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Suggest Treatment For Moderate Degeneration Of Lower Spine, Severe Headaches And Brain Fog
Question: I am sick
I saw the neurologist today, and he went over my lumbar MRI, and other than some moderate degeneration in my lower spine, the results were OK-no visible apsis or infection seen. I am still having bad headaches, along with the back and leg pain. I am also having severe Brain Fog(which I normally get after taking a course of Zithromax) and debilitating fatigue. I saw an prominent Infectious Disease doctor(recommended by my primary physician), and he believes I probably have Lyme(even though my previous tests have been negative) primarily because of my bulls eye tick rash from June-he prescribed a three week course of doxycycline. He tested me for Lyme, using a Western Blot Lyme test(Monday or Tuesday results). I am concerned about a another candida flair(like I am having currently)up while doing another course of antibiotics. I also continue to have a rash on my neck, which the ID doctor thinks is may be either a Zithromax reaction or some type of Lyme symptom. I need to turn my situation back around-this LP that I had done 5 weeks ago has really set me back, although I think I having less epidural headaches-it is somewhat hard to distinguish between the different types of head pain.
I would appreciate your input, and by the way, your previous responses have been both timely and EXTREMELY helpful.
Thanks in advance,
XXXX
I saw the neurologist today, and he went over my lumbar MRI, and other than some moderate degeneration in my lower spine, the results were OK-no visible apsis or infection seen. I am still having bad headaches, along with the back and leg pain. I am also having severe Brain Fog(which I normally get after taking a course of Zithromax) and debilitating fatigue. I saw an prominent Infectious Disease doctor(recommended by my primary physician), and he believes I probably have Lyme(even though my previous tests have been negative) primarily because of my bulls eye tick rash from June-he prescribed a three week course of doxycycline. He tested me for Lyme, using a Western Blot Lyme test(Monday or Tuesday results). I am concerned about a another candida flair(like I am having currently)up while doing another course of antibiotics. I also continue to have a rash on my neck, which the ID doctor thinks is may be either a Zithromax reaction or some type of Lyme symptom. I need to turn my situation back around-this LP that I had done 5 weeks ago has really set me back, although I think I having less epidural headaches-it is somewhat hard to distinguish between the different types of head pain.
I would appreciate your input, and by the way, your previous responses have been both timely and EXTREMELY helpful.
Thanks in advance,
XXXX
Brief Answer:
Rash unlikely to be due to Lyme's disease
Detailed Answer:
Hello, Sir.
I can understand your concern.
I have gone through your query in detail.
The headaches in your case are directly related to recent LP.
This will gradually subside. Do not worry.
The rash also seems to be unlikely to be Lyme's disease.
I cab guide you better if you can upload the images of the rash on the neck.
The brain fog and debilitating fatigue are directly related to side effects of Zithromax.
I advise you to get a baseline blood tests like Complete blood counts, serum Vitamin B12 and Vitamin D levels and update me with test reports.
Post your further queries if any.
Thank you.
Rash unlikely to be due to Lyme's disease
Detailed Answer:
Hello, Sir.
I can understand your concern.
I have gone through your query in detail.
The headaches in your case are directly related to recent LP.
This will gradually subside. Do not worry.
The rash also seems to be unlikely to be Lyme's disease.
I cab guide you better if you can upload the images of the rash on the neck.
The brain fog and debilitating fatigue are directly related to side effects of Zithromax.
I advise you to get a baseline blood tests like Complete blood counts, serum Vitamin B12 and Vitamin D levels and update me with test reports.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Prasad
I am having tremendous anxiety(both mental and physical), which started early this morning, and I woke up feeling depressed because I am Sick and Tired of being Sick. I have had bouts of anxiety since I stopped drinking over a year ago, and I also have, on occasion, some pretty intense anxiety attacks with the Lyme. The Lyme specialist(MD) that I have been to said that anxiety-panic attacks and depression are very real symptoms of Lyme, especially when you are attempting to kill the bacteria with some type of anti fungal(die off effect). I have been prescribed some anti anxiety medicine, and I am taking clonidine(0.2-0.4) mg per day for the physical anxiety, and I have Librium and Xanax(which I very rarely take) for extreme anxiety, I spoke to the dr. who has treated me for anxiety, and explained to her about anxiety and the racing thoughts that I am having(along with the headaches), and she and I meeting tomorrow morning. Please respond with your thoughts.
XXXX
XXXX
Brief Answer:
Few drug modifications can help to control your symptoms.
Detailed Answer:
Hello, Sir.
I can understand your concern.
The symptoms of anxiety/panic attacks/depression are unlikely to be associated with Lyme disease, especially during the antifungal therapy. I find this a bit illogical.
Instead of Clonidine, combination Librium and Escitalopram will wok good.The former will relieve anxiety/panic attacks and symptoms of alcohol withdrawal and the latter will control depression.
Clonidine and Xanax are inappropriate at this point. Please check with your physician if he can make these changes.
Update me with your doctor's opinion on your next consultation with regards to headaches.
Post your further queries if any.
Thank you.
Few drug modifications can help to control your symptoms.
Detailed Answer:
Hello, Sir.
I can understand your concern.
The symptoms of anxiety/panic attacks/depression are unlikely to be associated with Lyme disease, especially during the antifungal therapy. I find this a bit illogical.
Instead of Clonidine, combination Librium and Escitalopram will wok good.The former will relieve anxiety/panic attacks and symptoms of alcohol withdrawal and the latter will control depression.
Clonidine and Xanax are inappropriate at this point. Please check with your physician if he can make these changes.
Update me with your doctor's opinion on your next consultation with regards to headaches.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thanks-very helpful response. I will get back to you tomorrow with the doctors diagnosis on the anxiety/depression situation. I am taking the clonidine for the blood pressure as well as the physical anxiety-I get an INTENSE burning sensation in my legs, arms and chest from the Lyme. Also, do you think that the headaches are still coming from the LP 5 weeks ago, the Lyme disease, or the die off effects of the anti microbial medicine for the Lyme, or perhaps are their headaches possibly displaying themselves when my BP is high. Also, the back and leg pains that resurfaced a week ago from the LP-will they go away at some point as well as the LP headaches-as I mentioned above, the lumbar MRI was OK-no sign of infection.
XXXX
XXXX
Brief Answer:
Headache could be due to high BP or LP
Detailed Answer:
Hello, Sir.
I can certainly understand your concern.
In case, if Clonidine is prescribed for controlling your BP, then you need to take it.
Headaches in my opinion are related to lumbar puncture.
The possibility of a headache related to high blood pressure is also high.
The reason related to antimicrobial killing is very unlikely.
The leg pains and backache should come down soon as MRI is very much normal.You need not worry about them.
Update me with your doctor's response.
Post your further queries if any,
Thank you.
Headache could be due to high BP or LP
Detailed Answer:
Hello, Sir.
I can certainly understand your concern.
In case, if Clonidine is prescribed for controlling your BP, then you need to take it.
Headaches in my opinion are related to lumbar puncture.
The possibility of a headache related to high blood pressure is also high.
The reason related to antimicrobial killing is very unlikely.
The leg pains and backache should come down soon as MRI is very much normal.You need not worry about them.
Update me with your doctor's response.
Post your further queries if any,
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
My doctor has prescribed Lexapro, but I have not started it as yet. I am still deciding whether or not I want to go on a long time anti depressant. I believe my anxiety and recent depression are tied to my Lyme, because as I am killing off the bacteria, my anxiety gets more intense in the short term. I am hoping that my LP headache symptoms will completely subside soon, as I would like to move on and focus on my Lyme protocol. My neurologist has prescribed another Head MRI, and hopefully this will confirm once and for all that the pressure my brain is fine, and that this no CSF leakage(as well as everything else being fine with my brain). I still have some bouts of runny nose(primarily coming from my left nostril-do you think that there is any remote possibility that the fluid I am blowing out could be CSF from the LP. My back and leg pain has gotten better-not much leg pain left, but still some lingering back pain(not as bad as it was). Please advise.
Thanks,
XXXX
Thanks,
XXXX
Brief Answer:
Fluid emanating from nose is unlikely to be CSF
Detailed Answer:
Hello, Sir.
I can understand your concern.
It is advisable to start Lexapro straightway without a second though as it can dramatically improve your symptoms.
The fluid coming out after nose blowing is pretty unlikely to be CSF from LP.
CSF rhinorrhea is caused either by trauma to the nose or inherent defect in the cribriform bony plate in the root of the nose.However, MRI head can detect either.
Update me with Head MRI and Lyme workup protocol.
Post your further queries if any.
Thank you.
Fluid emanating from nose is unlikely to be CSF
Detailed Answer:
Hello, Sir.
I can understand your concern.
It is advisable to start Lexapro straightway without a second though as it can dramatically improve your symptoms.
The fluid coming out after nose blowing is pretty unlikely to be CSF from LP.
CSF rhinorrhea is caused either by trauma to the nose or inherent defect in the cribriform bony plate in the root of the nose.However, MRI head can detect either.
Update me with Head MRI and Lyme workup protocol.
Post your further queries if any.
Thank you.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
MRI good-still waiting to speak the ID regarding Western Blot Lyme results. AS I mentioned. I have a Candida overgrowth situation, for which I take various antifungals. I am concerned about some of the drug interactions that I am on right now.
List of drugs:
1)Clonidine .01 mg twice per day.
2)Percocet(as needed for pain-very rarely taken).
3)Fioricet(as needed for severe headache pain).
4)Protonix.
5)Librium((as needed for anxiety-used sparingly).
6)Doxycycline(have not started yet).
7)Lexapro(have not started yet.
8)Diflucan(100 mg once per day-took in this past Monday, Tuesday, and Wednesday).
9)Nystatin(switched over from diflucan this past Thursday).
I read that there was a possible major interaction between Diiflucan and Percocet, as well as some other combinations. Please advise.
XXXX
List of drugs:
1)Clonidine .01 mg twice per day.
2)Percocet(as needed for pain-very rarely taken).
3)Fioricet(as needed for severe headache pain).
4)Protonix.
5)Librium((as needed for anxiety-used sparingly).
6)Doxycycline(have not started yet).
7)Lexapro(have not started yet.
8)Diflucan(100 mg once per day-took in this past Monday, Tuesday, and Wednesday).
9)Nystatin(switched over from diflucan this past Thursday).
I read that there was a possible major interaction between Diiflucan and Percocet, as well as some other combinations. Please advise.
XXXX
Brief Answer:
9 significant/Major interactions are found-Which require close monitoring.
Detailed Answer:
Hello, Sir.
I can understand your concerns.
I have gone through your drugs in detail and took a great research into the possible interactions.
9 significant/Major interactions are found-Which require close monitoring.
To make you understand better, I am first listing out the concerned drug names from its trade names, as follows.
1. Fluconazole- Diflucan.
2. Chlordiazepoxide- Librium.
3. Butalbital/acetaminophen/caffeine- Fioricet.
4. Nystatin-Nystatin Systemic.
5. Doxycycline-Doxycycline.
6. Oxycodone/acetaminophen-Percocet.
7. Clonidine-Clonidine.
8. Escitalopram- Lexapro.
9. Pantoprazole-Protonix.
List of drug interactions as follows.
Significant - Monitor Closely:
1.fluconazole + escitalopram
fluconazole will increase the level or effect of escitalopram.Significant interaction possible, monitor closely.
2.butalbital + doxycycline
butalbital decreases levels of doxycycline by increasing metabolism. Significant interaction possible, monitor closely.
3.oxycodone + escitalopram
oxycodone increases effects of escitalopram. Potential for dangerous interaction. Use with caution and monitor closely. Opioids may enhance the serotonergic effects of SSRIs and increase a risk for the serotonergic syndrome.
4.butalbital + escitalopram
butalbital will decrease the level or effect of escitalopram.
5.butalbital + chlordiazepoxide
butalbital and chlordiazepoxide both increase sedation.
6.butalbital + oxycodone
butalbital and oxycodone both increase sedation.
7.chlordiazepoxide + oxycodone
chlordiazepoxide and oxycodone both increase sedation.
8.chlordiazepoxide + caffeine
chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution.
9.oxycodone + caffeine
oxycodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution.
Minor/Non-Significant interactions-
1.fluconazole + caffeine
fluconazole increases levels of caffeine by decreasing metabolism.
2.fluconazole + chlordiazepoxide
fluconazole increases levels of chlordiazepoxide by decreasing metabolism.
3.butalbital + fluconazole
butalbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents.
4.fluconazole + pantoprazole
fluconazole will increase the level or effect of pantoprazole.
Post your further queries if any.
Thank you
9 significant/Major interactions are found-Which require close monitoring.
Detailed Answer:
Hello, Sir.
I can understand your concerns.
I have gone through your drugs in detail and took a great research into the possible interactions.
9 significant/Major interactions are found-Which require close monitoring.
To make you understand better, I am first listing out the concerned drug names from its trade names, as follows.
1. Fluconazole- Diflucan.
2. Chlordiazepoxide- Librium.
3. Butalbital/acetaminophen/caffeine- Fioricet.
4. Nystatin-Nystatin Systemic.
5. Doxycycline-Doxycycline.
6. Oxycodone/acetaminophen-Percocet.
7. Clonidine-Clonidine.
8. Escitalopram- Lexapro.
9. Pantoprazole-Protonix.
List of drug interactions as follows.
Significant - Monitor Closely:
1.fluconazole + escitalopram
fluconazole will increase the level or effect of escitalopram.Significant interaction possible, monitor closely.
2.butalbital + doxycycline
butalbital decreases levels of doxycycline by increasing metabolism. Significant interaction possible, monitor closely.
3.oxycodone + escitalopram
oxycodone increases effects of escitalopram. Potential for dangerous interaction. Use with caution and monitor closely. Opioids may enhance the serotonergic effects of SSRIs and increase a risk for the serotonergic syndrome.
4.butalbital + escitalopram
butalbital will decrease the level or effect of escitalopram.
5.butalbital + chlordiazepoxide
butalbital and chlordiazepoxide both increase sedation.
6.butalbital + oxycodone
butalbital and oxycodone both increase sedation.
7.chlordiazepoxide + oxycodone
chlordiazepoxide and oxycodone both increase sedation.
8.chlordiazepoxide + caffeine
chlordiazepoxide increases and caffeine decreases sedation. Effect of interaction is not clear, use caution.
9.oxycodone + caffeine
oxycodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution.
Minor/Non-Significant interactions-
1.fluconazole + caffeine
fluconazole increases levels of caffeine by decreasing metabolism.
2.fluconazole + chlordiazepoxide
fluconazole increases levels of chlordiazepoxide by decreasing metabolism.
3.butalbital + fluconazole
butalbital decreases levels of fluconazole by inhibition of GI absorption. Applies only to oral form of both agents.
4.fluconazole + pantoprazole
fluconazole will increase the level or effect of pantoprazole.
Post your further queries if any.
Thank you
Above answer was peer-reviewed by :
Dr. Yogesh D
Had a bit of a scare this morning. After wiping my behind(after morning BM), my toilet paper was covered with blood. It didn't appear to be in the actual stool, but it was quite a bit of blood for a couple of wipes. I am waiting do hear back from my GI. I have slight discomfort in my rectal area. I would appreciate your thoughts on this matter. Could it be possibly be from the medication, and or the supplements that I am taking.
XXXX
XXXX
Brief Answer:
Possible anorectal disease. Need confirmation
Detailed Answer:
Hello, Sir.
I can understand your concerns.
As per your symptoms the possibility of hemorrhoids or piles is high.
This needs further evaluation.
I advice you to have a per rectal examination and FOBT(fecal occult blood test) .
The attribution of drugs and other supplements is unlikely in your case.
Post your further queries if any.
Thank you.
Possible anorectal disease. Need confirmation
Detailed Answer:
Hello, Sir.
I can understand your concerns.
As per your symptoms the possibility of hemorrhoids or piles is high.
This needs further evaluation.
I advice you to have a per rectal examination and FOBT(fecal occult blood test) .
The attribution of drugs and other supplements is unlikely in your case.
Post your further queries if any.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Sonia Raina
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