What is the cause of a patient's resolved intermittent throbbing pain in the right bicep, which improved after receiving a Toradol (ketorolac) injection, and is now presenting for X-ray results review, having stopped taking Zelux energy drink containing red ginseng due to concerns about increased bleeding risk?

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From the Guidelines

The patient's history of present illness (HPI) is a 1-week history of intermittent throbbing pain in the right bicep, which has now resolved with a current pain rating of 0/10, and he is concerned about the potential bleeding risk associated with the Zelux energy drink containing red ginseng, which he plans to discontinue, as supported by studies on the risks of dietary supplements and bleeding complications 1. The patient reports that he feels much better after receiving a toradol injection during his previous visit, and he is now in the clinic to review his x-ray results.

  • Key points in the patient's HPI include:
    • A 1-week history of intermittent throbbing pain in the right bicep, now resolved
    • Previous concern about a supplement purchased online causing bruising on his bicep
    • Plans to discontinue the Zelux energy drink containing red ginseng due to its potential bleeding risk, as informed by the potential for dietary supplements to affect hemostasis and coagulation 1
    • Denial of any active bleeding at this time
    • Current visit is primarily to review x-ray results from the previous visit The patient's decision to discontinue the Zelux energy drink is prudent, given the potential risks associated with dietary supplements and bleeding complications, as highlighted in a study on the use of dietary supplements in living kidney donors, which recommends discontinuing supplements that could affect hemostasis or sedation as soon as possible 1.

From the FDA Drug Label

The patient presents with a 1-week history of intermittent throbbing pain in the right bicep, today pain is rated as 0/10 in severity. The History of Present Illness (HPI) for this patient is:

  • The patient had a 1-week history of intermittent throbbing pain in the right bicep
  • The patient received a toradol injection last week and reports feeling much better
  • The patient's current pain level is 0/10
  • The patient is concerned about a bruise on his bicep and has stopped taking a supplement (Zelux energy drink with red gensigin) due to increased bleeding risk
  • A CBC is ordered, and the patient denies any active bleeding 2

From the Research

History of Present Illness (HPI)

The patient presents with a 1-week history of intermittent throbbing pain in the right bicep. The pain is currently rated as 0/10 in severity, indicating a significant improvement from the initial presentation. The patient reports feeling much better after receiving a Toradol injection last week.

Current Symptoms and Concerns

  • The patient is concerned about a bruise on his bicep, which he believes may be related to a supplement he purchased online, specifically the Zelux energy drink containing red ginseng.
  • The patient has decided to stop taking the supplement due to the potential increased bleeding risk associated with red ginseng 3, 4.
  • A CBC has been ordered to rule out any underlying bleeding disorders or other abnormalities.
  • The patient denies any active bleeding.

Relevant Medical History

  • The patient has a history of intermittent throbbing pain in the right bicep, which has improved significantly since the last office visit.
  • The patient has received a Toradol injection, which has helped to alleviate his symptoms.

Laboratory Tests and Results

  • A CBC has been ordered to evaluate the patient's blood cell counts and rule out any underlying bleeding disorders.
  • X-ray results are pending and will be reviewed during the current office visit.

Medications and Supplements

  • The patient has been taking the Zelux energy drink containing red ginseng, which he has decided to stop due to concerns about increased bleeding risk 3, 4.
  • The patient has received a Toradol injection, which is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation 5.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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