Medical Forum / Diseases and Disorders / Arthritis / December 2005
Article from Firechief that he wanted me to post.
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Squirrely - 10 Dec 2005 20:46 GMT Here is one of the articles Firechief wanted me to post. I tried to find urls for the other three articles I have but couldn't so guess I will type us some stuff from the article.
It is called:
Pain relief often comes at a price.
By Jane E. Brody
This is about pain control medications.
She says: There's not one without a potentially serious risk. Yet, far too many people use them carelessly, without adequate attention to dosage and warnings about risks.
She says: If aspirin had to go through the Food and Drug Administration's approval process today, it would never make it to market.
Nsaids, can equal or outdo aspirin's action against painful inflammation but at less risk of bleeding.
But they, too can have serious side effects: They can irritate the gastrointestinal tract and cause ulcers. People who use Nsaids chronically are often told to take an anti-acid drug to protect their stomachs.
This problem opened up a market for a new kind of drug called a cox-2 inhibitor, sold as Celebrex, Vioxx, Bextra and Mobic. These drugs are as good or better than ibuprofen for pain, although as patented prescription medications, they greatly multiplied the cost of pain relief.
Alas, these, too have come under serious fire as evidence emerged linking them to heart attacks and strokes among users already at risk for these problems. With many multimillion-dollar lawsuits looming, Vioxx was the first to be withdrawn from the market, recently followed by Bextra. Both drugs may come back, accompanied by more stringent warnings. Or their cox-2 cousins, Celebrex and Mobic, may join the ranks as drugs gone by.
But now acetaminophen is being hailed as an excellent first choice for chronic pain.
If consumers are unaware of its presence in different medications, or if they fail to adhere to cautionary statements about dosages, it is possible to take too much acetaminophen inadvertently.
Taking more than 4,000 milligrams a day of acetaminophen on a chronic basis can damage the liver of an adult.
It is easier than you may think to take more than 4.000 milligrams a day. With the higher-dose tablets (650 milligrams each) now sold to treat arthritis, you can exceed the safety limit if you do not follow the instructions to take two tablets every 8 hours, for a maximum daily does of six tablets in 24 hours, adding up to 3,900 milligrams a day.
Even if you follow these directions, you can exceed the recommended daily dose if you also take another medication - say, an over-the-counter cold or flu remedy - that contains acetaminophen.
A second warning on acetaminophen says: If you drink three or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage.
So, if your liver is already under attack from alcohol, acetaminophen can be that last straw, resulting in liver failure.
This year, the journal Emergency Medicine warned physicians about the hazards of overdoses of acetaminophen. Dr. Shirley Jung and Dr. Kennon Heard wrote that acetaminophen poisoning could often be much worse than it seemed at first.
Nausea and vomiting can progress to complete liver failure in as little as 24 hours unless the problem is promptly recognized and the proper antidote given within 24 hours of a toxic dose. To prevent liver injury, the antidote should be given within eight hours.
New York Times News Service
This is not the entire article. I just typed out the important parts of it.
Diane - 10 Dec 2005 21:57 GMT well, that was cheery. :-(
diane
Norman - 11 Dec 2005 03:05 GMT A couple of things to keep in mind:
For most of us, NSAIDs are not "pain meds" but "anti inflammatory meds". The pain relief is from the reduction in inflammation. The pain, while often debilitating, is not the worst part of the inflammation. The inflammation in arthritis often cause irreversible damage to the body, the joints erode, etc. Some of the anti-inflammatories won't reduce any pain that is not caused by the inflammation. Quite a few of us take separate pain meds to handle that aspect of our problems.
The other thing is that use of medicines should probably considered as a "lesser of two evils" kind of thing. Will the benefit from taking the medicine be greater than the possible side effects, which is determined by just how bad the side effects are.
You need a good doctor who informs you of the side effects, tells you what to do if they occur and prefers to prescribe the lowest dosage which will do the job. It took me a couple of tries to find a RD I can work with (he considers the patient as 'part of the team') but I'm glad I see him.
Nann Bell - 11 Dec 2005 04:51 GMT > But now acetaminophen is being hailed as an excellent first choice for > chronic pain. [quoted text clipped - 5 lines] > Taking more than 4,000 milligrams a day of acetaminophen on a chronic basis > can damage the liver of an adult. But...... acetaminophen has NO anti-inflammatory action. If you are taking it merely for pain that is not inflammation related, or as part of a cocktail to treat the pain from your inflammation, that's ok, but it is not appropriate to take only acetaminophen for an inflammatory condition - or to be prescribed only that by a doc.
and..... it also is the med of choice for bringing down a fever. If you have a virus, you may well need to let the fever rage some to kill off the virus rather than killing the fever with this med. I finally decided to drop my acetaminophen for a while when I was running fevers with this virus I've got and my PCP told me to stay off it at least until the fevers went away.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Diane - 11 Dec 2005 17:16 GMT by the way, nann, how are you feeling? fever gone?
diane
Squirrely - 11 Dec 2005 23:19 GMT diane,
I sent your post to firechief too so he knows he is getting responses to his articles. I forgot to mention it when I posted to Norman and Nann. Dah, if I had a brain I might be dangerous.
 Signature Love and hugs to all Good thoughts coming your way too.
Squirrely Jo
Nann Bell - 13 Dec 2005 03:58 GMT > by the way, nann, how are you feeling? fever gone? > > diane fever's gone, stomach is still strange. For now I'm dealing with it by taking bean-o before I eat. I'm scared to restart the Enbrel and mtx though with the stomach still being strange. I'll check in with the doctor tomorrow - I think I'm improved enough that I won't have to go back in this week, but if the stomach stuff doesn't clear up, we'll have to deal with it. I can live forever taking bean-o every time I eat something with a trace of fiber.
We got the last official piece of paper for Mike's ordination today. All is set for him to become a priest on Saturday.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Squirrely - 14 Dec 2005 11:12 GMT Nann,
Can I use a few of your comments in this post, and I will ask in the other post also over on my email group. There are alot of the girls over there having the same symptoms of the virus. I have been telling it is a problem with the virus. But I don't think they believe me. But if I could use what you said and what your dr told you, I might be able to get them to see that is what it is.
I will be letting Joe know about Mike, he has been asking about him.
 Signature Love and hugs to all Good thoughts coming your way too.
Squirrely Jo
>> by the way, nann, how are you feeling? fever gone? >> [quoted text clipped - 14 lines] > is > set for him to become a priest on Saturday. Nann Bell - 14 Dec 2005 13:29 GMT > Nann, > [quoted text clipped - 6 lines] > > I will be letting Joe know about Mike, he has been asking about him. Sure, Jo - use what you want. BTW, my doctor also had me start taking probiotic pills from GNC, though he really wanted me eating yogurt to get the probiotics until I reminded him about my milk allergy. The probiotics help the stomach and intestines normalize themselves again.
Yesterday I made it without any stomach meds! Maybe happier days really are coming, heehee.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Squirrely - 11 Dec 2005 21:29 GMT Nann and Norman,
both your posts brought up good points.
I use tylenol like three times a day just to try to keep the chest pain somewhat under control. but if I do anything, then the chest pain and back pain are not controlled with tylenol. It does help me if I take tylenol for the fms achies, if I get it right away. If not then it doesn't help with that either.
I know I am probably going to kill off my liver. But what can you do when you can't take many meds, and the drs won't try to give you anything else.
I did like you Nann, when my fever started going high and not backing down with the tylenol. I stopped it for a couple of days and it was ok then.
I am seeing where arthritis and treatment of it is a gamble with meds. But if you don't do the meds there are more serious issues. So you have to do something. I agree with you Norman on the meds and being the lesser of two evils.
Good posts, I am going to mail them off to firechief so he can see there were responses to the articles.
Any others that come in I will keep for him when they get here to visit on the 23rd. I am mailing these because I have to send him the update for the christmas card list.
It will be good to see them again.
 Signature Love and hugs to all Good thoughts coming your way too.
Squirrely Jo
>> But now acetaminophen is being hailed as an excellent first choice for >> chronic pain. [quoted text clipped - 25 lines] > got > and my PCP told me to stay off it at least until the fevers went away. Nann Bell - 13 Dec 2005 03:58 GMT > I use tylenol like three times a day just to try to keep the chest pain > somewhat under control. but if I do anything, then the chest pain and back > pain are not controlled with tylenol. It does help me if I take tylenol for > the fms achies, if I get it right away. If not then it doesn't help with > that either. yeah - I take tramadol and tylenol. I did ok with just the tramadol, but am so much better now that I can take the tylenol with it again. If only I felt safe to restart mtx and Enbrel.......
> I know I am probably going to kill off my liver. But what can you do when > you can't take many meds, and the drs won't try to give you anything else. that's why we are pincushions...... you know, I'm not even sure how many times I've had my blood drawn this year! LOL I even tried to get efficient and combine labs for two docs in one trip and they forgot to draw one tube! with it being 25-30 miles away for my docs/blood draws (when it's not 80 miles away), I'm tracking it all on the calendar. All that medical mileage may be important come tax time.
i sure miss seeing firechief here though....... even had trouble remembering his first name the other day, I'm so used to thinking of him as "chief"
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
Harvey R. Stone - 13 Dec 2005 14:30 GMT > i sure miss seeing firechief here though....... even had trouble > remembering > his first name the other day, I'm so used to thinking of him as "chief" What,,,, what his name is not Chief????? LOLOL A person could always get whats going around the internet with Joe,,,,Chief,,, that was funny or a stick in the eye type stuff.... We can thank his good wife for turning Joe into someone we can get along with....only a few of us could in the old days. LOL So it goes. Harv
Nann Bell - 14 Dec 2005 13:29 GMT > What,,,, what his name is not Chief????? LOLOL A person could always get > whats going around the internet with Joe,,,,Chief,,, that was funny or a > stick in the eye type stuff.... We can thank his good wife for turning Joe > into someone we can get along with....only a few of us could in the old > days. LOL So it goes. > Harv heh, a sure sign that he found the right person! I always say you can tell how a good a match is for someone by what kind of person they become through their partner's influence in their life. It's great to have him so happy.
 Signature Nann remove the Gator cheer to email me Simply the thing I am shall make me live --- William Shakespeare
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