10-year-old on Enbrel for arthritis. Other useful steroid?
Hello doctor,
The patient is 10 years old with psoriasis polyarthritis and received Methotrexate, and Enbrel for three years. As in medical remission, it was decided ten months ago to stop Methotrexate and continue only with Enbrel. Three months later started having infections and a paradoxical reaction to Enbrel (psoriasis), therefore stopped Enbrel and started again with Methotrexate. One ankle is swollen for six months. Steroid injection in the ankle did not help. Currently on weekly Methotrexate 17.5 mg for three months and daily steroid tablets 20 mg, and Monovas but still there is no improvement in the ankle. My questions are additionally to Methotrexate, steroid injections, and oral steroids is there anything else that can help in this case? How long will a joint swelling take to cause permanent joint damage?
17 May 2024 - 1 min read
I had odd reaction to breast implants. Need suggestion.
Hi doctor,
I got my breast implants (saline) removed two years ago. I had them for several years. Suddenly, I started having odd symptoms such as Raynaud's, poor circulation and heat, and redness in my hands and feet when hot. Since then I have changed my diet, started supplements, started low-dose Naltrexone, and solved a lot of histamine and allergy issues with the help of a homeopathic doctor. I felt really good then. Then I had an endometrial surgery. After stopping all my supplements and LDN for a week I felt almost exactly the same before I had implants. I am wondering now whether it was the removal of my implants or my medicines or lifestyle changes that helped me. I have a deformity in my breast now. I would really like to have implants again. What is your suggestion? My ANA is negative and all my blood tests are great.
17 May 2024 - 1 min read
What is another option for joint pain besides Indomethacin?
Hello doctor,
I am suffering from chronic gouty arthritis. It started ten-plus years ago and now progressed to every joint in my body with multiple joint attacks at once. I have constant pain in my joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and a prescription for Indomethacin, which is not working for me as it has been taken for more than 10 years. I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited.
16 May 2024 - 1 min read
Which body part’s MRI can best reveal spondyloarthropathy?
Hello doctor,
I am a 31-year-old male, and I was diagnosed with spondyloarthropathy seven years back. I am taking only Sulfasalazine tablets daily. Currently, I do not have any pain or stiffness. My HLA-B27 report is negative. Now, if I do the following MRIs, what chances are there that any abnormality might be found in my body?
Please tell me only about these three MRI tests as I need to show it to someone, and I do not want to be caught with any disease.
Last week, I did a blood test and chest X-ray (PA view). The X-ray report was normal. ESR was 20 mm. TC and DC were normal. Please help. I have attached the MRI report for your reference.
16 May 2024 - 1 min read
How to treat my daughter's PAN and multiple aneurysms?
Hello doctor,
My 21-year-old daughter suffered from severe abdominal pain and vomiting one month back. I consulted a local physician for treatment. He gave some antibiotics, but no relief. I consulted a gastrologist too. He prescribed some medicines, but no relief. He advised me to do the abdominal sonography; no abnormality was found. I consulted Rheumatologist, and she was diagnosed with PAN. The doctor advised doing a CT angiogram. The CT angiogram showed multiple aneurysms. The previous CT has done eight years back. She is currently taking Predace, Azoran 50 mg, Telma 40 bd, Stamlo 5 mg twice a day, and Cizaspa-X.
13 May 2024 - 1 min read
