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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Neuralgia can be treated with drugs



 (The Spokesman-Review)
Peter Gott United Media

Dear Dr. Gott: I regularly suffer from sharp pains that affect the left side of my face. Could I have trigeminal neuralgia? Should I see a neurologist?

Dear Reader: The episodic, shooting pains that involve the trigeminal nerves in the face and head are believed due to a nerve malfunction, but the precise cause is unknown. This neuralgia can be treated with drugs such as Neurontin and others.

I believe you would be prudent to ask your family physician for a referral to a neurologist, who will examine and test you. In general, although trigeminal neuralgia is incurable, it is certainly treatable.

Dear Dr. Gott: I am 90 and suffer from painful arthritis of my neck, shoulders and hips. I could not tolerate Vioxx, Celebrex or Bextra because of stomach problems. What’s my next step?

Dear Reader: If you haven’t tried Tylenol yet, I advise you to do so. Should this be ineffective, switch to ibuprofen.

If your pain persists, your doctor will have to consider non-narcotic, prescription pain relievers such as Ultracet or Darvon.

The final step is the judicious use of narcotic analgesics such as Tylenol with codeine, Vicodin and others.

I advise you to work closely with your family physician, who may be willing to refer you for physical therapy, acupuncture, hypnosis and other, alternative methods of pain relief.

To give you related information, I am sending you a copy of my Health Report “Osteoarthritis.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Your comments for the reader who questioned the “medical ethics that prevent one doctor from assuming the care of another doctor’s hospitalized patient” suggest you under-appreciate your clout as a doctor.

I was hospitalized on an emergency basis shortly after I moved to a new community. I was very concerned about the quality of care I was receiving from the specialist who admitted me. He was the “luck of the draw” as the physician on call. Without a primary care physician of my own to make the recommendation for a “second opinion” it was virtually impossible for me to wrest my case from his control. The doctors I asked to take my case politely refused. I believe “physician courtesy” was the term used. Once I left the hospital, I collected my records from his office, fired him and went back to my former community for medical care. Your advice reflects a civil process that should work, but in my experience did not. Any more comment?

Dear Reader: I have no more comments except to say that no system is perfect, especially when it involves physicians!