Patient's Query
Hello doctor,
My father has diabetes, and recently we noticed that his toes turn purple at night, especially when he is not walking or standing. They return to normal after he walks for a little while. We ran some tests, and I would like a specialist to review them. We consulted a cardiologist, but I am not sure they know what is wrong. I have the laboratory results and need a doctor to explain what they mean and what possible next steps we could take. I also want to share the list of medications he has been prescribed so far.
Please advise.
Hello,
Welcome to icliniq.com.
I have gone through the reports you provided(attachment removed to protect patient identity).He has diabetes. The reports suggest that he has blockages in both the leg arteries and the heart arteries. The doctors have started him on anti-platelet and cholesterol-lowering medications. The prescription looks appropriate. I would recommend continuing with all of these medications. If his toes do not improve within two to four weeks, he may need a procedure to open the blockages in the limb arteries. Since he is not experiencing any heart-related symptoms, such as chest pain or difficulty breathing, we can wait and monitor the situation for heart issues while continuing the prescribed medications.
Regards.
Patient's Query
Hello doctor,
Thank you for the reply.
Yes, he has diabetes. His cholesterol is normal, and I wanted to ask why the doctor would prescribe medication to lower cholesterol. Also, do you think the anti-platelet drug will be safe for someone his age?
Hello,
Welcome back to icliniq.com.
In individuals with blockages in the arteries, we prescribe cholesterol-lowering drugs even if cholesterol levels are normal because they are proven to help prevent future events such as heart attacks and strokes. Anti-platelet medications are safe for someone his age and are prescribed because the benefits outweigh the risks associated with them.
Kind regards.
Patient's Query
Hello doctor,
Thank you for the reply.
We conducted the attached tests again yesterday to provide you with the most accurate laboratory results possible. Please review the attached, and here are my final questions: His platelet count is 343×10³/µL—how much Aspirin should he take (what is the dosage?), and for how long (is there a specific time frame)? Does he need to take both Aspirin and Clopidogrel together? His cholesterol level is 200 mg/dL—how long should he take the cholesterol medication? Will this affect his memory? We read that this medication can have that side effect, so would it be advisable to take it for a long period? What do you recommend in terms of duration? As you can see in the laboratory tests, his monocytes are high at 12. Should this be a concern?
Please advise.
Hello,
Welcome back to icliniq.com.
The usual Aspirin dose is 75 or 150 mg. I would suggest 150 mg. It is typically given lifelong unless there are any absolute contraindications. If he does not undergo any interventional procedures for the limb or heart arteries, Clopidogrel can be discontinued after one month. After the procedure, Clopidogrel should be taken with Aspirin for approximately one year. Cholesterol-lowering drugs (statins) are prescribed to reduce the risk of future events. The exact duration of therapy depends on cholesterol levels at follow-up. Most patients require these medications for life. The side effects related to memory are questionable and have not been conclusively proven. The monocyte count is fine and not concerning.
I hope this helps you.
Thank you.
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Answered byDr. Sapkal Ganeshrao Patilba
Medically reviewed byDr. Divya Banu M
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