Patient's Query
Hi doctor,
My 68-year-old mother underwent spine surgery this month for multiple severe lumbar canal stenosis in which TLIF was done at L2-L3, L3-L4, and L4-L5 and decompression at L5-S1 and, after a week stay, discharged a few days ago. At the time of discharge, the following antibiotics and painkillers were prescribed:Linezolid is a combination of Cefixime and Clavulanic acid, Aceclofenac and Thiocolchicoside, and Paracetamol.So, in this regard, I just want to know what time we should take the above medicines post-discharge. If we stop antibiotics, is there any chance of infection later in the future? Also, for nerve health, Pregabalin was prescribed, but we have been taking a medicine containing Pregabalin and Nortriptyline since discharge. So, which of these two will be more efficacious for nerve conditions? And for how long does she need to take? Also, before surgery for BP, my mother was taking the following medicines:Telmisartan, Nifedipine, and Moxonidine. Her BP used to stay normal, but after surgery, the physician only provided Moxonidine 0.3 mg, and with this, only her BP used to stay normal post-surgery and post-discharge. Is there any harm if we stopped taking other BP medicines such as Nifedipine and Telmisartan and took only Moxonidine?
Also, she has been prescribed a medicine containing Domperidone and Rabeprazole twice daily before food for ten days. So, after ten days, if we stop this medicine, are there any withdrawal symptoms? Or will it be safe to stop? With the above surgery, how long will it take for my mother to walk normally without any walker or support? She is unable to walk or stand now without a walker, and with the help of a walker or anybody's support, she can walk. Are there any tips for her to recover quickly and walk normally like before?
Please suggest the best food and exercises for her to heal quickly.
Thank you.
Hi,
Welcome to icliniq.com.
I understand your concern.
Firstly, you should follow the treating doctor's advice in this regard, as everyone's protocols are different. However, in general, one to two weeks of antibiotics post-surgery are enough to prevent infection, after which the risk of infection is low. However, doctors may modify the duration of antibiotics from patient to patient.
Pregabalin and Nortriptyline are more effective than plain Pregabalin. Both these medicines stabilize the nerves, preventing pain, tingling, numbness, and burning. The treating doctor may gradually reduce the dose according to the response. However, it may be continued on a long-term basis if symptoms persist.
Regarding BP (blood pressure) medicines, we have to adjust the dose according to BP. So, as her BP is under control with a single medicine, it is alright to stop other medicines. If BP starts rising, then gradually, we might need to add one by one medicine.
The medicine containing Domperidone and Rabeprazole may be stopped as advised, and usually, there are no significant withdrawal symptoms. However, she might notice acidity symptoms like bloating, abdominal pain, and acid reflux. In that case, she might need to take medicine whenever required.
Again, it may take one to two months for complete recovery. However, it may take longer in some patients, especially in elders like her. It is important to keep a good diet rich in protein, vegetables, and fruits. Besides, physiotherapy is important in gaining activities fast. So, she should regularly and actively engage in activities advised by a treating doctor or physiotherapist. Generally, activities like walking (although with a walker) and leg movements in the bed are encouraged.
I hope this helps you.
Revert in case of queries.
Regards.
Patient's Query
Hi doctor,
Thanks a lot for your great and valuable response.
Regarding antibiotics, the neurosurgeon checked the stitches and incision health, and according to him, it healed completely. And told us that we could continue stitches for another 5 days, so for five more days, we will continue following antibiotics with a reduced dose and then stop.
Zifi cv 200 (0-0-1) (earlier 1-0-1).
Linid 600 (0-0-1) (earlier 1-0-1).
Also, he asked us to stop Pregabalin NT (0-0-1), and he prescribed the following medicines for nerve health.
Pregabalin D (50/20) (1-0-0)
Pregabalin D (75/20) (0-0-1)
So, how long should we continue taking these two neuropathy pain medicines appx?
Also, he was prescribed Shell XT (0-1-0) for calcium, vitamin D3, and vitamin B complex for nerve and bone health, and he performed TLIF L2 to L5 and decompression on L5-S1. So, here, my question is, how long should we continue shell XT (0-1-0) so that no vitamin toxicity occurs in the near future? She has been taking Shelcal XT (0-1-0) for the last 10 days.
Also, regarding painkillers earlier, he prescribed Zerodol TH4 (1-0-1) and paracetamol 1000mg(1-0-1) for 2 weeks post-discharge, and now he asked us to stop Zerodol TH4 and continue Paracetamol 1000mg (1-1-1) for pain for another 10 days so here my question is any harm taking high Paracetamol dose TDS for a prolonged period of time? Still, sometimes, my mother feels pain in her thigh radiating towards her leg despite taking Paracetamol 1000mg (1-1-1). So any remedy for that? Also, whenever pain occurs at that time, if she takes Zerodol TH4 (SoS), does any harm?
Also, in his prescription, one medicine name is not recognised, and the same has been highlighted in the attached doc. So, can you help me identify the name of the medicine he prescribed?
Apart from she is taking
Niditab 0.3 (1-0-1), and her BP is in normal range only post-discharge.
For sugar, she is taking Sitared MD 500 (0-0-1)(before food).
Gemer 1 (1-0-0)( before food).
Her sugar is in the normal range.
She is above 10 (0-0-1) for cholesterol, and her cholesterol is also in the normal range, so how long should we continue this cholesterol medicine?
Now, with the help of a walker, she can walk and do the tasks at home. So how long would it take for her to walk, stand or climb stairs without any support and do her tasks normally like before?
Sometimes, she feels a nauseous sensation, and sometimes, she vomits, despite taking a rabesec der (1-0-0) on an empty stomach, so is there any remedy for this assignment?
Once again, thanks a lot for the great response, and I expect the same cooperation from you in the future.
Thank you.
Hello,
Welcome back to icliniq.com.
Neuropathy medications (pregabalin) may be continued for one to two months. However, it depends on her symptoms, like neuropathic pain. If her pain gets completely resolved, the doctor may taper it earlier, and if the pain persists, then it may be continued in the long term.
Shelcal XT may be given up to a few months, and the probability of toxicity is low even if it's continued on a long-term basis. So it will probably be continued for a few months.
Most patients tolerate Paracetamol 1 gm tds well. However, it is a peak dose. I generally avoid such high doses unless it's absolutely necessary. Zerodol TH4 may be taken so if absolutely necessary. However, it can worsen gastritis and may cause nausea. Nausea and vomiting are probably related to gastritis due to so many medicines. Additionally, Syrup Sucral O or Gelusil may be taken whenever she is feeling nauseated to relieve acidity.
Regarding Atorva, we need to check her recent lipid profile and decide after the report.
She may require up to 2 months for complete recovery, depending upon her response to surgery.
I could not understand that tablet properly. It was probably wrongly written. The closest to that is Mbtron Plus, which is a multivitamin supplement.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byiCliniq medical review team
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