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Testosterone can be administered parenterally , but it has more irregular prolonged absorption time and greater activity in muscle in enanthate , undecanoate , or cypionate ester form. These derivatives are hydrolyzed to release free testosterone at the site of injection; absorption rate (and thus injection schedule) varies among different esters, but medical injections are normally done anywhere between semi-weekly to once every 12 weeks. A more frequent schedule may be desirable in order to maintain a more constant level of hormone in the system. [56] Injectable steroids are typically administered into the muscle, not into the vein, to avoid sudden changes in the amount of the drug in the bloodstream. In addition, because estered testosterone is dissolved in oil, intravenous injection has the potential to cause a dangerous embolism (clot) in the bloodstream.

Dr. Lee: What happens when NSAIDs don't do the trick, and the pain and the inflammation persists? Dr. Shiel: In the setting of intense pain or persistent pain, in patients who are already taking NSAIDs, we can supplement with short-term narcotic pain relievers. The reason we prefer to use narcotics short-term is because narcotics have the potential for habituation, which means the patient may require higher and higher doses for pain relief, and that they become habit forming. Dr. Lee: What are some of the examples of narcotic pain relievers that you use? Dr. Shiel: Typical narcotic pain relievers that we use include Codine or Codine derivatives and Darvocet or related medications to Propoxaphine and Ultram . Dr. Lee: Thank you, Bill, for sharing with us your perspective on proper use of pain relievers in your practice and also for reviewing the use of over-the-counter pain relievers. Dr. Shiel: Thank you Dennis for your questions. : The published answers represent the opinions and perspectives of the doctors and pharmacists of and are for educational purposes only. They should not be used to replace or substitute for timely consultation with your doctor. Accuracy of information cannot be guaranteed.

Please remember, information can be subject to interpretation and can become obsolete.

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Dr. Rymer is currently researching regulation of movement in normal and neurologically disordered human subjects, including sources of altered motoneuronal behavior in hemispheric stroke survivors, using electro-physiological, pharmacological, and biomechanical techniques. He currently serves as Director of the Single Motor Unit Laboratory of the Shirley Ryan AbilityLab (SRALab, formerly known as the Rehabilitation Institute of Chicago, or RIC). From 1987-2017 he served as Director of the Sensory Motor Performance Program at RIC, and was RIC’s Vice President for Research from 2008-2014. He is the most senior scientist at SRALab and the founder of many of its current research programs. Dr. Rymer has established himself as one of the most successful mentors of junior faculty, and has been able to relate to the many backgrounds that can contribute to rehabilitation research. In addition to his roles at SRALab, he holds appointments as Professor of PM&R, Physiology, and Biomedical Engineering at the Northwestern University Feinberg School of Medicine.

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