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What Causes Severe Swelling On Foot?
Question: I have severe swelling on both my foot above the fingers. My medical history is already in your records. I take Glucophage 500, 1-0-1, diamicron mr 60, 1-0-1, telma 40, 1-0-0, nexium 40 ,1-0-0, amlodipine 5 mg, 0-0-1, seloken xl 50, 1-0-1, and storfib 10 ,0-0-1 The swelling is there for the last one week. I have B.P., Cholosterol, and Sugar, all under control. Please advise how I get relief from the swelling. Thanks for your immediate advise.
Brief Answer:
Probable cause Amlodipine
Detailed Answer:
Good day,
Noted your concern.Also noted that your diabetes, hypertension and cholesterol profile are under control. There are many possible causes of swelling in legs.
1) Amlodipine. This can cause swelling in ankle and legs
2) Kidney problems: kidney impairement can cause swelling in legs.
3) Low albumin levels.
I would recommend following things,
a) Stop Amlodipine and observe ( you may need alternate antihypertensive during this time)
b) Check serum creatinine and blood urea
c) Check Urine Protein and Serum albumin
Please feel free to ask further
Regards
Binu
Probable cause Amlodipine
Detailed Answer:
Good day,
Noted your concern.Also noted that your diabetes, hypertension and cholesterol profile are under control. There are many possible causes of swelling in legs.
1) Amlodipine. This can cause swelling in ankle and legs
2) Kidney problems: kidney impairement can cause swelling in legs.
3) Low albumin levels.
I would recommend following things,
a) Stop Amlodipine and observe ( you may need alternate antihypertensive during this time)
b) Check serum creatinine and blood urea
c) Check Urine Protein and Serum albumin
Please feel free to ask further
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your quick response and advise. Will you please suggest me a drug to be replaced for amlodipine 5.m.g I have been taking amlodipine along with the other hypertension medicaments for the last so many years. Also advise me the details of the tests I will have to take and where I can have this done. No problem for lab tests. I live in Bangalore-
Sadashivanagar Area. Suggest me some good doctors if you have any. Thanks
Sadashivanagar Area. Suggest me some good doctors if you have any. Thanks
Brief Answer:
Amlodipine replacement
Detailed Answer:
Thank you for the mail. Yo can increase Telma to 80 mg when you stop amlodipine.
You may do
a) Free T4 and TSH ( thyroid fucton tests)
b) Serum creatinine ad blood urea
c) LFT
d) Urine protein.
You may visit doctors at XXXXXXX Hrudayalaya , Manipal hospital etc or any other good hospital in Bangaore
Amlodipine replacement
Detailed Answer:
Thank you for the mail. Yo can increase Telma to 80 mg when you stop amlodipine.
You may do
a) Free T4 and TSH ( thyroid fucton tests)
b) Serum creatinine ad blood urea
c) LFT
d) Urine protein.
You may visit doctors at XXXXXXX Hrudayalaya , Manipal hospital etc or any other good hospital in Bangaore
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good morning: This is further to my consultations with Dr XXXXXXX Parameswaran XXXXXXX As advised by you I have increased the Telma to 80 mg. The following are the test results: Albumin 3.9, T-4 1.19, TSH 9.00 Creatine 1.3, Urea 35 LFT Bilirubin Totoal 0.3 and Bilurubin direct 0.1 Urine Protein- Negative I am taking Thyronorm 125 one tablet every morning in the empty stomach. I have done very comprehensive test of the Blood and if you need to know any thing further I will give you the details. I still have the swelling on the legs, left leg more. Kindly advise me how I should proceed further. You have now in your file all the medicines I take daily.Thanks for your advise.
Brief Answer:
Need increase in Thyronorm dose
Detailed Answer:
Thank you for the reply.
Blood tests shows that TSH is high. This also can cause swelling in legs .Your Thyronorm dose has to be increased ( are you taking it regularly?). Please take Thyronorm 125 mcg 5 days a week ( monday to Friday) and Thyronorm 150 mcg on Saturday and sundays
It is only 3 days since you stopped Amlodipine. Please wait for 2 days more. If th swelling still persists after few days, you may need further evaluation
Need increase in Thyronorm dose
Detailed Answer:
Thank you for the reply.
Blood tests shows that TSH is high. This also can cause swelling in legs .Your Thyronorm dose has to be increased ( are you taking it regularly?). Please take Thyronorm 125 mcg 5 days a week ( monday to Friday) and Thyronorm 150 mcg on Saturday and sundays
It is only 3 days since you stopped Amlodipine. Please wait for 2 days more. If th swelling still persists after few days, you may need further evaluation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good morning: Many thanks for your advise. I am increasing the dosage of Thyronorm to 150 from 125. Still I have swelling on the legs more on the right foot.And
also I get cramps more often on the left leg below the thigh.In your reply above you have mentioned that kidney impairment also can cause swelling of the legs. Do I have to take any further tests for this Do you advise me any medicines for this. I have done the very comprehensive test of the blood. If you would like to have any details ,please let me know. Kindly advise. Thanks
also I get cramps more often on the left leg below the thigh.In your reply above you have mentioned that kidney impairment also can cause swelling of the legs. Do I have to take any further tests for this Do you advise me any medicines for this. I have done the very comprehensive test of the blood. If you would like to have any details ,please let me know. Kindly advise. Thanks
Brief Answer:
Give time
Detailed Answer:
hi,
your creatinine is 1.3 and it is worth looking at Urine routine test . An Ultrasound of kidneys and abdomen is worth. Once you inccrease the dose of thyronorm, please wait for around 15 days to 1 month and if the swelling hasnt improved, then we need additional tests. There is no point doing too many tests now. ( we have allready identified 2 possible causes like AMLODIPINE and HYPOTHYROIDISM and have done the corrective measures. You have to give few days tie now).
Some docors ay advice you to stop Telma seeing the creatinine value. But i must say that you should continue this. This will help to protect your kidneys from further problems.
Recheck your BP after few days and then we can modify the dose of antihypertensives.
Give time
Detailed Answer:
hi,
your creatinine is 1.3 and it is worth looking at Urine routine test . An Ultrasound of kidneys and abdomen is worth. Once you inccrease the dose of thyronorm, please wait for around 15 days to 1 month and if the swelling hasnt improved, then we need additional tests. There is no point doing too many tests now. ( we have allready identified 2 possible causes like AMLODIPINE and HYPOTHYROIDISM and have done the corrective measures. You have to give few days tie now).
Some docors ay advice you to stop Telma seeing the creatinine value. But i must say that you should continue this. This will help to protect your kidneys from further problems.
Recheck your BP after few days and then we can modify the dose of antihypertensives.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good After-noon Dr XXXXXXX I am back again.Very recently ,as informed to you in my previous report, I have made a comprehensive blood check and noticed the following on the higher side: Biochemistry -Calcium 8.5,,Lipid Profile : Triglycerides 191 mg/dl, HDL Cholesterol 86.8 mg/dl, Chemical Examination ; Urine-Glucose -Positive ( This may due to the intake of Sweets on the previous day),Haematology ,Blood RBC Count 3.89 /mill/cu.mim, Packed Cell Volume (PCV) 31,9%. In my previous ,report, I have already given , the details of all the medicines I take daily. Will you kindly advise me your opinion, how I should proceed. If you need any further details , kindly let me know. Thanks for your advise.
Brief Answer:
Photo of the leg swelling
Detailed Answer:
The calcium levels of 8.5 mg/dl is not high. It is normal. HDL of 86 is very good and it is protective. HDL is good cholesterol. Triglycerides should be less than 150.
Now you should wait few weeks to see if the leg swelling is reduced or not. With the stopping of Amlodipine and increasing in the dose of Thyronorm, if the swelling do not settle, then only we have to do further tests. Can you take a photo of the leg swelling and attach?
Photo of the leg swelling
Detailed Answer:
The calcium levels of 8.5 mg/dl is not high. It is normal. HDL of 86 is very good and it is protective. HDL is good cholesterol. Triglycerides should be less than 150.
Now you should wait few weeks to see if the leg swelling is reduced or not. With the stopping of Amlodipine and increasing in the dose of Thyronorm, if the swelling do not settle, then only we have to do further tests. Can you take a photo of the leg swelling and attach?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Good morning Dr.Parameswaran XXXXXXX - Kindly give me your advise on Blood RBC count and PCV, which I have reported earlier. And also kindly advise me how to improve the Triglycerides level. You have in my reports the details of medicines which I have been taking. -Kindly also advise me if I should the following tests. Ultrasound of kidneys and abdomen and Urine Routine Test. My swelling of the leg is little better now and getting reduced. Thanks for your advise.
Brief Answer:
You have low PCV and RBC count
Detailed Answer:
Glad to hear that your leg swelling is coming down. Yes, your RBC level is low and hence the PCV is low too. What about MCV and Hb levels?
Triglyceride levels are on the higher side which should improve once blood glucose levels improve. How is your blood glucose control? What was the last HbA1c test report. You are only taking a small dose of Metformin ( Glucophage 500 mg 1-0-1). I would usually maintain my patient on a minimum of 1500 mg of Metformin. Below this dose, it may not control diabetes well. For now, continue Storfib 10 mg at night.
Since your Serum creatiine is 1.3, it is surely worth rechecking the serum creatinine,blood urea and potassium levels after few days. Get Urine routine test as well. If they are abnormal, then you need an ultrasound scan of kidneys and abdomen
You have low PCV and RBC count
Detailed Answer:
Glad to hear that your leg swelling is coming down. Yes, your RBC level is low and hence the PCV is low too. What about MCV and Hb levels?
Triglyceride levels are on the higher side which should improve once blood glucose levels improve. How is your blood glucose control? What was the last HbA1c test report. You are only taking a small dose of Metformin ( Glucophage 500 mg 1-0-1). I would usually maintain my patient on a minimum of 1500 mg of Metformin. Below this dose, it may not control diabetes well. For now, continue Storfib 10 mg at night.
Since your Serum creatiine is 1.3, it is surely worth rechecking the serum creatinine,blood urea and potassium levels after few days. Get Urine routine test as well. If they are abnormal, then you need an ultrasound scan of kidneys and abdomen
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
Thanks for response and advise. As advised by you I will take Metformin 500 one tablet in the after-noon also.I am also taking every day Diamicron MR60 , 1-0-1.
Is this enough for the sugar control.
Kindly advise me for the Haemoglobin level of 11.1 g/dl. The other results are as under.
-MCV 82.0 fl, Serum Creatinine 1.3, Blood Urea 35, Potassium 4.0 mEq/l ,
- HBA1C 7.6 %, Mean Blood Glucose 171.42 mg/dl.
Very recently I have done a comprehensive blood check up. I will forward you a copy of the same,if you could kindly give me the e-mail address.After seeing the report, you can give me your detailed advise .
My blood pressure is on the higher side , some time it is 180/85 and above.. Hence the doctor in Geneva, where we were, for the last three months,has given me a drug ,containing amodopine 10 mg.to bring the pressure under control. Now I have discontinued the medicine and taking Telma 80 ,1-0-0.due to the side effects, like swelling of legs etc.
Thanks for your early response.
XXXX
Thanks for response and advise. As advised by you I will take Metformin 500 one tablet in the after-noon also.I am also taking every day Diamicron MR60 , 1-0-1.
Is this enough for the sugar control.
Kindly advise me for the Haemoglobin level of 11.1 g/dl. The other results are as under.
-MCV 82.0 fl, Serum Creatinine 1.3, Blood Urea 35, Potassium 4.0 mEq/l ,
- HBA1C 7.6 %, Mean Blood Glucose 171.42 mg/dl.
Very recently I have done a comprehensive blood check up. I will forward you a copy of the same,if you could kindly give me the e-mail address.After seeing the report, you can give me your detailed advise .
My blood pressure is on the higher side , some time it is 180/85 and above.. Hence the doctor in Geneva, where we were, for the last three months,has given me a drug ,containing amodopine 10 mg.to bring the pressure under control. Now I have discontinued the medicine and taking Telma 80 ,1-0-0.due to the side effects, like swelling of legs etc.
Thanks for your early response.
XXXX
Brief Answer:
Medicine modifications
Detailed Answer:
Dear XXXX
I would advice you to take
Diamicron-MR 60 mg 2-0-0 ( MR is a long acting preperation and hence there is no need of taking it two times a day. If you are taking 2 tablets, both can be taken at morning itself before breakfast)
Glucopahge-XR 850 mg 1-0-1 ( no need to take three times a day).
For BP, Amlodipine is good, but since it caused swelling in legs, we have stopped. Now you are taking Telma 80 mg daily. If the BP is still high, add S-Amlodipine 10 mg at night, ( It is S- isomer of Amlodipine and there will not be swelling). If you are still in Geneva, it may not be available. It is available in XXXXXXX By the way, how is the blood pressure now.
You have normocytic anemia. Rpt CBC after few days and if still low, let me know.
Check Ultrasound abdomen, kidneys and urine routine and please attach reports.
Medicine modifications
Detailed Answer:
Dear XXXX
I would advice you to take
Diamicron-MR 60 mg 2-0-0 ( MR is a long acting preperation and hence there is no need of taking it two times a day. If you are taking 2 tablets, both can be taken at morning itself before breakfast)
Glucopahge-XR 850 mg 1-0-1 ( no need to take three times a day).
For BP, Amlodipine is good, but since it caused swelling in legs, we have stopped. Now you are taking Telma 80 mg daily. If the BP is still high, add S-Amlodipine 10 mg at night, ( It is S- isomer of Amlodipine and there will not be swelling). If you are still in Geneva, it may not be available. It is available in XXXXXXX By the way, how is the blood pressure now.
You have normocytic anemia. Rpt CBC after few days and if still low, let me know.
Check Ultrasound abdomen, kidneys and urine routine and please attach reports.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Results reviewed
Detailed Answer:
Hi,
After my last reply, i got all the attachments. Reviewed them. The corrected calcium is little low. Hb, RBC count and PCV are low.
The Urine routine looks good. Lipid profile shows slightly high TG and Low HDL.
HbA1c is on the higher side and Fasting sugar also was elevted.
if the calcium is low, you may need to check Vitamin D levels.
For low Hb, you need a peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Foate levels.
Please do an Ultrasound of abdomen to look at kidneys.
Regarding the BP and Blood sugar control, i had explained in my last reply.
Results reviewed
Detailed Answer:
Hi,
After my last reply, i got all the attachments. Reviewed them. The corrected calcium is little low. Hb, RBC count and PCV are low.
The Urine routine looks good. Lipid profile shows slightly high TG and Low HDL.
HbA1c is on the higher side and Fasting sugar also was elevted.
if the calcium is low, you may need to check Vitamin D levels.
For low Hb, you need a peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Foate levels.
Please do an Ultrasound of abdomen to look at kidneys.
Regarding the BP and Blood sugar control, i had explained in my last reply.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Very Good morning. As advised by you I will take the medicines for B.P.
Kindly advise me on RBC Count and PCV which are low.
My BP is always between 170-180 and 80-90.
Doctor I have a very big problem every night.
I have severe cramps and pain on both the legs below the knee. This I get, when I sleep at night and some times during day also. I have also knee joint pain.
As advised by a medicin before, I am taking Osteocerin and MaxGalin 150-M150
every night one tablet before I go to bed. Can you advise me on this please.
As advised by you I will have the Ultra sound of abdomen to check kidneys and send you the report.
Incidentally where are you from.? I am from XXXXXXX
Regards
XXXX
Very Good morning. As advised by you I will take the medicines for B.P.
Kindly advise me on RBC Count and PCV which are low.
My BP is always between 170-180 and 80-90.
Doctor I have a very big problem every night.
I have severe cramps and pain on both the legs below the knee. This I get, when I sleep at night and some times during day also. I have also knee joint pain.
As advised by a medicin before, I am taking Osteocerin and MaxGalin 150-M150
every night one tablet before I go to bed. Can you advise me on this please.
As advised by you I will have the Ultra sound of abdomen to check kidneys and send you the report.
Incidentally where are you from.? I am from XXXXXXX
Regards
XXXX
Brief Answer:
Low Hb and Muscle cramps
Detailed Answer:
Good day,
Welcome back.
I have noticed that you have low calcium and this may be causing the cramps in legs. Another cause could be a peripheral neuropathy from diabetes. You will need to do a Vitamin D level to find cause of low calcium. ( especially because you were in Geneva where Vitamin D deficiency is common due to lack of sufficient sun exposure).
The Low HB and PCV need to be evaluated further. For low Hb and PCV, you need a peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Folate levels. PArt of anemia is also due to hypothyroidism.
For high BP, you may continue, Seloken-XL 50 mg 1-0-1, Telma 80 mg 1-0-0 and add either
Tab.S-Amlodpine 10 mg 0-0-1 OR Tab.Plendil 10 mg 0-0-1 ( ANY ONE)
. This is another type of medicine like Amlodipine which doesnt cause oedema in legs.
By the way, how is your ankle swelling now?
I will be glad to review the ultrasound reports.
I am from XXXXXXX settled in Kochi. Was working in XXXXXXX hospital, Kochi before. Now working in Apollo hospital, Muscat. Good to know that you are from XXXXXXX
I am going for a small trip today ( being Eid holidays today) and will return by evening. I shall reply further in the evening.
Kind Regards
Binu
Low Hb and Muscle cramps
Detailed Answer:
Good day,
Welcome back.
I have noticed that you have low calcium and this may be causing the cramps in legs. Another cause could be a peripheral neuropathy from diabetes. You will need to do a Vitamin D level to find cause of low calcium. ( especially because you were in Geneva where Vitamin D deficiency is common due to lack of sufficient sun exposure).
The Low HB and PCV need to be evaluated further. For low Hb and PCV, you need a peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Folate levels. PArt of anemia is also due to hypothyroidism.
For high BP, you may continue, Seloken-XL 50 mg 1-0-1, Telma 80 mg 1-0-0 and add either
Tab.S-Amlodpine 10 mg 0-0-1 OR Tab.Plendil 10 mg 0-0-1 ( ANY ONE)
. This is another type of medicine like Amlodipine which doesnt cause oedema in legs.
By the way, how is your ankle swelling now?
I will be glad to review the ultrasound reports.
I am from XXXXXXX settled in Kochi. Was working in XXXXXXX hospital, Kochi before. Now working in Apollo hospital, Muscat. Good to know that you are from XXXXXXX
I am going for a small trip today ( being Eid holidays today) and will return by evening. I shall reply further in the evening.
Kind Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Thanks for your advise.
I live in Geneva-Switzerland for the last 32 years. I am retired from United Nations-Geneva.I visit XXXXXXX time to time to see my daughter.
Previously I was taking Shelcal 500 1-0-0 and was not getting the cramps on the legs for some time. Now I started taking the same again. Can you advise me another medicine with Vit-D and Calcium and can I continue taking Shelcal..
I will forward you the other reports once done.
Thanks and with regards
XXXX
Thanks for your advise.
I live in Geneva-Switzerland for the last 32 years. I am retired from United Nations-Geneva.I visit XXXXXXX time to time to see my daughter.
Previously I was taking Shelcal 500 1-0-0 and was not getting the cramps on the legs for some time. Now I started taking the same again. Can you advise me another medicine with Vit-D and Calcium and can I continue taking Shelcal..
I will forward you the other reports once done.
Thanks and with regards
XXXX
Brief Answer:
Calcium and Vitamin D
Detailed Answer:
Hi, Good to hear from you again.Sorry for the late reply. I have been travellig around a lot ( Eid holidays here)
I hope you will arrange for a Vitamin D(total) test and Anemia tests (CBC, ESR,peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Folate levels).
Once after giving blood for the above investigations, you may take Shelcal 500 mg 1-0-1 ( for a month and later can reduce to 1-0-0). Along with this, you will also require Vitamin D loading. ( Shelcal has only minimal Vitamin D). You can take D-RISE Satchets ( 60000 units) weekly once for 6 weeks and then monthly once for 6 months.
I hope your BP is better now. HAve you started the medicines yet? How is the ankle swelling now.
Glad to hear that you are retired from UN and now living in Geneva. I had been to Austria 2 weeks ago, missed Switzerland.
Hope to hear from you soon
Regards
Binu
Calcium and Vitamin D
Detailed Answer:
Hi, Good to hear from you again.Sorry for the late reply. I have been travellig around a lot ( Eid holidays here)
I hope you will arrange for a Vitamin D(total) test and Anemia tests (CBC, ESR,peripheral smear, Serum Iron, TIBC and Transferrin saturation, Vitamin b12 and Folate levels).
Once after giving blood for the above investigations, you may take Shelcal 500 mg 1-0-1 ( for a month and later can reduce to 1-0-0). Along with this, you will also require Vitamin D loading. ( Shelcal has only minimal Vitamin D). You can take D-RISE Satchets ( 60000 units) weekly once for 6 weeks and then monthly once for 6 months.
I hope your BP is better now. HAve you started the medicines yet? How is the ankle swelling now.
Glad to hear that you are retired from UN and now living in Geneva. I had been to Austria 2 weeks ago, missed Switzerland.
Hope to hear from you soon
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Good morning. I will take the medicines as per your advise.
Will you please advise me if I have to take the Ultrasound and other lab tests, Vitamin D and Anemia tests in the empty stomach or I can go at any time.
Thanks for your advise for fixing the appointments.
Since you have all my reports now, please advise me,if I have to undergo any other tests other than the one above.
With warm regards
XXXX
Good morning. I will take the medicines as per your advise.
Will you please advise me if I have to take the Ultrasound and other lab tests, Vitamin D and Anemia tests in the empty stomach or I can go at any time.
Thanks for your advise for fixing the appointments.
Since you have all my reports now, please advise me,if I have to undergo any other tests other than the one above.
With warm regards
XXXX
Brief Answer:
Fasting preferred
Detailed Answer:
hello sir,
sorry for the delay.
Yes, it is better to do the tests in fasting icluding the uktrasound. How is the swelling in legs now and your Blood pressure ?
Regards
Binu
Fasting preferred
Detailed Answer:
hello sir,
sorry for the delay.
Yes, it is better to do the tests in fasting icluding the uktrasound. How is the swelling in legs now and your Blood pressure ?
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor
I am back again. I have attached the Abdomino-Pelvic Ultrasonography and all other Blood reports which you have advised me to take.Please advise me after going through the reports.in detail.I am also taking the medicines as per your advise.
My leg swelling is always there more on the left leg. It is more one the evenings.
My pressure is under control. Is the swelling due to varicose veins which I have on my legs. Please advise me some medicines for this.
Very Happy Deepavali and with best regards
XXXX
I am back again. I have attached the Abdomino-Pelvic Ultrasonography and all other Blood reports which you have advised me to take.Please advise me after going through the reports.in detail.I am also taking the medicines as per your advise.
My leg swelling is always there more on the left leg. It is more one the evenings.
My pressure is under control. Is the swelling due to varicose veins which I have on my legs. Please advise me some medicines for this.
Very Happy Deepavali and with best regards
XXXX
Brief Answer:
Havent got Ultrasound report
Detailed Answer:
Hello,
welcome back. Thank you and Happy Deepavai to you too.
I havent got the abdominal ultrasoud reports. All the attachmenst are old blood reports which i had seen before. I had advised you regarding the modification of BP, Diabetes and Thyroid medidines based on these reports.
The calcium is low. I can not see the Vitamin D results.
Yes, varicose veins itself can cause swelling in legs. You may apply a compression bandage for varicose veins or may meet a vascular surgeon for treatment of same.
Glad to know that your BP is normal now.
Could you please list all the medicines which you take now ??
Also, please attach the abdominal ultrasound report ( you may remove few of the old attachments)
Kind regards
Binu
Havent got Ultrasound report
Detailed Answer:
Hello,
welcome back. Thank you and Happy Deepavai to you too.
I havent got the abdominal ultrasoud reports. All the attachmenst are old blood reports which i had seen before. I had advised you regarding the modification of BP, Diabetes and Thyroid medidines based on these reports.
The calcium is low. I can not see the Vitamin D results.
Yes, varicose veins itself can cause swelling in legs. You may apply a compression bandage for varicose veins or may meet a vascular surgeon for treatment of same.
Glad to know that your BP is normal now.
Could you please list all the medicines which you take now ??
Also, please attach the abdominal ultrasound report ( you may remove few of the old attachments)
Kind regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Thanks for your advise. I have down loaded some reports to you including the
Ultrasound Report.
I am taking the following medicines daily.
Thyronorm 150 1-0-0 ( empty stomach)
Telma 80 1-0-0 (empty stomach)
Glucophage 750 1-0-1
Diamicron MR 60 2-0-0
Seloken XL 50 1-0-1
Nexium 40 1-0-0
Storvas 20 0-0-1
S.Amlopidine 10 0-0-1
Osteocerin 0-0-1
Maxgalin 150 0-0-1
Shelcal 500 1-0-1
Stilnoct 10 0-0-1
D.Rise 1gm-weekly
Thanks for your further advise on the above..
With warm regards
XXXX
Thanks for your advise. I have down loaded some reports to you including the
Ultrasound Report.
I am taking the following medicines daily.
Thyronorm 150 1-0-0 ( empty stomach)
Telma 80 1-0-0 (empty stomach)
Glucophage 750 1-0-1
Diamicron MR 60 2-0-0
Seloken XL 50 1-0-1
Nexium 40 1-0-0
Storvas 20 0-0-1
S.Amlopidine 10 0-0-1
Osteocerin 0-0-1
Maxgalin 150 0-0-1
Shelcal 500 1-0-1
Stilnoct 10 0-0-1
D.Rise 1gm-weekly
Thanks for your further advise on the above..
With warm regards
XXXX
Brief Answer:
medications
Detailed Answer:
Hello,
I can still see only 10 files which are attached. I request you to remove the older files and re attach the ultrasound and new reports.
Went through the medications.
1) Thyronorm has to be taken 125 mcg x 5 days and 150 mcg x 2 days ( Saturday and sunday). recheck TSH and Free T4 after 6 weeks.
2) D Rise satchet 60000 units is weekly once for 6 weeks and then monthly once later
3) Nexium may be tapered and stopped. Otherwise it can cause calcium and vitamin D deficiency and iron deficiency anemia. Take 20 mg for a month and try to stop it if you don't have any acidity symptoms.
4)
Stilnoct ( zolpidem) is to be taken only short term for anxiety and sleep disturbances.
regards XXXXXXX
medications
Detailed Answer:
Hello,
I can still see only 10 files which are attached. I request you to remove the older files and re attach the ultrasound and new reports.
Went through the medications.
1) Thyronorm has to be taken 125 mcg x 5 days and 150 mcg x 2 days ( Saturday and sunday). recheck TSH and Free T4 after 6 weeks.
2) D Rise satchet 60000 units is weekly once for 6 weeks and then monthly once later
3) Nexium may be tapered and stopped. Otherwise it can cause calcium and vitamin D deficiency and iron deficiency anemia. Take 20 mg for a month and try to stop it if you don't have any acidity symptoms.
4)
Stilnoct ( zolpidem) is to be taken only short term for anxiety and sleep disturbances.
regards XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor XXXXXXX
Happy Deepavali.
I have unloaded two times Ultrasound and other new reports, which you have not received. I am down loading the same to you again. Kindly go through them and
advise me accordingly.Also I do not know how to delete the old reports, Please do the same at your end. Thanks and with regards
XXXX
Happy Deepavali.
I have unloaded two times Ultrasound and other new reports, which you have not received. I am down loading the same to you again. Kindly go through them and
advise me accordingly.Also I do not know how to delete the old reports, Please do the same at your end. Thanks and with regards
XXXX
Brief Answer:
HAppy Diwali
Detailed Answer:
Good morning. Happy Diwali to you too.
Unfortunately, I can not delete the reports. Either yourself or the IT people of health care magic can do it. You may email them to me YYYY@YYYY or YYYY@YYYY
Once I receive the email, I shall check and reply to you. Once I have replied, then we can continue the discussion in this forum
Regards'
Binu
HAppy Diwali
Detailed Answer:
Good morning. Happy Diwali to you too.
Unfortunately, I can not delete the reports. Either yourself or the IT people of health care magic can do it. You may email them to me YYYY@YYYY or YYYY@YYYY
Once I receive the email, I shall check and reply to you. Once I have replied, then we can continue the discussion in this forum
Regards'
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Very good morning.
As desired by I have already forwarded to you the reports to the e-mails provided by you.Since I have not received the reply I have again re-charged the account.
Will you please let me know if you have any other e-mails to contact you in case
of emergency. Please advise after going through the reports.Thanks and with regards
XXXX
Very good morning.
As desired by I have already forwarded to you the reports to the e-mails provided by you.Since I have not received the reply I have again re-charged the account.
Will you please let me know if you have any other e-mails to contact you in case
of emergency. Please advise after going through the reports.Thanks and with regards
XXXX
Brief Answer:
Already answered
Detailed Answer:
Dear Sir
I had replied your mail yesterday morning itself. Please check again including your spam folder. I had given a detailed answer. Your Ultrasound is okay. Ignore the finding of fatty liver in ultrasound
Already answered
Detailed Answer:
Dear Sir
I had replied your mail yesterday morning itself. Please check again including your spam folder. I had given a detailed answer. Your Ultrasound is okay. Ignore the finding of fatty liver in ultrasound
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr XXXXXXX
Many thanks for your Deepavali Greetings and our belated wishes to you and your family..
Thanks for your advise on the reports.
Doctor, my sugar levels now a days are little high. Specially in the after-noon hours. Just now I checked the same and it was 210. I am taking Metfin 500,750 mg 1-0-1 and Diamicron Mr 60 2-0-0 as advised by you.Invariably it is high in the afternoon and post parandium. Kindly advise me on this. My BP is under control. Swelling during the day time. Thanks and with regards
XXXX
Many thanks for your Deepavali Greetings and our belated wishes to you and your family..
Thanks for your advise on the reports.
Doctor, my sugar levels now a days are little high. Specially in the after-noon hours. Just now I checked the same and it was 210. I am taking Metfin 500,750 mg 1-0-1 and Diamicron Mr 60 2-0-0 as advised by you.Invariably it is high in the afternoon and post parandium. Kindly advise me on this. My BP is under control. Swelling during the day time. Thanks and with regards
XXXX
Brief Answer:
YYour blood glucose levels
Detailed Answer:
Hello
hope you got my email. Please don't worry of a single high blood sugar reading. Please heck it for the next few days and let me know. If it remains high then there are many options to fix it. By the way my mail Ids are binubrunei @gmail.com and YYYY@YYYY
Regards
Binu
YYour blood glucose levels
Detailed Answer:
Hello
hope you got my email. Please don't worry of a single high blood sugar reading. Please heck it for the next few days and let me know. If it remains high then there are many options to fix it. By the way my mail Ids are binubrunei @gmail.com and YYYY@YYYY
Regards
Binu
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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