Dear doctor. Roach: What is the best medicine for arthritis? My doctor prescribed diclofenac sodium, and another doctor said it would damage the liver and kidneys with prolonged use. As you know, arthritis is a chronic disease. Let me know what medication I can use for arthritis. – AA
Answer: I assume you mean arthritis, which is the most common type, not inflammatory arthritis like rheumatoid arthritis. If you do not know which type you have, consult your doctor, because arthritis needs a very different and severe treatment.
Perhaps the best medicine for osteoarthritis is not medication. It’s an exercise. For people who are at the beginning of their arthritis course, a regular exercise program improves pain and function, but for people with more advanced arthritis, doing exercise may become more difficult. Severe hip and knee osteoarthritis often benefits from swimming, as the load is taken off the joints and movement is less painful.
Diclofenac is a commonly used anti-inflammatory drug that is effective for many people. All NSAIDs can cause stomach damage, including irritation, bleeding, and ulcers. Heart disease remains a concern, although diclofenac in particular is less likely to cause it than others. People with kidney disease need to be very careful about taking NSAIDs, as they can sometimes cause kidney disease. Liver disease is unusual with diclofenac.
Some people, such as those with osteoarthritis of the knee and hand, can do very well with topical NSAIDs such as diclofenac gel. It has little (if any) risk of digestive, heart, kidney, or liver problems. When topical treatment is not effective, most people choose to continue taking these medications, even after getting advice about a low but not zero risk of toxicity. They are sometimes the most effective drug therapy.
More severe arthritis should lead to a discussion about additional treatments, such as injections and surgery.
Dear doctor. ROACH: My doctor ordered a “microcreatinine ratio” test, but my result was “unable to calculate”. Can you tell me what this means? – js
Answer: The test your doctors ordered looks for protein in your urine, which is concerning because elevated levels can indicate one of several types of kidney disease.
The best way to determine the amount of protein in the urine – albumin is the main blood protein, which can leak into the urine – is to collect each drop for 24 hours. Although sometimes we need to do it this way, a good alternative is the urine microalbumin to creatinine ratio. People with a moderate increase in urine albumin (or a high ratio of microalbumin to creatinine) are more likely to develop overt proteinuria, which is a risk of developing chronic renal failure. They are also generally at increased risk of heart disease and death.
Experts recommend annual testing of the microalbumin to creatinine ratio, a higher score usually leads to better glycemic control, intensive treatment for high cholesterol, and often medications, especially angiotensin receptor blockers or ACE inhibitors, to strictly control blood pressure and protect the body. the kidneys;
If your result is “unable to calculate”, that’s great news, as it means you don’t have any microalbums. Determining the ratio involves dividing by the result of microalbumin, and any mathematician knows that you cannot divide by zero.
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