Conversation: The conversation between human and AI assistant.
[|Human|] Respected Doctor, My ECG result showed P 47 degree, Incomplete Right Bundle Branch Block QRS (T) Contour abnormality consistent with Inferior infarct Probably Old, dated 23-02-2013. I am Suffering From Transverse myelitis since1989 with sensory loss, low back pain , weakness left lower limb etc. In 2010, again diagnosed as old case of transverse myelitis / now with sequel. I was treated with dose of Methylprednisolone(Iv) and later orally for 20 days.(40mg,20 mg.10mg & 5mg, reducing ). 21-11-2010. MRI Multiplanner T1W,T2W,STIR Sequences done. Scan done on 1.5 T scanner. 13-11-10 report suggests:- Compression myelopathy( Extramedullary at D10 level. Degenerative changes:- Mild spondylosis appreciated in form of anterior and posterior osteophytes at multiple levels in dorsal spine. Fatty haemangioma at D12 level. Disk osteophyte complex indents the anteriorepidural fat at D2-D3level also. D8-D9 Dick level: Diffuse disk bulge with left sided posterior para central disk protrusion is appreciated with mass effect on the left sided exiting nerve roots at this level. central canal space per se is maintained. D10-D11: Diffuse disk bulge with focal central posterior broad based disk protrusion with associated stretch of the PLL is appreciated at this disk level. There is indentation of the anterior epidural fat with central canal space being reduced to anteroposterior of 10mm in the sagittal scan at this level. No cord edema/ malacia appreciated in scanned cord the dorsal spine. Besides the mentioned findings the following areas were also examined and found to be normal elsewhere-----. dorsal spine curvature maintained, interverteberal disk space maintained,vertebral bodies and posterior elements are normal, cord is with normal MR signal morpholgy, preverteberal,paraspine tissues normal, anterior and posterior longitudinal ligaments are normal, facet jointsare normal, epidural/ thecal/ formalin spaces are maintained in all dorsal vertebral levels, the AP sagittal diameters of the canal space at disk levels are within normal limits. L2-3 andL3-4 discs show mild bilateral posterolateral disc protrusion indenting the thecal sac and mild compromising both the lateral recesses Pain killers avoiding, only during acute pain,using muscles relaxant ointments massage, one multivitamins pill a day.(BECASULES / REVITAL capsules, On 05-03-2013:- CBC Investigations in normal range. urine R/E, C/S :- physical / Chemical,Microscopic examinations as all with in normal range. Latest report of Ultra sound for whole abdomen:- normal. On 05-03-2013:- MAg 160/100, Treatment- DEPIN / PROLOMET AM 50. Now mAg varies from 85 -95 / 130 - 150. shoots during reacting to others. My height is 173cms & gained weight after the treatment,resulting 95 kg. Presently Feeling acute back pain,Neuropathic Pain & symptoms related to T.M, specially in the morning, Hypersensitive,Spasticity,Depression,Fatigue,Problem after climbing stair cases, pain increases in lower back & results in sweating & mild deep breathing for few minutes then feel better,other than 24x7x365 pain in back, traveling in right leg,numbness,tickling,burning sensation etc. At present no odd feeling in chest, no heavy breathing or shoulder pain,other than pricking sensation feeling in center of left palm during Hypertension , due to uncontrollable situation created by others at work or family. I may be over reacting, though I try to avoid confrontations but some times it becomes intolerable. After relaxation or taking B.P Pill it vanishes. Positive Points:- Walking without support, on average office work sitting:- 6-7 Hrs a day , Driving,Traveling, but can t exert much or exercise as T.M aggravates, no satisfactory sexual relationship because of erectile dysfunction. Previously Sildenafil Citrate was effective to some extent, now even 100mg not helping. Food :- 95% Vegetarian intake,Low fat, green vegetables,fruits,wheat, rice,cereals,olive oil,milk,curd,nuts,juices, avoiding junk & oily food. Non Veg. only eggs & poultry, Red meat hardly twice a year, lots of water / liquids, Low sugar. Drinks:- Average;- Maximum 2-3 bottles of 650 ml whiskey in a month, with absent days in between.(Drink soothes acute pain & mood swings better at that hour). Cigarettes:- Average 4-5 a day. Age factor is also effecting my life, will power & grace of God, I have come out from total paraplegic condition in 1989. I feel better, but not normal any time in the past 24 years,please help. What does this means and what are the possible treatments. What do I need to do to improve quality of life. Thanks R.Kakkar
[|AI|]  Thanks for the details. Since you have many issues (old and newer ones) there should be proper monitoring under experts. I would suggest you make a diary and note your symptoms for spine and related disease in separate chronological order and group your other cardiac or related events in a separate sequence and make a third group of additional symptoms in chronological order. Likewise, treatment taken in past and present symptoms' treatment separately. This will give a clearer view of what needs priority attention and supportive treatment for acute and chronic problems. A check-up with spine specialist to sort your disc related problem, if your physical conditions allow objectively, then some surgical treatment for spine may be indicated.