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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will My Mother Have Another Seizure While Suffering From Irregular Heart Beat, Arthritis And Frequent Headache?

Hello Doctor, I have two questions for you. First, what can a nephrologist do to help my 87 year old mother with an unexplained low sodium problem? Her GP wants her to see one and the appointment is set for next Tuesday. I understand that a nephrologist deals with acute kidney problems which has not been a problem for my mother. And second, is there any reason why I can t use salt tablets to help keep the sodium up until we see this doctor? Previously, my mother s GP and neurologist have looked at the medicines she s taking to no avail. Her neurologist has said that the low sodium led to a few of her seizures. My mother is a heart patient with an irregular heart beat. She had a pacemaker put in several years ago and had surgery to put in a stint in 2001. In addition to this, she s a Type II diabetic, has significant arthritis in her shoulders, knees, and hands, and - in the past 2 years- has had 4 seizures with 2 prior seizures that were misdiagnosed as TIAs by her former doctor. She has frequent headaches in the area where the seizures have a occurred. The medicine she takes is as follows: Omeprazole DR- 1 tab (40 mg) taken - AM Digoxin- 1/2 of a 250 mcg tab taken - AM Isosorbide DN- 10 mg 2x per day Metoprolol Tartrate- 1/2 of a 25 mg tab 2x per day Pradaxa - 150 mg tab 2x per day Levetiracetem (Keppra) - 750 mg 2x per day Loperamide (Immodium over-the-counter) - 250 mg as needed for diaahrea I ve been able to keep her blood sugar down but she has sudden bouts of diaahrea, which we know can cause sodium and dehydration problems. We had a renal panel done yesterday and the results came back today saying her sodium was down to 128. She has seizures at 126. I wanted to give her sodium tablets but her GP said not to do that until she sees the nephrologist. In the meantime her GP knows that I am concerned that she will have another seizure. Any information or advice you could give me would be very helpful. Thank you, in advance, for your time. K. Dennison
Mon, 27 Jan 2014
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Neurologist 's  Response
Hi,

Thank you for posting your query regarding your mother.

I agree that nephrologist deals with kidney problems, but he also deals with abnormalities in sodium or potassium levels (as these abnormalities are common in patients with kidney problems).

I also agree with you that there is no harm in increasing the salt in her diet to improve her sodium level. However, we have to cautious as giving her more sodium can also worsen her heart status.

Her current medications seem to be fine and can be continued.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

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Will My Mother Have Another Seizure While Suffering From Irregular Heart Beat, Arthritis And Frequent Headache?

Hi, Thank you for posting your query regarding your mother. I agree that nephrologist deals with kidney problems, but he also deals with abnormalities in sodium or potassium levels (as these abnormalities are common in patients with kidney problems). I also agree with you that there is no harm in increasing the salt in her diet to improve her sodium level. However, we have to cautious as giving her more sodium can also worsen her heart status. Her current medications seem to be fine and can be continued. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in