Hello doctor, I am contacting you on behalf of my grandmother who is suffering from a number of issues and advice from her regular doctors is not coming up with a decent solution. I have asked her to write down from her point of view about the problems and here it is. Ailments are diabetic, chronic obstructive pulmonary disease (COPD), supraventricular tachycardia (SVT). Epileptic till the age of 50, She is 80 years.
Hi. The symptoms you are stating may be due to peripheral neuropathy due to diabetes or major depression. Also, there may be associated hypothyroidism. Diabetes affects small nerves of the extremities and results in a non-specific sensory complaint like you stated. Did she undergo a nerve conduction velocity test of extremities? If not, then she should undergo that test to confirm the diagnosis. For diabetic neuropathy, she can take Duloxetine or Pregabalin, Amitriptyline. These drugs are started at a dose of 20 mg, 75 mg, 25 mg, respectively. These drugs reduce the increased sensitivity of your nerve endings and may help you alleviate your symptoms. Also, some symptoms may be due to hypothyroidism. For this, I suggest a free thyroxin and TSH test and TSH is found to be high, she can take a thyroid supplement. For the depression part, I think she is suffering from depressive illness. She can take Escitalopram (10), or Fluoxetine (20) in the morning to manage your depression. Also, she should take Methylcobalamin (500) thrice daily as this vitamin rejuvenates peripheral nerves and may reduce symptoms.I suggest to continue the antidiabetic medications and strict control of blood sugar is recommended.