### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am on a variety of medications, but what I am most concerned about is the effects they have on my kidney s and liver-I am 52 and have severe depression (sucidal at times), PTSD, ADD, along with degenerative disk diesease (already had a hip replaced) Was paralized for over 2 yrs. and worked to get my sences back-I take ritilan 10mg tid, xaynax 1mg 4x s day, tramadol 4-50mg a day, gabipenitn 5-300 mg a day-just to name a few-I need the safest med for my pain while delivering the best results-in a narcotic-no one gives me the answers for the safest narcotic med to take? There are a few other meds I also take but these are my consistant ones-oh. also 90 mg of cymbalta 90 mg a day.I am on medicade and medicare which renders me broke

### output:

As per your explanation I understand you are on too many medications for pain. But here you need to understand taking multiple medication only for pain is not a solution of pain. Pain is symptom and not a problem so always suggest all my patient to treat the cause of pain rather than the pain. I suggest taking treatment for your basic problems due to which you have so much of pain. Along with this I suggest doing regular basic yoga, and paranasal, keep your food habit healthy, take proper rest and do regular cardio exercise like walking or cycling up to the possible level. For pain try to manage with cold pack and hot pack. As well do strengthening exercise for your spine. The best way is consulted a physiotherapist and talk to him about all your problems and take a good exercise program from him which can help you for improving strength and stamina of your spine. Along with this he will also guide you some more physiotherapy for pain management. And the painkiller what you are taking is enough. As well understand there is no painkiller without any side effects available in market. So better to take something after consulting your regular physician. Take care.