DOC TALK WITH DR. GIRLING AND DR. PALOMERA: WHEN SHOULD A PATIENT STOP TAKING THEIR MEDICATION?

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BELOW DR. GIRLING AND DR. PALOMERA ANSWER:

WHEN SHOULD A PATIENT STOP TAKING THEIR MEDICATION?

Dr. Palomera: A question I get a lot, especially when sharing patients with you guys who are doing surgery is, "Hey, I've been treating my pain. I've had surgery, I've had a broken bone. They gave me pain medication. When should I stop taking my pain medication?"

Dr. Girling: Yeah. It's a great question. Folks will come in all the time saying, "Hey, somebody gave me this." I ask, "Oh, why are you taking it?" "I don't know, somebody gave me the medication." My rule of thumb is if I give you a pain meds, you never have to take them. I'm giving them to you because I don't want you to be suffering with severe pain or discomfort to where it keeps you from being able to sleep—my biggest reasons—but also from being able to do your exercises, therapy, things of that nature.

Dr. Palomera: Right. Sometimes we will use, in fact, most of the time, we will use those type inflammatories for pain. Obviously, inflammatories in general are easier on your system, while they have some side effects, they're usually not very prominent. You might take an anti-inflammatory a little bit longer, but definitely pain medication is something you would take as needed. A lot of people need it the first two or three days, but the majority of people don’t after that—maybe here and there—but that's it. I understand a lot of people coming out of an urgent care or an ER, even though they provide good paperwork and information about what you have and what they're giving you and why they're giving you what they’re giving you, are hurt that they get a little confused. Definitely, if we've seen you and we're part of that treatment, you can always call us for a quick clarification. A lot of patients get off medications fairly quickly and even the ones that are taking them regularly, the majority of my patients within two to three weeks aren't even taking those anymore.

Dr. Girling: And we're pretty explicit. If we really want you to take something on an interval, we're going to tell you that part. I give out a pretty healthy number of meds after surgery, but none of them are that strong and they're doing something different. Anti-inflammatories are going to help with pain and inflammation, and swelling. I give nerve pain meds, Gabapentin, because that'll help with some of that tingling, help with some of the shooting sharp stabbing pains. Narcotics, there's a lot of different types, so usually we use more of the mild narcotics nowadays and try to avoid anything heavy unless we absolutely have to. So again, all these things have different purposes. I try to get patients to understand at least the fundamentals and I'll even put what this is for on the pill bottle. If you're having a reaction to something for the love of God, please stop it. Don't like take it all weekend long. It's like “Doc, every time I take this pill, I'm having vomiting and I'm constipated and I'm covered in hives, but I kept taking it.” I'm like you don't get an award for that. I promise.

Dr. Palomera: Yes. Any problem happens, call us and we'll give you some direction.

Dr. Girling: Yeah, absolutely,

Dr. Palomera: Absolutely, we’ll even be able to provide an alternative that doesn't have those side effects.

Dr. Girling: Exactly. Exactly.

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DOC TALK WITH DR. GIRLING AND DR. PALOMERA: DOES SMASA TREAT BACK PAIN?

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A DAY IN THE LIFE OF AN ORTHOPEDIC SURGEON WITH DR. ROBERT GIRLING