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I am sorry I am changing the subject, but

my hepatologist told me specifically not to use Advil since it is hard on the

liver. Is this something others have heard as well?

Regards,

Chaim Boermeester, Israel

From: [mailto: ] On Behalf Of kxcp236v

Sent: Sunday, January 28, 2007

04:29

To:

Subject: Pain Relief

For the last week or so I have been dealing with

excruciating pain, all

over. Mostly lower lumbar, but also in my toes, my knees and hips. Its

next to impossible to sleep.

Is there anyone else dealing with this?. Anyone on Opiods other than

Vicoden for the pain like Morphine?. At this point none of the meds

that I have been taking are working. Aspirin, Advil.

The x-rays of my lower lumbar spine only state that I have mild

spondylosis. Questionable diagnosis.

Andi, PSC Crohns 2001 2002 Modesto

California

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Ibuprofen (Advil) is primarily processed through the kidneys, so is less likely

to affect the liver. Acetaminophen (Tylenol) is processed by the liver. Even

so, most hepatologists recommend acetaminophen - at recommended dosages only.

Arne

===========================================================

I am sorry I am changing the subject, but my hepatologist told me specifically

not to use Advil since it is hard on the liver. Is this something others have

heard as well?

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Sorry you're going through this, Andi. The only pain I had prior to back

surgery 10 years ago was the " normal " sciatic pain.

After surgery, however - yow! They gave me demerol after I woke up, then

morphine for a couple of days, then " the big " ibuprofen.

Sorry - can't help you much with this one.

Arne

===========================================================

For the last week or so I have been dealing with excruciating pain, all

over. Mostly lower lumbar, but also in my toes, my knees and hips. Its

next to impossible to sleep.

Is there anyone else dealing with this?. Anyone on Opiods other than

Vicoden for the pain like Morphine?. At this point none of the meds

that I have been taking are working. Aspirin, Advil.

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Hi Andi:

Got your call a few weeks ago and am sorry I missed it. I did respond to you by

email did you get it?

There is a terrible virus that is going around here, it seems to have the

symptoms you described. My daughter was in so much pain that she was checked

for kidney stones and cervical cancer. The xrays and sonogram showed same as

yours. I guess the quantifing factor was she was so tired which is very unlike

her. She also has UC or IBD but refuses to be checked for insurance reasons. I

am not tryilng to simplify your pain but give you maybe another avenue to look

at.

Are you still thinking of moving? I forgot if you told me or not.

Email me privately if you want.

dee

> For the last week or so I have been dealing with excruciating pain, all

> over. Mostly lower lumbar, but also in my toes, my knees and hips. Its

> next to impossible to sleep.

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Arne/Chaim,

Yes, Advil is processed in the kidneys, but like asprin, it makes you

more prone to bleeding. I think that the reason that heps guide you

away from advil is because if you've got really bad liver function,

your risk of portal hypertension and bleeding go up. Often, these

things aren't found right away, so they'd prefer to get you used to

taking meds that don't increase your risk of bleeding. So, while the

advil itself might not be hard on your liver, the docs think it is best

to stay away from it because of the other complications it can cause.

In contrast, Tylenol is a known quotient. If you take less than 1000 mg

in 24 hours, you're not going to do any lasting damage...Even after a

liver transplant, I've been allowed to take that much tylenol, but

absolutely no advil.

Hope this helps iron out some of the confusion here...

Deb in VA

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>

> Sorry you're going through this, Andi. The only pain I had prior to

back surgery 10 years ago was the " normal " sciatic pain.

>

> Sorry - can't help you much with this one.

>

>

> Arne

> ===========================================================

Hoping its just a virus as Dee mentioned..if not Iam going to be in a

wheelchair in another 5 years (wink)

Andi

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Andi,

They have me on ursidol high dose/revolving antibiotics and was given

a perscription for Darveset from the transplant team medical director

for persistant left side pain. Went through about 160 out of 180

pills. Had a great streak for about 6 weeks until probably

traveling/work related stress (more than likely self induced)it

started hurting again. I carried the same two pills in my pocket until

they started deteriorating. This was a personal record.

I can't recommend the Darvy's. I hate them. Hate being in a fog and it

amplifies an already emotionally charged situation. Talk about

depressing. My nurse from the transplant team tried to talk some sense

into me because I was trying to just gut it out and refused to take

them until it got really bad. She basically told me to stop being dumb

because they are to help you deal with the pain. That's why he gave

them to you. I can handle the dull ache, but when it get's worse I

just give in.

Add to that that rumors have spread and people have started talking. I

am surrounded by over 1000 customers/coworkers/family members for the

next week out of state. Been asked questions by five different people

and this just started Saturday. Miss my wife and kids terribly.

Right when I get home I get my 3rd ERCP where I will truly need them.

You could imagine the look on my face and the wife's when I picked

them up. This can't be right, they gave me too much!

It could be worse. I am truly blessed. Be optimistic in the face of

adversity. Rest, relax, live life to the fullest.

Have a great week!

in Minnesota

PSC 2006, Factor V 2002

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I was told last month by our pharmacist that Lonnie shouldn't be

taking anything acetominophen-based anymore. And I was in to see my

Nurse Practitioner at work last week and she said the same thing.

,

Is there a new study out that liver patients should be taking

ibuprofen-based products instead?

Kathy

wife of Lonnie

'87 UC/PSC

'00 full colon removal, J-pouch

'04 liver transplant

STILL waiting on SS for permanent disability

>

> I am sorry I am changing the subject, but my hepatologist told me

> specifically not to use Advil since it is hard on the liver. Is

this

> something others have heard as well?

>

> Regards,

>

> Chaim Boermeester, Israel

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Unfortunately both Ibuprofen and Acetaminophen products are both hard

on the liver and can do harm....sorry

Sandi

05 PSC

> >

> > I am sorry I am changing the subject, but my hepatologist told me

> > specifically not to use Advil since it is hard on the liver. Is

> this

> > something others have heard as well?

> >

> > Regards,

> >

> > Chaim Boermeester, Israel

>

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Is there someone who can give a definitive

answer whether ibuprofen is hard on the liver? The opinions are still divided.

Regards,

Chaim Boermeester, Israel

From: [mailto: ] On Behalf Of sandi williams

Sent: Monday, January 29, 2007

22:47

To:

Subject: Re: Pain

Relief

Unfortunately both Ibuprofen and Acetaminophen products are both hard

on the liver and can do harm....sorry

Sandi

05 PSC

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Sandi,

I googled with Ibuprofen and liver and

came up with a large amount of articles stating the risks involved with liver

disease and Ibuprofen. It seams that my hepatologist was right when he told me

to stay away from Advil.

Regards,

Chaim

Unfortunately both Ibuprofen and Acetaminophen products are both hard

on the liver and can do harm....sorry

Sandi

05 PSC

_._,___

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Chaim,

I understand the confusion about it. The only reason I learned about

both is due to the fact that after my diagnosis my aunt informed her

gastro, and he took her off her ibuprofen regimen for arthritis cause

it was elevating her liver enzymes.

Glad to help

Sandi

>

> Sandi,

>

>

>

> I googled with Ibuprofen and liver and came up with a large amount

of

> articles stating the risks involved with liver disease and

Ibuprofen. It

> seams that my hepatologist was right when he told me to stay away

from

> Advil.

>

>

>

> Regards,

>

>

>

> Chaim

>

>

>

>

>

>

>

>

>

> Unfortunately both Ibuprofen and Acetaminophen products are both

hard

> on the liver and can do harm....sorry

>

> Sandi

> 05 PSC

> _._,___

>

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Chaim,

I understand the confusion about it. The only reason I learned about

both is due to the fact that after my diagnosis my aunt informed her

gastro, and he took her off her ibuprofen regimen for arthritis cause

it was elevating her liver enzymes.

Glad to help

Sandi

>

> Sandi,

>

>

>

> I googled with Ibuprofen and liver and came up with a large amount

of

> articles stating the risks involved with liver disease and

Ibuprofen. It

> seams that my hepatologist was right when he told me to stay away

from

> Advil.

>

>

>

> Regards,

>

>

>

> Chaim

>

>

>

>

>

>

>

>

>

> Unfortunately both Ibuprofen and Acetaminophen products are both

hard

> on the liver and can do harm....sorry

>

> Sandi

> 05 PSC

> _._,___

>

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Chaim,

I understand the confusion about it. The only reason I learned about

both is due to the fact that after my diagnosis my aunt informed her

gastro, and he took her off her ibuprofen regimen for arthritis cause

it was elevating her liver enzymes.

Glad to help

Sandi

>

> Sandi,

>

>

>

> I googled with Ibuprofen and liver and came up with a large amount

of

> articles stating the risks involved with liver disease and

Ibuprofen. It

> seams that my hepatologist was right when he told me to stay away

from

> Advil.

>

>

>

> Regards,

>

>

>

> Chaim

>

>

>

>

>

>

>

>

>

> Unfortunately both Ibuprofen and Acetaminophen products are both

hard

> on the liver and can do harm....sorry

>

> Sandi

> 05 PSC

> _._,___

>

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All drugs have risks (including water, as was recently shown). I'd include homeopathic remedies also.All drugs have benefits, at least for appropriate subjects. Chemotherapy and radiation therapy are extremely hard on the body, and may kill you, but the alternative is usually much worse. Immunosuppressants work very well, but may cause significant side effects. For a transplantee, the alternative may be to lose the graft.

The goal is to balance the benefit with acceptable risk. That's what physicians (and pharmacists) are trained to do. Our job is to make sure they understand what conditions we have and what medications we are taking. Ultimately, we choose what we put in our bodies, but it needs to be an informed decision.

I am fortunate that I seldom need pain relief. I take ibuprofen on those rare occasions because (for me), I don't need to take very much for very long to get relief. Acetamin0phen does not seem to work very well for me, so I almost never take it. For the stage of my PSC, it probably doesn't matter much (asymptomatic) - my hepatologist agrees. He also cautions me not to take more than the recommended over-the-counter dosage (duh). If I did have to take an NSAID more frequently, he would prefer I take acetaminophen. But, as I only have one kidney, and ibuprofen is processed by the kidney(s), it probably makes more sense to "save" the one I've got.

Risks, and benefits - have to find the balance for you. There is no "one size fits all" answer.

Arne

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All drugs have risks (including water, as was recently shown). I'd include homeopathic remedies also.All drugs have benefits, at least for appropriate subjects. Chemotherapy and radiation therapy are extremely hard on the body, and may kill you, but the alternative is usually much worse. Immunosuppressants work very well, but may cause significant side effects. For a transplantee, the alternative may be to lose the graft.

The goal is to balance the benefit with acceptable risk. That's what physicians (and pharmacists) are trained to do. Our job is to make sure they understand what conditions we have and what medications we are taking. Ultimately, we choose what we put in our bodies, but it needs to be an informed decision.

I am fortunate that I seldom need pain relief. I take ibuprofen on those rare occasions because (for me), I don't need to take very much for very long to get relief. Acetamin0phen does not seem to work very well for me, so I almost never take it. For the stage of my PSC, it probably doesn't matter much (asymptomatic) - my hepatologist agrees. He also cautions me not to take more than the recommended over-the-counter dosage (duh). If I did have to take an NSAID more frequently, he would prefer I take acetaminophen. But, as I only have one kidney, and ibuprofen is processed by the kidney(s), it probably makes more sense to "save" the one I've got.

Risks, and benefits - have to find the balance for you. There is no "one size fits all" answer.

Arne

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All drugs have risks (including water, as was recently shown). I'd include homeopathic remedies also.All drugs have benefits, at least for appropriate subjects. Chemotherapy and radiation therapy are extremely hard on the body, and may kill you, but the alternative is usually much worse. Immunosuppressants work very well, but may cause significant side effects. For a transplantee, the alternative may be to lose the graft.

The goal is to balance the benefit with acceptable risk. That's what physicians (and pharmacists) are trained to do. Our job is to make sure they understand what conditions we have and what medications we are taking. Ultimately, we choose what we put in our bodies, but it needs to be an informed decision.

I am fortunate that I seldom need pain relief. I take ibuprofen on those rare occasions because (for me), I don't need to take very much for very long to get relief. Acetamin0phen does not seem to work very well for me, so I almost never take it. For the stage of my PSC, it probably doesn't matter much (asymptomatic) - my hepatologist agrees. He also cautions me not to take more than the recommended over-the-counter dosage (duh). If I did have to take an NSAID more frequently, he would prefer I take acetaminophen. But, as I only have one kidney, and ibuprofen is processed by the kidney(s), it probably makes more sense to "save" the one I've got.

Risks, and benefits - have to find the balance for you. There is no "one size fits all" answer.

Arne

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