Brief Answer:
More detailed information is required

Detailed Answer:
Hi Ms XXXXXXX

Thanks for your query.

I wish that you had given as much details as possible about the duration of Restless Leg Syndrome (RLS), medicines tried for RLS so far; drugs being taken for angina problem so that the drugs advised by me do not interact with the current medication. Also, the test reports (if available) would have given me a clue to the cause of RLS.

Both problems are due to RLS.

However, the causes of RLS are usually anemia, Vitamin B12 deficiency; diabetic complication; Atherosclerosis (narrowing) of blood vessels of legs; or, injury/irritation (usually as a result of vertebra degeneration/disc herniation of lower back vertebra- called lumbar vertebra) of nerves supplying the legs.

The recommended course of action should be :-

* Get Hemoglobin levels tested --> If anemia is detected, iron-pills + Folic acid supplements will gradually improved symptoms of RLS.

* Exclude diabetes - get a fasting blood sugar test. If detected, anti-diabetic treatment will help. Recurrent Staph infection + presence of heart disease STRONGLY suggest Diabetes (undetected so far).

* Get Blood Vitamin B12 levels test done to see if there is a deficiency.

* However, in view of your co-existing angina, Atherosclerosis (narrowing of leg blood vessels due to deposition of cholesterol inside their lumen, leading to reduced blood supply to legs) is a strong possibility. Lipid Profile test and a Doppler flow study of both lower limbs ( to see for inadequate blood flow in leg blood vessels), would be very helpful.

* If you have co-existing backache (occasionally moderate/severe), an MRI/CT scan of Lumbar region will be diagnostic.

In the meanwhile, I strongly recommend oral Vitamin B12 (1500 micrograms) daily for a month or so. Also, take Pregabanyl 75mg TWICE daily, if the same has not been prescribed by your doctor so far.

Kindly forward all relevant details as highlighted above, at the earliest, so that a sound advice can be given to you.

Fond regards,

Dr. Rakesh Karanwal

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Brief Answer:
Get your blood sugar done to confirm diabetes

Detailed Answer:
Hi Ms XXXXXXX

Thanks for the feedback.

* So, the causes of RLS have narrowed down to three :-

- Complication of lower back fusion.

- Diabetes - which, I am sure, must have progressed to a XXXXXXX diabetes. Get your fasting/post-prandial blood sugar done immediately and start with anti-diabetic treatment under your doctor's close supervision. Addition of pregabanyl and Vitamin B12, to Sifrol and endep, will certainly reduce the symptoms of RLS. Or, the doctor may switch over to anti-epileptic drug, called carbamezapine.

- Atherosclerosis (plaques in the lower limbs' arteries) for which meticulous control of cholesterol is the need of the hour. Addition of Aspirin 75mg (if not already taking) should be done for both, unstable angina and atherosclerosis.

* Please consult your doctor and discuss the entire matter with him + my recommendations. He will then, order relevant investigations, including Nerve Conduction Velocity test for leg nerves; blood sugar; Doppler flow study of leg vessels and other tests, as required. He will also prescribe the drugs mentioned by me, under the Brand names available in Australia. Please note that- as per the policy of this website- I am prohibited from recommending drugs by their Brand Names.

Hope I have answered your clarifications. If you have further queries, I will be happy to answer them.

Fond Regards,

Dr. Rakesh Karanwal

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