Patient's Query
Hello doctor,
I am a 47-year-old male suffering from ankylosing spondylitis for the past 34 years. I underwent bypass surgery 18 years ago and have been experiencing depression since then. Currently, my eosinophil count is high at 1090. My current medications are Pantoprazole 40 mg in the morning, Fluoxetine 20 mg once daily after breakfast, Bisoprolol 2.5 mg once daily after breakfast, Atorvastatin with Aspirin after dinner, Aceclofenac with Paracetamol at night, and Alprazolam 50 mg at night.
Please suggest appropriate treatment.
Hello,
Welcome to icliniq.com.
I have reviewed a brief summary of your case. You underwent CABG (bypass heart surgery) and are currently on Bisoprolol, a beta-blocker, and a combination of Aspirin and Atorvastatin. For depression, you are taking Fluoxetine, and for anxiety, you are on Alprazolam.
Regarding ankylosing spondylitis, I want to emphasize that there is no permanent cure for this condition. The primary focus is on managing pain and discomfort. You are already taking a combination of Tramadol and Paracetamol as an analgesic. I suggest adding Methotrexate 7.5 mg weekly for three weeks, along with Folic acid once daily for the same duration. This may help alleviate your symptoms. However, do not continue Methotrexate beyond this period without consulting a doctor. To clarify, you should take Methotrexate 7.5 mg once a week for a total of three doses. Further treatment will depend on your response to this therapy.
As for the elevated eosinophil count, this condition can have many causes and requires detailed evaluation. When did you first notice the increase in your eosinophil count? Are you experiencing any other conditions, such as skin or lung diseases? The elevated count could also be due to worm infestation. In this case, I recommend taking Albendazole 400 mg with a meal, once a week for three weeks, and then repeating the eosinophil count. It is advisable to get a stool test done before starting Albendazole. Consult your specialist doctor, discuss with him or her, and take the medicines with take the medicines with their consent.
Cardiac evaluation: You had CABG (bypass surgery). Have you experienced any cardiac symptoms, such as chest pain, shortness of breath, palpitations, or fainting, since then? Are you following up regularly with your cardiologist? I recommend undergoing a non-invasive CT-guided angiography. This is not an invasive procedure and is similar to a standard CT scan.
I hope this helps you.
Thank you.
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Answered byDr. Amit Kumar
Medically reviewed byDr. K. Shobana
Same symptoms don't mean you have the same problem. Consult a doctor now!
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