Question:
I have
advanced cirrosis and hep c at high chronic
levels with extreme joint pain. From what
i read they say go to doctor. But let’s
get real. I am so tired of going to the doctors.
My question is Bottom Line, if i am having
arthritis, is there any medication for the
pain that I can take that won't harm my liver?
Answer:
It will be important to find
out the exact cause of the joint pain (e.g.
osteoarthritis, rheumatoid arthritis or even
hepatitis C related arthritis). This will
allow the appropriate use of medicine for
the pain. Please check with your rheumatologist
if the exact etiology of the arthritis is
known. He will be able to select an appropriate
medicine for you which is also safe for the
liver.
A Rheumatologist
Question:
I am
35 year old. I have both knees pain since
feb,2003. I went to doctor in feb,03 and he
suggested me to go for xray. After watching
xray and report, doctor told me my bones are
degenerated. I am using glocosamine whenever
i feel painful. I think it is not giving much
relief.
I don't
know my problem relating to arthritis or not.
If it is related arthritis what type of arthritis?
Still my both knees are very painful, but
i could not find any swelling? I would like
to checkup with doctor once again. Can you
refer me any specialist name or hospital name?
Answer:
You may be suffering from
osteoarthritis, a form of degenerative arthritis
where there is wear and tear of the cartilage,
and also changes in the bone around the cartilage.
Glucosamine can help with the pain and stiffness,
but it may not work for every patient. Perhaps
you can talk to your GP or OPD doctors who
can refer you to a rheumatologist for a definitive
diagnosis and treatment if the pain does not
improve.
A Rheumatologist
Question:
I have
had arthritis since 3 years old as a result
of rheumatic fever. My ankle is now immobile
and I limp several days a week. Since I'm
only 38 Doctors don't want to do a joint replacement
since I will out live the joint. Are there
any other options out there now. I haven't
seen a rhem. doctor in over 10 years. He is
basically a jerk. He comes in an hour late
to appointments (he golfs) and tells me to
deal with it. I can't help I'm the youngest
in his office. I have 3 kids to keep up with.
I need to be able to walk.
Answer:
Perhaps you can discuss your
ankle problem with your family doctor or the
OPD doctor who may be able to suggest a rheumatologist
or orthopaedic doctor for another opinion.
A Rheumatologist
Question:
Does
synvic help with osteo arthritis? Also what
about SAM-e, niacinamide, Vitamin C, Glucosamine
condroitin sulfate? My right knee is killing
me. The inside part has no cartlidge since
last year's arthroscopic surgery where they
said they smoothed out the cartlidge and instead
there is none left. What recourse do I have
other than knee replacement. I am tired of
limping and pain.
Answer:
There are evidences that
suggest Synvisc can be effective in reducing
the pain and stiffness of osteoarthritis for
a period of time. Unfortunately, the effectiveness
is less satisfactory in very severe disease.
There is no good evidence on the effectiveness
of SAM-e, niacin and vitamin C. Glucosamine
and to a lesser extent chondroitin has been
shown to help with the stiffness and pain
of some osteoarthritis patients. Knee replacement
is an effective treatment for severe osteoarthritis.
You should consider it if all other treatment
has been attempted and failed (including physiotherapy,
quadriceps strengthening exercise, tapping
of patellae, etc) and if the risk of surgery
in your case is not high.
A Rheumatologist
Question:
I am
a 42 year old woman. Two years ago my doctor
told me that an MRI revealed osteoarthritis
of the neck, on both sides but more pronounced
on the right. I take Vioxx daily, get massages
2-3 times per month, take daily whirlpool
baths, do "McKenzie Method" neck
exercises, always use a lower back support
on chairs and car seats and use heat and ice
as needed. I am careful not to lift above
a few pounds and have stopped carrying any
type of shoulder bag. Nonetheless, it is rare
for a day to go by without pain. I have a
very difficult time sitting for any length
of time due to pain in my tail bone. One or
both of the outer region of my shoulder often
hurts even without movement, and taking a
sweater off may cause a momentary severe pain.
The area on my forearm just before the elbow
often hurts and feels lumpy to the touch.
The area between the thumb and forefinger
of one or both hands often ache. My hands
usually feel ballooned, but do seem to "thin
out" when cold. There is usually some
muscular knot in one or both of my shoulder
blades causing pain. Turning my head sometimes
triggers a momentary shooting pain. There
is often pain at the base of my neck/head.
My neck pops and creaks. My scalp is sometimes
extrememly tender in one spot. I am a busy
mother and attorney. Is there another approach
I might take to help minimize these disturbances
to daily life? It seems that I spend a lot
of time trying to ward off pain, but I am
not sure the effort is paying off. Is it possible
that there is something at work besides OA?
Is there something else I should look into?
Answer:
Your symptoms certainly warrant
another visit to the doctor, including perhaps
the opinion of a rheumatologist. Sometimes,
inflammatory arthritis or other soft tissue
rheumatism may occur with osteoarthritis.
It will be prudent to evaluate that possibility
in your case.
A Rheumatologist
Question:
My
son is diagnosed to have rhematoid arthritis
and is currently under medication. He has
taken Sulphazazine and hydrochlorqine but
condition did not improved. He has taken Methotrexate
for 3 weeks and has some side effects like
abodminal pain and fever on the next day after
taking the medicine. The doctor has suggested
to prescribe him with enbrel the last time
(yesterday). I have read the articles in the
websites on the side effects when enbrel is
taken, it's really scary. Can you please advise?
Answer:
Doctors use medicine for
its therapeutic effects which are proven in
clinical trials for a specific condition.
They are also aware of the potential side
effects and will be looking out for them.
Most of the time, the side effects are mild,
reversible upon termination of the medicine,
or are treatable when detected early. Therefore
it is important to cooperate with you doctor
by being adherent to the treatment and follow
up schedules. Perhaps you can discuss with
your doctor who should be able to give you
more information about enbrel and other medications.
A Rheumatologist
Your Question: Just
diagnosed and presribed 20 mg prednisone.
Is there any alternative /complimentary treatment
that might help my body cope more quickly
thereby allowing me to reduce the dosage of
prednesone more quickly. I'm concerned about
the long term use of prednesone.
Answer:
Patients with Polymyalgia
Rheumatica usually do not need long term high
dose steroids. Hence there is usually no danger
with a short course. Usually, steroids lesser
than 10mg per day is safe for consumption
in the medium term. There is no alternative
therapy I know that is useful for the condition.
For more information, do check out www.arthritis.org.sg
Your
Question: I am 33yrs old and have joint pain
stiffness. The pain sometimes will come and
go. But regularly I will encounter these pains
when during rainy days. Are they rheumatism
or arthritis? If it is arthritis, can I still
go swimming? Some people advise not to swim
when having rheumatism or arthritis.
Answer:
It is difficult to give you
an opinion with the information supplied.
Suggest you check out with your doctor or
a rheumatologist. You may also need to do
some blood tests. Usually patients with mild
aches and pains can exercise – in fact
swimming is highly recommended in this regard.
Your
Question: My mom has fibromyalgia and has
had it for about ten years. What are some
treatments for fibromyalgia? She just takes
pain medication and muscle relaxers right
now. She abhors the very possibilty of counseling,
but I fear that she is very depressed.
Answer:
Fibromyalgia is a very common
condition. Although there is no specific treatment
for fibromyalgia, much of the symptoms can
be alleviated by anti-depressants, counseling
and exercise.
Sometimes, patients with
fibromyalgia may have hormonal imbalance which
used to be checked. Occasionally, they may
improve with acupuncture and massages. However,
there is no complete cure. Suggest your mum
to see a rheumatologist.
Your
Question: I heard a celebrity who is a spokesperson
for the National Arthritis Foundation talk
about Dairy Products being bad for arthritis.
I stopped consumption of them, and it has
improved. Where can I find information on
this theory. I am doing a college paper on
it, and cannot seem to find much on the subject.
Answer:
There is very little information
in the conventional medical literature regarding
diet and arthritis. It really depends on the
individual. If you are allergic to dairy products
then, elimination of dairy products may help
your arthritis. In the majority of patients
with arthritis, elimination of dairy products
does not help alleviate the condition.
Your
Question: During the last 8-12 weeks I have
developed pain and stiffness in my feet, knees,
and legs, in general. It changes daily. My
aunt had rheumatoid arthritis half her life,
age 40-80. My brother's daughter, age 45,
has it as well. My family came from England.
I find I hear of many people of British descent
with it. My parents have both had osteoarthritis.
My father lived to age 96. My mother is 96
now and in good health, except for pain in
her knees, where it started and other places.
I am 54 and can hardly walk or move at times.
Also, I get unexplained bruises. I have just
retired after 25 years as a flight attendant.
Answer:
I think you have some forms
of arthritis given your family history. It
is not possible to give more information.
I suggest you see your own family doctor or
a rheumatologist for further help.
Your
Question: Can a arthritis patient suitable
for pregnancy?
Answer:
In general yes. However,
it depends on what kind of arthritis you have,
whether the condition is still active or in
remission and whether you are still on medication.
Only a doctor can decide on this after an
examination and blood tests.
Your
Question: I have seen a lot of information
regarding this technology on the internet
and its use in treatment of arthritis by creating
a magnetic field that facilitates cell growth.
I am looking for a treatment center in my
area which is Hartford, Connecticut. Can you
help?
Answer:
Pulsed signal therapy is
only useful for osteoarthritis. The device
is widely available in Europe and some countries
in Asia. I do not think it is as yet approved
in the United States.
Your
Question: I have heard of
pulsed signal therapy and cartridge regeneration.
How effective is this? - Mr Tsoi
Thank you.
