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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35468
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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67 YOA male had a stroke June 21, 2011 from occluded left

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: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.

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 5 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 5 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 5 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 5 years ago.
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

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