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Doctor : Painkiller, arm, finger, what medicine can you take?

Dear Dr. Cockroach: My son experienced what he thought was neuralgia in his arms and fingers. Now he felt a severe pain in his finger. He had a tingling sensation as well. The orthopedic surgeon’s office puts him on meloxicam. And he wears an arm support and computer brace. Is Meloxicam used for these problems? Or is there another medication or test that should be given/do to relieve the pain? It made him sleepless. Do you have any suggestions? — CA

answer: Neuropathy is a general term referring to “Something wrong with one or more nerves.”

; Pain and numbness or tingling are common early symptoms. Weakness is a delayed, more serious condition. In the case of arm and finger pain in healthy people The most common neurological disease is sciatic nerve disease where the arm presses down to the finger. Ulnar entrapment, also known as cubital tunnel syndrome, is caused by compression of the ulnar nerve endings, which nerves to the little finger and part of the ring finger in general One or more nerves may be compressed in the neck or in the brachial plexus in the armpit.

Most general practitioners or specialists such as neurologists or orthopedic surgeons An accurate diagnosis is usually made by physical examination. A wrist strap (for the carpal tunnel) or elbow brace (for ulnar entrapment), and the use of an anti-inflammatory agent such as meloxicam is usually the first appropriate course of action. Injections and surgery may be considered. and there are other drugs that can be tried to relieve symptoms unless there is weakness or atrophy Deliberate action is prudent. And rushing to surgery is unwise.

before surgery or if the diagnosis is unclear Additional tests usually include an EMG (electromyography) and nerve conduction studies. This is the best way to determine precisely which nerves are involved.

Dear Dr. Cockroach: Your latest article on home immunosuppressant vaccination. My wife takes Rituxan every six months for rheumatoid arthritis. Twenty-one days after her last Rituxan. (It must be used twice within two weeks every six months.) She received her first vaccine. She received a second vaccine (Moderna) 28 days later, after her last vaccination. How quickly can she safely inject the booster? If you wait six months from your last vaccine You’ll be given another Rituxan, it’s Catch-22 –MDL.

answer: I can’t answer precisely. This is because there is no evidence of the effectiveness of booster injections. And there’s no solid evidence that rituximab (Rituxan) makes the vaccine ineffective.

However, based on my understanding of the vaccine and the effect of rituximab on antibody-producing B cells. I suggest you ask her rheumatologist about repeating her vaccine 4-6 weeks before her rituximab, which will be as much time after the previous injection and enough time for the vaccine to work before the next injection. go

Physicians are in unfamiliar water for some individuals with specific medical conditions and must use their best judgment. Five months from now, the COVID-19 situation in North America may be completely different than it is now. And there may be better ways to vaccinate people who are immunocompromised.

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Dr. Roach regrets that he was unable to answer one letter at a time. but will include them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu Or send a letter to 628 Virginia Dr., Orlando, FL 32803.

(c) 2021 North America Syndicate Inc.

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