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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17978
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Am bipolar needing a hip replacement but according to GP cannot

Resolved Question:

Am bipolar needing a hip replacement but according to GP cannot have any prescribed pain relief due to reaction - proved! There must be something whilst on a long waiting list.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
It will help if you could provide some further information.
Have you already seen the Orthopaedic Surgeon?
Is the long waiting list to get into the surgeon or to be scheduled for surgery?
What are all the medicines that you are currently taking for any medical problems?

Customer: replied 2 years ago.

Not seen Ortho Surgeon - first went to Osteo private, referred back to surgery, xray shows wear and tear. Drs unhelpful on pain control as I react to all bar paracetamol - it is very painful but am on monthly acupuncture, not proving helpful.

 

Meds: Priadel, citrizine, omeprazole (multi stomach ulcers) paracetamol buscopan I am genuinely distressed by this situation but when one is Bipolar you can be treated offhandedly. The pain is mostly awful and to be told by GP to walk down to Argos and buy a Tenz machine was a move too far.

Expert:  Dr. D. Love replied 2 years ago.
Thank you for the additional information.

There are several options to consider at this point.

In someone unable to take anti-inflammatory medicines, there are limited options available as true pain medicines. Other than the paracetamol, the only options are the tramadol that has already been tried and opiates. There are stronger opiates than what has been tried, but many doctors prefer to avoid the stronger opiates for someone with joint disease.

However, there are some other options that can be tried. There are some medicines that can be used for chronic pain from a variety of causes, and these medicines appear to work by suppressing the firing of the nerves carrying the pain message. In your case, it is complicated because of the presence of bipolar disease. But there is a medicine that can be used for bipolar disease that also may help with chronic pain, carbamazepine. Regardless of whether the bipolar disease is being managed by your GP or a specialist, you can talk with that physician about the use of the carbamazepine.

Some other options would be interventions that can be done on the joint itself, but would usually be done by the Orthopaedic Surgeon. For example, there are injections that can be done with a medicine that serves as a synthetic lubricant for the joint. There also can be injections of steroidal anti-inflammatory medicines or numbing medicines. These injections typically will only provide temporary relief in someone with severe joint degeneration, but it may be sufficient to provide relief until the surgery can be done. If it is not possible to be seen by an Orthopaedic Surgeon for consideration of such injections, then you can talk with your GP about whether it could be arranged via another mechanism. For example, Interventional Radiologists also may be able to perform these injections.

Lastly, some people also may be able to get some temporary relief by performing a nerve block. This would typically be done by a Pain Management specialist. You can also talk with your GP about whether this can be arranged.

If unable to be seen in a reasonable time frame by referral from your GP, it may be an option to be seen privately, but the specialists would be the same.

If I can provide any clarification, please let me know.

Customer: replied 2 years ago.

Thank you so very much for the info and I will act upon it - hip painful but yours was the most helpful approach toward bipolar (mild) and conventional medicine.

Expert:  Dr. D. Love replied 2 years ago.

You're welcome. I hope that you are able to get some relief.

If this has been helpful, please remember to provide a positive rating.

 

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17978
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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