Question to general practitioner Maarten: Pain in my left tibia
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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- Age
- Complaints)
- History
- Medication use, including supplements, etc.
- Smoking, alcohol
- Overweight
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Dear Martin,
- Age: 71 years
- Complaint(s): pain in the shin and sometimes in the veins it seems.
- History: cramps at night and now stiff muscles
- Medication use, including supplements, etc. none other than Vitamins and Minerals, Glucosamine and Magnesium.
- Smoking, alcohol: Never really smoked, sometimes 1 or 2 beers but not regularly.
- Overweight: think 10 kg
I approach you with a question that raises questions in my mind. Am a man of almost 71 years old always been sporty and still a sports heart as they say. Do not use daily medicines. Only if I have the symptoms of gout (right foot and big toe) then I take 1 tablet of Colchincina 2x a day for 2 or 1 days and then it will soon be over.
Two years ago I went here in the village to a Thai female doctor on the advice of my girlfriend, because suddenly one morning I couldn't stand on my feet. This doctor normally works in the state hospital in Kantharalak and has his own practice in the village every day.
Anyway back after my first contact got an injection and 3 kinds of colored pills with the command not to eat chicken and beef. Total cost less than 300 baht. After about 50 minutes I felt fine and walked 1 km on the treadmill in 9 hour. Everything was going well until the meds ran out and I ate chicken. So back again my girlfriend told me that I had been on the treadmill and eaten chicken. I didn't have to do that for a while, got another injection and pills and yes, within a short time I felt fine again.
But to reassure myself, I went to the hospital in Pattaya and the doctors diagnosed a low back hernia. They said that may have recovered on its own, but was probably due to a wrong move. And after that I didn't suffer from it for a long time.
The only thing I take, but not with a regular Vitamin and Minerals, Glucosamine and Magnesium. I had hardly taken this group in the last month.
I've always been between 95 and 98 kg and in Thailand that went back to 91/93 kg due to the diet.
In December I had some problems with my left shin and went to the doctor again. Again 1 injection and 3 types of pills and nothing to pay “Welcome to Thailand” Now I have fallen further in recent weeks to even 89 kg (Am 1.87 m) so in itself I liked that. However, now I had the problem that my muscles woke me up at night and I had to move a bit in the morning before everything felt good again. So lighter in weight and still not feeling well.
Now I have started taking 2 pills 3x a day again, I am 91 kg again and I feel very good again. I don't think my left leg (shin) is 100 percent yet, but I haven't walked on the treadmill since the visit to the doctor. That will change in the coming month, as I will walk between 10 and 40 kilometers every day during my hiking trips.
I am not worried any further, because last year I suddenly had a headache, which I had never had in my life. Except once when you hit your head. In fact, I decided to go to the hospital in the Blue Mountains Australia. Was worried (my father died of a brain tumor when he was 34). The doctor there ordered an MRI of my entire upper body and x-rays. The result was if all right, only a forehead cavity inflammation. One cure and all was over. Very reassured myself, because my whole blood was immediately examined.
Now my question
- Could it be that my body/muscles reacted because I lost weight?
- Could it be due to taking vitamins, Magnesium and Glucosamine again that the complaints have almost disappeared again. Am I 91 kg again?
- Only with long car journeys (actually only in an automatic transmission) do I have to stop for a while after a maximum of 2 hours and then the irritated feeling in the shin is gone again.
- Would it be wise, for example, to take an aspirin every day? Now I take a paracetamol when I have some trouble.
*******
Dear M,
A bit of a messy story.
Walking is indeed very healthy and an excellent form of exercise. However, as with anything, you can also exaggerate, which could be the case here. Overloading is never recommended.
The heat here can quickly lead to dehydration, which can cause these cramping symptoms.
It is not clear to me what is in the injections and in the three colored pills. Not eating chicken and beef seems like nonsensical advice to me and you would almost think that the doctor has a pig farm next to her practice.
I wouldn't worry about the hernia.
When you get older it is quite normal that the muscles have to get going in the morning.
It is also possible that the blood circulation in the leg is not 100% anymore, which could explain the irritation when driving.
The glucosamine has an anti-inflammatory effect and may be the explanation for reducing the complaints.
The gout can also play a role. Have the uric acid checked (Uric Acid).
You don't tell me how bad the pain is. Do you tend to move your leg? Then there may be a restless leg.
Other than that I can't say much.
Yours faithfully,
Dr. Maarten