Saturday, October 31, 2009
Friday, October 30, 2009
Degenarative disc disease
What is Degenerative Disc Disease?
Degenerative disc disease (DDD) is typically associated with aging. As you age, your discs, like other joints in the body, can degenerate (break down) and become problematic: that's a natural part of growing older as your body deals with years of strain, overuse, and maybe even misuse. However, DDD can occur in people as young as 20, so sadly, youth doesn't always protect you from this disc-related condition. In fact, some patients may inherit a prematurely aging spine.
Watch a video on how degenerative disc disease affects your spine.
Degenerative disc disease involves the intervertebral discs. Those are the pillow-like cushions between your vertebrae in your spine. They help your back carry weight and allow complex motions of the spine while maintaining stability. As you age, the discs can lose flexibility, elasticity, and shock absorbing characteristics. They also become thinner as they dehydrate. When all that happens, the discs change from a supple state that allows fluid movement to a stiff and rigid state that restricts your movement and causes pain.
If you have chronic back or neck pain, you may have degenerative disc disease. It commonly occurs in your low back (lumbar spine) or neck (cervical spine). Developing degenerative disc disease is a gradual process. As you can see in the illustration, there are even many stages and states your discs can go through as part of DDD. They can bulge, herniate, or thin. Because of disc changes, your vertebrae can be affected-you can see this in the illustration, too. For example, bone spurs (osteophytes) can form as your spine tries to adjust to the intervertebral disc changes.

ARCOXIA
1. WHAT ARCOXIA IS AND WHAT IT IS USED FOR
- ARCOXIA is one of a group of medicines called selective COX-2 inhibitors. These belong to a family of medicines called non-steroidal anti-inflammatory drugs (NSAIDs).
- ARCOXIA helps to reduce the pain and swelling (inflammation) in the joints and muscles of people with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and gout.
What is osteoarthritis?
Osteoarthritis is a disease of the joints. It results from the gradual breakdown of cartilage that cushions the ends of the bones. This causes swelling (inflammation), pain, tenderness, stiffness and disability.
What is rheumatoid arthritis?
Rheumatoid arthritis is a long term inflammatory disease of the joints. It causes pain, stiffness, swelling, and increasing loss of movement in the joints it affects. It may also cause inflammation in other areas of the body.
What is gout?
Gout is a disease of sudden, recurring attacks of very painful inflammation and redness in the joints. It is caused by deposits of mineral crystals in the joint.
What is ankylosing spondylitis?
Ankylosing spondylitis is an inflammatory disease of the spine and large joints.
2. BEFORE YOU TAKE ARCOXIA
Do not take ARCOXIA:
- if you are allergic (hypersensitive) to etoricoxib or any of the other ingredients of ARCOXIA (see Further information, section 6)
- if you are allergic to non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and COX-2 inhibitors (see Possible Side Effects, section 4)
- if you have a current stomach ulcer or bleeding in your stomach or intestines
- if you have serious liver disease
- if you have serious kidney disease
- if you are or could be pregnant or are breast-feeding (see ‘Pregnancy and breast feeding’)
- if you are under 16 years of age
- if you have inflammatory bowel disease, such as Crohn’s Disease, Ulcerative Colitis, or Colitis
- if your doctor has diagnosed heart problems including heart failure (moderate or severe types), angina (chest pain) or if you have had a heart attack, bypass surgery, peripheral arterial disease (poor circulation in legs or feet due to narrow or blocked arteries), or any kind of stroke (including mini-stroke, transient ischaemic attack or TIA). Etoricoxib may slightly increase your risk of heart attack and stroke and this is why it should not be used in those who have already had heart problems or stroke
- if you have high blood pressure that has not been controlled by treatment (check with your doctor or nurse if you are not sure whether your blood pressure is adequately controlled)
If you think any of these are relevant to you, do not take the tablets until you have consulted your doctor.
Take special care with ARCOXIA
ARCOXIA may not be suitable for you, or you may need to be monitored regularly while taking it if any of the following apply to you:
- You have a history of stomach bleeding or ulcers.
- You are dehydrated, for example by a prolonged bout of vomiting or diarrhoea.
- You have swelling due to fluid retention.
- You have a history of heart failure, heart attack or any other form of heart disease.
- You have a history of stroke or mini stroke.
- You have a history of high blood pressure. ARCOXIA can increase blood pressure in some people, especially in high doses, and your doctor will want to check your blood pressure from time to time.
- You have any history of liver or kidney disease.
- You are being treated for an infection. ARCOXIA can mask or hide a fever, which is a sign of infection.
- You are a woman trying to become pregnant.
- You are elderly (i.e., over 65 years of age).
- You have diabetes, high cholesterol, or are a smoker. These can increase your risk of heart disease.
If you are not sure if any of the above apply to you, talk to your doctor before taking ARCOXIA to see if this medicine is suitable for you.
ARCOXIA works equally well in older and younger adult patients. If you are elderly (i.e., over 65 years of age), your doctor will want to appropriately keep a check on you. No dosage adjustment is necessary for elderly patients.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
In particular if you are taking any of the following medicines, your doctor may want to monitor you to check that your medicines are working properly, once you start taking ARCOXIA:
- medicines that thin your blood (anticoagulants), such as warfarin
- rifampicin (an antibiotic)
- methotrexate (a drug used for suppressing the immune system, and often used in rheumatoid arthritis)
- medicines used to help control high blood pressure and heart failure called ACE inhibitors and angiotensin receptor blockers, examples include enalapril and ramipril, and losartan and valsartan
- lithium (a medicine used to treat some types of depression)
- diuretics (water tablets)
- ciclosporin or tacrolimus (drugs used for suppressing the immune system)
- digoxin (a medicine for heart failure and irregular heart rhythm)
- minoxidil (a drug used to treat high blood pressure)
- salbutamol tablets or oral solution (a medicine for asthma)
- birth control pills
- hormone replacement therapy
- aspirin, the risk of stomach ulcers is greater if you take ARCOXIA with aspirin.
- ARCOXIA can be taken with low-dose aspirin. If you are currently taking low-dose aspirin to prevent heart attacks or stroke, you should not stop taking aspirin until you talk to your doctor
- do not take high dose aspirin or other anti-inflammatory medicines while taking ARCOXIA
Pregnancy and breast-feeding
ARCOXIA tablets must not be taken during pregnancy. If you are pregnant or think you could be pregnant, or if you are planning to become pregnant, do not take the tablets. If you become pregnant, stop taking the tablets and consult your doctor. Consult your doctor if you are unsure or need more advice.
It is not known if ARCOXIA is excreted in human milk. If you are breast-feeding, or planning to breast-feed, consult your doctor before taking ARCOXIA. If you are using ARCOXIA, you must not breast-feed.
3. HOW TO TAKE ARCOXIA
Always take ARCOXIA exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
ARCOXIA Tablets should not be taken by children or adolescents under 16 years of age.
Take ARCOXIA Tablets by mouth once a day. ARCOXIA can be taken with or without food.
Do not take more than the recommended dose for your condition. Your doctor will want to discuss your treatment from time to time. It is important that you use the lowest dose that controls your pain and you should not take ARCOXIA for longer than necessary. This is because the risk of heart attacks and strokes might increase after prolonged treatment, especially with high doses.
Osteoarthritis
The recommended dose is 30 mg once a day, increase to a maximum of 60 mg once a day if needed.
Rheumatoid arthritis
The recommended dose is 90 mg once a day.
Gout
The recommended dose is 120 mg once a day which should only be used for the acute painful period, limited to a maximum of 8 days treatment.
Ankylosing spondylitis
The recommended dose is 90 mg once a day.
People with liver problems
- If you have mild liver disease, you should not take more than 60 mg a day.
- If you have moderate liver disease, you should not take more than 60 mg every other day or 30 mg a day.
If you take more ARCOXIA than you should
You should never take more tablets than the doctor recommends. If you do take too many ARCOXIA tablets, you should seek medical attention immediately.
If you forget to take ARCOXIA
It is important to take ARCOXIA as your doctor has prescribed. If you miss a dose, just resume your usual schedule the following day. Do not take a double dose to make up for the forgotten tablet.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4. POSSIBLE SIDE EFFECTS
Like all medicines, ARCOXIA can cause side effects, although not everybody gets them.
If you develop any of these signs you should stop ARCOXIA and talk to your doctor immediately:
- shortness of breath, chest pains, or ankle swelling appear or if they get worse
- yellowing of the skin and eyes (jaundice) – these are signs of liver problems
- severe or continual stomach pain or your stools become black
- an allergic reaction- which can include skin problems such as ulcers or blistering, or swelling of the face, lips, tongue, or throat which may cause difficulty in breathing
The following side effects can occur during treatment with ARCOXIA:
Common (occurring in greater than 1 out of 100 and less than 1 out of 10 people)
Weakness and fatigue, dizziness, headache, flu-like illness, diarrhoea, wind, nausea, indigestion (dyspepsia), stomach pain or discomfort, heartburn, changes in blood tests related to your liver, swelling of the legs and/or feet due to fluid retention (oedema), increased blood pressure, palpitations, bruising.
Uncommon (occurring in greater than 1 out of 1000 and less than 1 out of 100 people)
Stomach or bowel bloating, chest pain, heart failure, feeling of tightness, pressure or heaviness in the chest (angina pectoris), heart attack, stroke, mini-stroke (transient ischaemic attack), abnormal heart rhythm (atrial fibrillation), upper respiratory infection, high levels of potassium in your blood, changes in blood or urine tests relating to your kidney, changes in your bowel habits including constipation, dry mouth, mouth ulcers, taste alteration, gastroenteritis, gastritis, stomach ulcer, being sick (vomiting), irritable bowel syndrome, inflammation of the esophagus, blurred vision, eye irritation and redness, nose bleed, ringing in the ears, vertigo, appetite increases or decreases, weight gain, muscle cramp/spasm, muscle pain/stiffness, inability to sleep, sleepiness, numbness or tingling, anxiety, depression, decreases in mental sharpness, breathlessness, cough, swelling of the face, flushing, skin rash or itchy skin, urinary tract infection, platelets decreased, decreased number of red blood cells, decreased number of white blood cells.
Rare (occurring in greater than 1 out of 10,000 and less than 1 out of 1000 people)
Low blood levels of sodium, redness of the skin.
Very Rare (occurring in less than 1 out of 10,000 people)
Allergic reactions (which may be serious enough to require immediate medical attention) including hives, swelling of the face, lips, tongue, and/or throat which may cause difficulty in breathing or swallowing, bronchospasm (wheezing or shortness of breath), severe skin reactions, inflammation of the stomach lining or stomach ulcers that can become serious and may lead to bleeding, liver problems, serious kidney problems, severe increase in blood pressure, confusion, seeing, feeling or hearing things that are not there (hallucinations).
Not known (frequency cannot be estimated from the available data)
Yellowing of the skin and eyes (jaundice), inflammation of the pancreas, fast heart rate.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.
5. HOW TO STORE ARCOXIA
Keep out of the reach and sight of children.
Do not use ARCOXIA after the expiry date which is stated on the pack. The expiry date refers to the last day of the month.
Bottles: Keep the container tightly closed in order to protect from moisture.
Blisters: Store in the original package in order to protect from moisture.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
6. FURTHER INFORMATION
What ARCOXIA contains
- The active substance is etoricoxib. Each film coated tablet contains 30, 60, 90 or 120 mg of etoricoxib.
- The other ingredients are:
Core: calcium hydrogen phosphate (anhydrous), croscarmellose sodium, magnesium stearate, microcrystalline cellulose.
Tablet coating: carnauba wax, lactose monohydrate, hypromellose, titanium dioxide (E171), triacetin.
The 30-, 60- and 120-mg tablets also contain yellow ferric oxide (E172, colouring agent) and indigo carmine lake (E132, colouring agent).
What ARCOXIA looks like and contents of the pack
ARCOXIA Tablets are available in four strengths:
30 mg blue-green, apple-shaped, biconvex film coated tablets marked ‘ACX 30’ on one side and ‘101’ on the other.
60 mg dark green, apple-shaped, biconvex film coated tablets marked ‘ARCOXIA 60’ on one side and ‘200’ on the other.
90 mg white, apple-shaped, biconvex film coated tablets marked ‘ARCOXIA 90’ on one side and ‘202’ on the other.
120 mg pale-green, apple-shaped, biconvex film coated tablets marked ‘ARCOXIA 120’ on one side and ‘204’ on the other.
Pack sizes:
30 mg:
Pack sizes of 2, 7, 14, 20, 28 tablets or multi-packs containing 98 (2 packs of 49) tablets in blisters.
60, 90, 120 mg:
Pack sizes of 2, 5, 7, 10, 14, 20, 28, 30, 50, 84, 100 tablets or multi-packs containing 98 (2 packs of 49) tablets in blisters; or 30 and 90 tablets in bottles.
Not all pack sizes may be marketed.
Wednesday, October 28, 2009
Sleeping beauty
Subhanallah, Alhamdulillah
Alhamdulillah, hari ni kita masih mampu bangun, masih mampu melihat masih mampu tersenyum masih mampu membaca dan dikurniakan 1001 nikmat yang tidak ada gantinya, kalau nak disenaraikan tidak cukup nak di postkan di mana2 blog =) sujud syukur, maksimumkan ibadah semampu kita tanda syukur kita atas kurniaan rahmat dari Rabb Yang Maha Agung, Yang tidak pernah membiarkan kita walau satu saat! Subhanallah
Semalam, saya tidak dapat bangun seharian. Saya bangun pagi jam 5.30 dan selepas solat subuh, saya terus membaringkan diri di katil. Pening..sangat2 pening, saya tidak mampu untuk bangun. tekak terasa loya..
"Aduh, ni mesti kesan ubat semalam" saya membuat sedikit assumption berdasarkan pengalaman2 sebelum ini. Saya sangat susah untuk menyesuaikan diri dengan ubat tahan sakit yang lain. Saya biasanya akan mendapat side effect yang kadangkala hanya sedikit orang sahaja yang mengalaminya. Jam 11 pagi saya bangun untuk mandi, sampai separuh jalan, saya tak mampu bertahan. Balik ke katil dan terus memejamkan mata. Terasa sungguh tak larat! Dan akhirnya saya kembali tertidur dan bangun semula jam 2.30 petang.
Terasa lega sedikit, namun tak mampu bertahan, pening yang saya cuba untuk lawan kembali mengganggu jam 7 malam. Kali ini saya tak mampu untuk duduk. Selepas isya saya baring di katil dan tidur semula sampai pagi.
Hari tidur =), saya kemudian pantas menaip mesej kepada Dr Nizar. Alhamdulillah. Satu lagi nikmat dari Allah. Dr kemudian memberi persetujuan untuk saya berhenti mengambil ubat itu. sangat susah bagi Dr untuk memadankan ubat bagi saya.
Tuesday, October 27, 2009
Oxicodine 10mg
Oxycodine
Oxycodine is a common misspelling of oxycodone.
What is oxycodone (oxycodine)?
Oxycodone (oxycodine) is a narcotic (opiate-type) pain reliever used to treat moderate to severe chronic pain, such as cancer pain. It acts on certain area in the brain to provide pain relief. Oxycodone (oxycodine) should not be used as needed for mild pain which will go away in a few days or for prevention of pain after surgery. If you have not been on oxycodone (oxycodine) before surgery, you should not use it for acute pain in the first 12 to 24 hours after surgery.
Oxycodone (oxycodine) may also be used for other purposes not listed in this medication guide.
Before taking oxycodone (oxycodine), tell your doctor if you are allergic to it, or to other similar narcotic pain relievers such as codeine or hydrocodone.
Oxycodone (oxycodine) side effects include nausea, vomiting, constipation, mild itching, drowsiness, dry mouth, lightheadedness, loss of appetite and weaknesssumber: http://www.drugs.com/misspellings/oxycodine.html
Monday, October 26, 2009
Tiba2 terasa sangat bimbang
Astaghfirullah, Astaghfirullah, Astaghfirullah..
Akhir2 ni, rasa cepat je nak menulis di blog, mungkin banyak perkara yang terjadi
Saya bergantung dengan ubat, bukan ubat biasa tapi ubat tahan sakit..yang umumnya diketahui tidak baik untuk satu tempoh yang panjang. Saya sudah mengambil ubat tahan sakit untuk satu tempoh yang konsisten.
"Jangan kawan sangat dengan ubat tu, dia jahat jugak." pesan Dr Nizar apabila saya memberitahu mengambil arcoxia 120mg setiap hari untuk menahan sakit. Cadangan dr untuk cuba untuk kurangkan dos ubat tahan sakit yang satu itu.
arcoxia 120mgSaya tidak menulis untuk menarik simpati. Bukan juga untuk mengadu. Saya cuma terfikir, adakah satu cara untuk saya mengurangkan ubat tahan sakit yang akhirnya akan mendatangkan mudarat pada saya? Dalam masa yang sama saya masih mampu melakukan kerja2 seharian, minimum menguruskan diri saya?
Saya mohon petunjuk dari Allah, saya mohon agar diletakkan pergantungan sepenuhnya padaNya..hati saya tiba2 terasa bimbang, memikirkan side effect ubat2 tahan sakit yang sama ambil..
Perjalanan kali ini

Pagi ni agak letih, mungkin kerana perjalanan ke Kelantan semalam. Sampai rumah semalam lebih kurang jam 10 malam. 25 oktober, tarikh yang ditetapkan untuk berjumpa dr, dah pun berlalu, entah kenapa pagi sebelum berjumpa doktor semalam hati tidak seronok, mungkin menguji pergantungan dan keyakinan pada Yang Memegang hati2 manusia

"Kaki saya selalu rasa kebas, macam kurang function berbanding kaki kanan bila saya buat aktivit seharian" saya cuba menerangkan kepada dr. Memang itu simptomnya kepada masalah disc. Namun masih mampu dikawal. Saya cuma tidak mampu menahan sakit akibat dari duduk lebih dari sejam di kerusi.
"manageable tak?" soal Dr, saya berfikir sejenak..jika dibandingkan dengan satu ketika dulu. Kemudian saya memberi jawapan ringkas "ya".
"Dr, saya tak boleh tahan duduk lama. Macam sakit sumwhere dekat facet joint" Facet joint, satu lagi masalah yang saya hadapi menyebabkan saya kurang keupayaan untuk duduk statik dalam tempoh lebih dari sejam. Hasil pembacaan saya, saya rasa simptomnya begitu.
"ada muscle problem kat belakang ni, facet tu kita dah inject hari tu" ini penemuan terbaru untuk pemeriksaan semalam. Tapi muscle pain tu sakit. "awak jangan duduk lama sangat, lepas setengah jam berhenti, rehat kemudian baru sambung semula," komen seorang lagi dr
3 small injection diberikan di bahagian belakang. Injection terakhir sangat2 sakit. Saya tidak mampu lagi tersenyum. Mata saya pejamkan rapat, tangan saya genggam sekuatnya bantal di kepala. Jarum suntikan tepat kena pada tempat yang sakit. Biasanya saya akan senyum walaupun saya sakit ketika pemeriksaan, psikologi untuk diri sendiri mungkin. Dan adakalanya menyukarkan dr! "hang ni sakit pun senyum" kata dr.
Agak sejam berada dalam bilik dr, semuanya berakhir untuk hari ini, 3 jenis ubat dibekalkan. Berserta nasihat2 penjagaan kesihatan diri. 5 tube darah diambil untuk melihat kebarangkalian penyakit2 lain. "datang dengan masalah selori" kata2 dr menyebabkan saya tersenyum sendiri memikirkannya.
Saya cuma berharap dan berdoa agar dikurniakan yang terbaik dari sisiNya, jika dengan kesakitan ini, saya lebih akrab denganNya saya mohon doa agar dikuatkan menghadapi semua ini namun jika kesakitan ini menjauhkan saya dariNya, saya mohon dijauhkan..
