### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. Please help! My Dad has not been gentle to himself over the years having been a heavy smoker (ex - smoker now)and drinker. He is is on numerous meds including warfarin, inhalers for breathing, blood pressure, high colesteral, and also has lukemia of the bone which has not progressed since been diagnosed several yrs ago. He recently got a shock from the defrib for the first time while on holidays abroad. He was admitted to hospital for 48hrs for monitoring and on his return went to his regular hospital in home country to get a printout of the activity of the defrib. He has bveen advised that he may have a second shock (apparently nine times out of ten a patient will receive a second shock). This all occurred approx eight days ago and today he is complaining of pins and needles in his hands. Can someone pls advise if the pins and needles are associated with the activity of the defrib. From a very concerned family memeber

### output:

Hello, I carefully reviewed your dads medical history and would like to explain that his current complaints of pins and needles are not caused by the defibrillator activity.  It is true that electrical shocks emitted by the defibrillator are a source of major concern giving an unpleasant feeling and psychological distress.  Anyway, his current complaints need to be further investigated and a medical consultation with his neurologist is advisable. Neurological status examination and better control of the anticoagulant (warfarin) activity should be done. In addition, the adverse effects of heavy alcohol abuse should be sought as well. You need to discuss with his attending doctor on the above-mentioned issues. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. 