DEAR Dr. ROACH, I’ve been reading your column on radiofrequency ablation to treat back pain. I suffer from osteoarthritis in my spine and have experienced severe pain since August. My issue lies in my L4 L5 disc. I received an injection of cortisone just in the last couple of weeks and it didn’t alleviate the pain completely but it took the edge off which is why I’m no longer taking pain medications. It was suggested to me to think about a treatment using platelet rich plasma. I researched it and found that it’s not tested and proven to be successful. I’m wondering if you’ve read anything about it. — G.M.
Answer: Platelet-rich plasma (PRP) originates from the blood of a person and is a source of growth factors that are designed to aid in the repair of injuries, particularly to joints and tendons. Initial studies demonstrated benefits in the short term however, the more rigorous tests have not been able to prove any benefits over placebo injections in six months of following up. The procedure is not generally insured by any insurance.
The procedure is safe in the hands of an experienced professional, however you must be aware of the chance of an infection. If there isn’t any evidence that PRP can be beneficial in comparison to placebo treatments, I would not recommend it to treat pain caused by arthritis.
DEAR Dr. ROACH: I’m 64 years old and weigh 130lbs. I’m 5 feet, 8 inches tall. For several years, intermittently my primary doctor would inform me my sodium levels were low. My doctor recently told me that when my sodium levels are low , I will need to consult with an expert in kidneys. I thought that the low sodium levels are due to diabetes as well as taking metformin. Another doctor prescribed losartan in conjunction with Hydrochlorothiazide (HCTZ). I finally visited a nephrologist. He removed me from the losartan and HCTZ combo and I’m now taking losartan. A blood test was requested. The doctor who followed me was telling me to take a smaller amount of water. I was drinking approximately 80 fluid ounces of water, however I’ve cut back my consumption.
A friend of mine suggested that I might have Addison’s disease. She also suffers from it. My symptoms are at times, debilitating fatigue, weakness, loss of focus and concentration heavyness, diarrhea, stomach pain that feels like punches in the stomach nausea, and a deep belching. There are good days.
I’m scheduled for another appointment next year , which will be in mid-January and a second blood test is requested. I haven’t discussed Addison’s disease with the doctors. What’s your opinion and how can the disease being addressed? I’m so angry. — T.F.
Answer: Low sodium levels are common in those taking diuretics within the thiazide category, such as HCTZ. The years of taking HCTZ could also alter the body’s normal sodium levels which requires a person take fewer fluids for them to maintain their sodium levels within an acceptable range.
The symptoms you experience do not necessarily stem from low sodium on its own even if you have a lower sodium levels. The symptoms are not specifically related to low sodium or Addison’s Disease, which is the cause of low levels of cortisol. Addison’s Disease is extremely rare and is estimated to be around just one patient per 100,000. The most difficult part of diagnosing Addison’s disease is imagining it at all as the main symptoms of abdominal pain and fatigue aren’t specific. Low sodium levels are common in the case of Addison’s disease, so I think that mentioning this possible diagnosis to the doctor would be a good suggestion.
The first blood test for the presence of Addison’s disease isn’t typically done and will require the injection of a drug which will cause your cortisol levels rise. If it does not, it’s the strongest evidence for Addison’s Disease.
Dr. Roach regrets that he’s in a position to address individual inquiries and will be able to incorporate these into the column whenever it is. Readers may email questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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