U.S. doctors online nowAsk doctors free

Doctor Q&A for Dr. Leland Berkwits

A 26-year-old male asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Too much Tylenol (acetaminophen): You have taken 80 x 80mg = 6400mg and 102 * 500mg = 51000mg for a total of 57400mg of Tylenol (acetaminophen) over a period of 14 days. This means you are averaging 4100mg per day of Tylenol (acetaminophen). If you have a liver condition (such as hepatitis or cirrhosis), are drinking a lot of alcohol, or are taking this dosage over long period, permanent damage can occur.
A 29-year-old female asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Not safe...: Both Ibuprofen and Naproxen are Non-Steroidal Anti-Inflammatory Drugs (NSAID's). If you are taking one NSAID drug, you should not combine it with another NSAID drug. You risk having stomach issues and can potentially damage your kidneys. You should talk with your doctor regarding appropriate use of medications for your condition.
A 36-year-old member asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Chest pain go to ER: There are a number of causes for these symptoms, many of them serious. This could be due to heart problems and you should go to the ER for an evaluation to make certain this is not life threatening.
A 27-year-old male asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Head back to ER: It appears you were evaluated for heart problems and lung issues (pneumonia, collapsed lung, mass, etc). There are other causes for your symptoms that are too numerous to mention, all of which require a more detailed evaluation - with possible consultation by a general surgeon. I would encourage you to go back to the ER and request further testing, stating your symptoms have persisted .
A 62-year-old female asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Treating osteoporosi: Reclast (zoledronic acid) is an antiresorptive medication (like Fosamax, Boniva, etc) that is given IV. It will prevent further loss but will not rebuild bone. 5-10% increase/decrease is likely within the margin of error of a DEXA scan. Recombinant human parathyroid hormone rPTH (Forteo) is an injectable medication that does rebuild bone and increase density. rPTH cannot be given with a history of cancer.
A 32-year-old member asked:
Dr. Leland Berkwits
Pain Management 37 years experience
IV Sedation: In the 4 times that I have had IV sedation, when I wake up I have no knowledge of any discomfort or what happened over the period of time from when I received my first dose to the time that the medication wore off. You may be a little groggy and want to take a nap later in the day. Standard instructions dictate that you avoid driving for 24 hours.
A 59-year-old male asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Conscious sedation: Versed and Fentanyl are a standard combination of medications use for light-moderate conscious sedation when administered by a non-anesthesiologist. Most facilities require that an anesthesiologist (trained in intubation) be present for administration of Propofol (the drug used by Michael Jackson with clearly bad outcome.)
A 38-year-old member asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Cervical fusion: Cervical discectomy and fusion is usually indicated if there is significant compression of a nerve with loss of strength and/or numbness in the arm. This technique is usually not as effective for treating neck pain. If you do not have weakness or numbness, all conservative measures (PT, steroid injections, etc) should be exhausted prior to considering surgery.
A 39-year-old member asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Back pain: The most important thing to help your back is maintaining and developing core body strength. These include both back muscles and abdominal muscles. A physical therapist can help with assessing which muscles need to be strengthened and providing you with an exercise program to work on building strength in a safe manner.
A 37-year-old member asked:
Dr. Leland Berkwits
Pain Management 37 years experience
Scoliosis: As an adolescent, there is a greater likelihood of reducing spine curvature without surgery. Bracing does not usually work at age 37. The Schroth method is a form of physical therapy which can help reduce progression of curvature; by strengthening the inner muscles of the rib cage, this technique changes the shape of the upper trunk to correct any spinal abnormalities
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
Answer emailed
in 24 hours or less