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DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65671
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Hi, I am trying to make a big decision about my health and if i should come of many of my

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Hi, I am trying to make a big decision about my health and if i should come of many of my daily medications. I take Butrans (10) patches, amitriptylline, topirimate, baclofen, paracetamol, carbamazepiene, topiramate, montelukast, fexofenadine, seretide, ventolin, atroven, piroxicam gel, lidocain patches, carmellose eye drops, sumitriptan tablets and injections. I feel that these maybe affecting me cognitivley and may also start meaning that I cant drive and work, but I know without some of them I will be worse and need to use my wheelchair more rather than less.
Yes, I think this is excessive in the way of medication, just at first glance
But what type of doctor is in charge of this?
Customer: replied 3 years ago.


I have seen numerous doctors over a few years. My general practitioner has overall care.

I also have a rheumatologist, neurologist and cardiologist. However, i do not regularly see them my GP writes to them and I only see them when necessary.

I also see physiotherapists, wheelchair services, orthotics.

My asthma and allergy medications were all prescribed by a respiratory consultant a few years ago who I am no longer under as I am stable again.

My medical conditions - Dysautonomia - Postural Orthostatic Tachycardia, My report also says paroxysmal tachycardia, asthma - allergic, trigeminal neuralgia, migraine, fibromyalgia, congenital limb deformity with leg length discrepancy.

You are repeating medications in your list.
Please list only what you are on now
Customer: replied 3 years ago.

Im sorry: Here is an exact list of what I take now copied from my prescription:

Amitriptyline 25mg tablets

one To be taken Each Night

Baclofen 10mg tablets

take half 3 times/day

Buprenorphine 10micrograms/hour transdermal patches

apply one patch week

Carbamazepine 100mg tablets

take one Three Times Daily when needed

Carmellose 0.5% eye drops (Alissa Healthcare Research Ltd)

appply four times a day

Diprobase cream (Merck Sharp & Dohme Ltd)

apply as needed

Fexofenadine 180mg tablets (Dr Reddy's Laboratories (UK) Ltd)

take one daily

Fluticasone 250micrograms/dose / Salmeterol 25micrograms/dose inhaler CFC free

inhale 2 doses twice daily

Ipratropium bromide 20micrograms/dose inhaler CFC free

use as directed

Lidocaine 5% medicated plasters

use as directed

Montelukast 10mg tablets

take one at night

Paracetamol 500mg capsules

take two 4 times/day

Piroxicam 0.5% gel

apply as directed

Salbutamol 100micrograms/dose inhaler CFC free

inhale 2 doses as needed

Sumatriptan 50mg tablets

take one as directed

Sumatriptan 6mg/0.5ml solution for injection pre-filled syringes with device

use as directed

Topiramate 25mg tablets

take To be taken Twice Daily

Talk to the doctor in charge about the following potentially adverse combinations.
baclofen and topiramate...both increase sedation
bupenophrine and topiramate...same problem
amitryptalline and topiramate, same problem.
Sumatryptan and amitryptalline can both increase seritonin. In rare instances this can cause seritonin syndrome, which is dangerous.
baclofen and buprenorphine both increase sedation.
Same with baclofen and amitryptalline
Also buphrenophine and amitryptalline.
OK, so that is an initial answer….
Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 3 years ago.

Okay, Thanks for this. Can I just ask your imput on something else, i realise you cant see me nor have my full medical history at hand. But If I gave you a history and symtoms of:

Upto ago 11 no problems, asthma presented at age 11

Age 13 joint pains presented specifically knees going swollen, red hot and tender.

age 13 - kept falling playing sports, joints locking, grinding lots of crepitus.

Age 13/14 - identified leg lenth discrepancy, hip misaligned (no treatment given other than ankle and knee braces and orthotics)

Age 13-16 - same problems but started to present in wrists, shoulders, elbows, ankles. Given painkillers

Age 19 - ligament reconstruction in right wrsit due to chrnoic synovitis, tear of triangulofibrocartilage etc.

Age 20 - diagnosed fibromyalgia

Between these years - asthma getting progressivley worse lots of resus admissions, struggling to control it.

Age 23- diagnosed dysautonomia - pots and tachycardia

Other health conditions diagnosed inbetween these dates.

Progressively getting worse, developing foot drop, loss of deep tendon reflexes in knee and ankles, pins and needles in hands and feet, burning pain in hands and feet and still swollen, red and hot knees.

Family history -

Grandma - COPD,Asthma,osteoartritis

Grandfather - MS

Mother - skin Cancer

Father - Asthma

My questions is - do you think my diagnoses make sense? I have felt my gp rushed into diagnosing fibromyalgia and putting everything along with it because i was in pain. But I had pain before this diagnosis, fibromyalgia is not progressive, should not cause foot drop etc.

Kind Regards ***** ***** needed I am happy to pay for a more detailed response.

This is an entirely different question.
We are only paid per positive rating by ja.
I don't see one on the original answer
Was there a problem?
Customer: replied 3 years ago.

Oh My apologieis

Does this mean i need to finish this and ask another question?

Just rate the answer positive.
It would be preferable if you then find me by request in medical {using my request link and "for Dr. Thomas only" in the question title
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