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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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"To be answered by Dr. Prof XXXXXXX Saha. " Dr.

Answered by
Dr.
Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4372 Questions

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Posted on Mon, 4 Mar 2019 in General Health
Question: "To be answered by Dr. Prof XXXXXXX Saha. "
Dr. Saha, I spoke to you back in august 2018 about dizziness and nausea. I am having another problem now. I have pain across my lower back and on my left side near and above my waist. I also experience the nausea it seems when I do not sleep well and when my blood pressure is up.
150/100. My feet are swollen, left more than right and some fluid in my legs , non pitting. I get the chills once in a while. This has been going on for a while now. I was at my doctors office. The physicians asssistant said maybe kidney infection or diverticulosis. She ordered levaquin.
That was last Monday. She did a urinalysis and sent it to be cultured. It was clear.
On Wednesday, the pain was very strong. I went to the Emergency Room in our nearby hospital. They did blood work and a ct scan. They said it was not a kidney infection or diverticulosis. There was a trace of blood however inmy urine. They said it was musculoskeletal. They were very busy. the ct scan did not have the injection. That was almost a week ago. I still have the back pain, but not as bad, and the pain on my left side and nausea and now chills when in bed. I did not sleep well last night and feel badly today.. They said to stop the levaquin which I did. Can you answer me soon. please. "To be answered by Dr. Prof. XXXXXXX Saha.
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Follow up: Dr. Prof. Kunal Saha 0 minute later
"To be answered by Dr. Prof XXXXXXX Saha. "
Dr. Saha, I spoke to you back in august 2018 about dizziness and nausea. I am having another problem now. I have pain across my lower back and on my left side near and above my waist. I also experience the nausea it seems when I do not sleep well and when my blood pressure is up.
150/100. My feet are swollen, left more than right and some fluid in my legs , non pitting. I get the chills once in a while. This has been going on for a while now. I was at my doctors office. The physicians asssistant said maybe kidney infection or diverticulosis. She ordered levaquin.
That was last Monday. She did a urinalysis and sent it to be cultured. It was clear.
On Wednesday, the pain was very strong. I went to the Emergency Room in our nearby hospital. They did blood work and a ct scan. They said it was not a kidney infection or diverticulosis. There was a trace of blood however inmy urine. They said it was musculoskeletal. They were very busy. the ct scan did not have the injection. That was almost a week ago. I still have the back pain, but not as bad, and the pain on my left side and nausea and now chills when in bed. I did not sleep well last night and feel badly today.. They said to stop the levaquin which I did. Can you answer me soon. please. "To be answered by Dr. Prof. XXXXXXX Saha.
doctor
Answered by Dr. Prof. Kunal Saha 6 hours later
Brief Answer:
Get an x ray done

Detailed Answer:
Thanks for asking me again.

I am sorry that you are in pain. The pain is indeed likely to be musculoskeletal. I need to ask you if an X ray of lumbosacral spine (AP and lateral) has been done. If not, I would insist you to get it done. It would help is determining spondylois or disc problems as possible causes. Subsequently you might also need an MRI. Hot compress and physical therapy should help.

Feel free to write back.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
Get an x ray done

Detailed Answer:
Thanks for asking me again.

I am sorry that you are in pain. The pain is indeed likely to be musculoskeletal. I need to ask you if an X ray of lumbosacral spine (AP and lateral) has been done. If not, I would insist you to get it done. It would help is determining spondylois or disc problems as possible causes. Subsequently you might also need an MRI. Hot compress and physical therapy should help.

Feel free to write back.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prof. Kunal Saha 15 hours later
I have had an xray of my lumbar spine.

It says no compression fracture. A mild lumbar scoliosis is noted.

Grade 2 spondylolisthesis of L4 on L5 is present. There is 6 mm retrolisthesis L3 on 4. This appears stable.

Multilevel disc space narrowing is present throughout the lumbar spine. Anterior osteophytes are seen from L1-L3.

Lower lumbar facet arthrosis is present.

A gallstone is noted.
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Follow up: Dr. Prof. Kunal Saha 0 minute later
I have had an xray of my lumbar spine.

It says no compression fracture. A mild lumbar scoliosis is noted.

Grade 2 spondylolisthesis of L4 on L5 is present. There is 6 mm retrolisthesis L3 on 4. This appears stable.

Multilevel disc space narrowing is present throughout the lumbar spine. Anterior osteophytes are seen from L1-L3.

Lower lumbar facet arthrosis is present.

A gallstone is noted.
doctor
Answered by Dr. Prof. Kunal Saha 24 hours later
Brief Answer:
A physical therapist can help you out

Detailed Answer:
Thanks for the update. Sorry for the inadvertent delay. The findings corroborate with the back pain indicating spondylosis to be the likely cause. You need to see a physical therapist. He will be able to take care of the situation.

You need not worry about the gall stone. Unless you develop abdominal pain you need not even bother.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
A physical therapist can help you out

Detailed Answer:
Thanks for the update. Sorry for the inadvertent delay. The findings corroborate with the back pain indicating spondylosis to be the likely cause. You need to see a physical therapist. He will be able to take care of the situation.

You need not worry about the gall stone. Unless you develop abdominal pain you need not even bother.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha 3 hours later
Thank you again Doctor. I went to a new primary doctor today because I was in so much pain. He ordered Meloxicam. I hope it relieves the pain. It is an nsaid and I have high blood pressure but I am hoping it will be ok.
He also said to go to physical therapy. I will leave the discussion open for the next two days in case anything else comes up and then review it.

I think you are the best doctor I have ever spoken to. Thank you for getting back to me so soon.
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Follow up: Dr. Prof. Kunal Saha 0 minute later
Thank you again Doctor. I went to a new primary doctor today because I was in so much pain. He ordered Meloxicam. I hope it relieves the pain. It is an nsaid and I have high blood pressure but I am hoping it will be ok.
He also said to go to physical therapy. I will leave the discussion open for the next two days in case anything else comes up and then review it.

I think you are the best doctor I have ever spoken to. Thank you for getting back to me so soon.
doctor
Answered by Dr. Prof. Kunal Saha 3 hours later
Brief Answer:
Glad to be of service

Detailed Answer:
Thanks for your trust. Meloxicam is a good medicine and should help. But the role of physical therapy is more.

Feel free to write back in case of further queries.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
Glad to be of service

Detailed Answer:
Thanks for your trust. Meloxicam is a good medicine and should help. But the role of physical therapy is more.

Feel free to write back in case of further queries.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Prof. Kunal Saha 2 days later
Dr. Saha,
I have been afraid to take the Meloxicam because of the warnings of heart attack, etc. It also says if you have high blood pressure, etc. tell your doctor. As I said, I went to a new doctor who ordered the meloxicam. I am not certain he knows I have high blood pressure, which has been staying high lately. My feet and legs are still swollen and there is an odor when I urinate which I did not notice when I saw this new doctor. I am concerned it still may be something with the kidneys. Is there another medicine I could take for the pain? I have not been able to schedule physical therapy yet. Please answer soon. Thank you.
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Follow up: Dr. Prof. Kunal Saha 0 minute later
Dr. Saha,
I have been afraid to take the Meloxicam because of the warnings of heart attack, etc. It also says if you have high blood pressure, etc. tell your doctor. As I said, I went to a new doctor who ordered the meloxicam. I am not certain he knows I have high blood pressure, which has been staying high lately. My feet and legs are still swollen and there is an odor when I urinate which I did not notice when I saw this new doctor. I am concerned it still may be something with the kidneys. Is there another medicine I could take for the pain? I have not been able to schedule physical therapy yet. Please answer soon. Thank you.
doctor
Answered by Dr. Prof. Kunal Saha 14 minutes later
Brief Answer:
You could try paracetamol or acetaminophen without any worry.

Detailed Answer:
Meloxicam or any other pain medication has these risks associated but most often they are tolerated well. Nevertheless, indiscriminate use is what poses the risks. Paracetamol or acetaminophen 1g per dose can be taken as an effective pain medication which lacks these side effects. You could therefore try paracetamol or acetaminophen without any worry.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
You could try paracetamol or acetaminophen without any worry.

Detailed Answer:
Meloxicam or any other pain medication has these risks associated but most often they are tolerated well. Nevertheless, indiscriminate use is what poses the risks. Paracetamol or acetaminophen 1g per dose can be taken as an effective pain medication which lacks these side effects. You could therefore try paracetamol or acetaminophen without any worry.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prof. Kunal Saha 28 hours later
Dr. Saha,
what about the swollen feet and legs, left more than right. There is also a slight odor when I urinate.
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Follow up: Dr. Prof. Kunal Saha 0 minute later
Dr. Saha,
what about the swollen feet and legs, left more than right. There is also a slight odor when I urinate.
doctor
Answered by Dr. Prof. Kunal Saha 23 hours later
Brief Answer:
Drink plenty of water

Detailed Answer:
I attribute the swelling to high blood pressure. For the urine odor, it indicates inadequate water intake.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
Drink plenty of water

Detailed Answer:
I attribute the swelling to high blood pressure. For the urine odor, it indicates inadequate water intake.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prof. Kunal Saha 2 days later
Dr. On wednesday night I had a strong pain in my abdomen around the navel. It lasted for about an hour. Prior to the pain I had pain in my left shoulder . I also have been having back pain. I went to a new family doctor. He asked if I had nausea or palpitations during the episode. I dont remember but I dont think so. He also asked when was my last cardiology appt. It was in December. He took an electrocardiogram. He said it was ok. Do you think it was heart related or stomach or gallbladder related?
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Follow up: Dr. Prof. Kunal Saha 0 minute later
Dr. On wednesday night I had a strong pain in my abdomen around the navel. It lasted for about an hour. Prior to the pain I had pain in my left shoulder . I also have been having back pain. I went to a new family doctor. He asked if I had nausea or palpitations during the episode. I dont remember but I dont think so. He also asked when was my last cardiology appt. It was in December. He took an electrocardiogram. He said it was ok. Do you think it was heart related or stomach or gallbladder related?
doctor
Answered by Dr. Prof. Kunal Saha 12 hours later
Brief Answer:
Possibly intestinal pathology

Detailed Answer:
Thanks for writing back. Sorry for the inadvertent delay in responding. Going by the description the pain does not seem to involve the gall bladder or the stomach. The gall bladder pains are located in upper right abdomen whereas the gastric pains are usually in upper central or upper left abdomen. That does not seem to be the case here. It is possible that some toxins entered with your food and gave you intestinal cramps. They should resolve in a couple of days or so.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Prof. Kunal Saha 0 minute later
Brief Answer:
Possibly intestinal pathology

Detailed Answer:
Thanks for writing back. Sorry for the inadvertent delay in responding. Going by the description the pain does not seem to involve the gall bladder or the stomach. The gall bladder pains are located in upper right abdomen whereas the gastric pains are usually in upper central or upper left abdomen. That does not seem to be the case here. It is possible that some toxins entered with your food and gave you intestinal cramps. They should resolve in a couple of days or so.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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