Advice on pain medication and pocket duties, please

Megrose2

Forgive me if I've mentioned this before, but it's still an ongoing issue for me. I will be seeing my GP on Tuesday morning regarding better analgesia. I'm taking along the copy letter from the rheumatologist who said that with the OA, fibro and hip bursitis (although he did say the fibro and bursitis pain were one and the same!), I needed something more than 25mg Nortriptyline and paracetamol. I've also got an MRI booked in a fortnight to check my spine.

The last time I talked to my GP about pain relief, he asked me what I wanted, so I'm a little unsure how this is going to go. In the past, he has wanted me to double the Nortriptyline dosage, but, I'm a little reluctant to do this, as the side effects kick in at that level. I have tried it in the past for a couple of months and don't remember any real benefit during the day. Also, I'm unsure whether a higher dosage of Nortriptyline would really make any difference to the OA or bursitis pain. I understood that it's more for neuropathic pain, e.g. fibro. Maybe I'm wrong?

Basically, I want to continue to take the Nortriptyline at night - it works really well - and am looking for something a little stronger than paracetamol to take during the day, if necessary. Maybe co-codamol with a side order of lactulose?

Any thoughts and anybody available to hop into my pocket would be very welcome.

Meg

barbara12

Hello Meg
I am forever tweaking my meds, I find they dont have the same effect after a while, I have never taken Nortriptyline , but in the day I have But*an patch and they help take the edge off..I also have cocodamols but try not to take to many..I did ask for just codeine then I could take less or more paracetamol , depending on how I feel..have you ever been referred to a pain clinic they might help

dibdab

Hi Meg,
Juggling the pain meds is a constant puzzle. I currently have a combination of RA, OA and bursitis so maybe can understand some of your struggles. My GP has been tremendously supportive....including my mini meltdown in her surgery when I was having a particularly bad patch 3weeks ago. I currently have naproxen for the bursitis ,with a stomach protector, cocodamol which I use at bedtime then plain paracetamol during the day when I cope better with the pain, and now butrans patches which provide 24/7 pain relief....the latter have made a real difference got my pain levels. I was very wary about taking them because I was panicked by the list of side effects, but other than some drowsiness have had no problems so far.

I suspect most of us would rather take less than more in terms of meds, but at some point quality of life , or lack of the ability to function due to being in pain and unable to rest or sleep because of it, leads us further down the path than we are comfortable with. I really hope you can get some decent advice and support when you see your doctor, maybe you need to very honest about your pain leave and the effects they have on you?

Deb xx

Megrose2

Thanks a lot, Barbara and Deb.

Barbara - That's reminded me that the rheumatologist also said in the letter that the pain clinic may be an option for me, so that is something I could discuss with the GP. Just having the codeine, so you can take paracetamol as and when, is a good idea.

Deb - I don't think it has helped that the rheumatologist believes that bursitis is part and parcel of fibromyalgia and not an entity in its own right. He said this in the letter. I will be asking the GP if he agrees. You really hit the nail on the head when you said that the way we feel sometimes means we have to take stronger meds than we would comfortably want. This is me! In pain and tired most days, but worried about becoming dependant on powerful drugs with the associated side-effects. By the way, the rheumatologist suggested I try a non-NSAID gel on my hips. Has this ever been suggested to you? I've had the hip bursitis for two years, so I think it's fairly well established.

However, I do feel that it hasn't been fully understood that, to my mind, I'm dealing with three different kinds of pain here and paracetamol isn't making a deal of difference at the moment. So, I'll have a good think before I see the GP and make some notes. I'll let you know how I get on.

Thanks again. Much appreciated.

Meg x

Megrose2

Update. Saw the GP and we agreed that I would try doubling the Nortriptyline again, so I started taking 50mg last night. I asked him about the three types of pain and he told me that Nortriptyline did make a difference to all chronic pain. Well, we'll see. He also offered me Codeine, but I'm going to try with the Nortriptyline and paracetamol for the time being and see how I go. He did say to go back if things didn't improve, so, if necessary, I may try the Codeine and/or ask about the pain clinic at that point.

And he didn't agree with the rheumatologist that bursitis is not a separate condition!

Thanks for your support.

Meg

stickywicket

I hope the new regime helps, Meg. Let's know how you get on.