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After Having Surgery To Repair A Torn Achilles Tendon And
Question: After having surgery to repair a torn achilles tendon and as I am starting physical therapy I have developed a weakness in both legs that is making it increasing difficult to walk. I am on a lot of meds and having RLS that medicine is declining in it's ability to help control the RLS (Mirapex). Serious sleep deprivation I am scheduled for a sleep study Oct 21 which I am trying to move up - but this is starting to scare me. I also have epilepsy (Vimpat & Aptiom), Rx for depression (Pristiq), and meds for high blood pressure, pre-diabetes, and GERD. Any ideas?
Brief Answer:
May need neurological examination, drugs review and nerve conduction studie
Detailed Answer:
Hi! Welcome to Ask A Doctor service.
Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what you had been going through lately.
Based on the history you have shared, this weakness can be drug related as many of these drugs specially the anti epileptics you are takin can cause leg weakness, while drugs you are using for RLS can cause postural or orthostatic hypotension. Similarly many GERD medicines can counter the effects of these drugs.
First step should be to limit the polypharmacy, meaning that use lesser medicine and must be used smartly. Like for RLS and Depression, using duloxetine can help with both, similarly, Vimpat may be replaced with valproate which will help with depression and extra pyramidal side effects of other drugs too.
But all the prescription should be reviewed by one specialist, rather than swinging between too many sub specialists.
Other causes of leg weakness should Alos be ruled out. Neurologist review to specify the kind of leg weakness, whether upper or lower motor neuron type, and then deciding between brain imaging and nerve conduction studies. Levels of B12 folic acid may be needed as it can also cause weakness.
Metabolic causes and electrolytes may also be reviewed. Pre diabetes is not associated with neurological signs unless it has progressed to diabetes so that should also be ruled out.
Wishing you a speedy recovery. Regards
May need neurological examination, drugs review and nerve conduction studie
Detailed Answer:
Hi! Welcome to Ask A Doctor service.
Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all it's sad to know what you had been going through lately.
Based on the history you have shared, this weakness can be drug related as many of these drugs specially the anti epileptics you are takin can cause leg weakness, while drugs you are using for RLS can cause postural or orthostatic hypotension. Similarly many GERD medicines can counter the effects of these drugs.
First step should be to limit the polypharmacy, meaning that use lesser medicine and must be used smartly. Like for RLS and Depression, using duloxetine can help with both, similarly, Vimpat may be replaced with valproate which will help with depression and extra pyramidal side effects of other drugs too.
But all the prescription should be reviewed by one specialist, rather than swinging between too many sub specialists.
Other causes of leg weakness should Alos be ruled out. Neurologist review to specify the kind of leg weakness, whether upper or lower motor neuron type, and then deciding between brain imaging and nerve conduction studies. Levels of B12 folic acid may be needed as it can also cause weakness.
Metabolic causes and electrolytes may also be reviewed. Pre diabetes is not associated with neurological signs unless it has progressed to diabetes so that should also be ruled out.
Wishing you a speedy recovery. Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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