Medical Query

[Ignitionnet]

Heya,

Wonder if any pharmacist or medical type has any ideas.

I've had some arthritis like symptoms for a month along with a lot of pain and seen GPs, done blood test which came back normal.

Yesterday I saw the GP on an 'emergency' appointment as I was in a lot of pain and needed some respite. I explained what I had been taking, well tried to unsure if he heard me as he was constantly interrupting which was:

Diclofenac - 2 x 50mg twice a day
Paracetamol / Dihydrocodeine - 2 x 500/7.4mg every 4 hours.

His response was to try me on something which 'might suit me better' than the Diclofenac. Please bear in mind I was very clear that I required 100mg of Diclofenac as 50mg was ineffective and specifically mentioned this along with that I was hoping he could give me something as even taking all that I was still in a fair degree of pain and as I'd run out of the Diclofenac a few days before I was/am in agony. I'd had to take 2 of the Paracetamol / DHC along with 800mg of Ibuprofen just to be able to stagger to the surgery.

He evidently didn't listen as he prescribed 500mg Naproxen twice a day. A quick search finds that:

1) Naproxen 500 is similarly effective to Diclofenac 50 in anti-inflammation.
2) Naproxen 500 is an inferior analgesic to Diclofenac 50.

I'd appreciate a more definite reply before I really kick off just incase he had valid reasons for doing this. From what I can tell this numpty didn't listen and his prescription is woefully inadequate, the clue being I just failed to be able to walk 100 yards and have hours to go before I can take the Naproxen again.

I should also mention I saw him last week and he prescribed me nothing - the Diclofenac I had from a previous ailment, this was after I told him that I was being woken up by pain in the middle of the night.

Though this is a similar story with this cretin he ignored that I was swollen up like a balloon last time and wrote 'no swelling' on my records even though you can barely see my ankle bone... perfectly normal for a guy with a 34" chest.

All opinions welcome before I write to the practise manager to say this guy doesn't listen and only appears to be a revolving door operator with all the people skills of a vending machine.

[Raistlin]

I found Naproxen innefective at first when I was prescribed it a few months back, after a few days though it really started to kick in - that made me wonder if the effects might be cumulative rather than immediate.

Also it could be that Naproxen has actually been proven more effective at dealing with the specific type of pain, or in the specific area that you're having problems with.

Finally, it could be that your doctor is a moron that hasn't got a clue what he's talking about.

If you're seriously concerned you should go and see a different doctor, explain your concerns to them, and get a second opinion.

[haydnwalker]

I'd (a) give it a few days to kick in as Rob says. Then if it's of no use I'd (b) ask to speak to another Doctor for a 2nd opinion and explain the situation again.

Also, I'd go to your local pharmacist and explain what's happened, they might have something that you could take over the counter thats just as strong!

I used to regularly have to take 1200mg of Ibuprofen for an ear infection while I was on holiday, it was like having a large peach stone in my ear (well...thats what it felt like) as the swelling was so bad. Luckily some anti-biotics when I got back cleared it :)

My wife takes Tramadol 2x 50mg for general pain in her hip (she has walking difficulty) and that seems to do the trick (but many GPs are very wary about prescribing drugs that strong!)

---------- Post added at 16:00 ---------- Previous post was at 15:59 ----------

You should also note that it takes approximately 1hour for most tablets to be digested by the stomach...regardless of what they say on the box/bottle. Its just the way the body works.

[Ignitionnet]

Thanks guys.

I had looked at how long it takes the drug to achieve peak plasma levels, etc, and how long it should take to supply pain relief, sadly it remains ineffective today - I got downstairs by crawling as I was unable to walk.

I'm running not withe the doctor being a moron but being ignorant, he wasn't listening to me and kept interrupting and I don't think he's taking me seriously because first set of blood tests didn't find anything.

[pabscars]

it certainly sounds like your in a pretty serious situation, and although immediate pain relief is required, getting to the cause of the pain for me would be just as much of a priority,

Although you say "Arthritis like pain" has this been diagnosed by your GP, Although after what you have said, he does seem a bit incompitent.

I would at the very least see another GP.

Is there a possibility it could be gout, I had a touch of this last year, and the pain this creates is unbelievable, but a couple of days taking cider vinegar soon had it licked.

Good luck and may the force be with you

[Ramrod]

Speak to a pharmacist about the medication questions.
The big thing you should be worrying about is getting a proper diagnosis of your condition.
Just because the blood tests were normal doesn't mean that the GP should stop looking. Something like rheumatoid arthritis can be present but the patient can have completely normal blood results (not saying you have RA) or more esoteric blood tests could shed more light on whats going on.
If the GP has exhausted all his/her diagnostic abilities and drawn a blank then they should send you to a consultant rheumatologist.....

[Ignitionnet]

Cheers Ramrod. They think it's reactive arthritis at the moment so we'll see if the next set of tests show anything.

A proper diagnosis would be great though, that along with decent pain relief. Gout seems unlikely, it affects essentially every limb.

Thanks.

[Ravenheart]

Most anti inflammatory drugs can take a few days of taking them to work, even the likes of ibruprofen when used for a few days build up their anti inflamatory effects.

You say that the pain is all over your body, is there any swelling on the small joints like your fingers and knuckles at all? As Ramrod has stated Rheumatoid Arthritis can have negative readings in blood results, yet folks can still have it (again not suggesting this is what you have) and I can only back up what Ramrod has said that if your GP has exhausted his expertise he should refer you to the rheumatology department.

Hope you're feeling better soon :)

Jo.
(Sounding like Talos from jason & the argonauts for 16 years :) )

[Ignitionnet]

Hiya,

After results of further bloods came back they insisted on me going to hospital immediately, they weren't great.

More tests to do but they think I've some kind of auto-immune issues.

Yes I have swelling around some joints along with some bumps on bones close to skin, not nice.

[SMG]

Your GP should have referred you to see a specialist. Remember they are GP`s, & used to dishing out pills, most don't specialise in any particular field. Dishing out pain killers for a few weeks works on most, but not all.

I tried Naproxen for joint pain a long time ago, (sugar on the joints), it didn't work at all. A hot bath did ease the pain for a while.

The hospital should diagnose the problem & prescribe the correct medication. Hope your feeling a better soon m8.

[Ignitionnet]

I went to hospital and spent most of Thursday there - I am seeing rheumatologist shortly.