Doctor in the House: Free Medical Advice Available

As you have said, you get your catarrh in the rainy season. The lining of the nose is sensitive to changes in atmospheric temperature and humidity. Decongestant nasal drops may help. Things like Vicks sinex. Remember if you are an athlete, some of these contain banned substances by the IAAF.

See the answer to the catarrh problem as above. The nose is full of bacteria so having wounds in the nose and picking at it could be a source of infection. You could use an antibacterial nasal ointment or cream. Contents could be chlorhexidine/neomycin or mupirocin. All countries have different trade names for them

Thanks Doctors for giving free advice to the forum.  What do you think of the alkaline diet for improving ones health and wellness?  I have been on it for about a month now and have found that my allergy symptoms have been tremendously decreased.  I noticed an immediate improvement in my immune response to allergens.

To start with i am moved to compassion to respond to your mail, from your name you are of indian descent, a race with a high incidence of hypertension (which is the leading cause of myocardial infarction worldwide) diabetes mellitus and as a complication of such, renal failure.

I must say again your father has a terminal illness, one that will need close monitoring by his personal physician, i will give advise from time to time but that is just a supplementation to what he needs.

From the prescription your father is on it is obvious is hypertensive, which i suspect is the cause of the infarction, also it wont surprise me if his lipid levels are high, a major contributor.

why am i telling you all these?:

1) your father's case is one that needs careful monitoring.
2) he needs to adhere to some strict diet in addition to his medications.

Now to your question:

1) your fathers urea and creatinine is a function of the state of his kidney, from what you have said his kidney is on its way out.

2) How can it be reduced? the values can be reduced but the damage already done to the kidney im afraid, is irreversible.

he will need to do further tests as i wont be surprised if he is presently diabetic, in addition to the hypertention which could further compromise his kidney function, if he can see his doctor to rule out diabetes then they can focus on controlling his high blood pressure, which will slow down the progression of the kidney damage but cannot reverse the damage that has been done.

He can in addition to his present medication go on renal dialysis, expensive treatment but one that will prolong his life (it is estimated at about US$1000 per week to maintain him on this treatment)

4) number three has been answered with two, i am afraid the problem he is facing now is not only that of the heart but also his kidney, the prognosis is not encouraging, i cannot offer you false hopes.

his medications, strict dietary rules:

low fat

low salt, must be observed.

He can add simvastatin 10mg po od to his medications, this will help reduce his fat

He can add Atenolol 25mg po od to his medication, this will help prolong his heart life span

if he can afford the renal dialysis, he will live much longer but sadly its cost is astronomical, with his present compromised kidney, he needs to be monitored by a doctor for further medical trials such as

Enalapril 10mg po od, which will help the kidney recover a little but which his

urea, potassium, and creatinine must be monitored closely.

I hope i have been of help, not much of a hope but a hope all the same if he is obedient to his diet can afford his drugs and to emphasize again, the renal dialysis.

I have to add that all his present medications must be continued.

Good luck

nene, aka nicetohave

I am happy to hear that he is not diabetic.

The Hytrin is for his prostate, it is however not uncommon for men his age to be sick this way. (by the way, all men over the age the age of 40 must have at least a once a year screening for prostate cancer, its a life saving excersice, please)

The prostate could raise some of his blood parameters notably the urea but will not raise the creatinine to 5.4 has you have written, that is a sign of a compromised kidney, the high potassium is also a testimony to that.

I wouldnt want you to get hung on the blood parameters, urea and creatinine and potassium are not the problem on their own (even though high potassium is bad for the heart and must of  a necessity be reduced which the doctors are already doing by giving him the k-binder powder) they are simply pointers that something is wrong with the kidney.

Enalapril helps to improve renal function, yes (improve its present function not reverse already done damage, i like to emphasize so as not to give undue hope) but the reason its use has to be monitored in him is that in a patient with such renal compromise, enalapril may add to the increasing potassium and if that happens, it must be withdrawn, his only other hope will then be renal dialysis or continue his present medication and then sit and wait.

Urea and creatinine are metabolic body wastes that the kidney cannot clear from the system because its fucntion is deteriorating, giving enalapril wont reduce these values, k-binders can however reduce potassium but not the other two (urea and creatinine) neither will enalapril, which can either help or not depending on how far gone the kidney malfunction is.

what your father needs now is something that works in replacement of the kidney to clear the metabolics waste from the body, and that is what the dialysis machine does.

why am talking so much about the kidney when you don't even seem to mention it? because when metabolic wastes accumulate too much in the body uncleared, it kills faster than cancer or heart disease, talk to the doctors managing him about their options for him in this regard.

The doctors seem to been doing everything for him, i don't know his exact age but with one heart attack, one stroke, a fractured leg, a "tired" heart judging from the echocardiography report, a deteriorating kidney and a prostate cancer or BPH which he has, i am certain the doctors will want to be careful with how aggressive they get with his management.

At this stage he is getting all he needs from medicine, lets wait and see.

don't let him get excited at home for anything, emotions is a major provocant of heart pain.

I hope i have been of help.

Collectively, what you suffer from is called CONNECTIVE TISSUE DISEASES.

Before i go on you have to furnish me with more details:

you said you were diagnosed at age 18 but at what age did you first develop the symptoms?

Any family history?

How old are you now?

What medications are you presently on?

you have a multisystemic involvement of this disease, did your specialist tell you what surgical option he is considering?

If you are not comfortable with posting all the response on this forum, you can forward it to the site administrators email for onward transmission to me.

I always believe every problem has a solution, it may only take time for us to come up with an acceptable one.

Rolly,

I am not a doctor but i am an allergy sufferer. I just found a diet that has helped me tremendously.

I is very simple .  I make sure I eat lots of organic  alkaline fruits and vegetables every day.  My husband  and I are amazed  how well it works.  Reasearch this  for yourself  and get a list of the alkaline foods for your area.  You will be surprised how much better you will feel right away without any medication for allergies. 

It is hard to be productive when your are suffering.  Good luck.

@ jclord and nicetohave,

   thank you so much for your advice. i can try the fruit and tea part but as for the drugs, , i'm not a fan. i use it 3times aday for one day and thats it,, regardless of whether i feel better or not. i don't stick to drugs but the fruits should work and as for the tea, i'm soooooo adicted to it, on hot days sef, i take hot tea before i take water. but osan wewe is bitter now? i'll try it sha. thanks a lot 

nicetohave I am glad you have stepped in to attend to the questions. I would like as many doctors that visit this site to give advice. Presently my nephew visiting Nigeria for the first time in over 10 years has been involved in a horrific accident in Abuja. We are currently trying to see whether we can fly him back to Britain. We seem to have problems with the Nigerian neurosurgeon who refuses to send his scan over for us to have second opinion. I am based in Edinburgh as you can see. I would have thought as common courtesy to a fellow doctor I deserve that sort of respect. Thats Nigeria for you.

I better not say anything about Nigeria now because what i will say may be counted as treason against my country but what on earth stops a doctor from giving a priviledged access to a patients record to another doctor, especially to a fellow Nigerian, in matters of life and death as this?

Balogun, i pray the storm blows over and pray swift recovery to your brother.

Balogun,

It si sad to hear about the death of your nephew.  My condolences to you and your family.

May he rest in peace. Amen

Accept my condolence 

hi big_bumper, thank God you are alive and well (i hope) but what is happening here? people going home and having RTAs, God continue to keep us from danger o.

I am willing to discuss further with you and give suggestions, where necessary.

Health is wealth.

I wish above all that thou mayest prosper (all NLanders) and be in HEALTH even as thy soul prospers.

@balogun, sorry about your nephew, may his soul rest in peace

Glad 

welcome back boss

what kind of infection?

Bacterial? fungal?

If it is bacterial it might result from the integrity of the skin around the nails being breached and microbes finding its way into the nail bed, resulting in paronychia. This could easily be treated with a short course of appropriate antibiotics plus/minus drainage as the case my be.

If it is fungal it might result from moisture finding its way underneath the nail bed, encouraging fungus to proliferate and destroy the nail. Usually it is commoner in those that wear tight fitting wet shoes, so it is commoner around the big toes but can occur in any other nail in the body. Treatment includes ensuring dry shoes and nails, and antifungal agents like the ketoconazole or lamisil, usually it takes about 3 to 6 months for effective treatment depending on which part is affected.