Hello and thankyou for approaching DoctorSpring with your query.
Please can you answer a few questions so that I get a better understanding of your husbands condition.
1) Since when have his symptoms begun?
2) Is he having any weakness in his hand like difficulty in gripping or less power in his right hand as compared to his left?
3) Is he having any weakness in his leg, like unable to climb stairs, dragging of his feet while walking, or slippers falling of his feet?
4) Is he having any slurred speech or drooping of one side of his mouth?
5) Any nausea or vomiting or chest discomfort?
6) Is he having decreased sensations on one side of his body?
7) When you press your finger on the swelling of his ankles does it leave a depression for some time before the skin comes back to normal (pitting)?
If he is having any of the above symptoms please do not waste time and visit the ER immediately to rule out any stroke or cardiac involvement.
If the above symptoms are not present, you can reply as a follow up and let me know the sequence of events of development of his symptoms and any other symptoms that he may be experiencing.
Like I said if the above symptoms are present please visit the ER immediately. I will leave the consult open so you can get back to me anytime.
Thankyou
Patient replied :
Am responding to Drs questions. Husband symptoms began approx. 3/21/14, has less strength in right hand, walking OK, swollen ankles pit OK. Severe nausea, can't hold anything down including liquids. Smokes a pack a day, drinks 12 oz Yeagermeister a day.
Hello,
Thank you for the reply.
The tingling and numbness in the right arm and the leg swelling (edema) appears to be not related to each other. The tingling and numbness indicates a compressed nerve (pinched nerve ) supply to the arm. This could be in the neck level. The pinching could be from a compressed disc, a growth or a fracture. Most likely it is a disc bulge which should resolve on its own.
The biggest concern here is the ankle swelling. The ankle swelling indicates that water is getting accumulated in the body because either kidney is not excreting properly or heart is not pumping properly. Loss of protein , liver disorders etc can also cause this. Some non significant causes are prolonged standing, exercise etc. However whenever there is a new onset ankle odema in a 50+ individual it has to be evaluated FOR SURE.
The following tests are required - Complete Blood count, Liver, renal thyroid function tests, Chest Xray, ECG, Echo , Urine Studies as first step. This will give the diagnosis (or at least rule out the serious causes). The stomach pain could be related to any of these problems. DO NOT consume alcohol or alcoholic drinks for now. DO NOT take OTC pain medications.
Please get in touch with your Doctor for evaluation. You can get back to me with the results.
Thank you