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Dr.Dev
Dr.Dev, Doctor
Category: Health
Satisfied Customers: 2156
Experience:  MBBS, MD, FCCS, Post Doctoral Fellowship in Cardiac Anaesthesia and Critical Care Medicine.
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When I smoke my pipe I get stiffness, tingling, pain and burning

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When I smoke my pipe I get stiffness, tingling, pain and burning in my ankles and feet almost immediately. Is this a nervous system reaction or a vein system reaction or both. Should I see a neurologist or a cardiologist? I realize you are not a doctor, just looking for some general advice. I don't sue people who try to help me even if they fail to help me!
Hello.

As you might be aware, the nicotine in smoke causes an adrenergic reaction , wherein there is Central nervous system stimulation along with a vascular vasoconstriction.
Long term pipe smokers are prone to develop peripheral vascular diseases (Buergers disease).
I suggest you get an Arterial and Venous doppler of your legs. You can visit a Cardiologist for this.
Of course, cutting down on your pipe can only benefit you in the long run.

Dr.Dev M.D
Cardiac Anaesthetist and Intensivist

Please press "accept"if my communication has been helpful,so that i may get credit for my endeavour.


Dr.Dev and 4 other Health Specialists are ready to help you
Customer: replied 8 years ago.
May I ask a follow up? How serious is this? I have been taking oxycodone for 2 years and Topamax for 2 years. Could they have caused this condition or could they be materially aggravating it? Should I in the short-term before I consult a phyisician stop taking either drug, realizing the withdrawal problems with oxycodone. Thank you. You have been extremely helpful!
I would like to know, why you were on Oxycodone and Tobamax, and since how long.

Dr.Dev M.D
Cardiac Anaesthetist and Intensivist

Customer: replied 8 years ago.
I have been taking them under the supervision of a pain management specialist for a serious migraine and dizziness syndrome that was set off by a viral attack that I got from a virus contracted on an airliner 12 years ago that ruined my profession etc.

I will pay $100.00 for a thorough and thoughtful reply with some attention to the degree of the severity of the problem and a definition of Buergers Disease and the possible ramifications on my condition. My migraine and dizziness problem had cleared with the Topamax and Oxycodone; I was set to go back to work; and then this problem with my ankles etc. came up and blew me out of the water. I'd like to know whether that's permanent or whether there might be a quick fix etc. Hope you get the gist of what I am trying to say. I have to go out for a while to be measured for a tux, daughter getting married tomorrow, but would like to continue a follow up with you on this problem and am willing to expend some money on it this afternoon if we can work that out. I will in good faith process the payment through paypal right now if you think you can provide what I want. Can we do that right now before I leave?
Hy friend.

Sure, we can discuss this further.
Buergers disease is a peripheral vascular disease seen in chronic smokers- a situation where the veins of the legs get inflamed.
However,I was only hinting at a possible diagnosis . We can definitely clinch the diagnose with a Doppler and physical examination of the legs.
Tingling of the extremities is also a non serious side effect of Topiramate, that you are consuming for Migraine.
But , it would not be proper to with hold Topiramate on an assumption. We need to rule out other possible causes before altering the medications.

Oxycodone has nothing to do with the symptoms you have described.

I would be happy to resolve further queries.


Dr.Dev M.D
Cardiac Anaesthetist and Intensivist

Please press "accept"if my communication has been helpful,so that i may get credit for my endeavour.






Dr.Dev and 4 other Health Specialists are ready to help you
Thank you for the bonus.
But,please do not procrastinate visiting your physician .You need a thorough physical check up, including Blood lipid profile, complete counts and ESR.
If other comorbid features are ruled out, than your anti migraine regimen can be modified, withdrawing topamax and substituting with Sumatriptan , or any other potent antimigraine.

Best wishes for your daughters marriage.

Dr.Dev
M.D