Constant pain

dori2o

WeAreGhosts wrote: »

There's one drug that doesn't get mentioned much for pain relief - Piroxicam.

I'm in constant pain and while it doesn't totally get rid of the pain it does make it bearable most of the time.

i just read though that it should be used for 14 days at most - i've been on it every day for four years!

As long as you feel finer on it and are not sufferring any abnormal effects then there isn't a problem regarding how long you have been taking it.

The manufacturers/NICE guidelines regarding max doses and length of time a medication is taken are just that, guidelines, not a rule which must be adhered to. So long as the prescribing Doctor is keeping up to date with regards to your meds and their effects then you have nothing to worry about.

2 years ago I was on Nortriptyline. This was prescribed originally as part of my chronic pain treatment but being an Anti-Depressant it also helped with the depression I suffer from.

The maximum dose of this drug should be 150mg per day, usually taken in one dose, once a day (generally before bed).

Before the pain specialist took me off the drug due to it proving ineffective for my chronic pain condition I had reached a daily dose of 350mg, more than twice the recommended dose.

My specialist explained that unless the dose was having a detrimental effect on me or was causing other issues etc, then as far as he was concerned there is no problem with exceeding the recommended maximum dose.

It's the same with other drugs I have been prescribed, the specialist is happy to push the boundaries regarding dose guidance if he believes that there is a possibility that the higher dose will provide his patients some relief.

In order to make sure that he keeps up to date with his patients he does 3 things, sees them every 8-10 weeks without fail, he has his secretary call those patients whom he wants to keep a closer eye on, and finally he writes to his patients GP's to make them aware of the situation and asks that they contact him if the GP believes the patient is suffering adversely from the medications.

As always however, if you are concerned about the fact you have been on the drug so long speak to the GP/specialist who first prescribed it.

Indie_Kid

dori2o wrote: »

2 years ago I was on Nortriptyline. This was prescribed originally as part of my chronic pain treatment but being an Anti-Depressant it also helped with the depression I suffer from.

Urgh. They put me on this before putting me on Topamax. I took one dose. No-one had warned me that it can cause depression and thoughts of suicide.:( Thankfully, I realised what was going on, stopped taking the medication and asked for an emergency doctor's appointment. I hadn't felt that bad since 2010.

Awful, awful drug.

Ames

I'm another in pain. I have some kind of autoimmune disorder (they're not sure what). Last summer I was put on Hydroxychloroquine which worked, and had a steroid injection which was amazing. But the HCQ had a massive impact on my mental health (I have bipolar and the leaflet said that it should be prescribed with caution and close monitoring with those with mood disorders - I got neither caution or any monitoring). The diabetic nurse said I can't have any more steroids, the rheumy says that we're out of options other than steroids. I can't have 'normal' anti-inflammatories because of bowel problems.

I've got a health advocate and we're seeing the senior partner at my GP surgery in a few weeks. Pain relief is one thing we need to talk about, as well as the really bad medical 'advice' I've had from various GPs over the last year.

The one thing I wish would happen is all the doctors actually talking to each other to make decisions about meds taking into account all of my issues and other meds. I spent months last year being go between carrying messages back and forth between hospital and GP and gettign nowhere with it all.

Jellybro

I also suffer daily with chronic pain. I have pudendal neuralgia. I have not yet found the right pain medication. I'm currently on gabapentin 300mg twice a day, but it's not really touching the pain to be honest.
I'm struggling accepting the fact that this may now be me for the rest of my life..... Everyone at the pain clinic seems to want me to accept it even though I've had no treatment for it and have been left in limbo for months waiting for follow ups.
I'm struggling...... I know how you feel op.

dazza-mac

benniebert wrote: »

Having read that, could I ask what are you expecting your GP to do then?


We all (most of us) have difficulty in seeing a GP - fact, the majority never see the same GP twice - fact.
That is what it is. I don't like it, my wife doesn't either, but you have no other choice.
We don't bother to see the GP now (not since the last visit when we couldn't understand a damn word he was saying.)


We have reverted back to the old remedies that our mothers and grandmothers used - all pre NHS days.


At least we are finding some relief and the local pharmacy is fantastic in getting the medication/herbs/oils etc for us.

HI,

sorry for the delay in replying. I think I was very frustrated on the day I wrote my bit. And being in pain doesn't help.

In relation to what I wanted the doctor to do - the truth is 'I don't know' - but my point was that it's very frustrating not seeing the same gp, and I appreciate that it doesn't just apply to me. It's frustrating because you feel that you have to go over everything again which means by the time you've done that there isn't much time left.

I think the main source of frustration for me was that by offering anti depressants meant he was just in my view fobbing me off with treating the symptoms of an unknown cause. I felt that he should have investigated what was causing the problem and then once we knew he could then: a) possibly treat that, and: b) offer me the anti depressants if he felt they would help. but at least I would know if there's anything else to be concerned about.

It's the 'not knowing' that I find so upsetting. As I said, everything seems to be put down to the fibromyalgia when on at least 2 occassions the problems have been something else (although I do also think the fibro was also aggravating the problem).

Even if the fibro was also part of the problem, I really don't think it's unreasonable to at least know for definate (if possible) what the problem is so that any treatment is the correct one - otherwise what's the point of going to a so called professional 7 year trained expert? We might as well all just take pain killers the size of a dustbin lid and hope that whatever is causing the pain is not life threatening or gets any worse.

I'm still in a lot of pain and to be honest, that is making me depressed - but I still think it's wrong to just dole out anti depressants when it's the lack of finding out the initial problem which in turn is causing the second one! I'm not sure if I've explained myself clearly. I'm in the library and not got much time left on the computer.

I also take your point about not being able to understand the dr. That's a common problem too. Best wishes to you

dazza-mac

benniebert wrote: »

Maybe she had a point. Some pain is psychosomatic.


My wife was told to carry on with the pain killers and do as much exercise as she can cope with - long daily walks, swimming etc.
In fact she realises that the GP was right and the strenuous exercise does help and so does talking therapy.

Whilst psychosomatic pain can occur - it's something that I think a lot of people find upsetting because I imagine they would feel like they are not being taken seriously and really puts them in a no win situation - if they keep complaining they're thought of as a nusiance, and if they just go away and suffer the pain then their life is no better.

Someone once told me that when doctors don't know the cause it can be very easy for them to imply that it's all 'in the mind' as it absolves them of any responsibility - when the possible reality is simply that the MRI scan didn't show up what was causing the problem. MRI scans don't show up everything so just because it may not show what is wrong with a particular patient, that doesn't mean there isn't anything wrong.

dazza-mac

Mupette wrote: »

Can agree with you, i have MS and OA, and gp's but everything down to either, rather than spend time and money getting to the root of the problem, i have to try and find a new GP because the one i have in October was supposed to make two referrals, she didn't one i have to beg for in dec, and the other still hasn't been made, i worry that if i move any letters or info from consultants won't come back to the right gp, i couldn't trust the office staff to do the right thing, i moved home, told them, made sure they knew where they should send new prescriptions, and still they sent them to the wrong one, so that's telling them face to face and changing my details online, they still screwed up

That happened with my dad after he had his leg amputated. I went to the surgery with his new address. We waited ages for his referreal to physio. I eventually went to the surgery to ask why it was taking so long.

They said that 2 letters had been sent to his old address!!! and they just thought he had changed his mind about having physio - without bothering to ring us up or to double check whether they had sent the paperwork to the correct address!

dazza-mac

benniebert wrote: »

They are as human as you and I are. We all make mistakes - some trivial - some that cause death unfortunately. It would be an ideal world if everything went smoothly - but rather boring don't you think?

no, sorry, not when you're in constant pain.

Sorry, I'm being flippant now!

Indie_Kid

dazza-mac wrote: »

Whilst psychosomatic pain can occur - it's something that I think a lot of people find upsetting because I imagine they would feel like they are not being taken seriously and really puts them in a no win situation - if they keep complaining they're thought of as a nusiance, and if they just go away and suffer the pain then their life is no better.

Someone once told me that when doctors don't know the cause it can be very easy for them to imply that it's all 'in the mind' as it absolves them of any responsibility - when the possible reality is simply that the MRI scan didn't show up what was causing the problem. MRI scans don't show up everything so just because it may not show what is wrong with a particular patient, that doesn't mean there isn't anything wrong.

My mum said the same. There's a test that can be done to me to show what exactly the problem is. (a lumbar puncture) But it's easier for everyone to just tell me it's nothing and I'm just imagining all the symptoms I'm having. Funny how DVLA (I don't drive due to my vision) say it's a notifiable condition, despite all the doctors saying it causes no problems at all.

Bryando

I am also trying to find some hope as the pain is having a really massive impact upon me!

Pain constant in my back,neck and fingers. Fingers feel tight and my knee swells often. The other knee is patellar pain syndrome that is not responding to physio. This probably due to the Fibromalgia the pain clinic think I have.

For Fibromalgia there is no great hope of resolving the pain with the medication being very limited as the consultant said and confirmed by a conference I attended.

Some suggest swimming but unsure if that would help.