Thanks for your query
I am one of the In-house physicians at the DoctorSpring.com. We really feel sorry for your brother's condition. But I am afraid at this point we are unable to provide online chat service or phone consultation due to busy schedule of our physicians. But, I request you to ask any specific questions related to his condition we will try our best to help you. I would like to give a brief history of patient's conditions like, what is the main complaint? when has it is started? any associated morbidities or diseases, medical history and any previous investigations done before, previous reports if you could upload. This will help us to understand his condition better and to guide you in a best possible way.
Looking forward to your reply
Patient replied :
My description of his complaint, other treatment and history given in my first communication is complete and should enable you to answer.
I add that his diagnosis of amyloidosis was last Nov. 2014, that he has been in CyBorD chemo treatment since January.
His kidneys are damaged by the amyloidosis. His stem cells are no longer creating the amyloid cells.
His 24-hr protein has fallen from around 700 in January to about 450 last month. As you know, normal is under 50.
His primary complaint is the weakness in his legs as I reported. I believe his leg weakness is caused primarily by his being in his recliner most of every day. Until recently he exercised regularly, almost daily and vigorously, riding his bike, using his home treadmill and using the local excellent and large fitness center.
I believe his leg weakness is caused by lack of leg exercise. Very concerned with swelling in his ankles, he is in his recliner most of every day. Together with his sleep time, he is off his feet perhaps 22 or 23 hours of every day. We know that bedridden people lose strength in their legs. That is I believe the reason for his leg weakness.
I hope you can give him advice and encourage him to get out of his recliner, get back on his feet, go back to exercising his legs: walking, riding his bike, going back to the fitness center.
Thank you for posting your query.
I have noted John's medical history and his current clinical condition. It is unfortunate that he has a hematological malignancy and on top of that, he has developed weakness of both legs, hampering his daily activities.
Weakness is most probably related to his chemotherapy. In addition, vitamin and nutritional deficiency may play their parts.
Passive and active exercises would immensely help him.
Passive exercises could include lifting his legs by a physiotherapist or a caregiver a number of times, at regular intervals. This can be done while he is lying on bed, or while sitting in chair. John can himself do it by lifting his legs using his hands.
Active exercises would include making an effort by John to move his legs, whatever amount is possible, as many times as possible, while sitting or lying down.
In addition, we should try to do nerve conduction studies to ascertain the cause and degree of nerve damage.
I hope it helps.
Unfortunately we only communicate via emails, and I can help you only through this mode of communciation.
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist