Deadly mistake when using 'Mien' medicine to treat arthritis

Ho Chi Minh City University of Medicine and Pharmacy Hospital has just admitted a patient with vomiting blood and gastrointestinal bleeding due to using Miên drug.

Recently, the Emergency Department of Ho Chi Minh City University of Medicine and Pharmacy Hospital admitted a female patient named Nguyen Thi M, 42 years old, residing in An Giang, who was admitted with vomiting blood and gastrointestinal bleeding.

The patient’s medical history revealed that he had suffered from joint swelling, and was diagnosed with rheumatoid arthritis. The doctor prescribed anti-inflammatory drugs for treatment. However, after a week of using up the medication, the patient did not return for a follow-up visit, but was told by a neighbor that there was a type of “Mien” (the name of a drug in the Western region) that was very effective in treating joint pain.

The patient bought it and used it and felt the pain symptoms reduced. However, the patient had to use the medicine continuously, and after the medicine ran out, the symptoms started to reappear. After self-treating with the medicine "Miên" continuously for 3 months, the patient vomited blood and had to be hospitalized for emergency treatment.

Rheumatoid arthritis hand

Explaining this, Dr. Cao Thanh Ngoc, Clinical Allergy and Immunology Clinic (University of Medicine and Pharmacy Hospital, Ho Chi Minh City) said that the reason is that the patient has been using drugs containing Corticoid for a long time, drug dependence is called Cushing's syndrome. The doctor must both treat the disease and "wean" the patient. Currently, the patient is temporarily stable and is assured of treatment according to the doctor's regimen.

According to Dr. Cao Thanh Ngoc, there are two types of painkillers. One is non-corticoid anti-inflammatory drugs. When patients use them without a doctor's prescription, they cause very dangerous side effects such as gastrointestinal bleeding or increase cardiovascular events such as myocardial infarction, stroke, and worsen kidney failure.

Second is anti-inflammatory drugs containing Corticoid. When first used, the patient feels very comfortable, pleasant, pain relief, appetite, sleep easily. If the patient does not know, using it for a long time at high doses will lead to complications such as osteoporosis, high blood pressure, diabetes, stretch marks, easy infection, cataracts, etc. The above symptoms are collectively called Cushing's syndrome.

Signs of rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis characterized by chronic inflammation of the synovial membrane in multiple joints with or without extra-articular lesions.

VKDT is characterized by painful swelling of many joints accompanied by prolonged morning stiffness. The disease is more evident when the weather changes or the air is humid.

Rheumatoid arthritis can occur in all races and all ages. The age group most commonly affected is 30-50 years old (accounting for 73-85%). Women are 2-6 times more likely to get the disease than men. Men with the disease tend to have a more severe illness than women.

The joints commonly affected are the small joints in the wrists, hands, ankles, and feet. In addition, all other joints can also be affected, such as the elbows, shoulders, etc. If left untreated, arthritis can progress to narrowing of the joint space, adhesions, joint deformities, and disability.

The main signs of early arthritis in RA are joint pain and swelling. The joint may be swollen and warm, but there is usually little redness. The arthritis is considered active if it is painful to palpation or when the joint is passively moved. Joint swelling may be soft tissue swelling around the joint or swelling at the joint. Joint swelling is often accompanied by signs of joint effusion.

The disease may begin in one joint and asymmetrically, such as the knee, but most cases develop within weeks to months into polyarthritis with a symmetrical pattern, usually affecting the wrists, metacarpophalangeal joints, proximal interphalangeal joints, elbows, shoulders, hips, knees, ankles, and small joints of the feet. Distal interphalangeal joints are rarely involved.

Doctor Ngoc advises: Patients need to see a doctor when they have signs such as joint pain or frequent joint stiffness in the morning; persistent joint pain that worsens over time; swollen, hot, symmetrical joints; joint pain, fatigue, sometimes flu-like fever that limits movement and daily activities; joint swelling and pain lasting more than 2 months in middle-aged women.

Methods of early diagnosis and prevention

Dr. Ngoc stated: Early diagnosis and early treatment are very important because destructive joint damage can appear very early in the course of the disease. About 30% of patients show signs of bone erosion at the time of diagnosis and this rate can increase to 60% within 2 years. However, RA is difficult to diagnose because there is no specific test for this disease. The disease is easily misdiagnosed as well as easily missed. Therefore, patients need to see specialists for early examination and diagnosis. When going to the doctor, patients need to describe the symptoms in detail.

Doctor Ngoc warns: Joint pain can affect the entire health and life of the patient. It is a feeling of discomfort, pain, numbness in the joints, and is tormented a lot at night, affecting the patient's sleep. In addition, the disease also affects the patient's psychology through always feeling sad, and afraid to move, leading to stiff joints and the disease getting worse.

If left untreated, arthritis can progress to deformity due to destructive damage to the joints, tendons, and ligaments, causing subluxation. Common types of joint deformities in RA include wrist deviation toward the ulna (wind-blown hand), camel-back wrist, buttonhole finger (flexion of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint), and stork-neck finger (hyperextension of the proximal interphalangeal joint and flexion of the distal interphalangeal joint).

“The patient may have signs of extensor tenosynovitis manifested by swelling of the dorsum of the wrist. Flexor tenosynovitis can cause trigger finger.

Patients may have carpal tunnel syndrome due to inflammation of the flexor tendons that compress the median nerve in the wrist area, manifested as numbness, pain, or motor disturbances on the radial side of the hand. Similarly, patients may have cubital tunnel syndrome, tarsal tunnel syndrome due to compression of the ulnar nerve at the elbow, or posterior tibial nerve at the ankle; olecranon bursitis, Baker's cyst in the popliteal region," Dr. Ngoc emphasized.

This disease cannot be completely cured, but if the patient sees a specialist early and is treated properly, the inflammation will go away, the pain will go away, and joint deformities and future disability will be avoided.

Regular exercise helps maintain joint flexibility and strengthens muscles and joints. Dynamic exercises such as dancing or endurance exercises such as swimming or cycling are suitable because they can reduce joint swelling, improve cardiovascular health, help with weight loss and improve overall body function.

However, any exercise that does not cause more pain or swelling in the joints can be tried to reduce the symptoms of arthritis. Increased pain when moving is due to the inflammation in the joints not improving, not the movement causing the pain. Patients need to be treated to reduce inflammation in the joints and start exercising as recommended…/.

According to VOV