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Suggest Treatment For Severe Back Pain In An Elderly Person
Question: Hi sir,
My mom name ambujam age 56 . I hope you remember . Thanks a lot for your answers which you made before This is just a follow up question but I will give you a sum up of all the things which happened before My mom had severe back pain .After diagnosis they found that it is spine TB and since the bone erosion is more they planned for spine surgery and it was done a month before she don't have pain now but a week before she got some imbalance in the leg while she was trying to walk after which we admitted her back in hospital they did LFT test and all and they found bilirubin level is elevated . After treatment they did discharge my mom now again they asked us to take the test report when i see the report now bilirubin is in control and in normal range it was 9 before but now 1.3 but there is some new problem RBC level is 2.47 Milli/Cu mm but doctors are saying it is normal due to ATT medication and hemoglobin level is 7.4 I am bit worried about this . In addition to this when she got admitted in hospital they changed few ATT medicines so that the bilirubin will go low they said but now I see the ESR level a bit elevated the test results are 20mm in half an hour and 42 mm in 1 hour and CRP is showing positive now also Do we need to take urgent care and do we need to worry for this . I am very much worried please advise me :(
My mom name ambujam age 56 . I hope you remember . Thanks a lot for your answers which you made before This is just a follow up question but I will give you a sum up of all the things which happened before My mom had severe back pain .After diagnosis they found that it is spine TB and since the bone erosion is more they planned for spine surgery and it was done a month before she don't have pain now but a week before she got some imbalance in the leg while she was trying to walk after which we admitted her back in hospital they did LFT test and all and they found bilirubin level is elevated . After treatment they did discharge my mom now again they asked us to take the test report when i see the report now bilirubin is in control and in normal range it was 9 before but now 1.3 but there is some new problem RBC level is 2.47 Milli/Cu mm but doctors are saying it is normal due to ATT medication and hemoglobin level is 7.4 I am bit worried about this . In addition to this when she got admitted in hospital they changed few ATT medicines so that the bilirubin will go low they said but now I see the ESR level a bit elevated the test results are 20mm in half an hour and 42 mm in 1 hour and CRP is showing positive now also Do we need to take urgent care and do we need to worry for this . I am very much worried please advise me :(
Brief Answer:
Answers
Detailed Answer:
Hi there
Thanks for the query
I have read your current and past queries.
The tuberculosis spine would usually respond in 2 months by lowering ESR and CRP.
Since they are still elevated, I suggest a repeat biopsy and culture to find out if it is resistant tuberculosis bacteria we are dealing with.
The culture procedure will reveal which correct antibiotics to use to kill the bacteria, because nowadays MDR or Multi Drug Resistant and XDR or Extensively Drug Resistant TB bacteria have become common.
Spine fusion surgery is a good protective measure to prevent paralysis due to collapse of the affected part of the spine.
Do get her blood tested for Peripheral blood smear to look for the cause of the anaemia as it is not common with the ATT treatment.
Repeat MRI will also be useful to look for any pus pressing on the nerves which may be the reason for cause of weakness.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Answers
Detailed Answer:
Hi there
Thanks for the query
I have read your current and past queries.
The tuberculosis spine would usually respond in 2 months by lowering ESR and CRP.
Since they are still elevated, I suggest a repeat biopsy and culture to find out if it is resistant tuberculosis bacteria we are dealing with.
The culture procedure will reveal which correct antibiotics to use to kill the bacteria, because nowadays MDR or Multi Drug Resistant and XDR or Extensively Drug Resistant TB bacteria have become common.
Spine fusion surgery is a good protective measure to prevent paralysis due to collapse of the affected part of the spine.
Do get her blood tested for Peripheral blood smear to look for the cause of the anaemia as it is not common with the ATT treatment.
Repeat MRI will also be useful to look for any pus pressing on the nerves which may be the reason for cause of weakness.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Above answer was peer-reviewed by :
Dr. Prasad
I forget to tell you one thing sir ESR was in good level before i mean by march 13 it was in 30 once she got discharged and the ATT medication got changed it increased a bit now one more thing what i would like to know is , Is this elevation very high and is this something serious we have to deal with in urgency please tell me we are worried.they already confirmed that TB is resistant to few drugs and then only they planned for operation
Brief Answer:
Needs further investigation
Detailed Answer:
Usually raising ESR and CRP indicated that the infection is going on still.
Get a repeat MRI and then we can have a clear picture of the cuneiform and the right decision to take.
Needs further investigation
Detailed Answer:
Usually raising ESR and CRP indicated that the infection is going on still.
Get a repeat MRI and then we can have a clear picture of the cuneiform and the right decision to take.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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