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Love 'em or hate 'em, they're here to stay.

* Most have side effects, many of which need adjustment with guess what? - another drug!

* Many have knock on effects that weren't intended; some +ve and some -ve

* Only a minute few are supplemental eg thyroxine

* Only a minority fix the problem completely

* And even fewer can lay claim to being preventative medicine

I haven't done pharmacy for over 5 years now and there are other pharmacist SAUers on here who can keep this thread's Qs satisfied with up-to-date answers better than I.

On the lighter side...

Here's Lucy with...

http://www.youtube.com/watch?v=jVfBRRm7RgI

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Lol S4s are only S4s because they have heaps of contraindications, adverse drug reactions and a more narrow range of therapeutic indexes. Plus most of the drugs are subsidised by NHS for 34.20 so that makes it alright for most people to get

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I took myself off Pristiq a month ago (anti-deps) - was being used for depression & apparently to help pain relief, in conjunction with Durogesic (fentynal - ie morphine slow release skin patch). Wasnt going so well with the anti-deps, probably the 4th or 5th type Ive been put on (chronic pain leads to depression)....... I simply felt like I wanted to top myself, for quite a while too. 18months?

Was NOT a positive effect, far from it. I can now see clearly that for the past 3yrs Ive been on Pristiq Ive been making some terrible decisions.......

Would Not recommend.

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I took myself off Pristiq a month ago (anti-deps) - was being used for depression & apparently to help pain relief, in conjunction with Durogesic (fentynal - ie morphine slow release skin patch). Wasnt going so well with the anti-deps, probably the 4th or 5th type Ive been put on (chronic pain leads to depression)....... I simply felt like I wanted to top myself, for quite a while too. 18months?

Was NOT a positive effect, far from it. I can now see clearly that for the past 3yrs Ive been on Pristiq Ive been making some terrible decisions.......

Would Not recommend.

You mentioned how "chronic pain leads to depression". Is it also fair enough to say that depression heightens one's sensitivity to pain too? > Vicious circle Brendan?

Pristiq is within a group of drugs called SNRI like Efexor and Cymbalta. They work on both Serotonin and Noradrenalin levels. Because there is no accurate testing procedure for these, a Dr has to weigh up it seems, how to guesstimate what's best for you.

Do the X-Rays, CTs and MRIs reveal where the pain is coming from?

I wish that doctors, acupuncturists and naturopaths could all work together: same with physiotherapists, chiropractors and osteopaths.

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No, I've been in pain since I was 11, chronic pain since age 19. Depression is more likely from my perceived 'shithouse life' I'm leading. Lose of job, marriage breakdown, lack of access to my children, can't pay homeloan had to put my Castle on the market, depression from the fact that I can't find peace nor happiness in this life due to the 24/7 pain I have to deal with. Removal of patellas has left me unable to trust my body, gotten to the point that I see no positive future for myself. I feel useless, like a failure, see no hope for future comfort. Everyday I feel like I need to question "why" why do I have to put up with this. Specialists haven't been of much help terry.

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the US government has just launched a massive new program aimed at reducing the growing pharmaceutical drug addiction problem they're having... apparently its become a bigger problem than crack was in the 80's or heroine or even the meth epidemic...

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PM me your landline if you're willing pls.

Shall call you tomorrow night.

Thank you for your time Terry, I look forward to speaking with you again.

apologies for being a little emotional....... obviously Im not happy with the 'alround' situation I find myself in at the moment, and find it difficult to speak out/up in regards to my health.

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Tangles, would/have you considered options outside of Australia? Just asking as my sister has had multiple surgeries on her knees as well and one of the specialists had suggested to her that she may need a full replacement by the time she's 30 (she's 23 now). - if they won't do it here for you due to your age.

I believe she was also put in contact with pain specialists offering alternative/modern treatments/therapies that don't seem to be available in Australia either. (Heading on-topic with this!) This was due to her trying many different prescription pain killers (as well as anti depressants, only partially due to the knee issues) affecting her 'mental stability' if I can call it that I suppose.

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yes they wont do total knee replacements due to age... too young. My argument is how about my quality of life (or lack thereof), Im looking for the NOW not later when Im in my 70's.

I understand the argument in relation to how long the TKR lasts for and it wont get me by for my expected lifespan....ie age 35 have 1st TKR's. age 47 have second lot, age 59 have third round TKR's. After that, at this stage, its wheelchair time. In adelaide this time last year they did a 3rd TKR (total knee replacement) to a patient; he was the first to have the 3rd TKR. Its a bit of an unknown 'grey' area. And if one fails soon after surgery its still counted, due to the nature of the surgery - the rods that go down/up the tibia/fibular need to be replaced each time, your bone gets brittle due to the hollowing out.

Ive just gotten into my head I'll probably have to look outside the state (sth australia) for better advice / treatment. Perhaps I should be looking into overseas treatment..... doesnt seem right does it? The 4th surgeon Im seeing has decided he wants to get into the joints to looksee, being on public system now (cant afford private since Im on disability pension) that'll be sometime end next year. Last surgeon who removed both patellas was the ex president of aust.medical association, I trusted his opinion, but removing both kneecaps in a 6'8" giant just does not work.

thanks for the thoughts Brian, please tell your sister Im thinking of her, as I know right now she'll be going thru a dark period in her life.

Terry, your words are very kind. You sir are a genuine human being, thoughtful of others, forever trying to help. I for one appreciate that. Thank you again. I do look forward to speaking with you again.

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what are the pro's and con's of duramine?

Duromine used to come in strengths of 15mg, 30mg, and 40mg. There's only one strength now.

As you know already Brett, it's used to reduce appettite.

It works on the satiety centre of the brain as an amphetamine analogue.

Pro

* it works each day as you take it in the mornings (well - that's the usual time it's taken); and appetite decreases

* as a byproduct, weight comes off

Con

* it can keep you up at night (with insomnia if the dose is too strong - but the company has discontinued the lower strength)

* once the bottle's finished, the drug will not have taught your brain to settle into eating reduced quantities - so no new good habit is learned at all

* slight shaking or shuddering (typical of amphetamines)

* just a few people can get a bit depressed when the drug is discontinued

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What's this gov't thinking of?

Delaying life-saving drugs from the PBS when they're rolling out billions on an NBN?

I thought hospitals and money for vaccine/drug R&D + preventative health (Vs diabetes etc) would have and should have come first?

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i went thru 3 surgeons who told me i was 2 young for a total hip replacement and refused to do it even tho i could not weight bear on that leg and was told just to live with the pain till i was older . i was told as young person i would destroy the hip in no time .

well i found a great surgeon who agreed my hip need replacing and a week later aged 32 yrs i had my new hip in i went then on to work as a mechanic and drive tow trucks and race speedway for the next 15 yrs and ive just taking up racing again well guesses what im now 52 and i still have that same hip in now 20 yrs of pain free life if i had taken the advice of those other quacks i prob would still be in pain.

my hip now aches a bit when i try and do too much but recent xrays show its still in good condition showing only a little wear anyway ive had my rant now lol

cheers dean

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yes they wont do total knee replacements due to age... too young. My argument is how about my quality of life (or lack thereof), Im looking for the NOW not later when Im in my 70's.

I understand the argument in relation to how long the TKR lasts for and it wont get me by for my expected lifespan....ie age 35 have 1st TKR's. age 47 have second lot, age 59 have third round TKR's. After that, at this stage, its wheelchair time. In adelaide this time last year they did a 3rd TKR (total knee replacement) to a patient; he was the first to have the 3rd TKR. Its a bit of an unknown 'grey' area. And if one fails soon after surgery its still counted, due to the nature of the surgery - the rods that go down/up the tibia/fibular need to be replaced each time, your bone gets brittle due to the hollowing out.

Ive just gotten into my head I'll probably have to look outside the state (sth australia) for better advice / treatment. Perhaps I should be looking into overseas treatment..... doesnt seem right does it? The 4th surgeon Im seeing has decided he wants to get into the joints to looksee, being on public system now (cant afford private since Im on disability pension) that'll be sometime end next year. Last surgeon who removed both patellas was the ex president of aust.medical association, I trusted his opinion, but removing both kneecaps in a 6'8" giant just does not work.

thanks for the thoughts Brian, please tell your sister Im thinking of her, as I know right now she'll be going thru a dark period in her life.

Terry, your words are very kind. You sir are a genuine human being, thoughtful of others, forever trying to help. I for one appreciate that. Thank you again. I do look forward to speaking with you again.

Sorry to backtrack so far into the thread (I just found it now) but I just wanted to add my 2c in regards to Tangles looking outside of Australia for treatment.

I was treated in Australia for a relatively minor skin problem in Australia for 4 years with the problem getting worse and worse. I saw 3 different doctors and they kept me on basically the same medication (oral antibiotics) for all that time. I came to Japan, saw a GP and then a specialist and within a couple of months the problem became immeasurably better. She (the specialist) tried a variety of topical and oral medications until she found something that really worked. It isn't cured but the difference in symptoms is amazing.

I realise that my medical problem is completely different to yours but I would definitely recommend trying overseas. It really felt like the specialists in Australia were happy for me to keep coming in every month feeling miserable that the problem was getting worse as long as I kept paying the $100+ in their fees and $100+ in meds. Compared to the Japanese specialist who made me feel like she really wanted to help and cared for my wellbeing. Add to that the fact I only have to pay the equivalent of about $5 to see a specialist in Japan and you can see why I think you should at least consider looking overseas.

Edited by *LOACH*
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apologies for being off topic SAU

Have any of your specialists considered using pregabalin (Lyrica)? I know some are a bit in the dark with it's use, primarily they think it will only work in neuralgia (nerve related pain) but there is a bit more evidence for the treatment of pain arrising from muscles and connective tissue ec etc. It's not cheap but may be worth a crack as it could work very well.

I only mention it as I had a patient come in with similar chronic pain issues, I suggested she discuss with her GP the possibility of a short trial with Lyrica, when she came back 2 weeks later she had an 80-90% reduction in severity, so much so she had tossed her Panadeine, Tramadol and Fentanyl Patches that she had been relying on for the past 11 years. I've never seen such a change in mood in such a brief time.

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the US government has just launched a massive new program aimed at reducing the growing pharmaceutical drug addiction problem they're having... apparently its become a bigger problem than crack was in the 80's or heroine or even the meth epidemic...

That's f**ked !

I don't take anything I don't NEED to.

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