claude

question:i took a spill on my bike the other day, and hit my knee cap HARD on a rock. the knee feels fine to move it around, BUT hurts when you touch the cap. AND the area that i hit feels squishy to the touch, whereas the other knee does notis it something i should worry about?

answer:It looks like you have "pre patellar bursitis"- what this is an inflammation of the fluid sac (bursa) that is present in front of the knee cap. Being compressed against hard ground caused it to get inflamed and thats why you feel it squishy. Treatment is rest, ice, and non steroidal anti inflammatory drugs (over the counter Ibuprofen 800 mg three times daily- always take these medicines with or after food). Do not take Ibuprofen if you have a history of kidney problems or have had bleeding from your gut or have severe reflux. In that case you can take Acetaminophen (Tylenol) 325-650 mg every 4-6 hours. No more than 3,000 mg of Tylenol should be taken in a 24 hour period. If symptoms still persist, then you should see a primary care doctor

question:I AM A 100% DISABLED VIETNAM VET WITH SEVERAL ISSUES THAT THE VAMC GIVES ME MEDS FOR. ONE THAT THE PAIN MANAGEMENT GROUP RECENTLY GAVE ME IS AMITRIPTYLINE HCL 10MG TAB. WILL IT BE OK TO TAKE ALONG WITH VENLAFAXINE? WHAT WOULD HAPPEN IF SOME ONE WERE TO OD ON THIS MED? IF A SMALL CHILD TOOK IT HOW COULD WE KNOW AND WHAT SHOULD BE DONE FOR HIM ON THE WAY TO THE ER? THANKS, TWO CONCERNED GRANDPARENTS

answer:The combination of the two medications is not recommended due to a higher risk of Serotonin syndrome. You can get more information on this syndrome at Amitryptiline when taken in toxic doses can affect the heart and blood vessels- the biggest risk is that it can cause abnormal heart rhythms (arrhythmias). Other side effects include seizures, low blood pressure, drowsiness or confusion or disorientation. It should be kept out of reach of children. if you suspect a child has taken the medicine, immeidately take him/her to the ER/pediatrician.

question:Ive been experiencing left shoulder pain for over two years now. It has traveled into left arm and ribcage. Now the pain in getting worse in rib cage and noticed there has been swelling in left ribcage almost feels as if its spongy and raised and tender to touch. I ve been to drs had X-rays ultrasounds nothing has come up. Recently had mri shoulder has a suspicion for a tear. But this is not explaining the rib cage. And I m getting really nervous and upset because no one is doing anything. What can this be?

answer:In this situation, i would discuss with either your primary care doctor or orthopedic surgeon (whoever is the doctor seeing you for this symptom) about what the plan is since your symptoms are not better. One can try physical therapy and if symptoms do not resolve then you should let your physician know. If you feel your fears/concerns are not being addressed by your physician you should let them know that and if still not being addressed then consider a second opinion

question:Hi there. My name is Toni and I was wondering if a referral to a rheumatologist would be the best thing for me. I take Cymbalta for unknown nerve pain causes in hands arms legs feet, back and neck pain, and I would say tendon problems. also depression which I think was cause from the pain being untreated and facing the unknown future of my heath. after about 6 weeks of being on this I started to mostly feel like my self again so I start doing more housework like I used to be able to do over 5 months ago. little to be known I star having hip and shoulder pain and I would say is a 4 or 5 on the pain scale. I was told by one doctor I have RLS and was put on 50mg ?tramazone? for this originally. then had to be uped to 100mg because it was not affective. new doctor says that not even what that is for and now I have recently just started on Requip for that. my vitamin d level was 15.8 a few months ago and the norm is about 30 from what I hear so I take 5000 iu a day for that. I have only had blood test done. Also emg came back great. although no x-rays no cat scans, no MRI have been done. I don t know what all auto immune disorders I have been tested for but those came back fine. normal blood work ok along with vitamin d, Iron test are in the process. I m pretty frustrated at this point and really want some answers. my new doctor is really nice and seems to care. I just feel its time to see a specialist and want to know what you think about that, what kind of specialist, how to approach my doctor with this? Please help :-(

answer:Hi, from what you have said it appears that you have tried at least 3 different medicines (Cymbalta, Trazodone and Requip) but still have pain in multiple joints. Normal tests are reassuring. The one thing I did not see in there was physical therapy- if you have not done that I would recommend discussing with your primary doctor about that. Its also possible that you may have an underlying depression contributing to your symptoms (since they improved with Cymbalta, an antidepressant). So, it might be worth discussing with your doctor about behavioral therapy or seeing a psychiatrist to determine if depression is contributing to your physical symptoms. Pool therapy (swimming/water exercises) are often very helpful too. I do not feel strongly about seeing a specialist, I would suggest discussing your frustrations with your primary doctor and the things I discussed above and work with him/her. But if you feel your concerns are not being addressed, you can always seek a second opinion from a different primary care physician.

question:I am very concerned. I masturbated three times yesterday with my vibrator. I never orgasmed before, so i placed my vibrator on my clitoris and experienced it. I'm not a regular masturbator. I do it once in a while. The last time I did it was a day ago, and now my body still won't stop tingling. I feel it all over my body; my legs, buttocks, clitoris, stomach, squirming on my arm. I'm scared, I don't know what's wrong with me. I'm never going to masturbate again. I am 145 lbs, 5'6" and 19 years old, and I'm a virgin. Help! My body won't let me sleep and I'm horrified. I don't want to live with this for the rest of my life.

answer:Hello, There is no relation between the tingling of the body with masturbation. In that sense, the problem should be related to your own psychological anxiety. Do consult a psychologist for counseling. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. K. V. Anand, Psychologist

question:I have a dark line under my thumb nail running from the top to about the middle of the nail bed. Two months ago I noticed it because it started hurting pretty bad. The pain went away about two weeks later. It has now returned and the pain is worse then before. What is this?

answer:It is possible that it is a blood vessel. . Because there is limited space under neath the nail, any vessel can be painful. I would suggest seeing your primary doctor to see if you need referral. Meanwhile, try tylenol or anti inflammatory medicines like Ibuprofen (take with food only and avoid if you have chronic kidney disease, previous bleeding from the gut, or severe reflux) for pain.