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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
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

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Whether sitting, standing, walking, or lying down, CHF patient age 88, feels and hears a vibration.
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 and 2 other Neurology Specialists are ready to help you
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.
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 4 years ago.

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

I am here. come back anytime. Dr Frank t
Customer: replied 4 years ago.

Not necessary to contact me again.

ok