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

159 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.

Suggest treatment for numbness in the arms

Answered by
Dr. Sagar Makode


Practicing since :2013

Answered : 1754 Questions

Posted on Wed, 15 Mar 2017 in Hypertension and Heart Disease
Question: Continuing question for Dr. Makonde-
New update. Patient has been much more active today on the Drs. Recmendation. She has been making laps around the ward. After each session she has her BP and heart rate checked.
After each session her BP raises by approx. 20 points- her heart rate , however, is remaining at 40- 45.
My question is- can she be put on a pacemaker to help with the arrthymia's and to increase her heart rate. At the same time can she keep taking the beta blockers as it has helped the ectopics. If she had the pacemaker the heart rate could be increased to help with the numbness in the arms and at the same time help the energy level. Is that possible? Dr. Gillrie
Answered by Dr. Sagar Makode 53 minutes later
Brief Answer:
See the description

Detailed Answer:
It's not advisable because we have better alternatives. Beta blockers reduce blood pressure and pulse rate along with suppression of ectopics, so what she needs most is dose optimization. I guess her pulse rate prior to starting beta blockers was normal, if yes pacemaker will not be very useful.
Firstly, as I advised previously optimization of dose at which ectopics will be under control or have few ectopics, and heart rate will be in a range of 50-60 and bp readings more than 100 systolic is acceptable. Numbness, dizziness, is because of two reasons one is low bp and secondly low pulse rate. So decreasing beta blockers dose slightly will address both the issues, it will increase pulse rate and blood pressure and also suppress the ectopics. Once dose of beta blockers is changed it may take 2-3 days to wean off its effect.
The option which you gave serve the same purpose as that of reducing the beta blockers dose. Secondly, pacemaker or ICD won't treat ectopics, it will give shocks if she has ventricular tachycardia or fibrillation, which we are not expecting. And giving pacemaker and beta blockers togetherly, is not suitable because beta blockers are not very effective in suppression of ectopics and they may lose their efficacy of suppression of ectopics and we may need some other drugs later. So the very purpose of putting pacemaker will be lost.
Also, putting the patient at a risk of surgery, possible complications of pacemaker insertion like infection, periodic battery changing, in future she may be a candidate for different kind of pacemaker like ICD, so all these are there. Also, mere suppression of ectopics will give symptomatic benefit but will not change the prognosis as such. So taking this much risk is not worth. So all efforts should be taken to manage the things with drugs.
Also, more importantly her heart is functioning normal, so blood pressure more than 100 will be sufficient blood pressure according to her needs. so we should chase her blood pressure much, we ll just focus on symptoms. Resolution of symptoms will be our end point.
Heart rate not rising if because of beta blockers. Blood pressure rise is normal thing and good sign. Yes she should do activities and exercise, there is no contraindication as such. so get back if you have more doubts. All the best.
Above answer was peer-reviewed by : Dr. Nagamani Ng

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Medical Topics

Recent questions on  Low bp

doctor1 MD

I have been feeling dizzy ( vertigo ), nauseaous and very fatigued since Thursday. I feel ok when laying down. I measured my bloodpressure this morning (86/59).

doctor1 MD

My legs from knee s down to feet feel like ice when touched. When I get up in morning they feel warm but a couple hours later they feel like ice to touch. Could low BP cause this? Thank you.

doctor1 MD

can the body re-strengthen the fibrous cap in arteries to prevent rupture if in the right environment ( low BP , cholesterol , ect)?

doctor1 MD

My husband is suffering from Dengue since 15 September. His platelet count on Sunday (15 Sep) was 1.84 Lacs and it yesterday it hovered around 1.60 Lacs but today it dipped to 77 thousand.
I know there are no medicines as such for Dengue, for fever however he is prescribed Dolo (paracetamol)/Nice (if fever doesn't come down by taking Dolo) and Allegra 120 mg for rashes and sore throat. But his throat has developed white patches and throat is aching so Doctor prescribed Augmentin. Please suggest
- Should an antibiotic such as Augmentic should be taken in Dengue?
- Till what level of platelet count he should remain at home (without being hospitalized).
- Should his BP be monitored regularly as during Dengue internal weakness and bleeding may lead to low BP which can cause organ damage? I am saying this based on my knowledge, please correct if this is wrongly assumed.
- When should we hope him to start recovering as he is already in his 5th day of disease.

One of my cousins died last year because of dengue hemorrhagic fever and we are very worried for him. Please help.