im taking gabapentin 400mg 4x day and 50mg tramadol4xday and solpadol 100/50mg 4xday.. and today im in so much pain and my muscles have seized up in both legs i feel faint and my balance is bad ??? what can i take or do to get back feeling some what pain free.

doctor1 MD

i have crirrocis quit drihking 2years but i have bad itching

doctor1 MD

My entire right arm keeps falling asleep whenever I sleep, regardless of my position. This has been happening for over a week. I have a history of both stroke and neuropathy. I am a 54 yr old woman.

doctor1 MD

Hi my name is XXXXXXX I take trazodone, gabapentin and duloxetine HCL DR, with oxycodon-acetaminophen7.5-325 witch I have to drug test for. I was just told my test came back showing I have taken lorazepam . this is not the first time for this...