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Old 11-27-2011   #21
 
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Ibuprofen is similar to Naproxen and Meloxicam. All NSAIDs. The way I read it, the problem with drinking and doing NSAIDs is you increase stomach problems (acid), which can be easily treated with Prilosec (Proton Pump Inhibitor).

Why bother with Ibuprofen? It lasts only 4 hours. Your pain doesn't wear off after 4 hours? Naproxen (Aleve) lasts 12 hours. Meloxicam lasts 24 hours, but it is prescription, off patent so cheap. If your knee is that bad, get a Meloxicam prescription.
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Old 11-27-2011   #22
 
BV, CO
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Aleve bothers my stomach more noticeably that ibu. I'm often taking ibu cuz I'm about to do heavy work for the day and it will get me to the end of the day with less issues in the knee. I don't need it 24/7.
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Old 11-27-2011   #23
 
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I agree this is a good thread. I didn't know this, and take largish quantities of tylenol once a month since I am allergic to NSAIDS. I've avoided narcotics and just upped the dose of tylenol (yes everyone warns to be careful...) for a day or so. This is a good reminder to be really careful with meds, and sometimes good old fashioned codeine type stuff is where it's at.
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Old 11-27-2011   #24
 
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When you said "good old fashioned", I thought you were going to say something really good and old-fashioned . Like castor oil! That stuff is good for sore muscles and joints. Rub it in, leave it on (make a "castor oil pack", or, I've just been sacrificing old shirts or socks to cover the oil, and sleep on it).
http://www.gabrielcousens.com/LinkCl...language=es-MX

Homeopathic arnica gel is another great rub for sore muscles and bruising. I saw it used in the spa at a ski lodge in Alta; for an extra $10 the massage therapists will use arnica gel; or you can buy a whole tube for less than $10. You can also take homeopathic arnica pills concurrently, for overtraining, sprains, bruising, sore muscles. I have not heard of any side effects.
Really good hydration is also helpful. I like the filtered reverse osmosis water from the health food store machines. Drinking a liter in the morning, and a liter after a big workout, feels great.

There are lots of holistic, non-drug things that help. Turmeric and ginger can help reduce inflammation. Here is an article on curcumin (turmeric) research.
Curcumin May Reduce Tendinitis-Related Inflammation
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Old 11-27-2011   #25
 
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Quote:
Originally Posted by asleep.at.the.oars View Post
Two beers an evening - in a normally sized, normally hydrated male - shouldn't impact your NSAID use unless you develop gastric ulcers.
Likewise for APAP as long as you're not pushing the daily dosing limits.
The problem comes in with regularly elevated consumption of either or both. So chasing your 6-pack with 3000mg of Tylenol day after day is likely going to end up in liver failure some years down the line, even though neither one on their own might have. Putting down a case a day, or 1-2 fifths, is just counting down the time until you turn yellow.

You're kind of getting to the biggest problem with medicine. People are all different, and the situations vary, but our system and expectations are set up for definitive answers. Basically, for any concrete question the most honest answer is "it depends." Sorry.

As for personal anecdote: I drink way less since I've gone into medicine than I did before, but still use OTC pain meds in limited amounts.
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Old 11-27-2011   #26
 
Westminster, Colorado
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PGY-3
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Old 11-28-2011   #27
 
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Quote:
Originally Posted by asleep.at.the.oars View Post
PGY-3
In what? I may be interviewing in CO next fall!
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Old 11-28-2011   #28
 
Westminster, Colorado
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Family medicine - at St. Anthony's. If all goes well, I'll have a lot more free time to start playing again next year. Make sure you rotate out here if you want to match here.
Shoot me an email if you have questions about different programs. I looked hard at EM before deciding FM, went to CU for school, and worked a bit in the area before that, so know just enough to be dangerous.
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Old 12-14-2011   #29
 
Shit Creek, Colorado
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How did I miss this thread for so long? I am such an opinionated bastard, this is the perfect place to spew my BS.

Taking APAP for a couple of days or even a week when you hurt or are sick isnt going to hurt you in the long term. There are so many things that are so much more dangerous that we put into our bodies very regularly.
As for drinking with meds that say dont, it is a bad idea. There is a reason they tell you not to. Maybe it is CYA lawyer stuff, maybe it is actual research that led them to tell you that, unfortunately they dont put that on the label. Maybe not so big with APAP or ibuprofen if you have an iron stomach. As for narcs and booze, it is impossible to tell what may happen if you try a Brett Favre cocktail that didnt bother someone else (or the last 50 people that tried it).

The only time I use APAP personally is to fight fever. The rest of the time I hit my kidneys and use Ibuprofen. It works better for inflammation which is what causes most of our aches and pains.

As for weeding out drug seekers, it is like picking out the totaled car on a new car lot.

Mostly, like everything else, following directions and using this stuff in moderation is the key.
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Old 12-14-2011   #30
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OK I gotta chime in on this one...
I've personally known 2 people, and my brother knew 1 more, who have died because their liver shut down from drinking heavily while on prescription painkillers containing acetaminophen. Essentially they die from alcohol poisoning because their liver can't take any more and shuts down.
In general I stay away from acetaminophen anyway. When I broke my leg a few years back I was given percocet, but I made sure to get a variety without acetomanaphin as it's buffer. So I know for a fact that such a pill does exist, and now those are what I keep in my medical kit.
So if you ever have to get prescription painkillers you should request the same thing, even if you're not planning on drinking while on them. And never drink while taking tylenol.
It seems like a lot of people don't know about this, so I'm glad to see this topic on the buzz, where probably most everyone is a heavy drinker!!
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