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Treatment for SCLERODERMA with joint pains.

Resolved Question:

Hi, I am a 40 years women . I started getting joint pains in hand elbows and fingers in feet and ive consulted so many doctors. I dont have arthritis , the arthritis tests are negative.

I have been diagnosed with scelorderma as in the prescription attached.

My condition does get worst at cold , and i have consulted some specialist in India , and these are the medicine they recommended me and told i have to take medicine forever and adjust the medicines according to pain etc and game some sos medicines too.

Recently i consulted a doctor in here (I am from maldives) and he says the medicine im taking never should be taken continuously and he want me to stop them and change to others. since ive been on these for nearly 2 years now and this is what the specialist in India recommended me , what should i do?

There are no specialist available here that's why i am consulting you. should i go with these medicines, can you please guide about these drugs and about the disease i am suffering from. Thankyou


Category: Rheumatologist

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Category: Internal Medicine Specialist
Dr. Bimlesh Dhar Pandey is online now

Expert:  Dr. Bimlesh Dhar Pandey replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I sincerely apologise for the delay. I was out of station and did not have access to internet.
I have gone through your prescription. Can you kindly just make a note of the medicines you're currently taking? There are two prescriptions with 7 different drugs. So kindly just note it down and send it to me in the follow up.
Particularly Ultragard ( Celecoxib ) has long term side effects causing circulation problems, can impair vision, gastric ulcer, e.t.c
Hence, I need the list so that I can guide you accordingly.
Also, how severe is the pain on a scale of 1 to 10? Seeing the prescription, it does seem like it's pretty severe.
Feel free to discuss further,
Regards.


Patient replied :

Hi ,
For now i am taking :
1.Censprum 2.Cetapin 3.Nicardia 4.Dolonex SOS 5.Pentocid 6.Shelcal HD
And for Ultragard ( Celecoxib ) I took it as a SOS for 3 months and stopped
Now i have ran out of the medicine been a week and i consulted a docotor here ; he want to change the medicine and told i shouldnt eat these continuosly.
But the doctor who prescribed me these told to buy these again and continue as needed ;
I do normally have the pain always slight pain but if its rainy pain is like 8/10
Its been 13 years and these medicine are the best that worked so far on me as a treatment. Its been 4 years i have been on same medicine , i do go to india to the docotor and he do the checkups and give the same medicine.
Whats your advice for this situation > and please help me. should i continue with the same medicines? Can you please explain breifely.
Thankyou


Expert:  Dr. Bimlesh Dhar Pandey replied 3 Days.

Yes, provided you are taking Celecoxib on an SOS basis, the other medicines are safe and can be continued.
None of these medicines have any long term side effects apart from minor gastric discomfort or nausea.
In systemic sclerosis/ scleroderma, the symptoms recur and get severe at some points. Yours get worse during cold or rainy season, so in such cases Celecoxib can be taken SOS. You also take Pentocid, so that will counter the gastric discomfort of Celecoxib.
Why are you on Cetapin? Do you have a history of diabetes?
These drugs have worked well on you for a considerable amount of time and I see no reason to change it all of a sudden. In my opinion, you should continue the same.
Regards.


Patient replied :

Hi,
Thankyou for the reply ; When i started the medicine i had no diabetics but doctor prescribed it i think may be due to the medicines i might catch diabatics.
Also i am having GASTRIC seriously. What do you recomend for gastric?
And do you think these medicines will catch me diabetics ?
Thankyou


Expert:  Dr. Bimlesh Dhar Pandey replied 2 Days.

Hello,
Thank you for your follow-up.
Can you please get your FBS/PPBS done and also HBA1c? Based on these values I can decide if you need the Cetapin or not.
Also yes gastritis is a common side effect of this medicines. The only issue is the benefits outweigh the adverse effects.
You should take Rabeprazole 20 mg twice daily once before breakfast and once at bed time. This needs to be continued as of now, and let me know after using it for 2 weeks. This is a better drug than Pantoprazole with longer action.
Please follow up with your FBS/PPBS reports.
Regards.


Dr. Bimlesh Dhar Pandey
Category: Internal Medicine Specialist
Experience: 
Senior Residency: Rhematology, All India Institute of Medical Schiences, New Delhi, 2009
Post Graduate, Junior Residency: MD (Internal Medicine), Rajendra Institute of Medical Sciences, Jharkhand, 2006
Residency: Physiology, Institute of Medical Science, Banaras Hindu University, Varanasi, 2003
Internship: Government Medical College, Trichur, 2001
Medical School: MBBS, Calicut University, 2001
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