[abhishek_bmw]

First of all, I have been absent from the forum for personal causes; I got email alert for your post, which seemed to me need something to write from my side.

Originally Posted by kri$hna

I need to consult a Neurosurgeon or someone who can deal with migraine headaches in Bangalore/Hyderabad.

Other members will give you address, please wait.

I am suffering from very frequent and irritating headaches which last long and drain me off. I consulted a doc by name Mr. Deepak Sharan, in bangalore ( he is an Ortho surgeon) who diagnosed my condition as "fibromyalgia" which is some sort of a pain related syndrome.

As I have not examined you physically; its tough to say anything. Obviously I will take Dr.Sharan's diagnosis as final.
You can seek several patient-disease information regarding the condition in different website/ online peer group.

I have persistent pain in my neck reaching upto shoulders which causes lot of discomfort & also headaches.

Sometimes dizziness & indigestion (sort of gastroenteritis) is also there.

May be related or unrelated to your other problems.

When i was a kid aged 3yrs, i was operated on the neck by a neuro, for "Lymphangioma -- Cystic Hygroma", which caused a droop in my right shoulder, which is quite visible & this doesnt allow proper growth in my chest muscles.

Yes, every surgery carries some sort of risks. In your case, a branch of a specific nerve was damaged.

Doc says, this can be the reason for fibromyalgia/headaches.

Yes he explained rightly.

I also have a liquidy color less discharge in my ears ocassionally, which i am afraid, could be cerebro spinal fluid (it is not often there, but it dries up in the ears, often looking like dandruff stuck on ear walls)

Requires consultation with an ENT specialist. There is less chance of it being CSF, dont worry. See my suggestion later within this post.

I was prescribed a dose of Pregabalin 150mg, every night & it was getting lousy on me, not able to control sleep in office etc.. so i discontinued the medicine & stopped visiting him as well.

If you were having problem, you must must visit him then and tell the problem. Remember, sudden stoppage of some drugs can be life threatening.

I can understand your inconvenience, but please dont interfere a doctors treatment, anyhow.

Off late, my colleagues say i shall consult a neuro who can understand my condition better. The pregabalin only helped me in a relieved sleep but didnt get me rid off the headaches.
I am still not sure what is the problem & the solution to look for. Any help in this regard is greatly appreciated

You required to consult an MD general medicine for now. He/she will be your primary doctor; he may send you to ENT surgeon or others...but again come back to him/her with the super specialist's opinion/consultation.

You are facing too much problem because you are breaking the basic chain:

(General physician/MD medicine) > He/she send patient to Superspecialist if needed for opinion > again come back to (General physician/MD medicine).

Please understand the fact, your condition needs a time for a doctor to diagnose and treat completely/to the level best, give him/her the time required.

Thank you.

[maverick56]

sir, this is Dr Amarnath ( maverick 56 to all bhpians )
IMHO, migraine needs to be handled by a neurologist and the muscle pains u describe in the back are as a result of the migraine. Once the primary cause is handled i think the muscle pains also will come dowm

[Tejas@perioimpl]

Originally Posted by maverick56

sir, this is Dr Amarnath ( maverick 56 to all bhpians )
IMHO, migraine needs to be handled by a neurologist and the muscle pains u describe in the back are as a result of the migraine. Once the primary cause is handled i think the muscle pains also will come dowm

Welcome! Glad to have another doc on the thread.

[setuniket]

Calling GP/Cardiologists.

My Mother aged 48 during recent health check up has been diagnosed with high levels of LDL/Triglycerides/mean platelet count. The report is as follows:

Mean Platelet 12.3(6.8-10.5)
Cholesterol 222(under 200)
Triglycerides 162(Normal <150)
Direct LDL Cholesterol 143 (<100 optimal)
CHOL/LDL Ratio 4.5 (Low risk-3.3-4.4)
Very Low Density Lipoprotein 32.4(</=30)

Rest of the parameters like Blood Glucose, Blood Pressure is within range, We already have very balanced diet(very Limited saturated and trans fat consumption) since quite some years and her BMI is within healthy range. Our family has no history of High Cholesterol/Diabetes/Blood Pressure.

Sadly our regular physician is off to US for sometime and I have no other doc who knows us so well. What should be the first step of treatment so as to reduce cholesterol levels and can anyone recommend a good doctor in Noida(Please PM me). Do I need to consult a Cardiologist at this stage or a physician will suffice.

Thanks

Setu

[drasitkhanna]

hi setu
yr mom needs the following

1. even stricter no fat diet
2. vigorous daily workout-like fast walking or jogging for 30-45 mins daily
3. Some yoga preferably
4 Repeat S. Lipid profile after 3 months. If lipid levels are still elevated or not within desirable range, then she will need a tablet daily to bring them down. Not now.

[carboy]

Originally Posted by drasitkhanna

1. even stricter no fat diet

Dr. Khanna, what is your opinion on Low Carb diets instead of Low Fat Diets. There are several studies which show that Low Carb diets show comparable levels of Plasma Lipid Levels & cardio risk factors as compared to Low Fat Diets. And Low Carb Diets showed lower drop out rates as compared to Low Fat Diets.
One problem with Low Carb diets is that it's probably more difficult for vegetarians to go on a Low Carb Diet as compared to a non-vegetarian. A Low carb diet would essentially involve you consuming High Protien food.

A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia ? Ann Intern Med

Participants: 120 overweight, hyperlipidemic volunteers from the community
Conclusions: Compared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet.

Elsevier

Subjects and methods

Fifty-one overweight or obese healthy volunteers who wanted to lose weight were placed on a very low carbohydrate diet (<25 g/d), with no limit on caloric intake.

Serum total cholesterol level decreased 11 ± 26 mg/dL (P = 0.006), low-density lipoprotein cholesterol level decreased 10 ± 25 mg/dL (P = 0.01), triglyceride level decreased 56 ± 45 mg/dL (P <0.001), high-density lipoprotein (HDL) cholesterol level increased 10 ± 8 mg/dL (P <0.001), and the cholesterol/HDL cholesterol ratio decreased 0.9 ± 0.6 units (P <0.001).

Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-Living, Overweight Men and Women -- Meckling et al. 89 (6): 2717 -- Journal of Clinical Endocri

Overweight and obese men and women (24–61 yr of age) were recruited into a randomized trial to compare the effects of a low-fat (LF) vs. a low-carbohydrate (LC) diet on weight loss

Both groups of subjects had significant weight loss over the 10 wk of diet intervention and nearly identical improvements in body weight and fat mass. LF subjects lost an average of 6.8 kg and had a decrease in body mass index of 2.2 kg/m2, compared with a loss of 7.0 kg and decrease in body mass index of 2.1 kg/m2 in the LC subjects. The LF group better preserved lean body mass when compared with the LC group; however, only the LC group had a significant decrease in circulating insulin concentrations

[kri$hna]

Originally Posted by abhishek_bmw

You required to consult an MD general medicine for now. He/she will be your primary doctor; he may send you to ENT surgeon or others...but again come back to him/her with the super specialist's opinion/consultation.

You are facing too much problem because you are breaking the basic chain:

(General physician/MD medicine) > He/she send patient to Superspecialist if needed for opinion > again come back to (General physician/MD medicine).

Please understand the fact, your condition needs a time for a doctor to diagnose and treat completely/to the level best, give him/her the time required.

Thank you.

well said Doc! Thanks a lot for telling me about the "Chain". Most of the time I get to know "somebody who knows so & so doc who is good at so & so treatment", i go consult him and there goes the chain into the bin ! It has been like that ever since. Now I understand the mistake I have been doing always

I still dont get the point of visiting MD General Medicine ( i dont intend to offend you, but how is a General Medicine doc going to help me ?) In a lot of hospitals i see a Cardiologist qualified as MD general medicine/ MD & DM Cardio. Others are mostly MS in some branch of medicine (i guess they are surgeons). So MD General medicine is a doc who knows all the medicine to an extent that he can understand patient's physical condition & refer the right specialist ? doesnt he treat ? sorry if it is a little noobish or so, but am a hell lot confused whenever i see so many qualifications & no proper explanation anywhere. To get it straight, No one ever told me I should consult an MD General Medicine First, so how do i or any other patient know this ?

now to the point.. Can you suggest any good MD General medicine doc, in Hyd ( i ll be living in hyd from sept 20th onwards) ? I have consulted a neurologist already last week, but understanding your post, i am going to follow the Chain ! i guess that makes sense.

Originally Posted by maverick56

sir, this is Dr Amarnath ( maverick 56 to all bhpians )
IMHO, migraine needs to be handled by a neurologist and the muscle pains u describe in the back are as a result of the migraine. Once the primary cause is handled i think the muscle pains also will come dowm

Thanks a lot for the suggestion. I have consulted a Neurologist in St. John's hospital last week. He has ordered an MRI scan (brain) & prescribed Vaporate for 2 weeks. He says its' migraine or looks like that with the symptoms i say. But then how can the same symptoms be diagnosed as Fibromyalgia by one doc & migraine by another ?

I ll be starting the medication today onwards, but i wont be in bangalore to consult him again with the reports. I am only worried about popping in so many pain relievers or migraine medicines which will only worsen my digestive system ! but i dont find any good alternative either :(

[Gansan]

I saw a recent news item in papers. Health dept of TN govt had issued an advisory that two vaccines (one injectable and one nasal spray I think) for H1N1 flu are available in all govt hospitals and health centres, as well as in pharmacies, and people should get vaccinated well ahead of the NE monsoon season.

How advisable is it to go for this vaccine? Which of the two types will be better? Will there be any issues / side effects? I would be most grateful if a doctor can clarify about this. The monsoon season starts here around the last week of October.

[setuniket]

@drasitkhanna: Thanks so much for the advice, I will ensure strict compliance of the advice.... Can you recommend what all things to avoid especially wrt to carboy's concern over low carb diet.

[carboy]

Originally Posted by setuniket

@drasitkhanna: Thanks so much for the advice, I will ensure strict compliance of the advice.... Can you recommend what all things to avoid especially wrt to carboy's concern over low carb diet.

Setuniket, you misunderstood my post - I have no concerns about a low carb diet. All the links I posted are about how a low carb diet is as good an alternative as a low fat diet.

[drasitkhanna]

dear setu/carboy
i dont recommend either a low carb or a low fat diet. If u have to , then read up the TLC diet , which is the diet recommended by the ACC & AHA(American college of Cardiology/am heart association). It gives the percentage of fats, proteins, carbs etc that should be there in an ideal diet. read it up !

[EssYouWe]

Hi!

Just wanted some advice. The patient is suffering from acute gastritis for last three days. Started with Omez 20 twice daily two days ago, and accompanied that with Aciloc 150 (thrice daily) today.
Should the two be taken together?
Should the dosage of Aciloc 150 be increased?
And how many days should this course be continued for.

[drasitkhanna]

do not increase dose of either anymore. Add Digene or Mucaine Gel 2-4 teaspoon Fulls three times a day before meals . Continue as long as required. If still doesn't work.... SEE A GASTROENTEROLOGIST !!!!!!!!!

[docfreak]

hi everybody ,
i saw this thread for the first time today . i will be glad to help anyone who would need it , though i maybe a little slow to respond and also drop in a pm that u have posted a query, though the reply will be replied on the forum . this is only to alert me that a query has been put up for me.

i am pediatric gastroenterologist and a pediatric liver transplant physician.

so u could put queries regarding

• pediatrics(children)
• pediatric gastro problems
• transplant related issues
• vaccination
• neonatology(regarding new born babies)

regards

sharat

[frankmehta]

Hi docfreak. One of our patients suffering from Glomerular Nephritis passed away on Saturday due to renal failure. It was sad. He was all of 12 years of age, and had just started responding to treatment. Just thought i'd mention it here since you are someone who sees these kind of patients daily.