Dr. Sapkal Ganeshrao Patilba
Cardiology
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Patient's Query
Hello doctor,
My father has diabetes, and recently we noticed that his toes turn to purple at night, espcially when he is not walking or standing. It goes back to normal when he walks for a little bit. We run some tests, and I would like a specialist to look at them. We consulted a cardio doctor but I am not sure they know what is wrong. So, I have the lab results and I need a doctor to give me more information on what they mean and what possible directions we could take. I also want to share the list of drugs they gave him so far.
Hi,
Welcome to icliniq.com.
Gone through the reports you provided (attachment removed to protect patient identity). He is having diabetes. Reports suggest that he is having blockages in leg arteries and also in heart arteries. Doctors have started on anti-platelet drugs and cholesterol lowering drugs. Prescription looks okay. Further I will suggest be on all these medications. If his toes does not improve within two to four weeks he may need a procedure to open the limb artery blockages. As he is not having any heart related symptoms like chest pain, breathing difficulty can wait and watch for heart issue with continuation of prescribed medications.
Patient's Query
Hi doctor,
Thanks for your answer. Yes, he has diabetes. His cholesterol is normal, and I wanted to ask why would the doctor give him a medicine to lower cholesterol? Plus, do you think the anti-platelet drug will be okay for a person his age? Thanks a lot for your kind help.
Hi,
Welcome back to icliniq.com.
In persons with blockages in arteries we give cholesterol lowering drugs despite normal cholesterol levels. Because it is a well proven to help persons with further future events like heart attack, paralysis. Antiplatelets at his age is fine and is prescribed to him as benefits are more compared with risks associated with it.
Patient's Query
Thank you doctor,
We have done the attached tests yesterday again to show you his laboratory results as accurate as possible. Please check the attached and here are my final questions: His platelets are 343×103/µL so how much Aspirin does he need to take (What is the does?) and for how long (is there a specific time frame?) Does he have to take Aspirin and Plavix together? For the cholesterol, it is 200mg/dL, how long does he need to take the cholesterol medication for? Will this affect his memory? We read this medication has that side affect, so will taking that for a long period be a good idea? What do you recommend in terms of timeframe? As you can see in the lab tests, the monocytes is high, 12. Is that worrying? Thanks a lot for your kind help,
Hi,
Welcome back to icliniq.com.
Aspirin dose is usually 75 or 150 mg. I will suggest him 150 mg. It is given lifelong unless any absolute contraindications. If he does not undergo any interventional procedure for limb or heart arteries then Plavix can be discontinued after 1 month. After procedure Plavix to be given with Aspirin for approximately 1 year. Cholesterol lowering drugs - Statins is given to reduce future events. Exact duration of therapy depends on cholesterol levels on follow up. Most patients require these medications almost lifelong. Side effects related to memory are questionable and not proven conclusively. Monocyte count is fine, not worrisome.
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Cardiology
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