I have the complication of having a chronic back condition which means I am in pain all the time. I take gabapentin and co codamol and also recently ralvo patches. Last year and earlier this year, I suffered a heart attack, so now cannot take any kind of anti inflamatory. My GP worked with me last year to try to change my pain medication from gabapentin to pre gabalin. Unfortunately I had a pretty severe reaction to the pre gabalin and so went back on the gabapentin. I would now like to try again with a different pain regime. My thought are trying dihydracodeine instead of co codamol? ( I have used dihydracodeine before, some years ago) I would stay on gabapentin. As I can no longer take anti inflamatories, ( naproxen) I would like to ask my GP if I can take oramorph for breakthrou pain, (back flare ups), as this was given to me (safely) in hospital and it really helped. Does any one else here take oramorph or dihydracodeine?
pain medication: I have the... - British Heart Fou...
pain medication
Hi, I’m sorry you’re in so much long term pain. I have been there ( maybe not quite so bad). It’s a bummer that we’re not allowed any anti inflammatories but that’s potentially another heart attack for us. Why are you not allowed to take prescription strength co codomol because that’s what I take? Nowadays I only have to take them every two hours ( 1 pill) before and during long walks, exercise and being a granny.
I didn’t think I’d manage without my Tramadol and Naproxen but thankfully my chronic pain isn’t as bad since I’ve retired.
Hope you find something that helps. I’m sure others will be along soon with knowledge of Oramorph.
Hello 
I had 3 heart attacks and Bypass surgery and take Gabapentin for a pain condition
If I wanted I could take they say up to 900 mg a day but I never do as I think I do not want to get to reliant on it and with pain we can get to a stage we get used to something and then it stops working as well so the strength goes up and up
When I came out of Hospital and I had chronic shoulder pain they did also send e out with a week's supply of oramorph , I am not sure if they would have liked to have prescribed this long term though but this is something you can ask
I do hope you manage to find the right medications to control your pain as I know how it can affect us
Let us know how you get on x
I am sorry you are living with pain in your life too.
Oramorph is a type of morphine and there is growing reluctance to prescribe morphine long term for chronic pain.
Dihydracodiene is also an opiate.
This is caution given by the British National Formulary BNP.
'Dependence and addiction
Prolonged use of opioid analgesics may lead to drug dependence and addiction, even at therapeutic doses. There is an increased risk in individuals with current or history of substance use disorder or mental health disorders.'
bnf.nice.org.uk/drugs/dihyd...
We are between a rock and a hard place😪
Hi Momander, I've been prescribed both dihydracodeine and oramorph on different occasions for post-surgical pain relief, i.e. short term. I found both effective, but the length of time I needed either was short-term in the extreme by comparison with what you're dealing with. The oramorph was excellent, prescribed for a few days and only while I was in hospital. I've often been prescribed codeine following hospital discharge for pain management, but only a couple of weeks supply. I've been fortunate either not to need it or not to need it for long.I found an American website primarily offering advice regarding codeine addiction, which I realize is not an issue for you, but I wondered if its content might offer you some insight into "safer" pain medication alternatives to discuss with your GP?
codeine.com/addiction/getti...
I hope this isn't a daft question, but I wondered if you've ever been referred to a pain clinic? There are specialists out there who understand precisely how pain works between the site of injury/sensitivity and how the brain converts those stress signals into what we perceive as pain. Some of the work being done is interesting. I've put a reference here for you to read if the fancy takes you:
I hope this is helpful info and am sorry that I cannot offer something based more on personal experience and solid evidence of long-term pain relief on a practical level.
I wish you some good pain relief and peace in the near future.
PS. Almost forgot to say that on the 'Tame the Beast' website, there's a course offered that costs money. My advice is to disregard that completely and stick to the free information only.
I was referred to a Pain Management Programme.It is something that I recommended to anybody living with chronic pain.
I think in a previous post I have made this suggestion to Momander.
Can I ask if you have ever lived with chronic pain?
Pain and how we experience pain is complex, I have learned to respond in a different way emotionally to my pain.
I personally do not refer to my pain as a 'beast'.
I use this visual chart to try and express how my pain feels to me.
Hi Milkfairy, mine is chronic discomfort rather than pain and it's manageable. I have experienced severe pain both prior to and post surgery, but only short term, mercifully. The thought of anyone being in severe pain long term is a concept I find truly upsetting and people in that situation have my utmost sympathy, especially those with terminal illness.In my opinion, in this day and age long-term pain that renders one unable to function with any degree of normality really should be manageable without poisoning the patient or risking them forming an addiction. I think pain scientists are on the right track, but it's taking longer than perhaps it should to sort out an effective protocol that the NHS can adopt.
Nonetheless, I live in hope!
I, too, found the Tamethebeast site very useful, as well as the work of Dr Lorimer Moseley, Dr John Sarno, Dr Howard Schubiner and others. There is also the Curable App…all worth exploring.
I wasn’t keen on the idea of Gabapentin, suggested to me by my neurologist four years ago, and I found other ways of coping with the pain.
I found the curable app helpful too.It reinforced what I had learned on my Pain Management Programme.
curablehealth.com/?gclid=Cj...
I love your visual! Where can I find it to enlarge and/or print?
The curable app did nothing for me im afraid
That's a shame.
It can take a while to find what will work best for you as an individual.
Have you tried a TENS machine?
It sounds as though you also didn't have a good experience with the Pain Management Specialist you saw either.
I can understand it doesn’t help everyone. It’s shame it didn’t work for you.
Milkfairy’s suggestion of a TENS machine might be worth trying.
both curable and tame the beast are not free, so for anyone who is on a tight budget this is not an option i am afraid. it would be so lovely to find something that was free
I agree. However, whenever I did access Tamethebeast, I’m pretty sure it was free. Maybe there are more resources if you pay? Curable, certainly, you pay for.
Tame the beast is very expensive and a big risk financially if it doesn't work
Insight Timer is free.
insighttimer.com/search?que...
Vidyamala Burch is someone who lives with chronic pain.
I found her book " Living Well with Pain and Illness" helpful.
My husband as well as heart problems has ms. He was prescribed gabapentine. However decided he did not want to take it. However his pain flared up so the doctor has prescribed short term tramadol and put him on amitriptyline. He is seeing his Ms nurse next week so maybe more advice there. Chronic pain is hard to live with and needs management. I wish you all the best in getting it sorted it sounds like s pain management clinic is what you need take care.
I have been to a pain management clinic and the person a yualky changed and reduced the dose of my medication without my knowledge or permission. Not a good experience
Similar situation with psoriatic arthritis and heart issues. I think I’d avoid dihydrocodeine. It’’s quite addictive. After discussions between rheumatology and cardiology they’ve put me back on anti inflammatories as the benefits outweigh the problems. I already take steroids, anti TNF and methotrexate and the anti inflammatory, Etoricoxib, just tips the balance enough to give me mobility and some quality of life. The slight increased risk of another heart attack seems worth it to me but that’s me. The biggest difficulty was persuading cardiology to speak to rheumatology.
I know for a fact that I will never be put back on naproxen. Ieas told this by both my cardiologist and GP.
Great that you got one specialism to communicate with another! I am under three and they don’t.
Hello Momander, I’ve had two knee surgeries this year & both times had Oramorph for break through pain relief along with co-codamol (for my sciatica) as I can’t have anti inflammatories. Had absolutely no problems either time. Short & sweet but it really was that unremarkable - did the trick & took the edge off the pain when needed with no adverse reactions.Best wishes. Steve
Thank you so much!! I am so sick of hearing of the terrible side effects or addiction to these drugs. I have been on o codamol and gabapentin now for years and have no side effects or addition!! I have cone off both of them se really times with no problems. All I'm trying to do is work out a different pain regime that might give me a better quality of life
No worries, nice to read that you have a similar unconcerning relationship with them. Best of luck in your search/mission! I see your point, in fact I still have 1/4bottle of Oramorph left as I used it so sparingly (too much so at times) in the knowledge that it would be so difficult to get another which also goes to prove your point. I would not be concerned with somebody taking it that has your record of stopping opiates - I qualify that on doing so myself with co-codamol for long periods, currently slowing them down again on ease of knee pain as it’s approx 7weeks since surgery & the inflammation is subsiding. I don’t find them difficult in the slightest to manage. Hoping to return to my normal levels of use or less next year (recovery is going to be a long road) when my knees hopefully don’t irritate my sciatica / alignment so much.. Again, all the very best & stay strong.💪
Steve
Ask your GP if you can be referred to either a physio or the Pain Clinic for a TEN's machine - but not if you have a pacemaker.
I ha enough been to both the physio and the pain clinic and I have a tens machine. The physio wasn't hands on, just exercise advice. The pain clinic ic doctor changed and reduced my medication without my knowledge or permission.
Have you tried changing the settings on the TENs machine, and leaving it on all day, apart from driving?
I was put on oramorph around 20 years ago but I was allergic to it ( itchy rash and tight chest) so it was changed to oxycodone which works the same way and is an opiate and which I've been on ever since. It wasn't changed after my HA. HOwever they are very reluctant to prescribe opiates now and they are certainly not something you want to be on long term ( I speak from experience). They are very addictive and have long term nasty side effects. Your doctor may be willing to give oramorph short term for breakthrough pain but I suspect it would only be very short term.
I am so sorry for you suffer from this new set back about withpain control for your bad back. It looks as if you need a serious
medicine review with your GP to advise you. I was surprise that
you name gabapentin as anti-inflammatory, I have been on it for
many years, and I was always told that it is antiepileptic, but that it
is also used for neurological pain control, so I am not sure why you
are considering stopping it, if it helps you. You definitely need more
medical advice what painkiller method will be best for you.
I am sorry but I do not know where you are getting the information regarding gabapentin being an anti inflamatory?? I am on gabapentin as a nerve blocker for sciatica and WAS on naproxen as an anti inflamatory.I am having a meds review tomorrow thank you
Obviously, a misunderstanding, Momander.
I read what you said in your original entry that you cannot take anti inflammatory, and this was followed in the next sentence, by the decision to change your gabapentin:
" I suffered a heart attack, so now cannot take any kind of anti inflamatory. My GP worked with me last year to try to change my pain medication from gabapentin to pre gabalin. "
I was naturally puzzled by the above decision, since I know that gabapentin is not an anti inflammatory (but helps with neuropathic pain conditions) so why change it.
I do wish you, that you will soon find the best solution in this difficult situation. Sadly it is often trial and error, to find something that suits you best.
I have quite bad back pain around my L4/L5 and I have taken the non-painkiller route (but I do take them when I have no choice) by doing Pilaties. I also see an Osteopath and a Chiropractor when needed. I'm seeing the Osteopath about every 6 weeks at the moment but I have been well enough to only see Osteopath and/or Chiropractor 2 or 3 times a year. The key for me is Pilates, I go to class once a week and found it keeps my back pain at a tolerable level where I don't need painkillers. If you have not considered/tried Pilates it is worth giving it a go. You will need to try for about 6-12 weeks to really start feeling the benefit. I've now been doing Pilates for about 7 years and really notice it if a stop. Osteopaths and Chiropractors are expensive but could be money well worth spending. I do hope you find a solution that works for you.
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