HIV, Hip Injury, Heart Attack, Atripla, Tireness, Breathlessness, Warfarin, High Cholesterol, Anxiety
Thanks for your query.
You have a number of issues going on and I think the most important thing for you is to be in the hands of an excellent XXXXXXX medicine specialist or internist who can coordinate the care you will need from sub-specialists. I will try to provide you with some helpful recommendations here as well.
The first thing that stands out to me is that you mention that you take ibuprofen. This is an absolute contraindicated medication for you in my opinion. It places you at high risk for gastrointestinal bleeding. I would like to discontinue the ibuprofen for now and your doctor can give you an alternative pain medicine which does not increase risk of bleeding.
You are a young man and the fact you had multiple heart attacks is surprising. I hope you are in the hands of a good cardiologist as well. Cardiac rehabilitation will be key to your gradual and healthy improvement. You need to be on an aggressive regimen of exercise at a minimum of 45 minutes per day - 5 days per week. Anything less than this is not going to help your overall health. Your diet should be optimized and if you are at all above your ideal weight you need to attack that aggressively by seeing a dietician or weight loss coach who can give you the tools you need to do so. I think this will dramatically affect your energy level.
As for the hip, if you are not getting the answers you need from your orthopedician you need to seek a second opinion. This is appropriate for you if you have symptoms which are persistent and no one is giving you solutions or recommendations. Pain medications only block the pain but do not address the underlying cause which might include something which a procedure can correct. Ideally we would get you off of the codamol because that can be sedating as well.
Also regarding the coumadin. Alot of things affect the levels - certainly medications but other things such as diet play a big role. Vitamin K intake affects coumadin levels. If you eat alot of XXXXXXX leafy vegetables this can lower the effect of the coumadin and vice versa.
You do have alot of things going on and I think you can still get a hold of this, control it and take a step by step approach to health optimization. You need a captain of your ship in a sense and this is a primary internist who can make such a big difference in coordinating your care and advocating for what you need. If you feel any of your physicians are not listening or providing suggestions or solutions for you then I really think it is time to seek second opinions.
I hope this answer provided you with helpful information. Should you have additional concerns I would be happy to address them.
Sincerely,
Dr. Galamaga.
Could I ask about another medical problem for another member of my family?
Kind regards
Steve
Sure, what is your other concern?
Dr. Galamaga