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My Husband,age 50, Software Engineer, There Is Terrible Pain In Shoulder And Neck. Suddenly It Trigers Please Suggest Proper Diagnosis Followed By Treatment.
Question: Dear Dr,
My husband,age 50, software engineer, has following symptoms,
1. Since last 2 days,Blood pressure is high.140/100,which used to be 130/90earlier.he is vomitting. there is terrible pain in shoulder and neck.Suddenly it trigers.
We did MRI brain, a month ago.will upload reports later.But according to our doctor,MRI of brain is normal .In remarks it is mentioned as migraine.We did ECG yesterday.. It was also normal.
He is taking LOSAR -25mg a day.
2.Migraine since last 15 years.He takes provinal 10mg a day.
3.In last month he had nausia and vomitting.Endoscopy of abdomen showed H.pylori infection.After taking antibiotics from specialist,He was feeling relief against nausea.
pl suggest proper diagnosis followed by treatment.
My husband,age 50, software engineer, has following symptoms,
1. Since last 2 days,Blood pressure is high.140/100,which used to be 130/90earlier.he is vomitting. there is terrible pain in shoulder and neck.Suddenly it trigers.
We did MRI brain, a month ago.will upload reports later.But according to our doctor,MRI of brain is normal .In remarks it is mentioned as migraine.We did ECG yesterday.. It was also normal.
He is taking LOSAR -25mg a day.
2.Migraine since last 15 years.He takes provinal 10mg a day.
3.In last month he had nausia and vomitting.Endoscopy of abdomen showed H.pylori infection.After taking antibiotics from specialist,He was feeling relief against nausea.
pl suggest proper diagnosis followed by treatment.
Brief Answer:
Need to examine him in person, could be gastritis,
Detailed Answer:
Hello,
After going through your question carefully, I can understand your concern.
Since your husband is a known hypertensive, his blood pressure has gone up due to additional stress from abdominal pain and pain in the shoulders and neck.
But it can also be due to reduced blood supply to heart due to high blood pressure.
Migraine will also make things worse.
Since there are overlapping conditions affecting your husband, one can not be sure about the diagnosis without properly examining him in person and getting some essential investigations.
I hope to have addressed your concern to your satisfaction, if you have any doubts, I will be happy to oblige.
Regards.
Need to examine him in person, could be gastritis,
Detailed Answer:
Hello,
After going through your question carefully, I can understand your concern.
Since your husband is a known hypertensive, his blood pressure has gone up due to additional stress from abdominal pain and pain in the shoulders and neck.
But it can also be due to reduced blood supply to heart due to high blood pressure.
Migraine will also make things worse.
Since there are overlapping conditions affecting your husband, one can not be sure about the diagnosis without properly examining him in person and getting some essential investigations.
I hope to have addressed your concern to your satisfaction, if you have any doubts, I will be happy to oblige.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thx for reply.
1.Visited heart specialist.Got ECG done.It was found normal.
2.Doctor changed his tablet from Losar 25 to
Telma -ct 40/6.25 once a day,
On friday BP was 140/100,which is now 120/96
,after exact 48 hrs,
3.I have uploaded brain mri report.Already taking the tablet provanal 10mg.
4.Uploaded the treatment given for h.pylori infection.
5.Still he is having vomiting sensation ; more burping..
6.Having right shoulder pain,getsrelief when he takes NICE tablet twice a day,
pl suggest remedy
1.Visited heart specialist.Got ECG done.It was found normal.
2.Doctor changed his tablet from Losar 25 to
Telma -ct 40/6.25 once a day,
On friday BP was 140/100,which is now 120/96
,after exact 48 hrs,
3.I have uploaded brain mri report.Already taking the tablet provanal 10mg.
4.Uploaded the treatment given for h.pylori infection.
5.Still he is having vomiting sensation ; more burping..
6.Having right shoulder pain,getsrelief when he takes NICE tablet twice a day,
pl suggest remedy
Brief Answer:
Good to know that the heart is fine and BP has reduced, stop NICE tablets.
Detailed Answer:
Hello,
Since you got the ECG done and consulted the cardiologist and was told that heart is fine, the problem now seems to be due to gastritis caused by the NICE tablets.
NICE has been banned in may countries because of its side-effects, and it causes severe inflammation and erosions in the stomach.
You should stop that tablet promptly.
consult an orthopedic surgeon for his shoulder pain.
1. Take Capsule. Sompraz-D .
2. Take Surup. Mucaine Gel 10 ml.
3. Take Syrup. Sucralfill 10 ml .
All these above medications to be taken before meals. You will need a prescription for these, so please ask your local doctor for a prescription.
4. The shoulder pain needs to be evaluated properly, we need to know why he has shoulder pain, so a proper examination by an orthopedic surgeon will help, and you can request that doctor not to prescribe any NSAIDS like NICE for the shoulder pain as they all cause gastritis, instead, Tramadol can be prescribed.
5. Apply ice to the affected shoulder, this will reduce inflammation and pain in the shoulder.
6. Consult a physiotherapist and get ultrasonic massaging of the shoulder.
7. Do not eat spicy and oily foods.
8. Do not drink carbonated beverages.
9. Eat at a regular fixed time everyday.
10. Walk for half an hour after eating meals, do not lay down immediately after meals.
11. Drink plenty of water.
I hope I have been able to help you.
Wishing your husband a speedy recovery.
Regards
Good to know that the heart is fine and BP has reduced, stop NICE tablets.
Detailed Answer:
Hello,
Since you got the ECG done and consulted the cardiologist and was told that heart is fine, the problem now seems to be due to gastritis caused by the NICE tablets.
NICE has been banned in may countries because of its side-effects, and it causes severe inflammation and erosions in the stomach.
You should stop that tablet promptly.
consult an orthopedic surgeon for his shoulder pain.
1. Take Capsule. Sompraz-D .
2. Take Surup. Mucaine Gel 10 ml.
3. Take Syrup. Sucralfill 10 ml .
All these above medications to be taken before meals. You will need a prescription for these, so please ask your local doctor for a prescription.
4. The shoulder pain needs to be evaluated properly, we need to know why he has shoulder pain, so a proper examination by an orthopedic surgeon will help, and you can request that doctor not to prescribe any NSAIDS like NICE for the shoulder pain as they all cause gastritis, instead, Tramadol can be prescribed.
5. Apply ice to the affected shoulder, this will reduce inflammation and pain in the shoulder.
6. Consult a physiotherapist and get ultrasonic massaging of the shoulder.
7. Do not eat spicy and oily foods.
8. Do not drink carbonated beverages.
9. Eat at a regular fixed time everyday.
10. Walk for half an hour after eating meals, do not lay down immediately after meals.
11. Drink plenty of water.
I hope I have been able to help you.
Wishing your husband a speedy recovery.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear doctor, thx a lot for detailed reply.
1.Today morning he took tablet telma 40/6.5.but in the afternoon he took Losar 25 as he experienced headche,
2.He had vomitting sensation since afternoon.
3.Have u seen the uploaded MRI ??is angio test necessary along with mri?
4.Second uploaded report is of endoscopy.He burped a lot ,yesterday .
5.Followed up with cardiologist.He prescribed
telma 40/6.5 twice a day,
1.Today morning he took tablet telma 40/6.5.but in the afternoon he took Losar 25 as he experienced headche,
2.He had vomitting sensation since afternoon.
3.Have u seen the uploaded MRI ??is angio test necessary along with mri?
4.Second uploaded report is of endoscopy.He burped a lot ,yesterday .
5.Followed up with cardiologist.He prescribed
telma 40/6.5 twice a day,
Brief Answer:
MRI suggestive of migraine, he has gastritis as I mentioned.
Detailed Answer:
Dear XXXXXXX
Thanks for writing back with further details and the MRI report and the endoscopy report.
Endoscopy is quite confirmatory of what I always suspected, that is your husband is suffering from Gastritis.
The reason for headache seems to be migraine as indicated by the MRI.
I have seen the MRI report, since there is no change in those small hyperintense T2 flairs/foci, there is nothing worrying in the MRI.
Consult a neurologist once for the migraine. Addition of specific medications like sumatriptan or topiramate for migraine will help tremendously.
Continue the treatment I advised above... that is..
1. Take Capsule. Sompraz-D twice a day for 15 days.
2. Take Surup. Mucaine Gel 10 ml thrice a day for 15 days.
3. Take Syrup. Sucralfill 10 ml thrice a day for 15 days.
Add Tablet. Emeset 4 mg thrice a day for 5 days for the burping and nausea.
You can also give him a probiotic (Sporolac sachets).
For blood pressure, continue Telma 40 as advised by the cardiologist, since the blood pressure is now under control, headache will also come down slowly.
If there is too much of headache, then he can take one tablet of Dolo 650 mg.
Please do not worry excessively, things will return to normal gradually.
Do consult a neurologist once for the headaches and migraine.
Ask your doctor to prescribe you all the medicines that I have suggested.
You may take a printout of this conversation and show it to him/her.
I hope I have been of help.
Looking forward to hearing good tidings from you.
Best wishes.
MRI suggestive of migraine, he has gastritis as I mentioned.
Detailed Answer:
Dear XXXXXXX
Thanks for writing back with further details and the MRI report and the endoscopy report.
Endoscopy is quite confirmatory of what I always suspected, that is your husband is suffering from Gastritis.
The reason for headache seems to be migraine as indicated by the MRI.
I have seen the MRI report, since there is no change in those small hyperintense T2 flairs/foci, there is nothing worrying in the MRI.
Consult a neurologist once for the migraine. Addition of specific medications like sumatriptan or topiramate for migraine will help tremendously.
Continue the treatment I advised above... that is..
1. Take Capsule. Sompraz-D twice a day for 15 days.
2. Take Surup. Mucaine Gel 10 ml thrice a day for 15 days.
3. Take Syrup. Sucralfill 10 ml thrice a day for 15 days.
Add Tablet. Emeset 4 mg thrice a day for 5 days for the burping and nausea.
You can also give him a probiotic (Sporolac sachets).
For blood pressure, continue Telma 40 as advised by the cardiologist, since the blood pressure is now under control, headache will also come down slowly.
If there is too much of headache, then he can take one tablet of Dolo 650 mg.
Please do not worry excessively, things will return to normal gradually.
Do consult a neurologist once for the headaches and migraine.
Ask your doctor to prescribe you all the medicines that I have suggested.
You may take a printout of this conversation and show it to him/her.
I hope I have been of help.
Looking forward to hearing good tidings from you.
Best wishes.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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