Rory's Medication

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Re: Rory's Medication

Postby Tom Jonas » 18 Feb 2014, 19:10

Osteoarthritis is a disesase which appears with increasing age. If the hands are affected it is most common in the distal fingerjoints (ie at the fingertip end) Often it is a progressive disease, and the most common reason for hip joint replacements.
I suppose you could get it in joints in the wrist area if you use the hands playing guitar for many years.
Take a look at Keith Richards fingers. It's amazing he still can play!
But osteoarthritis is hardly developing into a crippling disabling disease, like rheumatoid arthritis, which mostly affects the ground joints (where the fingers are connected to the hand). In severe cases all fingers are affected and the hand very deformed with all fingers bent in severe angles at the joint of the hand. But people can still work with medication. My dentist has a quite severe disease, but is still doing a perfect job. But playing guitar would be impossible.
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Re: Rory's Medication

Postby Tibbierocks » 24 Feb 2014, 09:47

R.A - his hands would have been mangled up. Now bursitis... not so often seen in the hands, but that's what the appearance reminded me of. Steroid injections to the hands can be used to treat it, but only short term to avoid damage. Rest is the answer - ie, putting the guitar down. I'm sure that was hard for Rory to do.
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Re: Rory's Medication

Postby Annie Elliott » 26 Feb 2014, 23:19

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Re: Rory's Medication

Postby RobertaSparrow » 27 Feb 2014, 00:14

Annie Elliott wrote:Dr. Jonas have you heard of paracetamol being administered IV for anxiety? I came across a reference to it in a book and wondered at it. One of our ED docs told me recently they are restricting acetaminophen even below the recommended doses now.

Donal mentions some medications that had been prescribed to Rory that are now off the market. And it's my understanding he was under the care of several different physicians - possibly some complex polypharmacy going on there as well.

Thanks for your expertise.


Paracetamol/acetaminophen is a very dangerous drug because it is seen as so harmless, because it is in so many other OTC blends, because the therapeutic dose is a hair's breadth from the toxicity level, and because it is seen as so "easy on the stomach," that people ignore the warnings about taking it with alcohol and wash it down with a beer or wine without a second thought. Losing Rory so soon was heartbreaking, a tragedy. If there is anything at all of value to come from it, it would be the red flag about Paracetamol/acetaminophen, handle with caution, it can destroy a person's liver without them even realizing how badly they have injured themselves.
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Re: Rory's Medication

Postby Tom Jonas » 27 Feb 2014, 11:38

No, paracetamol is never administered for anxiety, there's no such effect. But it potentiates other analgetics and could be given together with most drugs in this category, both non-opiates and opiates.
If I have a common cold or inflenza, headache or pain in some muscle or joint, I think Aspirin has a better effect. But not so good for a sensitive stomach. But for children Paracetamol is more safe, and often with good effect, if you are careful with recommended doses.

I started this discussion because I was surprised if my colleagues in Britain (or Ireland) prescribed potential liver-toxic drugs. But perhaps Rory had several different doctors.
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Re: Rory's Medication

Postby Annie Elliott » 27 Feb 2014, 16:59

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Re: Rory's Medication

Postby RobertaSparrow » 27 Feb 2014, 18:10

I think it is a potentially painful topic for Rory's family, it would be unduly upsetting to anyone who watched a loved one suffer so.

Suffice to say, Paracetamol/acetaminophen is imo a dangerous drug because it seems so harmless. It is not itself addictive at all, but combined with opiates it is, because of the opiate, but even on its own, it has been the cause of liver failure and death in this country at near therapeutic levels over long term use, and it is in so many OTC products it is VERY EASY to overdose someone, especially if they already have a damaged liver.

When my daughter was just a toddler, she was prone to frequent coughs, colds, and respiratory infections. The doctor used to order prescription-strength decongestants to her. My mother used to watch her while I was at work. Once while on a night shift, my daughter had gotten a bad cold, so my mother had the doctor call in a script. The pharmacy filled the prescription right before they closed for the day- it was a busy day, and they were swamped. But my mother picked up the medication, a liquid form decongestant with acetaminophen.

She called me at work when she got home, the dosage didn't look right to her, so she wanted to know what to do- It didn't sound right to me either, so I told her to wait till I got home.

When I returned from work and looked at the bottle, the pharmacy had erred (or the doctor- I never got a straight answer as to who called it in and whether it was transcribed wrong or dictated wrong). Not only was it adult-strength decongestant/acetaminophen, but it was also an adult dose. Somehow the dose was for an age measured in years, not months.

Suffice to say, you would not have wanted to be the person on the other side of the counter when I got to the pharmacy,

Fortunately we did not give her the medication that night, if we had, as directed, every 4-6 hours, I wonder to this day what would have happened? The decongestant would have been bad, but the amount of acetaminophen would have been toxic.
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Re: Rory's Medication

Postby Tibbierocks » 01 Mar 2014, 12:27

All this talk of paracetamol makes me twitchy as I have fibromyalgia (chronic pain/chronic fatigue in a nutshell) and I'm having a flare up of all symptoms at the moment and I try not to use painkillers and just stick to using a TENS machine, but I have been hitting the paracetamol over the last couple of weeks as I've had enough of the constant pain. Up until about 5 months ago, I rarely drank, but I have been drinking a bit lately - I mean Vodka on a saturday night. I try not to drink as I do have to use painkillers and other meds because of all my health issues, but reading all this, I really should just still tee-total because I fear for my liver!

As to Rory, well we don't know, do we? We can guess and infer etc, but really only the family know what Rory was given by doctors. It would appear it was all very wrong and the consequence is he's not here now and it's should be his birthday I believe tomorrow? Wouldn't it be nice if he was on stage tonight? I'll be having a Rory night tonight to celebrate his birthday.
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Re: Rory's Medication

Postby Annie Elliott » 02 Mar 2014, 13:29

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Re: Rory's Medication

Postby Tibbierocks » 02 Mar 2014, 17:37

I take st johns wort for the pain. I take it at such a low dose it doesn't have any anti depressant effect and normally that's fine, but over the last few months, I've been having a flare up of my fibro due to stress, so it has been a bit bananas at the moment and it's only been the last couple of weeks I've actually given in to the pain and taken some paracetamol. It's been at night as I've been having huge problems sleeping due to pain. Hopefully it'll settle down. It will settle, just when it's ready. I'm riding it out right now. Acupuncture is something I have considered in the past but the money involved... I live in pain and with pain and I'm used to it, just at the moment... getting a bit much at times. Nevermind. there's far worse things in life to have. I only have a couple of vodkas on a Saturday - and that's not even every week. I did last night for Rory as it is his birthday. :-D
Thank you for your advice. x
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