I am a 60 year old known diabetic. Since two years, I am having severe leg pain when I walk even for a small distance. I have shooting pain in my calves after just 10 minutes of walk. Doctors have diagnosed it as calcification of nerves. I have attached my reports for your reference. Please help.
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You are having intermittent claudication due to a peripheral arterial disease as demonstrated by your arterial ultrasound (attachment removed to protect patient identity). I am hoping it is a Doppler ultrasound.
It appears that your diabetes is under control and you do not have heart failure. I understand that you have no history of heart attack either.
Peripheral vascular disease, less likely but sciatica is also possible. You have normal EMG, but there is no MRI and nerve conduction study available.Investigations to be done:
If ankle-brachial index is normal, then nerve conduction study has to be takenProbable diagnosis:
Peripheral vascular disease.Treatment plan:
1. Increase the Cilostazol to 100 mg twice daily if there is no history of heart failure, heart attack and not taking two blood thinner agents together.
2. If taking Aspirin only, then it is safe to increase the dose to 100 mg twice daily.
3. I would encourage you to take 81 mg of Aspirin daily.
4. Also, do exercise grading. It is a three month program that will gradually build your exercise tolerance.
Follow up in a month to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician
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