Good that I'm not angry... : So I went to see my GP... - NRAS

NRAS

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Good that I'm not angry...

skbladt profile image
11 Replies

So I went to see my GP today. I was determined to speak my mind in regards to pain management and my overall needs that I expected from him as a provider. It actually went really really well, or so I thought. I discussed the horrible headaches I had been having probably because of my combo of methaltrexate and prednisone, I talked about weight gain, again prednisone. He seemed very proactive and wanted to prescribe a migraine med and tramadol for pain. It was discovered that these two meds can't be taken at the same time. Fine. I'm just going to take tramadol for pain. 50mg. I had taken it in the past. I pick up the script and it reads no more than two pills daily, take one pill every 12 hrs as needed for pain.. ???? I'm willing to give it a shot, but I'm really not convinced that it isn't just a heavier dose of Tylenol... I'm not asking to be drugged up, just in better control of flare pain. I just don't get it.

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skbladt profile image
skbladt
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11 Replies
nomoreheels profile image
nomoreheels

There's little to compare paracetamol with tramadol, the two are opposite ends of the analgesia spectrum! Paracetamol whilst it can be prescribed it is generally an over the counter med, tramadol is prescription only, it's considered an opioid med, a Class C Schedule 3 drug. It's usually titred up, the recommended starting dose is 25mg once a day so your GP appears to recognise your need for pain relief according to your current need prescribing 50mg twice a day.

Please do be careful when you start taking it, have your family (or whoever you live with) aware. It can be a good pain relief med for many but some don't tolerate it. It's not a good idea to have alcohol with tramadol just so you're aware if you do drink. The main thing is it helps you with your pain, that's what's needed just now.

Valletta1 profile image
Valletta1

I feel for you. I also went to pain management here in New Zealand. They told me that they do not understand pain!!!! I had Prednisone which made me gain 10 Kg's in one month. I reduced them slowly now I am off them and lost 20 Kg's. I am still in pain and do take Tramadal and Paracetamol. Pain management think that pain is all in our mind. I do not go to see them anymore. I have been in pain for 12 years and some times the flair up is unbearable that I cannot sleep. I have Osteoarthritis, RA and Gout. I also suffer from pain in Achilles tendon due to my injury. To tell you the truth I gave up going to the doctor about it and I just take the medication. They do not know how to treat us. I have seem many doctors and even a specialist. The specialist will not do my knees yet as I am too young and it is not always successful. I am currently looking into the stem cell option. Good luck with your health. Wish you well. x

Simba1992 profile image
Simba1992 in reply to Valletta1

Many get good relief from pain with LDN. Have you looked into it?

ldnresearchtrust.org

I hope you will find something for the pain soon it's so hard to bear longterm:(

Jinnybabs profile image
Jinnybabs

Sorry you're having so many problems with pain; I am on a 5mcg Buprenorphine patch, which is controlling much of my joint pain, with paracetomol, and Oramorph at night to help with pain. I have had Tramadol in the past, and the main thing to watch is not only how it affects you as you start, but also if you want to come off of it; this has to be done gradually, as the withdrawal effects are really but if you stop it suddenly. I'm waiting to start Biologics, as none of the DMARDS have worked for me so far. If I could cross my fingers (which I can't!) I would!

Lynnels profile image
Lynnels

Hi!

Tylenol and Tramadol are completely different drugs, Tramadol being a very effective opiate type drug only given for medium to severe pain so please don't despair at the apparent 'low' dosage with only having to take it twice a day. It is likely it is a slow release type of delivery system that once taken releases a small amount into your system over the 12hrs between doses. It should cover the pain over that period of time and usually takes no more than 1 hour to give you pain relief.

Take note of what is said by nomoreheals above. It is a very strong medication and could take some time to get used to.

I do think your doctor listened to you if he prescribed this so good luck

skbladt profile image
skbladt

So I started the tramadol and so far today I really feel like it's working! I took 1 tab this morning and then 2tabs excedrine tension an hour later (has acetaminophen instead of aspirin) per my drs suggestion, and that horrible right arm pain with this horrid tightening is actually subsiding some! I don't feel perfect, but I do feel better! Thank the lord! : )

nomoreheels profile image
nomoreheels in reply to skbladt

It's good you're responding at a relatively low dose, let's hope your pain & the tightening (?) is kept in check & it's nit necessary to increase the dose. The lower the better with tramadol, it can be a you know what to come off.

skbladt profile image
skbladt in reply to nomoreheels

It's like I'm wearing a blood pressure cuff a lot of the time, and hands and elbows were just radiating pain like they'd been smashed with a hammer. Rheumatologist feels that it's part of a flare that starts in my shoulder. Had an X-ray and thankfully no damage in the shoulder, just still trying to get a handle on my RA. And yes, I want to be able to keep meds low so I can continue to work full time. I've worked with special needs clients my entire career and at 46 definitely not ready to give it up 😊 thank you for the reassurance!

nomoreheels profile image
nomoreheels in reply to skbladt

Could be a muscle/tendon problem, goes hand in hand. This explains the mechanics of RD well, rheumatoidarthritis.net/wha.... I find it helps if we understand the process. Particularly relevant to you just now maybe the section entitled How does RA affect soft tissue?

Are you prescribed anything specifically to ease inflammation?

What a worthwhile job you have, good on you! I hope you're able to become better controlled fulfil your wish.

skbladt profile image
skbladt in reply to nomoreheels

I take 15mg of prednisone

nomoreheels profile image
nomoreheels in reply to skbladt

No NSAID? I really meant something specifically intended for inflammation you could take longer term really. Steroids are good for acute inflammation, short term, whereas NSAIDs are better at keeping inflammation in check. That is unless your Rheumy has you on them long term. I'm near to tapering mine (once my nurse ap/t comes). After 5 years on them I'm desperate to be off them to maintain my bone density but I do take an NSAIDs alternate days.

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