Now let’s go to what a lot of people like to avoid sometimes but sometimes unavoidable which is anti-inflammatories and in some more serious cases opioids your thoughts on both doctor long-term short-term. Opioids have been the news quite a bit and it’s been an epidemic especially combined with benzos it’s basically killing lots of Americans and over the last decade there’s been this kind of upswing and now down swing of using heavy opioids for pain we actually know now chronic opioids are not really the best solution for any kind of chronic musculoskeletal pain which is not from a cancer origin but rather can cause even your pituitary gland your endocrine system your hormones to be irreversibly effective which can affect mood and everything else related to that other medications like over-the-counter NSAIDs and Tylenol we think that these are benign meaning that they don’t have any side effects but they can if you’re taking these everyday chronically they really need to be monitored so if you’re taking any medications more than a week you should probably see a primary care physician to evaluate it and in general for chronic use opioids is not the answer. Something that happens a lot is when everybody gets together at the mall to get moving and doing exercise they’re talking to each other and they’re saying you know I’m taking this it’s working fantastic and I’m taking this and it’s working fantastic but this is something where you have to discuss it with your doctor correct because what works for Maria may not be working for Cynthia you see where I’m going with this? Absolutely so we have to take all your core amenities or medical conditions that you have into consideration so if you have a some kidney issues we might go with a different medication if you have a liver issue we might go with a different medication so you really have to think of what’s going on and for example if you’re on a blood thinner for anticoagulation for atrial fibrillation you have to be really cautious in what you take over-the-counter so please talk to your cardiologist primary care doctor or specialist