Wonder Drug Request

Sounds like you want Vioxx. Or Celebrex, or any of the other COX-2 inhibitors. This is precisely why they were developed.... how's your heart?

You should talk to your doctor. (I am not a physician but I am medicinal chemist from pharma industry.) What you describe is pretty typical problem with mixed COX1+COX2 antiinflamatories. They allways have the stomach-ulcer problem in background. One thing you can do is to keep taking your Advil or Alieve and combine it with some over-the-counter stomach medication like Omeprazole (Prilosec) or Zantac to counter the stomach nasties.

But I think you are ready to see your primary care doc at this point - because you do not want to have a worsening peptic ulcer that can rupture (and kill you). What the doc can do is 1) have a look on your neck spasms and order tests to make sure your stomach problem is benign (and not something that your antiinflamatories just uncovered) 2) if it turns out that you actually have peptic ulcer (that got worsened by Advil) he can give you anti-heliobacter treatment with antibiotics and your ulcer will heal, over few months so you can eat bad pizza with Advil toping without problems. 3) He can give you Celebrex or Vioxx prescription. These COX-2 selective antiinflammatory drugs are milder on stomach but carry some liability of increased heart attack, especialy if taken in large doses of them over long time. (The risk is not actualy that high and Merck was pretty unlucky with Vioxx, but some increased risk is there because of increased plateled aggregation). Celebrex is supposedly less risky than Vioxx and Bextra but also slighly less effective. You need to see a doc to get it. Anyway, a visit to primary-care is considerably cheaper than ER co-pay.

I know a chemist who was taking mephenesin capsules in France for similar problem (spine muscle spasms) and was swearing it was the only thing that helped her. I do not know if this muscle relaxant (mephenesin) is approved for oral use in US. Maybe it is part of some ointment, etc. Ask your doc.

Also, oil of wintergreeen on your neck (localy) may be of some help but you will smell like mouthwash.

ask for Ponstel (mefenamic acid). it's like ibuprofen but a lot more gentle on the stomach. also, take the pills only with food and drink, and don't take them for more than three days straight.

but honestly, i think you should try massage therapy or some kind of bodywork, like shiatsu or yoga. something is out of whack for you to be having these problems. you would probably benefit a lot just to have traditional swedish massage every few weeks for a few months. sounds like you are 'stuck'.

I recommend Ascriptin. It is aspirin and Maalox. For years I played tennis almost daily and always took 1000 mg. of Ascriptin before playing - never have had any stomach problems with it.

Sounds like you've got a lot of advice already, but I'll throw in anyway. When I had to get a prescription for back pain a few years ago, I started with a big dose of ibuprofen. It bothered my stomach (though it not as much as yours does, by the sound of it), so I switched to naproxen sodium, and that seemed to be better. It may not be as fancy-shmancy as a COX-2 inhibitor, but you may just try using Aleve instead of Advil for a while.

And also, they're serious when they say take with food.

What the heck's wrong with enteric-coated aspirin? And, didn't somebody just get a Nobel for proving you could cure ulcers with antibiotics by giving himself ulcers, and then curing them?

It never ceases to amaze me what will draw comments in blogdom-- I never would've thought that whiny venting on a Saturday night would get any comments at all, let alone helpful ones.

A couple of follow-up comments: I had an endoscopy last weekend, to see what the source of the stomach problem was, and the official diagnosis was "Beats me." They said everything looked normal-- no ulcers, etc. I've got a follow-up appointment on Friday, where I'll probably get charged $30 for hearing the same thing in more detail.

It has gotten slightly better since earlier this year, when I was miserable all the time. Now it only really bugs me if I do something to make it act up.

As for the shoulder problem, as I said, this landed me in the emergency room last year, after which I spent six weks or so doing physical therapy, and got a set of stretches and so on to do in the morning. The current flare-up is probably because it's the end of the term, and I wound up spending a lot of time grading papers and writing exams and other tasks (coughbloggingcough) that involve sitting at a desk or table for a long time. It started to act up a bit back in November, at the end of the fall term, but at that time, I didn't have any problem taking Advil, and got through it without a major incident.

As for the various other drug suggestions, I'm a little hesitant to experiment with taking other things that might work (we've got some Aleve in the medicine cabinet), because if they don't, it pretty much ruins an entire day. It is a little better this morning than it was yesterday, so I'll go with the heat packs and Flexeril, and hopefully get a chance to talk to my doctor before I try any other pain-killers.

Sitting at a desk can be hard on my neck and shoulders. I recently retired from a career as a software guy and my neck and shoulder aches dropped by about 80%. Now days I can spend 2 days a week in my whitewater kayak.

I still need swimming and yoga to maintain my flexibility. I don't understand the biomechanics but abdominal exercises are the the most useful for my neck and shoulders. Maybe they promote better posture. Try short sets of sit ups, leg lifts and stretches throughout your day, 15 to 20 minutes every 3 or 4 hours. Exercise at an easy pace, don't set goals or worry about building strength. It ain't the meat it's the motion.

The worst shoulder spasms I ever got (and for which I was prescribed Flexeril -- mmmmmm, Flexeril) were from using a laptop without paying attention to my posture. When you use a laptop, the screen is lower than it should be, and you tend to lean your head forward, straining your neck. Keep your head back and tilt down only your eyes, and you can fend off spasms. Incidentally, bad head posture is also a frequent cause of wrist pain; you can tell if it's really nerve-pinching in the neck by measuring your grip strength; anything actually happening in your wrists can't affect your grip strength.

"Enteric-coated" aspirin means it doesn't start to dissolve until after it leaves your stomach. Your stomach only sees aspirin from the bloodstream, and not (in much more concentrated form) in the stomach. I don't trust Naproxen or Vioxx; give them a few more decades to prove their safety.

I take it acetaminophen (Tylenol) alone isn't enough to do anything for your pain. It's easy on the stomach, and can be taken along with a smaller dose of enteric coated aspirin or Advil, for a synegistic effect. That's how Excedrin works--aspirin, acetaminophen, and caffeine.

Enteric-coated aspirin is certainly worth a try. So is the old trick of taking ibuprofen only after meals to reduce stomach irritation. Arnica also tends to reduce inflammation -- you can get it as a gel to rub on directly. I've seen it in homeopathic pills, too, but can only vouch for the gel.

I'm not a doc, but a computer geek with crampy little vestigal arms, neck spasms and bad posture and occasion insomnia - former problems with GERD -- I started taking valerian before bed - an herb that works as a muscle relaxant and does not affect my stomach.

I'm fine now. It's cheap. Of course, do your own homework and YMMV.

Update: Saw the doctor today, and was given prescriptions for Flexeril and Darvocet, which I'm trying now. I was warned not to take them before going to work, as they might cause drowsiness. With me, "may cause drowsiness" usually means "will knock you out cold," so we'll see how that

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I cannot recommend Darvon for long-term use. It is addictive like other opiates but it has pretty low margin of safety (=easy overdose, should not ever be combined with booze) and is not very effective in treating pain. I would go with codein or oxycontin for a short period of time.

There is a world of difference (and drugs) between codiene, darvoset, and oxycontin.

Personally, I would try naprox (2 Alieve) or Relafen (requires rx). They both seem to have lower incidences of stomach problems -- and Relafen does especially.

Try either of the following:

Excedrin tension headache (acetaminophen + cafeine)

or

Percogesic Extra Strength (acetaminophen + diphenhydramine)

both contain agents to boost the pain killing power of acetaminophen (Tylenol)

Seeing your doctor would probably be a wise idea

I am suppose to take darvocet for severe arthritis. Up to 3 tablets a day. I want to know what drugs make up this one drug.