instruction: hi doctor this query is for my aunt who is 60 years old she has knee pain both for more than 15 years initially she used to get swelling around the knee and pain she keeps taking injection and painkillers for pain for the last 15 years recently she was ill for around three months with a bacterial infection in her legs as she was under treatment for that infection her pain got subsided for some time due to pain killers and other antibiotic effects now again she is getting pain she also has some kidney issue and her current creatinine is 5 but it was high six months ago she was prepared for knee replacement surgery and it was canceled as her husband got a stroke a day before surgery while going through the tests before surgery we got to know that her kidney is under trouble her creatinine was so high at that time as I am far from her I could not present any of the reports now also she was advised to stay away from pain killers and other medicines to prevent further kidney problems kindly suggest some ointment or medicinal oil to apply for knee pain
output: hi you need to take the following tablets tablet tramadol 50 my 0 for 10 days after food rabeprazole 20 my 0 for 10 days before food shelcal calcium 500 my 0 for 30 days before food wintogeno cream ayurveda formulation which can be purchased from ebay can be used by her twice daily take these tablets only if you are not allergic to them do not take them if you are a known case of bronchial asthma follow up immediately in case of any untoward reactions advice activities that cause pain should be avoided temporarily if the knee is swollen or sore squatting kneeling twisting and pivoting jogging aerobics dancing and playing sport should be avoided until knee pain and swelling resolve you should wear a knee cap for support to the knee joint wear it all day and you can remove it at night apply ice packs twice daily for 15 minutes each you need to get your ray of both knee joints ap standing and lateral views do the rays and upload them for accurate advice this professional advice provided by me stands subject to the actual examination of report image and is based entirely on inputs provided to me it should be correlated with clinical findings