Dr. Sugreev Singh
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 59-year-old male. For decades, I have been struggling with chronic pain and fatigue, which naturally was making my sleep significantly disrupted. Last week, I did a sleep apnea test, and they diagnosed me with moderate to severe sleep apnea.
The doctor said that my age and medical history of cervical fusion of C5 and C6 cervical spine before 19 years were the reason for my systemic pain. My muscles have become tight, and even standing or walking for five minutes makes my muscles very tight.
My question is, how do I figure out whether sleep apnea is an ENT problem or the result of the long story and painful life as I described?
Also, my mom passed away at 54 years with cardiac arrest, and I know her sleep was very disturbed for other physical ailments. I have attached my reports. Please review them and give your opinion.
Hi,
Welcome to icliniq.com.
Thank you for writing, and I can understand your concern.
I have gone through your reports, and your sleep apnea is mild only (attachments removed to protect the patient’s identity). It is not related to the ENT issue. In contrast, it needs neurological assessment. Sleep apnea is not associated with any severe health condition. It does not have any relation with your mother's health issue. You are not able to sleep due to pain and severe weakness. This may be due to a kind of stress and also because of continuous thought about that.
Can you please tell me what medications you are taking currently?
Thanks.
Patient's Query
Hello doctor,
Thanks for the reply.
My current medications are Citalopram, Meloxicam, Lipitor, Cholesterol medicine, Claritin allergy medicine, Aspirin, and Tylenol. How do you say that my sleep apnea is mild and not moderate or severe?
Thanks.
Hello,
Welcome back to icliniq.com.
As per your reports, it is suggestive of mild to moderate sleep apnea. It is said to be severe if there is no sleep at all. Since you get some episodes of good sleep, we can say that your condition is mild.
Do you have an earache or discharge?
Regards.
Patient's Query
Hello doctor,
Thanks for the reply.
I do not have any earache or discharge.
Thanks.
Hello,
Welcome back to icliniq.com.
1) What is your blood pressure?
2) What dosage of Tylenol are you taking?
Regards.
Patient's Query
Hello doctor,
Thanks for the response.
Without medicine, my blood pressure is 160/101 mmHg, and with medications, it is 107/67 mmHg. I take 500 mg of Tylenol.
Thanks.
Hello,
Welcome back to icliniq.com.
Kindly take your BP medicine regularly and maintain it below 140/85 mmHg. Please reduce salt intake, and I would suggest you take more fruits, juices, and liquids. It will help to keep you hydrated and help in improving weakness and fatigue. Kindly take tablet Ultracet (Tramadol and Paracetamol) if you have severe pain.
Along with your medications, please add tablet Pantoprazole 40 mg and a multivitamin tablet once a day before the meal to avoid the side effects of the medicines you are taking.
Take care.
Patient's Query
Hello doctor,
Thank you for the reply.
I have attached my MRI and x-ray. I am at a state that any tiny hip movement (even while sleeping) makes the pain worse. What should I do now?
Does tablet Ultracet contain Ibuprofen? I forgot to say that I started taking the tablet Meloxicam two days ago.
Is pantoprazole called as Protonix?
Thank you.
Hello,
Welcome back to icliniq.com.
I have not received your file. Can you please send it again?
Regards.
Patient's Query
Hello doctor,
Thanks for the response.
I have attached both the recent and older version to show the progression.
Thanks.
Hello,
Welcome back to icliniq.com.
I have received your reports (attachments removed to protect the patient’s identity). There are severe degenerative disc changes. Due to that, you have severe back pain. As the disc is compressing your spinal cord, your legs might feel numbness. Take Calcium and vitamin supplements to improve the condition. And daily exercises are a must. You can take physiotherapy.
Thanks.
Patient's Query
Hello doctor,
Thanks for the reply.
I will take the supplements. I cannot walk or exercise as standing for even five minutes gets my body all tight, and it affects the head and skull causing much brain fog and fatigue. So I cannot do physical therapy. Is surgery my only option to fix this?
Thanks.
Hello,
Welcome back to icliniq.com.
Ultracet is combination of Tramadol and Paracetamol. Protonix is different from Pantoprazole. Pantoprazole is an antacid.
Regards.
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Internal Medicine
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