Patient: I had a cough caused by a cold in February 2008, and the cough improved with injections and medication. In March, I had a cough induced by eating oranges, congestion in the pharynx, constant swelling and pain on both sides of the mouth, swelling in the teeth, discomfort in the upper jaw, discomfort in the mouth that wanders, constant itching and pain in the pharynx, and sometimes a dry throat. I had an electronic rhinolaryngoscopy and MRI of the head at the First Affiliated Hospital of Southern University. From April ’08 to January ’10, I visited many large hospitals (ENT), Western doctors and Chinese doctors. In July 2008, the Jiangxi Provincial Dental Hospital saw the oral cavity without examination, and the doctor did not prescribe any medicine, so he told me to pay attention to oral hygiene. Hopeless in 2010 gave up the treatment. (June 08 in my county hospital did a microwave) now my mouth left upper jaw the same part of a strange feeling, both sides of the mouth and continuous pain and swelling, constant pain in the pharynx, but eat something is better, fall asleep also do not know the pain (April 08 – August is very difficult to sleep). Oh, and in November 2008, I took 20 days of medication at the pain department of Wuhan Union Medical College Hospital. Director Lu: Hello! The director of your stomatology department, Wen Weimin, suggested that I consult the pain department. Seeing you respond so patiently and meticulously to patients’ questions online, you must be an enthusiastic one who gives hope to patients! Director Lu: I suspect that this is not chronic pharyngitis. Chronic pharyngitis does not have constant pain, nor does it have oral pain. Chronic pharyngitis is recurrent. I do not know where to find medical treatment for this torment of nearly four years of persistent oral pain, pharyngeal pain is what disease? How should I treat it? Thanks! I look forward to your reply. I wish you: good health and peace for life!
Lu Guijun: Hello. The symptoms you described feel like “complex regional pain syndrome”, if convenient, please reply to the following content has been to not confirm the diagnosis.
I would like to know more detailed information about the pain attacks, such as 1) the trigger of the first attack, 2) the factors related to the aggravation and relief of each attack, 3) whether the pain attacks are accompanied by other uncomfortable symptoms, 4) whether there are other underlying diseases in the past, 5) the consultation and treatment after the current disease, 6) whether there is a regularity of the pain attacks, 7) whether you think the appearance of this unpleasant symptom is 7. Do you think the appearance of this unpleasant symptom is related to some of your life habits? …Continued attention
Patient: Director Lu: Hello! Thank you for your busy reply. 1): In 2008, I had a cold that had not been cured because I ate some sugar oranges that induced congestion in the throat and mouth. 2): Since March 2008, I have had a burning sensation in the left upper jaw of my mouth with a swelling of the tooth bed, and it wanders. Pain in the throat, burning, dry throat, no cough and no sputum. (I feel better when I eat.) I can’t sleep because of the pain. Now I have a constant pain in the throat, a strange sensation in the same area of the left upper jaw of the mouth, and a constant swelling on both sides. I don’t have any factors related to the aggravation and remission of each attack, because I have a constant pain. (3): There is no other discomfort except for the symptoms of difficulty described above. 4): I used to get a cold twice a year in spring and winter, and in 06 and 07 I had a cold and cough for a longer period of time. 07 April cold caused a very difficult throat, and the symptoms of a difficult throat were similar to those of 08 March, but the mouth was not difficult. (5): Since March 08, treatment, injections and medication countless, in the county hospital, Jiangxi University, a hospital in Jiangxi Province, the Department of Otolaryngology, Provincial Hospital, the Department of Otolaryngology, Jiu Si Hospital, Department of Otolaryngology, Wuhan Union Hospital, the Department of Otolaryngology said chronic pharyngitis injection, take Western medicine, Chinese medicine, acupuncture countless are unable to eliminate pain, oral hospital in July 08, see the non-prescription of drugs. 09 November, a hospital in Nanda I don’t know where to look in 10 years and gave up the treatment. 6): The pain persists, except for eating and falling asleep. I don’t know what this symptom has to do with my life habits, I’m an acute person, things at home have to be put away neatly, the house must be clean, otherwise I get upset. Director Lu, thank you! I’m sorry for the long-windedness. I look forward to your reply!
Patient: Director Lu: Hello! If I have complex regional pain syndrome, how do I need to be treated? How long will it take to treat? Will the pain go away? Thank you!
Lu Guijun.
If this is really the diagnosis, the course of treatment is rather long. I hope you can come to Beijing for an interview for prudence.
Patient: Director Lu; thank you for your quick reply. I would also like to go to Beijing, but now I have no one to accompany me, and I am afraid to go so far away alone. Can I see you at the hospital in Nanchang, Jiangxi? How long do I have to stay in Beijing to see you? Do I need to be hospitalized? The ENT doctor suggested to take a CT of the maxilla, CT of the stoma and 3D reconstruction to see if the stoma is too long. Director Lu, you can only reply to me once on the Internet, what should I do if I want to consult you again? How can I get in touch with you again? What a precious opportunity! (I’m a slow typist). Thank you so much! I wish you a good life!
Lu Guijun: I have a night clinic every Wednesday night, the stem protrusion is easy to diagnose through imaging, you can first as a pre-screening except, if it is which disease I mentioned, it is possible to treat, but the medication time is long. I wish you a speedy recovery!
Patient: Director Lu: Thank you very much for your patient and detailed reply. I’m going to Nanchang in a few days to have a CT scan, and I want to go to Beijing after the New Year to see you because I don’t have anyone with me. How long do you think I should stay in Beijing? (Because of family matters to be scheduled) Thank you very much!
Lu Guijun: General treatment takes about 10 days
Patient: Director Lu: Hello! I went to the First Affiliated Hospital of Nanchang University yesterday, and the director of the ENT department said I didn’t need to have a CT of the maxilla and the stoma, and she said that if something had grown in the maxilla, it would have grown out in the past four years, and if the stoma was too long, it would hurt to turn my neck, but I don’t have pain from turning my neck. I went to the pain department and the doctor diagnosed it as neuralgia. I was prescribed: 1) Gabapentin capsules 0.1GM*50 capsules*3 boxes. 3 capsules, 3 times|day. 2) Mecobalamin tablets 0.5MG*24 tablets*3 boxes. 2 tablets, 3 times|day. 3) Celecoxib capsules (Celebrex) 200GM*6 capsules*2 boxes, 1 capsule, 1 time|day. I will come back for follow-up after I finish taking it. Director Lu, I’ve had a painful, tight circle on the top of my head this week recently. I bought Tianma Honeysuckle tablets at the pharmacy, can I take them together with the above? Will these medicines have those side effects? I look forward to your reply! Thank you! I wish you all the best!
Lu Guijun.
Unfortunately, I have not tried the medication you mentioned, so it is difficult to reply to you.
Patient: Director Lu: Good New Year! Good luck in the Year of the Dragon! All the best! Last year, I took the medicine prescribed by the pain department in Nanchang for 13 days, but it didn’t work, so I went to the doctor’s office on December 21 for a follow-up visit (the doctor told me to take the medicine and then to return). I told the doctor that the pain was still the same after taking the medication, and he told me to go to the counseling department and then see him again and prescribe medication. The doctor in counseling diagnosed: anxiety state. Prescribed medication: Duloxetine Hydrochloride Enteric Capsules 60MG*14 capsules/combination*2 combinations. Dosage: 1 capsule orally once every morning. The doctor convinced to come back for a follow-up. Pain department – physical examination: chronic congestion in the oropharynx, left palate as a painful area. Diagnosis: neuralgia. Medication: mecobalamin tablets 0.5MG8*24 tablets*3 in 2 tablets 3 times/day. (I feel that the pain doctor is out of options.) After I went home and read the instructions of duloxetine hydrochloride, I was afraid to eat it, and I didn’t eat it, and I still had the same pain after taking the mecobalamin tablets. I didn’t go to see it again. Director Lu: I now have constant pain in the same part of the palate of the mouth, affecting the entire mouth on both sides uncomfortable and painful. The pharynx also hurts. Eating will be more comfortable. What do you think I should do? I look forward to your reply! Thank you!
Lu Guijun: Duloxetine hydrochloride is still a good medicine, the doctor who diagnosed you suggested you to use it, it is still reasonable, you can confirm with him again and use it, wish to recover soon.
Patient: Director Lu: Thank you for your reply! Duloxetine hydrochloride is a medicine for depression, will it work for my constant pain? You said that I can be cured of complex regional syndrome, that is, it takes longer to take the medication. I feel hopeful and I want to go to Beijing next month to see you. How long do I have to take the medication to get rid of the pain that has been tormenting me for years? Will it be possible to get pregnant after I am cured? (I haven’t taken any medicine since January this year.) I look forward to your detailed reply! Thank you very much!
Lu Guijun: Welcome to the clinic!
Patient: Director Lu: Hello! Duloxetine hydrochloride is a medication for depression, is it effective for my constant pain? You said I can be cured of complex regional pain syndrome, but it will take a little longer to take the medication, how long do I have to take it before the pain goes away? The constant pain that I have been suffering from for more than four years has caused a lot of pain in my life, and it is like a stone weighing down on my heart. Director Lu, can I get pregnant after I am cured? I look forward to your reply! I wish you all the happiness in the world! All the best!
Lu Guijun.
1. Duloxetine hydrochloride is a commonly used drug for the treatment of chronic pain.
2, the disease is dynamic development and change of treatment time and effect depends on many factors, the exact efficacy and cure is not good blindly asserted.
3, the prerequisite for pregnancy is to take care of the body, and after these current problems are solved, eugenics experts should still be consulted.
Patient: Question: persistent sore throat, oral pain suffered from the disease. Director Lu: Hello! I am Xiao Lei who saw you on March 14, do you remember? Thank you for your patience in listening to me and explaining to me in detail. You are a good doctor, a good person, and I wish you a lifetime of peace! I wish you a happy and prosperous life! I took the medicine for two days and felt dizzy, my limbs were weak and I always wanted to sleep. You said I have somatization form disorder, what is the difference between it and complex regional pain syndrome?
Lu Guijun: This kind of discomfort after taking medication will gradually reduce from the fourth day. The two diseases you asked about “somatization form disorder and complex regional pain syndrome” are somewhat intertwined, and the treatment methods are similar.
Patient: Question: Persistent oral pain and sore throat. Director Lu: Hello! Are there any contraindications for me to take these medications? What are some things I can’t eat? I want to see you in the ward after 12 days of medication, is it okay? Thank you!
Lu Guijun: Just eat a light diet, it is best to go to the clinic to find me, one of the knives to find me is not easy to find, and even if you find in the ward can not prescribe for you.
Patient: Director Lu: Hello! If I go to you on the 21st, I will only take 7 days of medicine to see the effect, and on the 28th, I will go to you on the 28th, and I will be two days short of the medicine, I only have 12 days of medicine, how can I do?
Patient: Director Lu: Hello! I’m going back to Nanchang today. Yesterday I went to see you in the ward and your kind smile made me relax in front of the doctor. Although I say thank you every time, I still want to say thank you this time, thank you! Because only these two words can express my feelings. I will keep taking the medicine when I go back. Will I gain weight after taking this medicine for a long time?
Lu Guijun: There will be a little weight change early on, but it won’t affect too much. I wish you a speedy recovery!
Patient: Director Lu: Hello! For the past ten days, I have been having irregular bowel movements, once every two days, I have to squat for a long time, and the amount is not much. The amount is not much. Before, it was normal to get up once in the morning. Is it because of the medication? Flupirtine maleate and Prevacid have been taken for January, and today I stopped without the medication. Today I felt a vague pain on the right side of my abdomen, and by the afternoon I was vomiting, but I just couldn’t throw up anything. Is this the reason for stopping the medication? I read the instructions not to stop abruptly, but to slowly reduce the dosage and stop within a week. I look forward to your reply! Thank you!
Patient: Hello, Director Lu! I had insomnia last night and woke up with diarrhea in the morning. I ran to the toilet a few times in the morning, but I had a couple of drops of water, and I had weakness, dizziness and headache. If so, how do I need to adjust? I look forward to your reply! Thank you!
Lu Guijun: You stopped taking those drugs, but you are still taking those drugs, please give a detailed account of your current medication!
Patient: Hello! Director Lu. There are still two capsules of pregabalin and one box of maleic acid, you said these two drugs can be taken for a month, I stopped taking them yesterday, and now I am only taking duloxetine. One capsule in the middle of each breakfast. Now I feel that I have no strength in my hands, no energy, and I can’t sleep. My mouth also feels uncomfortable and painful.
Patient: Director Lu, how long do I have to take duloxetine in this case and how should I take the next amount? What are the side effects on my body? I want to get pregnant as soon as possible because of my age, how long should I take duloxetine for the shortest time? Thank you!
Lu Guijun: Flurbidine maleate can be stopped, Premarin should continue to take, you review these drugs are taken at the same time during the symptoms yo how much better, talk about the course of medication we must first determine whether there is an effect after the use of drugs.
Patient: Director Lu: Hello! Thank you for replying to me late at night! Last night, I was so uncomfortable that I almost didn’t sleep all night. I wanted to poop but could not, wanted to vomit but could not. My limbs are weak, especially my hands are struggling to type. Now I feel pain in my throat. Are these symptoms related to the sudden stop of Prevacid? I only have two capsules of Pregabalin left, and there is no pain department in our county hospital, so I can’t buy this medicine. If it is related to the abrupt stopping of Prevacid, will the above symptoms disappear on their own after two days? What can I do? Director Lu, do you think I should see an internist at our county hospital first? It’s urgent! I look forward to your detailed reply! Thank you! This is my phone number 18270506822
Lu Guijun: Pregabalin should not be completely stopped, as for the problem of vomiting and diarrhea you should see the internal medicine department is not suffering from gastrointestinal diseases, wish you a speedy recovery!
Patient: Director Lu: Hello! I went to the doctor and he said there was no problem with the intestinal tract and did not prescribe any medication, so it might be related to stopping the medication. In Beijing, Dr. Zhao prescribed Pregabalin and Flupirtine Maleate for 18 days, and I feel better today than yesterday, and my limbs are not weak. You said that I have to take Prevacid, how long do I have to take it? Is it still the same as before? I can’t buy it here, so I have to ask my friend in Beijing to buy it for me and send it to me, and it will take a few days on the road. I look forward to your reply! Thank you!
Lu Guijun: It is best to take it continuously, repeatedly stopping the medicine is definitely not conducive to recovery.
Patient: Dear Director Lu: Hello! It has been a long time since I contacted you. Now I feel that my throat sometimes hurts, and the same part of my mouth still feels strange, but it’s better than before. Because of my age, I want to get pregnant as soon as possible, and I have stopped taking my own medication for more than half a month. Now I want to regulate my mood and make myself happy and cheerful every day. I insist on exercising for one hour in the morning and brisk walking for half an hour at night. Do you think it will help my condition? Thank you for your prompt and detailed replies! Thank you! I wish you all the best!
Lu Guijun: Timely physical exercise is definitely beneficial to your smooth recovery, and I wish you a speedy recovery.
Patient: Director Lu: Hello! Happy Dragon Boat Festival! My points are not enough to express my feelings here. Thank you for your kind replies! I don’t feel much pain in my throat now, but I still have a strange sensation in the same part of my mouth and palate. How long do I have to stop taking the medication before I can get pregnant? Thank you!
Lu Guijun: I’m glad to hear from you. It’s safer to stop taking the medication for about three months, and you can also consult your obstetrician and gynecologist for details. Happy Dragon Boat Festival!