Question to general practitioner Maarten: I feel lethargic after medication from an orthopedist
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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Dear Martin,
Here I am again, because I am not satisfied with myself and have been to an orthopedist, enclosed documents. He did x-rays, blood and heart tests again and the end result was 4000 baht worth of pills, which after 10 days made me feel very uncomfortable. It was difficult to urinate, dry mouth, felt tired and sex worthless. I stopped taking it, I don't feel sick but lethargic, the heat can also cause this.
Do you still have my old documents? Here are my latest data, unfortunately no ESR this time, but new ones.
I know I can't be a young man anymore, what's your advice to feel a little better again?
He prescribed me these pills:
- Gabapentin GPO 300mg.
- Tramadol HCL 50mg.
- Domperidone 10mg.
- Paracetamol orphenadrine citrate.
- Vitamin B Complex TAB(PL).
This for 3 months.
Many thanks in advance.
Regards,
H.
******
Dear h,
I found your old data. Nothing has actually changed. The photos show a parrot's beak between the 1st and 2nd lumbar vertebrae. A kind of natural fusion. The hips look good.
Your medication has undoubtedly done more harm than good. Gabentapin is an antiepileptic drug that sometimes helps with nerve pain and tramadol is a highly addictive opiate.
Domperidone is an anti-nausea medication that can make you drowsy, as can Gabentapin and Tramadol.
It is very understandable that your doctors do not know how to deal with your complaints. There is no real solution, at most fixation of the lumbar spine. This can be done internally (operating) and externally (a tailor-made corset). Both options have drawbacks.
As a medication, there is also not much on offer. You could try soproxen (naproxen) 300mg 2-3 times a day after meals, possibly combined with 25mg Lyrica a day. In addition, 20mg Omeprazole before breakfast and one extra in case of stomach complaints.
Lyrica is related to Gabentapin, but is better tolerated, especially in low doses.
Gabentapin only works for you in high doses of 900-1800 mg per day. The side effects therefore become greater, but habituation often occurs.
I would also make sure that your bowel movements are always in order. Accumulation of faeces can exacerbate the symptoms. A teaspoon of Duphalac after each meal and at bedtime will help.
A good walking stick of the right length can also bring relief. Correct length means that the cane is an extension of your arm, so that you can walk upright when you use the support of the cane. The best, in your case, seems to take the stick in the left hand, but while that seems logical, it doesn't always make sense.
Unfortunately, not much more can be done.
Fortunately, every little bit helps.
Yours faithfully,
Martin Vasbinder