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Meniscal injury and gout - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3479 Questions
Doctor :   hi
Doctor :  
how can i help u?
User :   Hello. Its about my father so please bear with me as I fill you in with the specifics
Doctor :  
sure
User :   I will try to be as clear and short as possible. My father is 65 years old and has had "problems" with his blood-pressure and gout for over 20 years now. In October 2008 he was diagnosed with Diabetes and was prescribed Glucophage 500 mg 1x2 (Swedish medicine name)
Doctor :  
ok
Doctor :  
we have ur chat history
User :   Ok, so you know about it?
Doctor :   just now i have seen it
Doctor :  
so ur father is hypertensive
Doctor :  
but main concern is gout
User :   So you need time to read through?
Doctor :  
he was also given steriod shot
Doctor :  
to reduce inflamation
Doctor :   i have read ur fathers problem
User :   Well he is afraid now because he is not sure if its the gout or the minsic injury in his leg, (knee) that is causing him problems.
User :   He is terrified that he will be forced to walk with crutches all his remaining life now. He has troublety walking on his own without help
User :   Why do you mean with hypertensive?
Doctor :   why are u suspecting miniscal injury?

User :   Because the ortopedic Dr. x-rayed his left knee and found that he has that injury but should NOT consider an operation due to his different ailments
Doctor :  
ok
User :   It would be too risky for my father the Dr said, the ortopedic. So now he cannot walk without crutches and that scares him.
Doctor :  
so already miniscal injury has been diagnosed
User :   Yes!
Doctor :   minuscal injury is painful condition
Doctor :  
it is operable but
User :   Well my father says that he has no pain right now other than when he had his gout attacks dated two months ago
Doctor :  
problem is his age/diabetes/hypertension
Doctor :  
ok
Doctor :  
gout attack to which joint?
User :   What do you mean Dr.?
User :   Feet, big toe...
Doctor :  
ok
Doctor :  
is there any clicking sound during the movement of knee joint?
User :   My father has always been a meat lover but all his young and adult life he was skinny. The past 8-9 years he has put on a lot of weight which has caused him problems with gout, diabetes and high blood pressure.
Doctor :  
ok
User :   No clicking sound
Doctor :   ok
Doctor :  
ow coming to his problems now
Doctor :  
1)meniscal tear
Doctor :  
2)gout
Doctor :  
for meniscal tear treatment options for ur dad are
User :   Yes....
Doctor :  
1) antiinflamatory medicines ,guess he is alreday taken that
Doctor :  
2)cortisone shot
Doctor :  
3)ice pack application
Doctor :  
4)physiotherapy
User :   Yes but those medicines has caused him kidney problems so he cannot take them
Doctor :   what problem?
User :   His acid levels in his urine were very high due to a bladd infection caused by a catheder which the nurses administered
Doctor :  
ok
Doctor :  
what is the diagnosis given to his kidney problem by the doctors?
User :   he couldnt pee so the nurses put a cather that resulted in a infection which he took an aribotic for. Well due to anti-inflammatory medicine his kidney levels are a bit elevated
Doctor :  
what kidney levels?
Doctor :  
infection is fine ,u can take antiinflamatory drugs during infection
User :   I'm not sure really, acid levels or something to that affect?
Doctor :  
uric acid levels?
User :   Certain blood pressure and anti-inflammatory drugs caused him problems with his kidneys which are elevated a bit. He takes medicine for that now
User :   Yes
Doctor :  
ok
Doctor :   antiinflamatory drugs increase uric acid levels
Doctor :   so only option left is ice pack and physiotherapy
User :   Natriumbicarbonat Recip 1x1, Trombyl 75 mg 1x1, Spironolakton Nycomed 25 mg 1x1, Bisoprolol ratiopharm 5 mg 1x1, Amlodipin Actavis 5 mg 1x1, Zyloric 100 mg 1x1
Doctor :   ok

User :   These are the medicines which he takes everyday for his bloodpressure, gout and so on
Doctor :   ok
Doctor :  
ask him to go for physiotherapy
Doctor :  
also
User :   Yes but he uses crutches to go to the bathroom how can he manage to do physiotherapy?
Doctor :  
the medicines which he is taking are good enough
Doctor :  
no change is required
Doctor :  
why not
Doctor :  
physiotherapy can be given it is not a problem
User :   Because he has problems walking to and from the bathroom, let alone doing physical stuff
Doctor :   physiotherapy is given to immobile persons also

Doctor :  
a physiotherapist will assist him in this
User :   Ok. What kind of medication for gout can my father take knowing his medical history
Doctor :   ZYLORIC
Doctor :  
this tablet is the universal drug against gout
User :   Yes...
Doctor :  
along with that NSAIDS are the given
Doctor :   but now as he cant take it,he should be managed with dietary change
Doctor :   like avoiding red meat
Doctor :  
reducing his weight
Doctor :  
avoid alchohol intake if he is addicted to it
User :   But is it the gout or miniscal injury that is causing him to walk with crutches. He drinks very seldom so alcohol is no problem
Doctor :   it must be meniscakl injury

User :   I see...
Doctor :  
as gout effects mostly small and peripheral joints
Doctor :  
along with this u give TAB TYLENOL 2 times a day after taking food
User :   My father takes Lyrica, does that interfere with his kidneys?
User :   Tylenol doesnt work for him. That's just a drop in a bucket I'm afraid. He takes Oxcycotin and Oxy-derm when he has to...
Doctor :   ok
Doctor :  
lyrica will not cause any kidney problem
User :   Ok so he can take it?
Doctor :  
yes
Doctor :  
he can take it
Doctor :   no problem
Doctor :  
for meniscal tear there is no permanent treatment for ur dad
Doctor :   the permanent treatment is surgery which cannot be done on ur dad
User :   600 mg of Lyrica he takes every one or two weeks
Doctor :  
ok
User :   So he will have to walk with crutches, will his condition improve?
Doctor :  
u dont worry about crutches
Doctor :  
his condition will improve but it will take time
Doctor :  
u need patience for that
User :   Well he has been bed-ridden for more than 2 months now so he is very impatient and nervuous
Doctor :   i can understand

User :   The gout, bladder infection and meniscal tear has left him very disheartened
Doctor :  
at this age and having complications like daibete and hypertension
Doctor :   we cannot go for operation
Doctor :  
that is the main draw back
User :   Yes it is too risky the ortopedic Dr said.
Doctor :  
yes
Doctor :  
so we should treat him with the options remaining
Doctor :  
they are all slow process
User :   Yes...
User :   I understand.
Doctor :   we should understand the problem and adjust for atleast some days ...
Doctor :  
good
Doctor :  
u explain him everything
User :   So what is the best advice for him Dr?
Doctor :   the tablets which he is taking now are good
User :   Watch his weight and his eating habits, avoid alcohol and start with physical teraphy
Doctor :  
along with that go for physiotherapy
Doctor :  
and also dietary changes
User :   Yes...
Doctor :  
most important thing now is patience
User :   Yes.
Doctor :   thats it
Doctor :  
may be my advice did not satisfy u
Doctor :  
but there is no other option left
User :   No its not that, I understand and value for advice Dr. its just I'm worried for him and he is also impatient which makes it a little hard.
Doctor :   i can understand
Doctor :  
u try to explain his situation to him
User :   But that's life, you have to do the best with what God has given you. I will.'
Doctor :  
initially its very hard to take it
Doctor :  
slowly he will get adjusted to the situation
User :   One last quick question. My sister has Hep C and had a biopsy which has revealed that he has cirrhosis, can she take diet pills? They are called DIET CAPS here in Sweden?
Doctor :  
just a minute
Doctor :  
please
User :   Sure...
Doctor :  
is it an homeopathic medicine?
User :   Her blood test are very good and her liver function is also very good. Pardon, explain please
User :   Its organic I believe
Doctor :  
diet caps are to reduce her weight?
User :   Yes
Doctor :  
i dont know about that tab.as it is organic medicine .but i don't suggest her to go for any weight reduction pill
Doctor :   all most all of them have some or the other side effect
Doctor :  
u there?
User :   yes
User :   are they dangerous to her condtion?
Doctor :  
not dangerous
Doctor :  
weight reduction must be natural
Doctor :  
either through exerscise or jogging or dieting
Doctor :  
not through tabs
Doctor :  
they have side effects
User :   Ok thank you very much and have a wonderful day....
Doctor :  
did u follow what i have said?
User :   Yes I have, to the letter....
Doctor :  
Is there any thing else I can help you with?
User :   I think I'm satisfied for now but thank you for your time and advice Dr.
User :   Have a great day....
Doctor :   welcome
Doctor :  
Please fill the feedback form say done when done.
Doctor :   u to have a great day
User :   Will do...
Doctor :  
bye
User :   bye
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