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Suggest Treatment For Radicular Pain In The Arm
Question: I am having pin in my left arm from shoulder to the elbow from last 2 weeks and doctor has prescribed nurokind G and tryptomer 10, is it ok
i am diabetic at border level and take xmet sr 500 1 tab daily and pp is controlled between 120 to 145 and fasting is 90-120 along with last hba1c at 6.8
i am diabetic at border level and take xmet sr 500 1 tab daily and pp is controlled between 120 to 145 and fasting is 90-120 along with last hba1c at 6.8
Brief Answer:
Suggestion
Detailed Answer:
Hi
I am Dr Mittal
I have read your message.
I think I can help you.
The symptoms of the query are suggestive of a radicular pain.
I would suggest retesting the MRI to see if the changes have increased.
Meanwhile continue the medicines.
I would have suggested a higher dose of pregabalin.
Watch your posture.
Start with physiotherapy including TENS.
Let me know the report of the MRI and I may be able to help you further.
Please feel free to ask a follow up query with any related doubt.
I would also suggest testing a ekg, because in diabetic patients, cardiac events do not always come with chest pain.
I have tried to make it as simple as possible.
Best of luck,Dr Mittal
Suggestion
Detailed Answer:
Hi
I am Dr Mittal
I have read your message.
I think I can help you.
The symptoms of the query are suggestive of a radicular pain.
I would suggest retesting the MRI to see if the changes have increased.
Meanwhile continue the medicines.
I would have suggested a higher dose of pregabalin.
Watch your posture.
Start with physiotherapy including TENS.
Let me know the report of the MRI and I may be able to help you further.
Please feel free to ask a follow up query with any related doubt.
I would also suggest testing a ekg, because in diabetic patients, cardiac events do not always come with chest pain.
I have tried to make it as simple as possible.
Best of luck,Dr Mittal
Above answer was peer-reviewed by :
Dr. Remy Koshy
As of now i am prescribed Nurokind G + Tryptomer10 in morning
and Nurokind G + Tryptomer10+Ultracet+Myospaz at night
Am already having additionally xmet sr500 before breakfast and multivit cd+avion 600 after breakfast and one Storfib at night
i have also uploaded my 15th october reports for your ref
Please tell me if this medicines am prescribed are ok by you
and Nurokind G + Tryptomer10+Ultracet+Myospaz at night
Am already having additionally xmet sr500 before breakfast and multivit cd+avion 600 after breakfast and one Storfib at night
i have also uploaded my 15th october reports for your ref
Please tell me if this medicines am prescribed are ok by you
Brief Answer:
Report not attached
Detailed Answer:
Hi
I am sorry, but the oct 15 report has not got attached.
You may try again. Or If you want, reports / pictures can be sent to YYYY@YYYY with Sub: ATTN 'Your Name'. Once my team receives the photos or diagnostic reports from the user, my team will send reports / pictures to my email.
If however you mean the MRI report c3-c4-c5 nerve root compression, please continue with the treatment. I would however prefer adding pregabalin. Watch your posture. Start with physiotherapy including TENS.
I have tried to make it as simple as possible.
Best of luck, Dr Mittal
Report not attached
Detailed Answer:
Hi
I am sorry, but the oct 15 report has not got attached.
You may try again. Or If you want, reports / pictures can be sent to YYYY@YYYY with Sub: ATTN 'Your Name'. Once my team receives the photos or diagnostic reports from the user, my team will send reports / pictures to my email.
If however you mean the MRI report c3-c4-c5 nerve root compression, please continue with the treatment. I would however prefer adding pregabalin. Watch your posture. Start with physiotherapy including TENS.
I have tried to make it as simple as possible.
Best of luck, Dr Mittal
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Please find the attached reports
Doctor Mittal Sir i had BP on last monday at 150/96 and yesterday also 150/100
Is it due to sheer pain or else because it was normal before that.
have also sent my reports on the email as suggested in your reply.
My doctor says no need of MRI at this time. And this is the same doctor who treated me 5 years back when i had a similar kind of problem and it was quite severe at that time.
This time its 15 days but mild pain continues in shoulder and arm despite medication.
You mean to say that i continue with
Nurokind G + Tryptomer10 in morning
and Nurokind G + Tryptomer10+Ultracet+Myospaz at night
And also already having xmet sr500 before breakfast and multivit cd+avion 600 after breakfast and one Storfib at night
Needyour kind opinion
Doctor Mittal Sir i had BP on last monday at 150/96 and yesterday also 150/100
Is it due to sheer pain or else because it was normal before that.
have also sent my reports on the email as suggested in your reply.
My doctor says no need of MRI at this time. And this is the same doctor who treated me 5 years back when i had a similar kind of problem and it was quite severe at that time.
This time its 15 days but mild pain continues in shoulder and arm despite medication.
You mean to say that i continue with
Nurokind G + Tryptomer10 in morning
and Nurokind G + Tryptomer10+Ultracet+Myospaz at night
And also already having xmet sr500 before breakfast and multivit cd+avion 600 after breakfast and one Storfib at night
Needyour kind opinion
Brief Answer:
Suggestions
Detailed Answer:
Hello.
Thanks for the report and updated information.
First, I hope this doctor is a neurologist or a neurosurgeon.
I would respect his/her opinion since I cannot examine you on this forum,and this doctor must have examined you thoroughly. So if the Dr feels there is no need for a repeat MRI, I would respect that decision. However, considering your pain is not resolving, I would still suggest the scan.
Second, yes, continue the treatment. You may discuss starting and stepping up the dose of pregabalin with this doctor.
As for the reports, few things are remarkable.
1. Your lipid profile is deranged. Watch your diet, do regular exercise, and atrovastatin in a low dose for a brief period may hemp you.
2. Sugars and HbA1c are affected, but thats expected as you are a diabetic and on medicines.
3. Vitamin D is low, and Vit B is high. Latter may be due to multivitamin supplementation. However, after this, I think you dont need Neurokind for too long. Vit D supplementation is needed. You may take any brand available locally like uprise d3, calcerol etc.
4. SGPT is mildly raised- this may be due to medicines you are on like painkillers and even metformin.
Finally, your BP is raised. This may be due to the pain. However, your cholesterol levels are high and this itself may be a cause of raised BP. I suggest that you start salt restricted diet and start daily exercises. If this does not help in 15 days, medicine may be needed for BP. Monitor BP in the meantime and let us know if it goes too high.
I think you should start physiotherapy with TENS. I think it will help you.
Please consider the EKG in view of the diabetic status and deranged lipid profile, as discussed previously.
Best of luck, Dr Mittal
Suggestions
Detailed Answer:
Hello.
Thanks for the report and updated information.
First, I hope this doctor is a neurologist or a neurosurgeon.
I would respect his/her opinion since I cannot examine you on this forum,and this doctor must have examined you thoroughly. So if the Dr feels there is no need for a repeat MRI, I would respect that decision. However, considering your pain is not resolving, I would still suggest the scan.
Second, yes, continue the treatment. You may discuss starting and stepping up the dose of pregabalin with this doctor.
As for the reports, few things are remarkable.
1. Your lipid profile is deranged. Watch your diet, do regular exercise, and atrovastatin in a low dose for a brief period may hemp you.
2. Sugars and HbA1c are affected, but thats expected as you are a diabetic and on medicines.
3. Vitamin D is low, and Vit B is high. Latter may be due to multivitamin supplementation. However, after this, I think you dont need Neurokind for too long. Vit D supplementation is needed. You may take any brand available locally like uprise d3, calcerol etc.
4. SGPT is mildly raised- this may be due to medicines you are on like painkillers and even metformin.
Finally, your BP is raised. This may be due to the pain. However, your cholesterol levels are high and this itself may be a cause of raised BP. I suggest that you start salt restricted diet and start daily exercises. If this does not help in 15 days, medicine may be needed for BP. Monitor BP in the meantime and let us know if it goes too high.
I think you should start physiotherapy with TENS. I think it will help you.
Please consider the EKG in view of the diabetic status and deranged lipid profile, as discussed previously.
Best of luck, Dr Mittal
Above answer was peer-reviewed by :
Dr. Prasad
Dear Dr.Saumya Mittal,Goodmorning
I am giving you my medical data from 2013 to study my sugar levels and advice
I have uploaded the comparison data for your reference
I am going to be 55 years in april and have 71-73 Kg of weight band with height 155 cm
I do daily walk at least 5 times a week @ 3-5 km a day and am turned vegetarian from last 16 years
My only problem is the sugar fasting is between a range of 125 - 160 and PP is much lower band of 80-115
Presently am having XMETSR 500 once a day at night, Multivit CD and evion 500 one in morning and also was having 1 Storfib at night from last 3 months
I also keep a check on my sugar weekly basis thru personal checks at home
Please advice if my medicines are ok
I am giving you my medical data from 2013 to study my sugar levels and advice
I have uploaded the comparison data for your reference
I am going to be 55 years in april and have 71-73 Kg of weight band with height 155 cm
I do daily walk at least 5 times a week @ 3-5 km a day and am turned vegetarian from last 16 years
My only problem is the sugar fasting is between a range of 125 - 160 and PP is much lower band of 80-115
Presently am having XMETSR 500 once a day at night, Multivit CD and evion 500 one in morning and also was having 1 Storfib at night from last 3 months
I also keep a check on my sugar weekly basis thru personal checks at home
Please advice if my medicines are ok
Brief Answer:
My suggestions
Detailed Answer:
Hi
Thanks for your follow up query.
I will answer your questions in the order that you have asked them.
1. your diet scheme and exercise regime seem to be good specially considering your HbA1C are comparatively in a very good range compared to general population.
2. About your pp sugars, you need not worry. 2 reasons- except for 1 sugars of 80, all other sugars are above 100. Second, it happens because you are probably a type 2 diabetic. So you secrete insulin, but not effectively. You need to understand the mechanism. The food we eat stimulates insulin secretion. In type 2 diabetes, the insulin is insufficient or inefficient. Metformin (compound in your medicine) helps secrete the insulin. So your fasting is higher. When you eat, with the action of the tablet, the body releases enough insulin. So your sugars get better controlled. If you have no symptoms of hypoglycemia, you need not worry.
3. You can have the multivitamins. No issues. However, your XXXXXXX 17 Lipid profile is fine. I would suggest changing Storfib to normal simvastatin, or atorvastatin. Too low lipid profile is known to increase the risk of brain hemorrhages, It was probably prescribed because your triglycerides were consistently high. It may still be needed again if the subsequent triglycerides are raised again.
4. Keeping a personal check of the sugars is the best way of checking sugars. Continue the same.
5. Your creatinine levels seem to be rising. Could be due to the painkillers that you are taking for neck pain. So reduce the painkillers as far as possible.
Those were my suggestions. Please feel free to ask a follow up query to clarify any issue regarding which you may have doubts.
Best of luck, Dr Mittal
My suggestions
Detailed Answer:
Hi
Thanks for your follow up query.
I will answer your questions in the order that you have asked them.
1. your diet scheme and exercise regime seem to be good specially considering your HbA1C are comparatively in a very good range compared to general population.
2. About your pp sugars, you need not worry. 2 reasons- except for 1 sugars of 80, all other sugars are above 100. Second, it happens because you are probably a type 2 diabetic. So you secrete insulin, but not effectively. You need to understand the mechanism. The food we eat stimulates insulin secretion. In type 2 diabetes, the insulin is insufficient or inefficient. Metformin (compound in your medicine) helps secrete the insulin. So your fasting is higher. When you eat, with the action of the tablet, the body releases enough insulin. So your sugars get better controlled. If you have no symptoms of hypoglycemia, you need not worry.
3. You can have the multivitamins. No issues. However, your XXXXXXX 17 Lipid profile is fine. I would suggest changing Storfib to normal simvastatin, or atorvastatin. Too low lipid profile is known to increase the risk of brain hemorrhages, It was probably prescribed because your triglycerides were consistently high. It may still be needed again if the subsequent triglycerides are raised again.
4. Keeping a personal check of the sugars is the best way of checking sugars. Continue the same.
5. Your creatinine levels seem to be rising. Could be due to the painkillers that you are taking for neck pain. So reduce the painkillers as far as possible.
Those were my suggestions. Please feel free to ask a follow up query to clarify any issue regarding which you may have doubts.
Best of luck, Dr Mittal
Above answer was peer-reviewed by :
Dr. Remy Koshy
I am also worried on account of my fasting sugar which is at increased level
Last 2 days my pp has been 80 and 78 before dinner nd my fasting of 8 hours in morning today was 128. Is it fine
And ia my dosage of one tablet of xmet se 500 good enough
Last 2 days my pp has been 80 and 78 before dinner nd my fasting of 8 hours in morning today was 128. Is it fine
And ia my dosage of one tablet of xmet se 500 good enough
Brief Answer:
Suggestions
Detailed Answer:
Hi.
I don't think you need to worry about the fasting glucose levels.
And I have already explained to you why your PP sugars are dropping.
I am assuming you are recording both around breakfast. Please correct me if this is not so.
Now, I also told you that your kidney functions are rising. it's still normal , but rising.
The medicine is excreted via kidneys. so , if you have abnormal kidney functions, the medicine will not be well excreted and may collect in body.
And diabetics are prone to kidney disease. Therefore, I suggested that you should avoid the painkillers.
Also, if you do not have the symptoms of hypoglycaemia, you need not worry at all.
I have tried to make it as simple as possible. Feel free to contact me for clarification on any point.
Best of luck. Watch your kidney functions. Dr Mittal
Suggestions
Detailed Answer:
Hi.
I don't think you need to worry about the fasting glucose levels.
And I have already explained to you why your PP sugars are dropping.
I am assuming you are recording both around breakfast. Please correct me if this is not so.
Now, I also told you that your kidney functions are rising. it's still normal , but rising.
The medicine is excreted via kidneys. so , if you have abnormal kidney functions, the medicine will not be well excreted and may collect in body.
And diabetics are prone to kidney disease. Therefore, I suggested that you should avoid the painkillers.
Also, if you do not have the symptoms of hypoglycaemia, you need not worry at all.
I have tried to make it as simple as possible. Feel free to contact me for clarification on any point.
Best of luck. Watch your kidney functions. Dr Mittal
Above answer was peer-reviewed by :
Dr. Prasad
Sir i had mentioned in my followup question that pp is evening before dinner reading
and the fasting figure given is before morning tea with 8 hours fasting only
Secondly i would like to meet u in person at XXXXXXX on 25th XXXXXXX evening if possible because i live in XXXXXXX and that evening only i am there.
Grateful for ur appointment
and the fasting figure given is before morning tea with 8 hours fasting only
Secondly i would like to meet u in person at XXXXXXX on 25th XXXXXXX evening if possible because i live in XXXXXXX and that evening only i am there.
Grateful for ur appointment
Brief Answer:
Explained, with suggestions
Detailed Answer:
Hello,
Thank you for your response.
The sugars, pre and post meal should be done around a single meal.
So if you are considering fasting, test post meal 2 hours after breakfast.
If you want to consider PP sugars, do half hour pre dinner and 2 hours post dinner.
For regular monitoring, what you usually do is ok.
But this is how it should be done ideally.
As for the appointment, I am unfortunately away during the last week in view of a conference.
Best of luck, Dr Mittal
Explained, with suggestions
Detailed Answer:
Hello,
Thank you for your response.
The sugars, pre and post meal should be done around a single meal.
So if you are considering fasting, test post meal 2 hours after breakfast.
If you want to consider PP sugars, do half hour pre dinner and 2 hours post dinner.
For regular monitoring, what you usually do is ok.
But this is how it should be done ideally.
As for the appointment, I am unfortunately away during the last week in view of a conference.
Best of luck, Dr Mittal
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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