Paracetamol dosage and feeling a little down. :-(

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Megrose489
Megrose489 Member Posts: 779
edited 7. Aug 2015, 13:49 in Living with Arthritis archive
I've had hip bursitis, both sides, for over 18 months. I saw a rheumatologist in March who gave me a strong steroid injection, which really helped. At the same time, as well as OA in my hands, thumbs (for which she gave me injections) and knees, she also diagnosed fibromyalgia and reported that I had tennis elbows and tender shoulders - she mentioned the bursa there. I must admit that I was more aware of the pain from the hip bursitis and OA than anywhere else.

However, over the past few nights I've noticed that when I lie on either side the top of my shoulders hurt, so, presumably, the inflamed bursa are now making themselves known! The pain from the hip bursitis is edging back gradually and my thumbs are starting to bother me again. Sigh! Plus I've got my eye appointment tomorrow and I will be going on my own because Mr MR is not very well - pocket dwellers would be very welcome. :-)

At the moment I take 25mg Nortriptyline at night for the fibromyalgia, which works pretty well, and paracetamol as and when. I do try not to take painkillers if I can. Now I'm wondering if I would be better taking maybe six a day, regularly, instead of just when it all gets a bit much. Would having a steady dose of painkiller in my body work better than just taking it spasmodically, do you think?

Sorry if this has turned into a moan, but I felt quite down this morning when I realised why my shoulders were so sore. I'm pretty upbeat normally, but this extra thing has got me down a bit.

Meg

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  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    It is tough when one thing piles on top another and all the others to boot, it's not on. :( When it comes to pain I am a believer in taking a little and often rather than letting things build to such a pitch that the dullers don't even remove the sharpest edges (this approach was suggested by both my rheumatologist and a GP). I take four 30/500 cocodamol per day, this leaves me wiggle room to increase (I am allowed a maximum of eight in twenty-four hours). I usually take two at bed time and another pair around twelve hours later. OK, things still hurt but that is the nature of my beasts.

    Steroids of any kind are always a temporary 'fix', you could consider asking for more (and your wish may be granted) but there is no guarantee that they will be so effective. One can but hope, yes? I have always viewed the pain meds as part of my armoury when it comes to getting on with things, if my pain can be lessened even by a small amount then that is a result, but I do keep it to the minimum so I have room to increase if required. I know that one has to be careful with paracetamol, it may be worth chatting things over with your pharmacist about a suitable dosage for your needs. I will happy jump into a pocket tomorrow - when do you need the company? DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicket
    stickywicket Member Posts: 27,726
    edited 30. Nov -1, 00:00
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    You are under the cosh right now, megrose, and no mistake about it. The steroids have worn off (as they do) and you are left combatting the disease without their help.

    I think how we take the dullers can be a personal thing. Medics will often tell us to take them round the clock for best effect. I prefer not to. When I was on strong ones (dihydrocodeine) I found that the more I took the less effect they had so more were needed to maintain the effect. I preferred the pain which I found more honest.

    However, there have been times, especially immediately post and pre-op when I've needed them round the clock.

    Only you can decide what's right for you, now. It's a tough decision but things do sound tough for you right now. Why not try it and see? You can always gradually delay the next dose and so cut back that way.

    I, too, will be with you tomorrow and I hope Mr Megrose makes a speedy recovery.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • theresak
    theresak Member Posts: 1,998
    edited 30. Nov -1, 00:00
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    Sorry things are bad for you at present. My GP insists that taking paracetamol regularly throughout the day gives better control, but I don't always do this. You could always try it for a couple of days to see if it helps.
  • Susiesoo
    Susiesoo Member Posts: 358
    edited 30. Nov -1, 00:00
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    I am currently seeing a Physiotherapist and after talking to her and my GP, I have been persuaded to take a constant dose of paracetamol. I hate the idea of constant pain meds, but I take 2, three times a day. I refuse to take the evening dose as I am generally not in pain then and not having trouble sleeping, although I would if I thought I needed to. I saw Physiotherapist today and she was happy with this regime, as long as I am sleeping. They seem to think that a constant, low-level pain relief is the best way to deal with my pain.

    As we know, we are all different. I do hope things are easier for you very soon.

    Susie
  • Megrose489
    Megrose489 Member Posts: 779
    edited 30. Nov -1, 00:00
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    Thank you all for your replies. A few years ago, one of the doctors at my surgery advised me to take six paracetamol a day and obviously had the same idea as your medics, that keeping the pain relief medication at a constant level was the way to go. I tried to wash up this evening and my son had to finish for me as it was just too painful to hold a saucepan - honest! But, I think I will follow your advice, Theresa and Sticky, and increase the dose for a few days to see if I can get things to settle down. I'll also try to see my pharmacist, DD and discuss it with her. She's very good.

    The last time I saw the rheumatologist she said I probably needed to be thinking about surgery next for my thumb, as I've had four steroid injections into my left thumb joint now and the relief from the last injection hasn't lasted nearly as long as the one before. So, although I hate doing it - my GP must think I live at the surgery - I may have to go back and see him about a referral.

    My appointment tomorrow is at 08.40 and, because I have to travel a fair distance, I will have to leave about 07.30. Sorry that it's so early, DD and Sticky. :D So, an early night, tonight! Thanks again for your help.

    Meg
  • mig
    mig Member Posts: 7,154
    edited 30. Nov -1, 00:00
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    I'm up early so will be ready when you are,good luck. Mig
  • theresak
    theresak Member Posts: 1,998
    edited 30. Nov -1, 00:00
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    Good luck tomorrow, Meg.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    It could be that once things are more settled on the pain-duller front you could be able to drop the six to four, or maybe even five (and that is not as daft as it sounds, sometimes I take just the one five or six hours after the two just to tide me over that little bit further through the day).

    Right, it's 7.35 so we're on our way to your appointment! Good luck. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicket
    stickywicket Member Posts: 27,726
    edited 30. Nov -1, 00:00
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    Phew, that was an early start! There with you, megrose.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • Megrose489
    Megrose489 Member Posts: 779
    edited 30. Nov -1, 00:00
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    Well, what a waste of time! I had all the tests/scans etc., but then the consultant told me that she wasn't a vitreoretinal surgeon and so I would need to see him. So, now I wait for another month to six weeks for an appointment at the same hospital.

    Very tired. Thank you all for your support. Much appreciated.

    Meg

    By the way, I've made an appointment to see the GP tomorrow about my thumb joint. No more messing about!
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    Oh my word, I am sorry (I must have nodded off when you were told that bit :oops: ). I too have had those important appointments which turn out to be anything but and they are very frustrating. I have to go now but will be back later. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • dibdab
    dibdab Member Posts: 1,498
    edited 30. Nov -1, 00:00
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    Oh dear how frustrating. :( . I hope the next appointment comes through quickly. It's horrible when you psych yourself up for an appointment to walk away none the wiser.

    Hope your GP appointment is more satisfactory.

    Deb xx
  • stickywicket
    stickywicket Member Posts: 27,726
    edited 30. Nov -1, 00:00
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    Of course you're tired. Up early, no spousal support and a disappointing end. I think it's something we all go through from time to time when we expect a lot of an appointment and nothing changes.

    I like you r resolve re the thumb, though, Megrose. Go for it.
    If at first you don't succeed, then skydiving definitely isn't for you.
    Steven Wright
  • Megrose489
    Megrose489 Member Posts: 779
    edited 30. Nov -1, 00:00
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    Just a quick update. After simmering for a while, I phoned the eye clinic yesterday afternoon and expressed my disappointment about my appointment. It turns out there had been a mix-up between my optician and the hospital and they had booked me in to see the wrong consultant. However, after an apology, I was then offered an appointment on 8th September, with the right man, which I took. So that's good.

    Saw a new GP this morning about my thumbs. Before I'd finished telling her about the number of injections I'd had, etc., she had referred me to orthopaedics and also OT, who will be able to give me splints as I don't know how long I will to wait either to see an orthopaedic surgeon or have the operation. Very pleased with that. She is quite young and speaks very quickly. Do you find your speech speeds up in response when you meet somebody like that, or is it just me?

    So, feeling more positive today. :D Thank you everybody for your support.

    Meg
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
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    Well done on sorting out the eye mix-up and I hope your next appointment is one that will be of actual use! Well done to your GP too, that sounds like a sensible course of action.

    Young people do speak quickly, my Ma used to complain about it and now I am getting older I am finding the same. Maybe we did too when we were younger, age not only slows us physically but possibly in other ways too - it takes us longer to absorb and understand information. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben