How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29564
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
Type Your Health Question Here...
Dr. Arun Phophalia is online now
A new question is answered every 9 seconds

67 YOA male had a stroke June 21, 2011 from occluded left carotid

Resolved Question:

67 YOA male had a stroke June 21, 2011 from occluded left carotid artery. No parylsis, visable left side weakness. Placed on Plavix and Zocor and zoloft for anxiety and depression following stroke. Early in October Zoloft dose was increased to 50 mg. He began feeling light headed and nausea - stayed in bed for three weeks, at least 21 hrs a day until I tritated him off completely with doctor's permission. since that time he has experienced almost constant swelling of left hand, no pain, minimal redness if at all. OT, PT, Primary Care Provider, Neurologist, Cardiologist seem to dismiss this. We just had an appointment with a Physatologist (sp) who at least had a vascular doppler and shoulder X-ray. Our question while we await results is, could this be a DVT ?
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
Greetings.

There is a definite possibility of the deep vein thrombosis; as this seems to be the most likely explanation. Since it has been for quite long; chance of migration of clot to lung becomes less (incidence wise). The other possibilities are;

1) There may be minimum weakness of the limb which was not recognized. This minimal muscular weakness causes dependent edema (swelling), as the lymphatic flow is not optimum.
2) Shoulder hand syndrome also called as reflex sympathetic dystrophy. (RSD).

Please feel free for your follow up questions.

 

I would be happy to assist you further, if you need any more information.

 

Dr. Arun
Customer: replied 2 years ago.
sorry I incorrectly said left carotid artery - it was the right. patient also has had 2 occurances of proximal a-fib in 2010.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Sorry for the delay in answer. I apologize for your wait.

The same three possibilites would be the most likely explanation. The affection of the right side of the brain, involves left side of the body.

It is privilege assisting you.

Dr. Arun
Customer: replied 2 years ago.
thank you for your reply. The chance of migration seems to put us somewhat at ease until we hear from the Physatologist (again, sp). I assume the vascular doppler would pick up the DVT . . . ? RSD really does not seem to fit as there is no pain, no progression of the swelling and not related to a joint. Dependant edema also doesn't seem too likely as we have tried elevation with no change. This patient also takes 12.5 mg of HCTZ with Losartan (for blood pressure) which has had no change on the swelling. I guess our concern was the DVT or blood clot may travel while we waited for doppler results.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Yes, the vascular doppler would pick up the clot if it is there. In the upper limb DVT of so long duration; chance of complication is quite negligible.

It is privilege assisting you.

 

I hope this was helpful to you. If it was, please remember to ACCEPT the answer so I can get compensated for my work. If you have any more questions, please feel free to ask. I am truly privileged to help you, and I want to make sure that you are satisfied with the answer. Good luck!

 

Dr. Arun

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29564
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 4 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery