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    Suggest treatment for swollen ankles, sleep apnoea and high BP

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Posted on Tue, 3 Feb 2015 in Diabetes
Question: My husband has very swollen ankles continuously. His GP doesn't seem to think it is a problem, but we're not sure. He has Type 2 diabetes, vascular problems, sleep apnoea, high blood pressure, plus he drinks at least 10 standard alcohol drinks (heavy beer and whiskey), or more, daily. He sees a diabetes educator, diabetes nurse, dietician, or the doctor ask him about his drinking , or caution him about alcohol abuse. He takes Kavezide, Noten & Minipress and Monduretic for high blood pressure daily. Should we see another GP?
doctor
Answered by Dr. Niranjan G 23 minutes later
Brief Answer:
He needs to stop alcohol and get evaluated further.

Detailed Answer:
Dear madam, greetings from HCM. I have read your query.

He has multiple problems and need to be evaluated thoroughly. First above all, he needs to quit alcohol and smoking, if he smokes. He is on right medications but lifestyle changes are needed.
First get his fasting and post prandial glucose, microalbuminuria, HbA1c, sleep study, pulmonary functions, hepatobiliary and renal functions, ECG, echocardiogram done. Meet a cardiologist, pumonologist, and an endocrinologist.

He might not be having proper sugar control. He might need insulin. Along with all the medications have to be decided based on the reports.

Ask him to be strict on diet. Give him more of green leafy vegetables, oats, nuts and millets. Also good proteins with egg, fish and sprouts. Based on this, meet a dietician and get a proper diet chart and strictly follow that.

Ask him to practice yoga and meditation. Some amount of physical activity is must.
Send me all the reports and I will guide you what to be done. Of course he should be determined for lifestyle management.

Thank you
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Niranjan G 13 hours later
Thank you Dr XXXXXXX You have confirmed my thoughts on how best to manage his health issues, but getting my husband to agree is another thing.

He has had a sleep study and uses a CPAP machine to sleep. His recent HbA1c reading was 7.5. He started on Insulin injections in December, but despite my best efforts will not accept that he must reduce or eliminate his alcohol consumption.

He gave up smoking 6 years ago.

He weights approximately 150 kg. I do my best to incorporate your diet recommendations into what he eats, but he went out and bought himself a deep fryer machine! He does not accept any suggestions I make about his lifestyle and since I am not backed up by his GP I feel it is a losing battle and only causes friction between us.

He will not exercise, even a short 50 metre walk to visit neighbours. He has two raised vegetable beds which he tends and considers he gets enough exercise by pottering in the garden - this does not include mowing, digging, or pruning, just putting the sprinkler on, spraying bugs, etc.

Unless he is prepared to help himself, I guess it is useless for me to nag!

Thank you once again.
doctor
Answered by Dr. Niranjan G 5 hours later
Brief Answer:
He needs counselling to boost his self motivation

Detailed Answer:
Dear madam, I appreciate your sincere efforts to keep up your husbands health. Try to take him to a psychiatrist and let him have concelling with him also some medications to come out of it. And bringing some self motivation to him.
Now that HbA1c is bit high we need to think of changing his medications to better ones. Put on insulin injections if he is not totally ready for lifestyle changes.
Push him to yoga classes you also go with him . meditation . lifestyle changes are more important..
Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Niranjan G

Diabetologist

Practicing since :2003

Answered : 633 Questions

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