[Deep Blue]

Originally Posted by JMaruru

What might be the treatment options for elderly anaemic patients? Please advise!

Treatment options would depend on the cause of anemia, - nutritional, blood loss etc - So the person would require a physician visit and based on the clinician's impression, few investigations. Once the cause is determined, treatment is directed at the cause.

[Geo_Ipe]

Originally Posted by callvvijay

For the past few days, my 5-month old son's head (esp. the back-portion of the head) is warmer compared to the front-portion or the rest of his body. If we touch the head, it feels like he is having some temperature. However, the body temperature seems to be normal.

We checked with the pediatrician too and he says that this is quite normal. My wife also says that since that portion of the head is always in constant touch with the ground, it might be so.

You don't need to worry about that! your wife is right. Plus, in babies, the head might feel a little warmer compared to the body normally. That is not fever.

Originally Posted by JMaruru

Could anyone here suggest a good hemotalogist in Bangalore?

This is for an elderly whose HB(Haemoglobin) levels keep dropping and he gets chest pain/upper back pain. The doctors at Jayadeva are clueless on, how he is losing the haemoglobin content in the blood. The HB levels are around 7 and he has been diagnosed as CKD stage IV. They have suggested to contact hemotalogist first and then if needed a nephrologist.

Please advise!

CKD Stage IV is quite advanced kidney failure. Anemia may be due to the renal failure. See a Nephrologist ASAP, followed by (if required), a Hematologist.

[TheTeacher]

Originally Posted by JMaruru

This is for an elderly whose HB(Haemoglobin) levels keep dropping and he gets chest pain/upper back pain. The doctors at Jayadeva are clueless on, how he is losing the haemoglobin content in the blood. The HB levels are around 7 and he has been diagnosed as CKD stage IV.

I'm not a doc, but will chip in.

Haemo of 7 is pretty low (about half). If a normal person's haemo drops that much in a short while (like in an accident), they will go into a state of shock.

Can the patient walk about and is reasonable alert?

Has the patient been given blood transfusion?

One cause for low haemo is internal bleeding somewhere and further investigation is required.

[FrozeninTime]

@JMaruru - CKD stage 4 is the terminal stage of kidney failure.
Erythropoetin a hormone produced by kidney is required for development of RBC and it is deficient in CKD patients making them prone for development of anaemia. What patient requires is EPO along with blood transfusion and regular dialysis.kindly consult a Nephrologist first as Anaemia in my view is mostly due to CKD so also get a Haematocrit and peripheral smear for Blood picture which would give a clue whether anaemia is due to CKD or any other cause. Though there are many tests but I would advice to do above test and Renal function test only.

[JMaruru]

Originally Posted by TheTeacher

Haemo of 7 is pretty low (about half). If a normal person's haemo drops that much in a short while (like in an accident), they will go into a state of shock.
Can the patient walk about and is reasonable alert?
Has the patient been given blood transfusion?
One cause for low haemo is internal bleeding somewhere and further investigation is required.

He was given a pack of plasma, last week. This boosted his HB levels closer to 9. He walks around home, else sleeps most of the time. As per doc's advise we are doing the stool occult and the first test is positive for the presence of blood.

Originally Posted by FrozeninTime

@JMaruru - CKD stage 4 is the terminal stage of kidney failure.
Erythropoetin a hormone produced by kidney is required for development of RBC and it is deficient in CKD patients making them prone for development of anaemia. What patient requires is EPO along with blood transfusion and regular dialysis.kindly consult a Nephrologist first as Anaemia in my view is mostly due to CKD so also get a Haematocrit and peripheral smear for Blood picture which would give a clue whether anaemia is due to CKD or any other cause. Though there are many tests but I would advice to do above test and Renal function test only.

We consulted the nephrologist, and he ordered some more investigations of blood. Today's blood work has come out with serum creatinine at 1.7gms. Also, the hemotalogist had asked for a report on the free kappa light chain, which is around 127mg/l and free lambda light chain which is around 119mg/l (way beyond the reference range).

[Eddy]

Guys, where can I get a complete Cardio Check done for my mother in Delhi ?

[vibbs]

Originally Posted by Eddy

Guys, where can I get a complete Cardio Check done for my mother in Delhi ?

My father is a heart patient and he goes to batra hospital. One Dr. Sanjiv sharma. I guess for a check up any of the good hospitals should do. Max, Colombia Asia etc. You are based in dwarka if I am not mistaken. Dr. Amit Baweja is a very good heart specialist. He was our family doctor too has his clinic healing touch in the Sector 9 DDA flats. There are a couple of other good heart specialists in sector 6 too.

[car-dent]

Originally Posted by carboy

She was fitted with a PFM crown because the dentist said that the metal free wouldn't have enough strength to take the loads on that teeth. Thank you everyone for all your help.

Just for your information. Solid Zirconia is what i prefer especially for posteriors.

http://www.youtube.com/watch?v=2ZRfQK6Ipb0

[Eddy]

Originally Posted by vibbs

My father is a heart patient and he goes to batra hospital. One Dr. Sanjiv sharma. I guess for a check up any of the good hospitals should do. Max, Colombia Asia etc. You are based in dwarka if I am not mistaken. Dr. Amit Baweja is a very good heart specialist. He was our family doctor too has his clinic healing touch in the Sector 9 DDA flats. There are a couple of other good heart specialists in sector 6 too.

Thanks Vibbs. Will check out the doctors that you have mentioned.

I want an independent doc to suggest what tests etc are required.

[carboy]

Originally Posted by mroptimist

Yes Eltroxin is Levothyroxin. For symptomatic hypothyroidism the dose looks less. Nevertheless please go to a regular physician or endocrinologist not a quack. She does require a thorough check up.

Done. The physician upped the dose to 50. He said to take it for 2 months. and then retest it & come back. He said on the day of the test, take the medication only after the test.
Since there was hairloss, he suggested Biotin, Calcium and other supplements for a month.

Originally Posted by car-dent

Just for your information. Solid Zirconia is what i prefer especially for posteriors.

Nice video :-)

It's not a posterior teeth - it's one which is somewhere in between the front and the back. I think the dentist called it upper premolar. And if the dentist suggested it (it's done and dusted now), it's not easy for me debate that with the dentist - may be next time. However, I have a PFM crown done 3 years back (lower left back teeth - 2-3 teeth away from wisdom teeth) and I don't have any problems with it yet.

Are there any issues with PFM crowns?

Another tooth question, my wife also a filling done at the same time (after the fitting of the crown) - at the end, I asked the dentists assistant about what material the filling was & she said it was silver - does silver mean mercury? This was a refilling actually. The earlier filling (done by a dentist who wasn't that good) had come off.

I also have a mercury filling - one of my teeth fillings was done with non-mercury stuff in the US. It came off after some years. So I redid it again in India. It came off again after a couple of years. So finally my dentist(not the same one used by my wife now) said, mercury the only thing which will hold here & he did the filling with mercury and it has held fine for around 4 years now.

So the question is - how dangerous is mercury for fillings? I saw a post from SS-Traveller earlier thread saying that he advises against it.

[Tejas@perioimpl]

The debate of toxic hazards due to minute amounts of mercury in silver fillings is as old and controversial as the chicken and the egg debate.

Current consensus is this: If you have an existing filling leave it. More mercury is released while removing the filling due to the drilling process. To be safe, any new fillings could be non mercury composite fillings.

[car-dent]

Originally Posted by carboy

It's not a posterior teeth - it's one which is somewhere in between the front and the back. I think the dentist called it upper premolar. And if the dentist suggested it (it's done and dusted now), it's not easy for me debate that with the dentist - may be next time. However, I have a PFM crown done 3 years back (lower left back teeth - 2-3 teeth away from wisdom teeth) and I don't have any problems with it yet.

Are there any issues with PFM crowns?

There are no issues as such with PFM as such. PFM are and have been the most commonly used material. Crowns are more of a Patient's preference based thing. I just showed this for your information that there are New and better things available these days. The problems with PFM is sometimes a black line shown near the gums and there is a possibility of metal showing-through after some prolonged use.

Originally Posted by carboy

Another tooth question, my wife also a filling done at the same time (after the fitting of the crown) - at the end, I asked the dentists assistant about what material the filling was & she said it was silver - does silver mean mercury? This was a refilling actually. The earlier filling (done by a dentist who wasn't that good) had come off.

I also have a mercury filling - one of my teeth fillings was done with non-mercury stuff in the US. It came off after some years. So I redid it again in India. It came off again after a couple of years. So finally my dentist(not the same one used by my wife now) said, mercury the only thing which will hold here & he did the filling with mercury and it has held fine for around 4 years now.

So the question is - how dangerous is mercury for fillings? I saw a post from SS-Traveller earlier thread saying that he advises against it.

Silver fillings are basically Amalgam Fillings which contain mercury as one of the constituents. Silver fillings are hardly used these days more because of cosmetic reasons rather that mercury safety issues. The mercury safety with dental fillings is still not very clear but i guess they have been so extensively used, 1 or 2 mercury fillings shouldn't be a great threat to your health.
But anyways, I have not done a silver filling in last 10 years. The only thing we use now for fillings is Light Cure Composites. Regarding the fillings coming out repeatedly, that could probably be an issue with case selection, material or technique.

[RajeshK]

Off late I have been detected for a kind of reflex Epilepsy. Got blackout 3 times in last one month, every time in Bathroom only. The combination cold climate, outside rain and sleepless previous nights are seems to be the triggers so far. I had an episode on last Sunday, it was only for a split second. But after this I drove for 350kms without any issue. Went to doctor on Monday and the EEG has shown some spikes. Now I have started taking Valparin Chrono 500 as per his advice. Doctor also told not to drive, but for me all the episode happens connected with bathroom. Requesting the doctors to provide advice on "Can I continue to drive"..? If it is "no", how about short distances..?

[SohailPistawala]

Can someone from Mumbai please help me with contacts of a good Neurologist, for a patient who is suffering from Epilepsy. Preferably South Mumbai.

Thanks In Advance!

[asit.kulkarni93]

Hello docs,
I have been facing this problem since last 5-6 years. So basically this happens with every climate change wherein, The size of my tonsils turn it to a big tomato + i catch cold. So in all this when my nose is blocked i tend to breath from my mouth which in turn increases the tonsils size. I always go to Dinanath Mangeshkar hospital as soon as this starts. The Doctors always conclude it to be throat infection, But every time doctors give me different medicines and the last time it happened in July they said i need to remove the tonsils. Anyway is there any medicine i can always keep with me to help me reduce the size of tonsils apart from gargling? I have my exams on now and off lately has become impossible for me to study with nose and mouth blocked.
Will removing the tonsils be of any help?
help!

Asit