RN13 wrote: ↑Tue Sep 03, 2024 5:12 am
Hallo. Any other recommendations for an orthopaedic surgeon please?
My hip was done on GESY by Dr Kampouris, operates at the Iasis, but has a practice in the same building as George Vorkas. I get the impression that Drs Kampouris and Aspros are the most popular on here (see other postings on orthopaedic surgeons on this site), but my GP said the orthopaedic surgeons at General are very good - esp as they won't operate unless absolutely necessary.
RN13 wrote: ↑Mon Sep 02, 2024 3:24 am
Hallo. I am experiencing intermittent pain in my left knee. Best physiotherapist in Paphos who accepts GESY patients? Diagnosis is osteoarthritis but doctors not keen to operate. Only suggest exercise. Walking at length triggers inflammation requiring Panadol & rest.
if its intermittent then it not serious enough in the Drs opinion, when it gets really bad you may get cortisone injections, but they can only give so many of those per year as it can damage the Cartlidge in the joint. the next phase would be for surgery, but only the if its the last resort.
I take 1 Diclac 75 ID Hexal tablet a day, this keeps the knee inflammation down.
If I stop taking them my knee swells up after a few days and make it difficult to bend my knee, and pain full too.
You can buy them over the counter, the last box was €8.79 for 30 tablets.
Surgery ruled out. My knee pain (worse in left knee) is mainly triggered by extensive walking. Two Panadol tablets do the trick as regards pain. Not sure but THINK left knee a bit swollen. Voltarol emulgel and Phorpain gel maximum strength both very effective.
I have knee problems too, mine locks sometimes and can be very painful. But I keep it mobile by seeing an excellent osteopath, plus doing targeted exercises in a gym which help to strengthen the leg muscles to support the knee.
You can have very occasional cortisone injections, by seeing an orthopedic surgeon, but they aren't a cure. And they can cause more problems. There isn't a magic bullet for many knee problems, but I can walk freely and avoid taking painkillers.
I want to avoid knee surgery and have so far!
Paul wrote: ↑Wed Sep 04, 2024 4:43 pm
I take 1 Diclac 75 ID Hexal tablet a day, this keeps the knee inflammation down.
If I stop taking them my knee swells up after a few days and make it difficult to bend my knee, and pain full too.
You can buy them over the counter, the last box was €8.79 for 30 tablets.
Have you spoken to your doc about alternatives? Chronic use of diclofenac has it´s risks (e.g. gastrointestinal ulcerations) and there may be less risky alternatives available and/or additional measures advisable (like e.g.taking proton pump inhibitors like omeprazole)
Firefly wrote: ↑Fri Sep 06, 2024 11:38 am
You can buy Diclofenac gel, instead of taking tablets.
That won't change the risk/benefit ratio. Depending on how big an area you're applying it to, the plasma concentration will likely be lower or higher as compared to taking a tablet (and so will be the effect). If you administer enough to achieve the same plasma concentration as via oral administration, you'll have the same risk profile. It's not as if the diclofenac you rub onto your knee will permeate directly into the joint. It will be flushed away by the bloodstream before having reached it. That's what the marketing department conveniently forgets to mention in their adverts.
That may be so, but it won't cause gastrointestinal ulcerations, as posted by you.
I always thought that long term use of omeprazole, was frowned upon.
It very definitely can. I was mistakenly prescribed some at new year to relieve inflammation of a tendon. It took only 3 tablets to trigger a massive relapse, the worst in 20 years, of my ulcerative colitis. In the patient leaflet it says not to be taken if you have that, or crohns. An unfortunate one that slipped through the system and took several weeks to recover from. Needless to say it now appears in the allergies section of my GESY record.
That may be so, but it won't cause gastrointestinal ulcerations, as posted by you.
I always thought that long term use of omeprazole, was frowned upon.
It very definitely can. I was mistakenly prescribed some at new year to relieve inflammation of a tendon. It took only 3 tablets to trigger a massive relapse, the worst in 20 years, of my ulcerative colitis. In the patient leaflet it says not to be taken if you have that, or crohns. An unfortunate one that slipped through the system and took several weeks to recover from. Needless to say it now appears in the allergies section of my GESY record.
Ian
Firefly was referring to the gel. I have no idea if that makes a difference, but she wasn't talking about pills.
Web Designer / Developer. Currently working on Paphos Life.
Living in Polemi, Cyprus with my wife and daughter.
That may be so, but it won't cause gastrointestinal ulcerations, as posted by you.
I always thought that long term use of omeprazole, was frowned upon.
It very definitely can. I was mistakenly prescribed some at new year to relieve inflammation of a tendon. It took only 3 tablets to trigger a massive relapse, the worst in 20 years, of my ulcerative colitis. In the patient leaflet it says not to be taken if you have that, or crohns. An unfortunate one that slipped through the system and took several weeks to recover from. Needless to say it now appears in the allergies section of my GESY record.
Ian
Firefly was referring to the gel. I have no idea if that makes a difference, but she wasn't talking about pills.
It doesn´t. What matters is the plasma concentration, no matter whether it was applied orally, as a gel or a suppository, injection or whatever other route you can think of. I may have been retired (I was a pharmacologist) for almost 30 years, but that much I still remember.
Interesting comments about Voltaren / Diclofenac as for a number of years various doctors including a General Surgeon, Orthopaedic Surgeon and A&E Consultant have all advised us not to take it in any form since we were 65+ years old.
(One person was treated for stomach problems several years ago but otherwise both healthy and not on any prescribed medication).
Firefly wrote: ↑Sat Sep 07, 2024 5:38 pm
I'm no spring chicken, but my GP still prescribes Diclofenac gel for me. Thankfully, I don't appear to suffer side effects.
As Paracelsus already said: Sola dosis facit venenum - the dose makes a drug a poison. I'd deem it unlikely that you'll absorb enough diclofenac to get an ulcer if you only rub it onto your knee. You'd probably have to administer it onto a larger area to achieve plasma concentrations high enough for that (unless there are factors increasing the risk). However, other potentially adverse effects may occur at lower plasma concentrations and shorter treatment periods already (e.g. an anesthesist will probably be reluctant to perform spinal anesthesia if you applied diclofenac gel on a larger area even once recently, due to increased risk of bleeding as it may affect the function of platelets).
