[Deep Blue]

Originally Posted by CrAzY dRiVeR

appendicitis.

Suppose the results confirm it, should we explore the option of anti-biotics? Given its the first occurrence? I've heard a lot of cases where operation had to be done.

The preferred treatment for acute appendicitis is surgery if the patient is diagnosed within about 48hrs after the onset of pain. After this period, the surgeon will assess and decide on whether to proceed for surgery or manage with antibiotics. Generally it is managed with antibiotics if there is a "mass" formation wherein the appendix gets adhered to adjacent intestines and forms a mass making surgery a little difficult. So the surgery is done about 6 weeks after the acute attack subsides with antibiotics.

Once the patient has one episode of acute appendicitis, he or she has higher chances of repeat attacks, hence appendicectomy is always advised whether emergency or interval.

[CrAzY dRiVeR]

Originally Posted by drmohitg

I am not a surgeon but off late the trend has shifted to conservative management with antibiotics and once the inflammation settles down then you can get it operated electively at a later date.

Originally Posted by Deep Blue

The preferred treatment for acute appendicitis is surgery if the patient is diagnosed within about 48hrs after the onset of pain. After this period, Tyre surgeon will assess and decide on whether to proceed for surgery or manage with antibiotics. Generally it is managed with antibiotics if there is a "mass" formation wherein the appendix gets adhered to adjacent intestines and forms a mass making surgery a little difficult. So the surgery is done about 6 weeks after the acute attack subsides with antibiotics.

Once the patient has one episode of acute appendicitis, he or she has higher chances of repeat attacks, hence appendicectomy is always advised whether emergency or interval.

Thank you.

We've got her admitted. Surgery scheduled for tomorrow itself. Nice to get second opinion, since initially- I felt we were being pushed into choosing this option

[kpzen]

Hi docs.

My dad was suffering from chest congestion since last one week.
Coughing starts around evening time and it increases while lying down so he was unable to sleep well due to the cough.

Consulted a doctor, he suggested blood test and chest x ray.

Blood test : All Ok except High ESR = 60

X ray : All Ok except " Costophrenic angles are blunt"

After seeing the X ray, our doctor has asked us to consult a specialist with the X ray.

Meanwhile, the medicines are working well, Cough has reduced considerably but he's feeling drowsy and weak, may be due to the antibiotics.

What are the effects of high ESR and how to control it ?
Also, can someone shed some light on the above two observations.

[SILVERWOOD]

Originally Posted by kpzen

Hi docs.

My dad was suffering from chest congestion since last one week.
Coughing starts around evening time and it increases while lying down so he was unable to sleep well due to the cough.


Blood test : All Ok except High ESR = 60

X ray : All Ok except " Costophrenic angles are blunt"

What are the effects of high ESR and how to control it ?
Also, can someone shed some light on the above two observations.

High ESR in this case signifies infection.

Costophrenic angles are blunt because of pleural effusion (Collection of excess fluid in the pleural cavity)

I am sure your father also has shortness of breath and chest pain along with cough.

Waseem

[kpzen]

Originally Posted by SILVERWOOD

Costophrenic angles are blunt because of pleural effusion (Collection of excess fluid in the pleural cavity)

I am sure your father also has shortness of breath and chest pain along with cough.

Waseem

Thanks Waseem.

How do we proceed to nail the infection ?

And, your advise on further course of action regarding the observations found in blunt costophrenic angles ?
Sometimes, he does have chest pain and shortness of breath.

I would be taking him to the specialist today with X ray reports.

[SILVERWOOD]

Originally Posted by kpzen

I would be taking him to the specialist today with X ray reports.

Yes, i think your should see a Pulmonologist for proper diagnosis.I will not be able to comment further without seeing the X-Ray report.(blunting of the costophrenic angle in one or both lungs etc).

Let us know what the Pulmonologist has to say.

Waseem.

[pyrodrive]

Originally Posted by kpzen

Hi docs.

Blood test : All Ok except High ESR = 60

X ray : All Ok except " Costophrenic angles are blunt"

What are the effects of high ESR and how to control it ?
Also, can someone shed some light on the above two observations.

A couple of questions, does he have any heart problem? swelling around the ankles and/or breathing difficulty?
If no, then he is likely having a chest infection.ESR of 60 is expected in that case. Nothing to worry about if he is improving with antibiotics. ESR will come down as the infection gets controlled. You can put up a pic of the x ray here if possible.

[kpzen]

Originally Posted by SILVERWOOD

Yes, i think your should see a Pulmonologist for proper diagnosis.I will not be able to comment further without seeing the X-Ray report.(blunting of the costophrenic angle in one or both lungs etc).

Let us know what the Pulmonologist has to say.

Waseem.

Thanks. Will keep you posted.

Originally Posted by pyrodrive

A couple of questions, does he have any heart problem? swelling around the ankles and/or breathing difficulty?
If no, then he is likely having a chest infection.ESR of 60 is expected in that case. Nothing to worry about if he is improving with antibiotics. ESR will come down as the infection gets controlled. You can put up a pic of the x ray here if possible.

I think you hit the nail on the head.

1. Heart Problem - NO
(ECG/ BP/ Cholesterol/ Sugar) - All OK

2. Swelling around the ankles - YES
Few months back, he developed a shoe bite around the ankle, it got swollen like a boil and ruptured finally.
It left a hole like a scar, after 2 weeks of KMnO4 solution treatment, the hole finally got patched up.
Swelling is still there and recently it has increased and started paining for him.

We though age factor (65) has increased the the curing time and never thought it would be connected with ESR/ Chest X ray. So didn't mention earlier.

3. Breathing Difficulty - NO

Could you please elaborate on the above and guide us on further treatment.

Will post the X ray soon.

Thanks

[pyrodrive]

Originally Posted by kpzen

Thanks. Will keep you posted.


2. Swelling around the ankles - YES
Few months back, he developed a shoe bite around the ankle, it got swollen like a boil and ruptured finally.
It left a hole like a scar, after 2 weeks of KMnO4 solution treatment, the hole finally got patched up.
Swelling is still there and recently it has increased and started paining for him.

We though age factor (65) has increased the the curing time and never thought it would be connected with ESR/ Chest X ray.
Thanks

Its probably not related then. I was asking about swelling without any apparent cause of BOTH ankles (to exclude cardiac causes). Apparently he doesnt have that and is quite healthy otherwise. The antibiotics he is recieving for his chest condition should help clear up any residual infection in his injured foot.
keep us posted.

[kpzen]

Originally Posted by SILVERWOOD

I will not be able to comment further without seeing the X-Ray report.(blunting of the costophrenic angle in one or both lungs etc).

Originally Posted by pyrodrive

You can put up a pic of the x ray here if possible.

X Ray report attached.

With antibiotics for cough, he feels out of energy and needs support while walking.
Giving him energycal drink on regular basis.

[pyrodrive]

Sorry for the late reply.I did see your post yesterday, but on the small cellphone screen could not make out the X ray.
Only the right costophrenic angle seems hazy. Probably a minimal effusion due to an infection. How is he now? A little weakness is expected. How is the cough? dry/expectoration? Feverishness?

[sagarpadaki]

My mother is experiencing pain in the heels. This pain is present when she gets up after a sleep or when she gets up after sitting for more than half hour. Also the pain goes off after she starts walking for some time.The pain is pretty severe and she cant put pressure on her heels. Any pointers to what could be the problem?

[carboy]

Originally Posted by sagarpadaki

My mother is experiencing pain in the heels. This pain is present when she gets up after a sleep or when she gets up after sitting for more than half hour. Also the pain goes off after she starts walking for some time.The pain is pretty severe and she cant put pressure on her heels. Any pointers to what could be the problem?

Not a doctor - but this sounds like plantar fascitis or one of the related problems. I used to feel as if I am walking barefeet on sharp rocks even when I was wearing shoes and walking on good roads. I had it - my wife has something which is related. Best solution is to do stretching of underfeet before getting up from bed in the morning in such a way that even the calves get stretched - i am unable to describe it. Google for plantar fascitis - you will the description of how stretch before getting up in the morning. Also, wear shoes all the time while walking (even inside home) & use this inside the shoes - http://www.shopping.com/schering-dr-...ring/info?sb=1

The Dr. Scholls thing was like magic for me. My problem went off permanently after wearing those for 2-3 years.

[sagarpadaki]

Originally Posted by carboy

Not a doctor - but this sounds like plantar fascitis or one of the related problems. I used to feel as if I am walking barefeet on sharp rocks even when I was wearing shoes and walking on good roads. I had it - my wife has something which is related. Best solution is to do stretching of underfeet before getting up from bed in the morning in such a way that even the calves get stretched - i am unable to describe it. Google for plantar fascitis - you will the description of how stretch before getting up in the morning. Also, wear shoes all the time while walking (even inside home) & use this inside the shoes - http://www.shopping.com/schering-dr-...ring/info?sb=1

The Dr. Scholls thing was like magic for me. My problem went off permanently after wearing those for 2-3 years.

Thanks for the suggestion. So these heels should be worn inside another footwear is it?

Where can i purchase these from?

[carboy]

Originally Posted by sagarpadaki

Thanks for the suggestion. So these heels should be worn inside another footwear is it?

Where can i purchase these from?

Since I am not a doctor - please first confirm the diagnosis with a doctor. Don't assume it's plantar fascitis (or something related) just because I said so.

The heels need to be worn inside shoes. I was living abroad when I got this. But, I have seen Dr.Scholls inserts at Bata shops & some other footwear shops also.

When I was diagnosed, I was given stretching exercises (easily found on google) and was asked to wear shoes all the time even at home - I used to wear a velcro kind of slip on shoes at home which was easy to take off & put on - but it was a shoe and not a sandal or chappal. And these inserts go well only inside shoes - it will fall off inside chappals or sandals.

The exercises and shoes helped somewhat but for me the real relief came after I inserted the Dr.Scholls into the shoe - I accidentally saw this at a footwear shop and picked it up. However, the stretching exercises prevent the problem from worsening.