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Ask Internist Your Own Question
Internist, Board Certified Physician
Category: Medical
Satisfied Customers: 1066
Experience:  MBBS,MD (USA)Diplomate American Board of Internal Medicine
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I am an 80 year old male, I am on Warfarin after suffering

Customer Question

I am an 80 year old male, I am on Warfarin after suffering a pulmonary embolism in 2000. I have an irregular heart beat and have just recently been diagnosed with Polycystic Kidney Disease which does not run in my family. For these problem I take my blood pressure before breakfast and before my evening meal this averages 115/65 - 137/77. I take 3 /3.5 mg to control my INR at 2.5. I take Atorvastatin 10 mg Flurosemide 40 mg for ankle swelling and PKD. Candesartin 8mg for Irregular Heart Beat & Carvedilol 25 mg to control my blood pressure as required 1 tablet night and morning although my blood pressure is usually low in the morning. My problem is that I still run my bookshop and although I am unable to take much exercise I only sleep for 5 hours each night. irrespective of how much liquid I have drunk, my bladder reminds me although I pass little urine. I find that I cannot sleep after getting up and lay awake. If I go to bed at 10pm I wake at 3pm so usually I go to bed at midnight. Would it be safe for me to take Urostemol or better to calm my anxiety with Valerian or Melatonin? Please advise
Submitted: 2 years ago.
Category: Medical
Expert:  Internist replied 2 years ago.
Dear JA customer,
sorry to hear about your problem,
i am online and will be happy to assit you.

I recommend not only decreasing liquid intake , but more importanly decreasing caffeine intake and no caffientaed beverage after 4 p.m and i do not think your symptoms are due to overactive bladder, so no need for urostemol.
Regarding sleep, no caffeine after 4p.m and no liquid bed time, voiding before bedtime. if still unable to sleep, you may use sedatives for short term on as needed basis.

but more importantly, i would like to check for your prostate enlargement. by doing a per rectal examination and ultrasound. also to evaluate bladder and kidney status . so i would suggest to see your doctor for these tests.

i hope this helps
Customer: replied 2 years ago.

I have had a recent ultra sound scan which found my Polycystic Kidney problem. This was followed by a MRI scan to see if my bladdrer had a restriction. The urologist refered me back tio the kidney specialist, I do not drink coffee and seldom drink after 6pm although one night per week I drink 4 pints of beer which doesn't cause me a problem. I take my flurosemide at 7pm each day. So am I safe to try Valerian or Melatonin concidering the medication I am presently taking?

Expert:  Internist replied 2 years ago.
yes, in fact there is an article saying it might be beneficial
but i also recommended to check for you prostate gland.
i mentioned some lines of abstract of the article
goo luck

Patients with Chronic Kidney Disease (CKD), especially those who are on hemodialysis, frequently suffer from sleep disturbances. In this review an overview is given of the classification of stages of chronic kidney disease, followed by a presentation of the circadian rhythm disorders in renal disease involving sleep disturbances in relation to melatonin deficiency. The therapeutic benefit of melatonin treatment in sleep disorders related to chronic kidney disease including the controlled trials solving this topic, is described. Furthermore, the beneficial effect of melatonin on blood pressure alterations in CKD states and the protection of melatonin in oxidative stress and inflammation in renal disorders are explore
Expert:  Internist replied 2 years ago.
If You have any follow up questions,feel free to ask. If the answer satisfies your query,Kindly click 'ACCEPT'
Customer: replied 2 years ago.

Not wishing to lumber my own doctor with my question on the safety of alternate medicines. I found your web site and having given you a detailed description of my past & present medical condition I was happy with your answer, although having been diagnosed with polycystic kidney decease which requires ultra sound and MRI scans, your answer seemed to invite more questions which my own GP has already answered. Having paid my £18 I then was offered an un-checkable boxes offering me something for £28 having tried to un-check the box I exited the site, not knowing if I had been conned into a contract. I then had to wait for my October credit card statement to see if I had,. I am pleased that I did not have to resort to the Trading Standard authority but I shall not be using your services in future.

Expert:  Internist replied 2 years ago.
Although you were happy with my answers , but you did not accept my answer ( and i did not receive any credit of answer).I wish you good health.take care