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

### input:
Hello, I was diagnosed with hep c in 1980, am taking narcotics and gabapentin for pain relief from degenerative disc disease, I was apparently having allergic reactions to the gabapentin and was prescribed lactulose with no questions, warnings, contraindications or instructions to follow. Also, no instructions to follow at least 6 hours prior to a serum ammonia level test that was high, now have suffered severe insomnia, nausea, gas, bloating, headaches , rash and pain due to my reluctance to take my regularly prescribed narcotics(Oxycodone and Morphine XR) because they cause constipation, I am taking several of the medications that are contraindicated with LACTALOSE. What should I do and how long should I wait to take my medications that are contraindicated with lactulose. Thank You, Sincerely, Harry Hoskins

### output:

Hi, thank you for Providing the brief history of you. A thorough clinical Neuromuscular assessment is advised along with MRI of spine. As you have degenerative disc disease and also on medication, then to make you understand and help better there is a limitation of the medicine for symptomatic relief. The degenerative disc disease occurs dude to weakness of the spinal muscles which allows the spinal column to reduce in size and then later provides compression on the disc and the pinching of the nerve roots. Usually in my clinical practice such cases with degenerative disc disease are recommended with physical therapy as to get the maximum outcome and reduce the medication. As medicine over a longer run are not good for the kidneys and may lead to damage. Physical therapy like - Therapeutic ultrasound therapy and TENS therapy are useful to control the pain without any side effects and also exercises on a later stage provide the maximum outcome score of Strength of the muscular system. Also, TENS works even better when you are under medication for a shorter time.regards Jay In Chat Doctor. 