Aa
pott spine/ spine tb
my son nikhil jindal aged 20 years had neck pain and stiffness abt a month back followed by fever (100 to 101.6) after 3-4 days of neck pain started.
on 26 mar he was put on topcef 200mg 2 tabs a day for 3 days all medicines were given to patient
on 27 mar his blood was tested and report was as under
TLC 12,600,
DLC- NEUTROPHILS 69.2, LYMPHOCYTES 21.3, MONOCYTES 7.8, EOSINOPHILS 1.1, BASOPHILS 0.6
ESR(WESTREGEN'S) 102
S.G.P.T.(A.L.T.) 31.23
WIDAL TEST WAS NEGATIVE
BASED ON ABOVE TESTS DOCTOR SUGGESTED FOR CHEST X RAY
0n 29 mar he was put on topcef 200mg tab mobizox for another 3 days all medicine wr given to patient
x ray report of chest was normal
but still fever (99 to 101) and pain continues
doctor suggested x ray cervical spine on 29 mar
report was as under
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
ADVISED - MRI CERVICAL SPINE
DOCTOR REFERRED THE PATIENT TO ORTHOPEDIC BASED ON ABOVE REPORT
ortho doc put on the following treatment
inj monocef 1gm I.V - BD
inj Acenac MR 1 BD
these injections were injected for 5 days
doctor suggested for MRI cervical spine
report dated 05 apr his test report was as under
there is straightening of cervical spine
cervicodorsal vertebral bodies from c2 to d4 level reveal focal or diffuse marrow signal intensity alterations hypointense on T1W1 and hyperintense on STIR images, suggestive of marrow edema/inflation. marrow edema is most marked in c6 vertabral bodies.
large prevertabral abscess is seen in cirvicodosral region displaying hypo to isointense signals on T2W1. abscess is predominantly seen on the left side of midline involving preverbtal muscles with mild extensions on right side in right preverbtal muscles.
cranially it is extending upto c2 verteba and caudally till d4 in posterior aspect of superior mediastium. abscess is also seen to extending into left c5-6 and c6-7 neural foramina with mild posterolateral wall of oropharynx and upper esophagus.
CSF shows normal signal intensity. cord shows normal morphology and signal.
CV junction is normal.
IMPRESSION - MR imaging features aree suggeastive of infective spondylitis with large pre vertebal abscess from c2 to d4 and mild epidural extension at c6 level.
Etiology - likely tubercular
his blood test report dated 06 apr was as under
TLC 10,600
DLC- NEUTROPHILS 68.4, LYMPHOCYTES 22.1, MONOCYTES 7.6, EOSINOPHILS 1.4, BASOPHILS 0.5
ESR(WESTREGEN'S) 110
S.G.P.T.(A.L.T.) 48.57
TSH- 2.020
BASED ON ABOVE INVESTIGATIONS and his continue temp (99 to 100) and neck pain
doctor put him on
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD
a second opinion was taken and it was suggested that patient is suffering from pott spine( cervical spine)
and he put on
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised
the patient started taking AKT4 and pyridoxine from 06 apr as par above suggestion
another opinion was taken and it was suggested
to start phase I
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning
shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint
kindly suggest if it is 100% sure that my son is infected with pott spine
or any other test is reqd to be done for confirmation
i want to give treatment after only 100% confirmation of the disease and not in doubt pls
how can it be confirmed
3 doctors have suggested 3 types of treatment although all 3 diagnosed same disease and other one suggested for COTS
sir, i m in total confusion
kindly advice which medicine is the best in india for pott spine
an advice from an expert doctor like u will be a real help to humankind
regards
10 apr 10
pawanj
on 26 mar he was put on topcef 200mg 2 tabs a day for 3 days all medicines were given to patient
on 27 mar his blood was tested and report was as under
TLC 12,600,
DLC- NEUTROPHILS 69.2, LYMPHOCYTES 21.3, MONOCYTES 7.8, EOSINOPHILS 1.1, BASOPHILS 0.6
ESR(WESTREGEN'S) 102
S.G.P.T.(A.L.T.) 31.23
WIDAL TEST WAS NEGATIVE
BASED ON ABOVE TESTS DOCTOR SUGGESTED FOR CHEST X RAY
0n 29 mar he was put on topcef 200mg tab mobizox for another 3 days all medicine wr given to patient
x ray report of chest was normal
but still fever (99 to 101) and pain continues
doctor suggested x ray cervical spine on 29 mar
report was as under
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
ADVISED - MRI CERVICAL SPINE
DOCTOR REFERRED THE PATIENT TO ORTHOPEDIC BASED ON ABOVE REPORT
ortho doc put on the following treatment
inj monocef 1gm I.V - BD
inj Acenac MR 1 BD
these injections were injected for 5 days
doctor suggested for MRI cervical spine
report dated 05 apr his test report was as under
there is straightening of cervical spine
cervicodorsal vertebral bodies from c2 to d4 level reveal focal or diffuse marrow signal intensity alterations hypointense on T1W1 and hyperintense on STIR images, suggestive of marrow edema/inflation. marrow edema is most marked in c6 vertabral bodies.
large prevertabral abscess is seen in cirvicodosral region displaying hypo to isointense signals on T2W1. abscess is predominantly seen on the left side of midline involving preverbtal muscles with mild extensions on right side in right preverbtal muscles.
cranially it is extending upto c2 verteba and caudally till d4 in posterior aspect of superior mediastium. abscess is also seen to extending into left c5-6 and c6-7 neural foramina with mild posterolateral wall of oropharynx and upper esophagus.
CSF shows normal signal intensity. cord shows normal morphology and signal.
CV junction is normal.
IMPRESSION - MR imaging features aree suggeastive of infective spondylitis with large pre vertebal abscess from c2 to d4 and mild epidural extension at c6 level.
Etiology - likely tubercular
his blood test report dated 06 apr was as under
TLC 10,600
DLC- NEUTROPHILS 68.4, LYMPHOCYTES 22.1, MONOCYTES 7.6, EOSINOPHILS 1.4, BASOPHILS 0.5
ESR(WESTREGEN'S) 110
S.G.P.T.(A.L.T.) 48.57
TSH- 2.020
BASED ON ABOVE INVESTIGATIONS and his continue temp (99 to 100) and neck pain
doctor put him on
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD
a second opinion was taken and it was suggested that patient is suffering from pott spine( cervical spine)
and he put on
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised
the patient started taking AKT4 and pyridoxine from 06 apr as par above suggestion
another opinion was taken and it was suggested
to start phase I
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning
shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint
kindly suggest if it is 100% sure that my son is infected with pott spine
or any other test is reqd to be done for confirmation
i want to give treatment after only 100% confirmation of the disease and not in doubt pls
how can it be confirmed
3 doctors have suggested 3 types of treatment although all 3 diagnosed same disease and other one suggested for COTS
sir, i m in total confusion
kindly advice which medicine is the best in india for pott spine
an advice from an expert doctor like u will be a real help to humankind
regards
10 apr 10
pawanj
hello
blood test reports are attached for ur review pls, latest being on 05/06/10 i.e. after 2 months of ATT
Investigation 27.03.10 06/04/10 28/04/10 14/05/10 05/06/10 Given values
Hb - 13.1 14.7 14.1 14.9 13-18
TLC 12600 10600 8300 8700 9600 4000-11000
Lymphocytes 21.3 22.1 31.7 33 22.5 25-50
ESR 102 110 45 43 40 < 15
RDW - 11.6 13.9 - 16.7 11.6-14
SGOT(AST) 20.41 32.47 17.55 19.42 < 40
SGPT(ALT) 31.23 48.57 75.94 25.83 31.13 < 41
S. TSH - 2.020 3.520 - - 0.27-4.2
S. Creatine - - - 0.62 0.69 0.7-1.2
S. Uric acid - - - 13.48 12.14 3.4-7
S. Calcium - - - - 10.92 8.6-10.2
C Reactive Protien - - - - positive
Titre - - - - 12
his Lymphocytes has again fallen down, reasons?
his ESR although has come down but insignificantly reasons?
his RDW has risen. reasons?
his uric acid values are worrying me a lot. any suggestion to bring it down pls?
reason for S calcium raised values?
C Reactive Protien is positive. what it means?
Titre is 12 what it means
what overall u see
regards
pawan
blood test reports are attached for ur review pls, latest being on 05/06/10 i.e. after 2 months of ATT
Investigation 27.03.10 06/04/10 28/04/10 14/05/10 05/06/10 Given values
Hb - 13.1 14.7 14.1 14.9 13-18
TLC 12600 10600 8300 8700 9600 4000-11000
Lymphocytes 21.3 22.1 31.7 33 22.5 25-50
ESR 102 110 45 43 40 < 15
RDW - 11.6 13.9 - 16.7 11.6-14
SGOT(AST) 20.41 32.47 17.55 19.42 < 40
SGPT(ALT) 31.23 48.57 75.94 25.83 31.13 < 41
S. TSH - 2.020 3.520 - - 0.27-4.2
S. Creatine - - - 0.62 0.69 0.7-1.2
S. Uric acid - - - 13.48 12.14 3.4-7
S. Calcium - - - - 10.92 8.6-10.2
C Reactive Protien - - - - positive
Titre - - - - 12
his Lymphocytes has again fallen down, reasons?
his ESR although has come down but insignificantly reasons?
his RDW has risen. reasons?
his uric acid values are worrying me a lot. any suggestion to bring it down pls?
reason for S calcium raised values?
C Reactive Protien is positive. what it means?
Titre is 12 what it means
what overall u see
regards
pawan
Sir, I have been taking Rcinex600 and combutal 1000 from the past 1 year.
But from 3 months , i am suffering from severe numbness in both legs.
Is it due to the heavy dose of those prescribed medicines? please give me a suggestion as i am unable to walk more than 15 min. pls pls sir...
But from 3 months , i am suffering from severe numbness in both legs.
Is it due to the heavy dose of those prescribed medicines? please give me a suggestion as i am unable to walk more than 15 min. pls pls sir...
1 Comments
Sir please suggest me
Uric is the big problem, thr will some pain also....because I m also suffer from spine tb. After 4 weeks of akt I suffer in left side chest pain in check the all get uric is at 12.4 doc advice take fabuxacare 40mg twice a day. So discuss with doc
hello doctor
from some time my father was regular coughing..... so he went to a doctor..... the doctor advised for X-ray.... the report says that there is water in his lungs.
The doctor told that its TB and has advised AKT4 for about 9 months in the morning before breakfast.
his weight is around 62kgs.
plz tell me the correct treatment and is the dose correct?
also should all the 4 tablets be taken in the morning.?
and which one should be taken first.. the doctor told to take the red one first.
apart from this what other medicine he should take.
from some time my father was regular coughing..... so he went to a doctor..... the doctor advised for X-ray.... the report says that there is water in his lungs.
The doctor told that its TB and has advised AKT4 for about 9 months in the morning before breakfast.
his weight is around 62kgs.
plz tell me the correct treatment and is the dose correct?
also should all the 4 tablets be taken in the morning.?
and which one should be taken first.. the doctor told to take the red one first.
apart from this what other medicine he should take.
dear Doctor,
My mom is 67 years old and weighs 63 kgs. She was diagnosed with spine tb after 6 months of back pain. The back pain is unbearable.
She started on atk since few days. She is on pain killers now and even that does not kill the pain completely.
How long do you think that the pain will last and when will she be able to feel better.
Please help us by answering.
Regards,
My mom is 67 years old and weighs 63 kgs. She was diagnosed with spine tb after 6 months of back pain. The back pain is unbearable.
She started on atk since few days. She is on pain killers now and even that does not kill the pain completely.
How long do you think that the pain will last and when will she be able to feel better.
Please help us by answering.
Regards,
sir, advised the following treatment for 02 months for my son. now 02 months will be over on 05 Jun 2010 since he started this treatment on 06 Apr 2010. now you may like to review ur treatment. kindly advice the further treatment to my son.
i am highly grateful to ur this kind act.
it is confirmed that pain of the neck has subsidised but fever remains consistent between 98.6 to 99 in the evening. fever is normal if checked in the day time that is before 7- 730 pm. also rarely fever may rise upto 99.6 in the night.
his esr is 43 and uric acid is 13.48, S. Creatinine. : 0.62 mg/dL
as of now he is on following medicines as advised by you
Tab R-Cinex 300 mg + 600 mg – 1 OD – 2 months (before breakfast)
Tan Ethambutol – 800mg – 1OD – 2 months (Afternoon )
Tab. Pyraziharide 750mg –1-0-1 - 2 months
Tab. Pyridoxine 20mg – 1OD – 2 months
kindly advice further treatment
regards
i am highly grateful to ur this kind act.
it is confirmed that pain of the neck has subsidised but fever remains consistent between 98.6 to 99 in the evening. fever is normal if checked in the day time that is before 7- 730 pm. also rarely fever may rise upto 99.6 in the night.
his esr is 43 and uric acid is 13.48, S. Creatinine. : 0.62 mg/dL
as of now he is on following medicines as advised by you
Tab R-Cinex 300 mg + 600 mg – 1 OD – 2 months (before breakfast)
Tan Ethambutol – 800mg – 1OD – 2 months (Afternoon )
Tab. Pyraziharide 750mg –1-0-1 - 2 months
Tab. Pyridoxine 20mg – 1OD – 2 months
kindly advice further treatment
regards
hello
my son is on Rcinex 600+300, pyrazinamide 1500mg, Ethambutol 800mg
which is an expensive combo in comparison to akt4
can he take akt4 and rifamipicin 150 mg in place of above combo
if he can in that case dose requirement will be met and we wl be saving lot of money also as akt4 contains Isoniazid 300 mg, rifampicin 450 mg, pyrazinamide 1500 mg and ethambutol 800 mg which is only 150 mg less than the above combo which can be met by giving additional tab of rifamipicin 150 mg
regards
my son is on Rcinex 600+300, pyrazinamide 1500mg, Ethambutol 800mg
which is an expensive combo in comparison to akt4
can he take akt4 and rifamipicin 150 mg in place of above combo
if he can in that case dose requirement will be met and we wl be saving lot of money also as akt4 contains Isoniazid 300 mg, rifampicin 450 mg, pyrazinamide 1500 mg and ethambutol 800 mg which is only 150 mg less than the above combo which can be met by giving additional tab of rifamipicin 150 mg
regards
hello
sir, r u busy or not interested to reply? if u r busy i wl wait for ur reply bcs i have complete faith in ur advices. but if u dont want to reply my queries for any reasons then most humbly i request u to kindly let me know so that i can approach some other specialist
regards
sir, r u busy or not interested to reply? if u r busy i wl wait for ur reply bcs i have complete faith in ur advices. but if u dont want to reply my queries for any reasons then most humbly i request u to kindly let me know so that i can approach some other specialist
regards
dear Dr Vinod
thanx a lot
we have been helped a lot by answering our queries
we find that ur answers are to the point and very helping in treating nikhil
we have got full faith in ur advices
kindly reply to our queries above as we are waiting ur valuable advice
regards
thanx a lot
we have been helped a lot by answering our queries
we find that ur answers are to the point and very helping in treating nikhil
we have got full faith in ur advices
kindly reply to our queries above as we are waiting ur valuable advice
regards
11. can thr be a chance to get 'gout' due to high uric acid?
12. sud i discontinue taking pyrazinamide now?
13. sud i start taking the medicine advised by Dr SM Tuli(he is the best doctor for pott spine in india) that does not contain pyrazinamide and ethambutol which are responsible for raised uric acid?
14. how serious is raised uric acid?
12. sud i discontinue taking pyrazinamide now?
13. sud i start taking the medicine advised by Dr SM Tuli(he is the best doctor for pott spine in india) that does not contain pyrazinamide and ethambutol which are responsible for raised uric acid?
14. how serious is raised uric acid?
his blood report dated 14/05/10 is as under
Haemoglobin. 14.1 g/dl
TLC . 8,700 /c.mm.
Differential Leucocyte count
Neutrophils : 56.5 % A : 50 - 80 %
Lymphocytes : 33.0 % A : 25 - 50 %
Monocytes : 7.1 % A : 2 - 10 %
Eosinophils : 2.9 % A : < 6 %
Basophils : 0.5 % A : < 2 %
E.S.R. (Westregen's) : 43 mm/1st Hr
Liver Function Test
S. Bilirubin (Total) : 0.20 mg/dL
S. Bilirubin (Conjugated) : 0.09 mg/dL
S. Bilirubin (Unconjugated) : 0.12
S.G.O.T.(A.S.T) : 17.55 U/L M : < 40 U/L
F : < 32 U/L
S.G.P.T.(A.L.T ) : 25.83 U/L M : < 41 U/L
F : < 33 U/L
S. Alkaline Phosphatase : 68.38 U/L M : 40 - 129 U/L
F : 35 - 104 U/L
S. Protein. : 8.20 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.43 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 3.77 gm/dl
A/G. Ratio : 1.17 : 1
S. Creatinine. : 0.62 mg/dL M : 0.7 - 1.2 mg/dL
F : 0.5 - 0.9 mg/dL
S. Uric Acid. : 13.48 mg/dL M : 3.4 - 7 mg/dL
F : 2.4 - 5.7 mg/dl
wat are ur overall comments on the report?
my querries are
1. there is no change on ESR from the earlier report i.e. it was 45 on 28 apr. is it that now medicine is not effective?
2. we have changed from akt4 on ur advice to Rcinex 600+300, pyrazinamide 1500mg, Ethambutol 800mg. as body wt of my son is 67 kg.
3. sud we revert back to akt4?
4. or there may be any other reason for no change in ESR value.
5. his SGOT(AST) is now down to 17.55 from 32.47. reason?
6. his SGOT(ALT) is now down to 25.83 from 75.94. reason?
7. is that now medicine is not effecting his lever?
8. or medicine is not at all effective?
9 S. Creatinine is 0.62. anything to worry? what are the effects of lower value?
10. S. Uric Acid is 13.48. anything to worry? what are the effects of higher value?
Haemoglobin. 14.1 g/dl
TLC . 8,700 /c.mm.
Differential Leucocyte count
Neutrophils : 56.5 % A : 50 - 80 %
Lymphocytes : 33.0 % A : 25 - 50 %
Monocytes : 7.1 % A : 2 - 10 %
Eosinophils : 2.9 % A : < 6 %
Basophils : 0.5 % A : < 2 %
E.S.R. (Westregen's) : 43 mm/1st Hr
Liver Function Test
S. Bilirubin (Total) : 0.20 mg/dL
S. Bilirubin (Conjugated) : 0.09 mg/dL
S. Bilirubin (Unconjugated) : 0.12
S.G.O.T.(A.S.T) : 17.55 U/L M : < 40 U/L
F : < 32 U/L
S.G.P.T.(A.L.T ) : 25.83 U/L M : < 41 U/L
F : < 33 U/L
S. Alkaline Phosphatase : 68.38 U/L M : 40 - 129 U/L
F : 35 - 104 U/L
S. Protein. : 8.20 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.43 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 3.77 gm/dl
A/G. Ratio : 1.17 : 1
S. Creatinine. : 0.62 mg/dL M : 0.7 - 1.2 mg/dL
F : 0.5 - 0.9 mg/dL
S. Uric Acid. : 13.48 mg/dL M : 3.4 - 7 mg/dL
F : 2.4 - 5.7 mg/dl
wat are ur overall comments on the report?
my querries are
1. there is no change on ESR from the earlier report i.e. it was 45 on 28 apr. is it that now medicine is not effective?
2. we have changed from akt4 on ur advice to Rcinex 600+300, pyrazinamide 1500mg, Ethambutol 800mg. as body wt of my son is 67 kg.
3. sud we revert back to akt4?
4. or there may be any other reason for no change in ESR value.
5. his SGOT(AST) is now down to 17.55 from 32.47. reason?
6. his SGOT(ALT) is now down to 25.83 from 75.94. reason?
7. is that now medicine is not effecting his lever?
8. or medicine is not at all effective?
9 S. Creatinine is 0.62. anything to worry? what are the effects of lower value?
10. S. Uric Acid is 13.48. anything to worry? what are the effects of higher value?
his earlier x-ray report dated 01/04/10 was
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
now x-ray of spine lat view dated 14/05/10 is
compared with previous film- soft tissue thickening appear more marked.
pls advice
has his condition is improved ? or otherwise
thickening of soft tissue is good or not
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
now x-ray of spine lat view dated 14/05/10 is
compared with previous film- soft tissue thickening appear more marked.
pls advice
has his condition is improved ? or otherwise
thickening of soft tissue is good or not
MEDICAL PROFESSIONAL
Hello!
You should go for an X-ray after couple of months, but if his orthopedician wants an MRI you can go ahead, it is important to understand the healing and his response to anti tubercular medicines.
Various methods to understand healing from Tuberculosis spine are:
1) X-ray and MRI
2) ESR
3) Weight gain after treatment
Take care!
Take care!
You should go for an X-ray after couple of months, but if his orthopedician wants an MRI you can go ahead, it is important to understand the healing and his response to anti tubercular medicines.
Various methods to understand healing from Tuberculosis spine are:
1) X-ray and MRI
2) ESR
3) Weight gain after treatment
Take care!
Take care!
MEDICAL PROFESSIONAL
Hello!
You can walk with decrease in your symptoms of back pain. My suggestion for you is to go for a present day X-ray and if the healing is fine then go ahead with your 15 min walks. You can do lots of exercises in sitting and sleeping postures, learn from an expert physiotherapist.
Resistant Tuberculosis is serious; my suggestion for you is to complete the full course of medications for 6-9 months till you are certified tuberculosis cured, after this there is no reason to worry.
Follow up with a TB specialist.
Take care!
You can walk with decrease in your symptoms of back pain. My suggestion for you is to go for a present day X-ray and if the healing is fine then go ahead with your 15 min walks. You can do lots of exercises in sitting and sleeping postures, learn from an expert physiotherapist.
Resistant Tuberculosis is serious; my suggestion for you is to complete the full course of medications for 6-9 months till you are certified tuberculosis cured, after this there is no reason to worry.
Follow up with a TB specialist.
Take care!
Dear sir,
i am in bed rest for 2mnths now may i walk at home?atleast 15min may i walk?
Once spinal tb is cured, is there is any chance to again come in FUTURE or not at all? what prblm may comes in FUTURE for this? pls tell some suggestion sir.thank you
i am in bed rest for 2mnths now may i walk at home?atleast 15min may i walk?
Once spinal tb is cured, is there is any chance to again come in FUTURE or not at all? what prblm may comes in FUTURE for this? pls tell some suggestion sir.thank you
Sir, Thank you very much for your advice.
My doubts are more or less cleared. But when one is lying down for such a long period of time, will one not lose muscle and legs become weak? My husband feels that no excercise will make him weak. Are there any excercises he can do while lying in bed?
His ortho is asking us to get another MRI done. Will another MRI at 5 weeks sho/ pick up any improvement ? Or should we wait longer?
If we should wait then what is the best time ( at how many weeks) should MRI be done?
Thank you very much for the info.
My doubts are more or less cleared. But when one is lying down for such a long period of time, will one not lose muscle and legs become weak? My husband feels that no excercise will make him weak. Are there any excercises he can do while lying in bed?
His ortho is asking us to get another MRI done. Will another MRI at 5 weeks sho/ pick up any improvement ? Or should we wait longer?
If we should wait then what is the best time ( at how many weeks) should MRI be done?
Thank you very much for the info.
MEDICAL PROFESSIONAL
Hello!
Any problems in the lumbar vertebra can cause symptoms of pain in legs.
After 2 months of medications, (4 drugs for tuberculosis regularly) and seeing his response and weight gain and seeing the changes on his X-ray scan his physician will allow him to walk with a stick and support.
I would suggest X-rays every 2 months for the maximum of 3 times in a year to monitor his progress and response after anti tubercular medications. If suggested then go for 1 more MRI, that would be enough without any complications.
He can start physiotherapy after 2-3 months.
Take care!
Any problems in the lumbar vertebra can cause symptoms of pain in legs.
After 2 months of medications, (4 drugs for tuberculosis regularly) and seeing his response and weight gain and seeing the changes on his X-ray scan his physician will allow him to walk with a stick and support.
I would suggest X-rays every 2 months for the maximum of 3 times in a year to monitor his progress and response after anti tubercular medications. If suggested then go for 1 more MRI, that would be enough without any complications.
He can start physiotherapy after 2-3 months.
Take care!
MEDICAL PROFESSIONAL
Hello!
As you had tuberculosis and bone pathology your physician suggested calcium to you. You can take it for 3 months and also drink milk during the treatment for getting dietary protein and calcium.
Get your minerals checked and know the present value of serum calcium and discuss with your physician before stopping calcium supplements.
Take care!
As you had tuberculosis and bone pathology your physician suggested calcium to you. You can take it for 3 months and also drink milk during the treatment for getting dietary protein and calcium.
Get your minerals checked and know the present value of serum calcium and discuss with your physician before stopping calcium supplements.
Take care!
Sir , after reading your advice to many patients I have been wanting to get my doubts cleared too.
Mty husband was diagnosed with spinal tb. The lesions were at L5,S1. It was extreme pain that drove us to hospital for MRI and other tests.
The MRI showed the TB problem and complete bed rest was ordered. with medicines for tb started 2 April.
We are continuing with the bed rest but could you tell me at what point should we get MRI done to monitor the treatment?
It is over 5 weeks now in bed. Should we start rehab execrises? He wants to start walking agin but is it too soon? Will it cause him any problems?
There is still pain in the legs.
Pregalin provides relief.
Will appreciate your considered opinion.
Mty husband was diagnosed with spinal tb. The lesions were at L5,S1. It was extreme pain that drove us to hospital for MRI and other tests.
The MRI showed the TB problem and complete bed rest was ordered. with medicines for tb started 2 April.
We are continuing with the bed rest but could you tell me at what point should we get MRI done to monitor the treatment?
It is over 5 weeks now in bed. Should we start rehab execrises? He wants to start walking agin but is it too soon? Will it cause him any problems?
There is still pain in the legs.
Pregalin provides relief.
Will appreciate your considered opinion.
hello sir, thanks for ur answer. now my pain 95percent cured. this month 22nd my tablet course will be changed by doctor. sir kindly tell me that what happen whn taking more calcium dose? becoz im take 'bio-D3 plus calcium capsule' how long may i use this?somewhere i hear that taking more calcium can cause kidny stones are formed is it true
MEDICAL PROFESSIONAL
Hello!
1) I have given the standardized doses for his weight but titration of doses should not be done by me or you but by the treating physician as he will understand the side effects of all these antibiotics and how Nikhil responds. As you have changed the doses, inform his doctor.
2) Always take him to an orthopedician consultancy after end of every month for first three months then after 2 months till the treatment is complete.
3) A total of 3 X-rays for a period of 6months-1yr is sufficient.
4) Only go for further tests if his treating physician wants.
5) DO NOT DISCONTINUE DRUGS. After 2 months of 4 drugs now he will need 2 drugs for further 6 months. Remember the treatment is for 6-9 months.
Take care!
1) I have given the standardized doses for his weight but titration of doses should not be done by me or you but by the treating physician as he will understand the side effects of all these antibiotics and how Nikhil responds. As you have changed the doses, inform his doctor.
2) Always take him to an orthopedician consultancy after end of every month for first three months then after 2 months till the treatment is complete.
3) A total of 3 X-rays for a period of 6months-1yr is sufficient.
4) Only go for further tests if his treating physician wants.
5) DO NOT DISCONTINUE DRUGS. After 2 months of 4 drugs now he will need 2 drugs for further 6 months. Remember the treatment is for 6-9 months.
Take care!
based on ur confirmation the dosage for more than 50kg body weight: i have changed the medicines of my son from AKT4 to Rcinex 600+300, pyrazinamide 1500mg, Ethambutol 800mg. as body wt of my son is 67 kg
is it ok?
now sud i consult ortho splst or TB specialist or medicine splst for his further treatment?
sud i also go for CPR test alongwith Xray?
pls also suggest if i can go for QuantiFERON®-TB Gold now as i came to know just now that this test is 100% confir test for TB? and if it is negative for TB can i discontinue the TB medicines at this stage?
is it ok?
now sud i consult ortho splst or TB specialist or medicine splst for his further treatment?
sud i also go for CPR test alongwith Xray?
pls also suggest if i can go for QuantiFERON®-TB Gold now as i came to know just now that this test is 100% confir test for TB? and if it is negative for TB can i discontinue the TB medicines at this stage?
MEDICAL PROFESSIONAL
Hello!
A weight gain of 8kgs for 2 months is a good sign after taking AKT4. Good that you are hungry and I would suggest you to take good protein diet and milk which is rich in calcium and protein.
Your treatment will continue for atleast 4-6 months.
Discuss with your TB specialist or orthopedician as when to start 2 drug?
Go for a present day X-ray.
You would need isoniazid and rifamipicin for next 4-6 months after taking AKT 4 for 2 months. In some cases AKT 4 is taken for 3 months.
Take care!
A weight gain of 8kgs for 2 months is a good sign after taking AKT4. Good that you are hungry and I would suggest you to take good protein diet and milk which is rich in calcium and protein.
Your treatment will continue for atleast 4-6 months.
Discuss with your TB specialist or orthopedician as when to start 2 drug?
Go for a present day X-ray.
You would need isoniazid and rifamipicin for next 4-6 months after taking AKT 4 for 2 months. In some cases AKT 4 is taken for 3 months.
Take care!
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