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Dr. Andrew Rynne

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Suggest treatment for chronic microvascular echymic disease

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Dr. Rahul Tawde

General & Family Physician

Practicing since :1980

Answered : 1 Question

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Posted on Thu, 28 Aug 2014 in Medicines and Side Effects
Question: Hi! I was just diagnosed with Chronic microvascular Echymic Disease. I was shocked-never had any symptoms except some dizziness. I don't smoke. Don't have elevated glucose levels, I am overweight and just lost 20 lbs(now 197) and have had high cholesteral followed by my family physician keeping the cholesterol in the 200-210 rane. My trigylcerides are in the 150's. How do I manage this-I can't get into my neurologist very soon and don't know what to watch for or be alarmed about? Please explain!
doctor
Answered by Dr. Rahul Tawde 2 hours later
Brief Answer:
Lifestyle modification and medical managemant

Detailed Answer:
Hi, thanks for posting your concern in the HCM.


I need to know how were you diagnosed? Please attach all the available reports and doctor's advice in your follow up query.

However, for the time being, my recommendations are-
1. Regular exercise or yoga for at least 30 min. Or else, please start brisk walking.
2. Dietary advice- Salt and fat restricted diet- Sodium restriction <2300 mg/day. Two tablespoon of oil is allowed in 24 hrs. 100 gm of fresh fruit (especially citrus fruit), High fiber diet and diet rich in green leafy vegetables and animal protein (if you are non-vegetarian) should be consumed. A proper diet chart can only be prepared after calculating your daily calorie, protein, fat and micronutrient need, based on present medical illness and BMI.
3.Please follow the advice of your family physician regarding maintenance of your serum cholesterol level.
4. If you have ischemia in brain, urgent treatment with antiplatelet medications may be needed.
5. Routine blood examinations are needed alongwith ECG to rule out any concurrent medical illness. Based on that further medications can be advised.
6. Be careful of warning signs- speech abnormality, memory problem, difficulty in maintaining body balance, convulsion, loss of consciousness, chest pain, shortness of breath, calf muscle pain, excessive sweating, fever, numbness, weakness in any limb, deviation in face etc. If they occur at any point of time, you need to call your house-physician or visit the ER of nearest hospital urgently.

Hope you are satisfied with my answer. If you think I have satisfactorily resolved your query, please rate my answer. If you have any further query related to this, please write back.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Rahul Tawde 4 hours later
Thank you very much... It was diagnosed on a Mri of the brain. I don't have the report, but it said all blood flows, hydrocephals, so , and son were normal, except for increased high flair and T2 intensity. I called my doctor back to ask about all this, and all I got was a call the next day from his nurse saying that I am stable. I said, stable for what??? So I sent my MRI discs to him along with the reports and my symptoms of falling a lot, memory loss, tremors, etc. I asked him to call me after he read them. Haven't heard from him. So I called office and got an appointment for August 15th. I have a friend in California who is a professor of radiology so I sent another disc for him to read it too. I am worried about the in between time from now until August 15th if I need to be on medication, etc. I am very upset with this Dr.Dhuna that I saw for the first time in the middle of July. Perhaps he feels this is something minor that he sees all the time, but to me it is not and a stroke scares me. Can you advise as to what I should do?
doctor
Answered by Dr. Rahul Tawde 8 hours later
Brief Answer:
Treatment for PVWMH

Detailed Answer:
Hi, thanks for posting specified symptoms and MRI findings. That helped me to understand that you have developed white matter hyperintensity most probably in periventricular region. And this condition does correlate with your current symptoms.
Now, regarding the treatment management part, my recommendations ( in addition to what I wrote earlier) are-
1. For the time being you can start taking B complex vitamin to halt the progression of the disease.
2. Please check your BP(Blood pressure), because apart from your age, a high BP is one of the most important risk factors. And strict control of BP needs to be maintained along with salt restricted fat restricted diet.
3. Please again check the lipid profile report if not done in last one month. A strict control of bad lipids is also of supreme importance.
4. Please consult your neurologist or a Neuropsychiatrist at the earliest. If not possible, please consult a doctor of internal medicine. You may also need in patient treatment with hyperbaric oxygen.
5. A detailed clinical examination and relevant investigation are needed because WMH is quite unusual at this early age. Autoimmune diseases and any form of neuropsychiatric illness must be ruled at the earliest to prevent further decline in cognition.
For any further questions, please write back to me directly.

If you are satisfied with my answer, please close the thread and rate my answer.
Regards,
Dr. Kaushik

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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