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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Whether sitting, standing, walking, or lying down, CHF patient

Customer Question

Whether sitting, standing, walking, or lying down, CHF patient age 88, feels and hears a vibration.
Submitted: 11 months ago.
Category: Neurology
Expert:  Dr. Frank replied 11 months ago.

neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

neuromd2012 :

hello. I am waiting for you to come online for a chat

neuromd2012 :

as you are offline, I will leave you some questions, please get back to me when you come online to discuss

neuromd2012 :

I would need a list of his medications. My suspicion would be that this is a medication effect, but would ask you

neuromd2012 :

if he has lost weight, does he use oxygen daily? at what rate? I assume his is on some "sympathomimetic" medications, like albuterol, that would be his most likely reason for the "internal" tremor and hearing a vibration.

neuromd2012 :

has he had an imaging study of the brain? does he have microvascular disease?

neuromd2012 :

Dr Frank t

Customer:

Thank you. Meds are: Norvasc 10mg; aspirin 81mg;coreg 25mg 2x;lanoxin o.125; lasix 10; levothyroxine sodiukm synthroid 25mg; ulti-vit 1x; omega fish oil 1000 2x; provachol 40mg; co-q-10 100mg; diovan 150mg; digoxin/lanoxn 160. He is 5'7, wt 205, has not lost weight;

Customer:

Mild cognitive impairment long time.

Customer:

nOt sure of microvascular.

Customer:

Digoxin is taken every other day.

Customer:

I have been online but no chat window. Hope I have answered everything, will check my email.

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Expert:  Dr. Frank replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Frank replied 11 months ago.
Ok. So forget what I said about medication effect. My concern as a neurologist would be that he has ET, essential tremor, as a result of hypoxic encephalopathy (cognitive impairment is a key here) from his CHF. You could see that on MRI scanning of the brain, but a better idea would be a DatScan, which is a SPECT scan to look at his dopamine stores in the brain, as related to Essential Tremor or Parkinson's Disease. He really needs a neurologist. Please get back to me with questions, and I will reply. Dr Frank t, There are medications to treat ET, but they all will make his CHF worse, so this can be a problem. You need to exclude Parkinson's maybe.
Expert:  Dr. Frank replied 11 months ago.
Joan. the software is failing today. sorry. I don't know if you can see this, we were knocked off the chat (actually I was,, and you weren't) Please get back to me with questions. I will paste in what I previously wrote.

Ok. So forget what I said about medication effect. My concern as a neurologist would be that he has ET, essential tremor, as a result of hypoxic encephalopathy (cognitive impairment is a key here) from his CHF. You could see that on MRI scanning of the brain, but a better idea would be a DatScan, which is a SPECT scan to look at his dopamine stores in the brain, as related to Essential Tremor or Parkinson's Disease. He really needs a neurologist. Please get back to me with questions, and I will reply. Dr Frank t, There are medications to treat ET, but they all will make his CHF worse, so this can be a problem. You need to exclude Parkinson's maybe.
Customer: replied 11 months ago.

Thank you Dr Frank t, very helpful information. I may contact you againj. Good service.

Expert:  Dr. Frank replied 11 months ago.
I am here. come back anytime. Dr Frank t
Customer: replied 10 months ago.

Not necessary to contact me again.

Expert:  Dr. Frank replied 10 months ago.
ok

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