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question:My father is65yr old,paraplegic since 25yrs.,has multi drug resistant uti since then,off n on on antibiotics.recently developed evening rise in temp for more than one month,burning sensation at night,dry cough.has been on i'v antibiotics fr last 5 days but no reduction in fever.plain urine exam normal,culture shows uti fr which he is taking i'v antibiotic,urine Afb normal.chest X-ray normal.kindy advise.
answer:Hi,Thank you for posting your query.Recurrent urinary tract infection (UTI) in your father can be explained by neurogenic bladder that may have happened because of spinal cord injury. In a neurogenic bladder, there may be incomplete evacuation of bladder with residual urine after evacuation, which predisposes to recurrent UTIs. The first issue here is to treat the current infection, which can be done by using broad spectrum antibiotics. Second and more important issue to prevent UTIs from occurring in the future. This can be done by using antibiotics as prophylactic agents. In addition, clean intermittent catheterisation (CIC) may be taught to the patient, which can alleviate the problem of incomplete evacuation.I hope it helps.Best wishes,Dr Sudhir Kumar MD DM (Neurology)Senior Consultant Neurologist
question:After undergoing a C/T scan following a concussion, my doctor told me that they found an "additional finding." I either have a tumor hanging down from my pituitary gland or, as she thinks, a brain aneurysm. Both my father and paternal grandmother died of brain aneurysms. My father was in his 70's and in overall poor health. My grandmother, however,was only 62 and in good health. I am 60, a non-smoker, and in relatively good health. I teach high school, so I'm also quite tough - you have to be. What should be my main concerns? I have an MRI scheduled for Monday after school. Thanks for your input. Debbie Kelly
answer:Hi,Thank you for posting your query.I have gone through your case details. As per that, there is an incidental finding, which could either be a tumor or an aneurysm.The diagnosis would get further clarified once we have the MRI reports. Until then, there is no need to worry.In the case of a tumor, surgery may be required.An aneurysm in the brain can either be treated by surgery or without a surgery (an endovascular procedure).I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website: My blog:
question:during the night when I go to sleep on my back I get woken up with my thumb and first two fingers numb.it takes me 10/15 minutes to wake them up..i try and sleep on my side with same results..tried every pillow and none ,no difference..my same shoulder was frozen 20 years ago and after I unfroze it myself I have had pain in the back of the shoulder..tried everything from my gp for pain ie norspan+p/forte..i can deal with this but this numbness is only giving me 4 hours sleep so I stay up for a few hours then try and get a few more hours,until the numbness wakes me up again..any advice I would be thankful for..i am a 77 year old male in a1 health apart from this..thank you.....
answer:Hi,Thank you for posting your query.Numbness in the thumb and first two fingers suggests an involvement of median nerve, a nerve that supplies sensation to thumb and first three and a half fingers. The most common reason for the involvement of median nerve is entrapment of the nerve at the level of wrist, a condition called as carpal tunnel syndrome. Another possibility is increased sensitivity to pressure palsies. Doing a nerve conduction study would help diagnose these conditions.They improve with medications such as gabapentin or pregabalin.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website: My blog:
question:i have been having problems with numb tingiling and pain in legs and feet. had a mri done said there was 2 small with spots on the brain.. which i was told it was normal but they wanted to do a spinal tap to rule out ms since my mother has ms. what are the chances that is what i could be. I also have neck and shoulder pain.
answer:Hi,Thank you for posting your query.White spots on MRI (also called as hyperintense lesions) are not specific for multiple sclerosis (MS). These lesions can occur in other neurological conditions including migraine, infections, stroke, etc. Doing an MRI of spine would help, as if lesions are found in the spine, it would favor a diagnosis of MS.Spinal tap would also help, as presence of oligoclonal bands in the CSF would also favor a diagnosis of MS.However, with just two lesions, and normal spinal tap, MS is unlikely.I hope it helps.Please get back if you require any additional information.Best wishes,Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)Senior Consultant NeurologistApollo Hospitals, Hyderabad,My personal URL on this website: My blog:
question:I have been in chronic pain for about 8 years. I have fibermalgia, permenant nerve damage from herniated disc that had surgery on but never fixed. Medicines act differently with me than most people. I also have scoliocis. Nothing the pain clinic in Staunton, Virginia has helped me. I would like to try this if it could help. I have also had mental depression issues. you name it, I have it.
answer:HIThank for asking to HCMI really understand your problems, you just hold it every thing will be fine with time, you better have strong will power, for to fight against every health problem you have, do not think that you are the only patient going through this, there are numbers of such patient those are facing the same problems, but certains are doing very nice among them, without any medicine,, why because of their strong will,, so why do not you have it, have good day.
question:My dad lost his ability to control his urination a couple of years ago. Following this he had a doctor perform surgery on his upper back to cut a tangled blood vessel. Since then the doctor he went to diagnosed him with parkinsons disease that I am not so sure is the case. Approximately two weeks after the surgery which was more complicated than expected he had a blood clott. Since then he has progressively went down hill loosing his motor functions, speech issues and loss of balance all within a year to 18 months. He has no insurance and is to young to get on medicare. He is only 55. I dont think the original diagnosis of parkinsons is quite correct. They based this upon his hands that has always shook since he was in his 20's. Can anyone please lead me in a direction that would help me. He has recently got to the point to where he is dazeing off a lot and is just too weak to even get up or move too much.
answer:HIThank for asking to HCMIt seems neurological problems in such case Imaging study is required, It may not be because of surgery, the hemodynamic system has to be look for certain disorders Like Blood pressure, he needs complete evaluation such cases needs intensive care, oral supports, regular follow up, even slight mistake can lead to a bad consequences, so please take care of your father, have nice day.