Sore Foot

[AlexLah]

Hi all,

Last week I was in Aus and during that week my right foot was swelling.

On the third day my foot was about 2 times more thick.

Very painfull.

I have a medical check up every year and al is fine.

A litlle bit high blood pressure (120-90).

Could it be becouse of the 10 hours I stay in the airplane?

[Westerner]

Hi all,

Last week I was in Aus and during that week my right foot was swelling.

On the third day my foot was about 2 times more thick.

Very painfull.

I have a medical check up every year and al is fine.

A litlle bit high blood pressure (120-90).

Could it be becouse of the 10 hours I stay in the airplane?

I would say almost certainly. You should always exercise your legs whilst you are seated and walk about every hour.

[Sheryl]

See a doctor. You may have a blood clot.

This can happen as a result of being seated in a plane for a long time, and it is dangerous because the clot can come loose and travel to your heart, lungs or brain (causing heart attack, stroke, possibly death...you get the idea).

[AlexLah]

Hi all,

Went to Bumrungrad hospital and have my foot checked.

Doctor said I have an infection of the Tendon.

He gave me some cream: Voltaren and two types of medicine.

One is called:Prexige and the other is: Rebamipide.

I am a bit reluctant to take them after I visited these websites:

http://www.tga.gov.au/recalls/2007/lumiracoxib.htm

http://gut.bmj.com/cgi/content/abstract/35/10/1375

Any doctor/nurse here with some better advice?

[Sheryl]

Alex,

Glad to hear it is " only" tendonitis, and congratulations on being a smart health care consumer. Prexige is one of the newer nonsteroidal anti-inflammatory drugs (NSAID) and it has indeed been pulled off the market in several countries because of serious adverse liver effects. You are right to question its use.

Personally I recommend you stick with the older NSAIDs like ibuprofen (readily available at any pharmacy in generic form and very cheap), I have not been much impressed with the newer versions and at least these old stand-bys have been around long enough that one can be pretty sure their adverse effects are known and accounted for.

This advise is contingent upon you not having any contraindications to NSAIDs as a class. Contraindications would be if you had a history of ulcer disease or gastritis, or any bleeding abnormalities. And these drugs must always be taken with food as they are otherwise very irritating to the stomach.

Voltaren is also an NSAID for topical use, it will have more effect is you apply it after first soaking the foot in very warm water. Hot soaks are helpful in and of themselves but will also dilate the blood vessels allowing for more local absorption of the Voltaren.

Rebamapide is used to treat gastric ulcers and gastritis, unless you had complaints in that department then I suppose the doctor gave it to offset the side effects of the NSAIDs, but most docs would simply advise that you take the NSAIDs on a full stomach and if necessary take antacids or any irritation that may develop. Also, rebamapide is a very new and hence very expensive drug, which also means that there has not been as much experience with its use and hence adverse effects as there has been with the numerous older drugs used t for the same purpose. I just can't see any reason for using it unless there is a lot more to your medical history than you mentioned.

Heat, NSAIDs and rest (to the extent practical) are the mainstays of treating tendonitis. You may find that ace bandage wraps help too. Also depending on what tendon is affected, sometimes special shoes or arch supports are needed, and also specific exercises can be very helpful, but I can't advise on either of these without knowing which tendon is involved.

Keep the foot elevated as much as possible and walk on it as little as possible.

[AlexLah]

Hi Sheryl,

Thank you so much for your advice and explanation of the medicine they gave to me.

I really have no medical history of having an ulcer so I really do not know why the doctor give it.

I will stick to elavate my foot and rest and use the Voltaren as you suggested.

I will also get back to the doctor and ask him why he prescribes a medicine that is known to cause serious side effects.

This is the second time I was prescribed dangerous medicine from a respected hospital (Bumrungrad).

Thank you so much, Sheryl

Alex