Hi, my mum was diagnosed with RA at 17 and through many surgeries and personal strength has done so well over the years. But now is in too much pain and is getting very limited support. She can no longer take normal tablets and has to take dispersible ones. Shes been told she can no longer have the voltarol dispersible ones they are not being made any more apparently. She's on methotrexate and other biological treatments but voltarol helped manage the pain. Nothing else she's tried is working. Something like oromorph or tramadol would knock her out she's very susceptible to some drugs. Is there any way of her getting dispersible voltarol? Other areas still providing it or buy it privately? Any other alternative ideas on helping her with her pain? Good consultants? Any help of info gratefully received. Like most chronic pain sufferers she's hidden this most of her life but it's shocking to see how much pain she's in now she cannot hide it.
Dispersible voltarol: Hi, my mum was diagnosed with RA... - NRAS
Dispersible voltarol
The PIL is still available for dispersible Voltarol: medicines.org.uk/emc/PIL.45...
But, I can't find it listed here as one of the prescribable forms nor is it listed as discontinued: medicines.org.uk/emc/search
Diclofenac (also an NSAID) is in the BNF in the dispersible form: bnf.nice.org.uk/drug/diclof...
Tho' it is available here (and presumably elsewhere): clinidirect.co.uk/voltarol-...
I'm baffled, tbh. Perhaps it's worth a call to the NRAS Helpline to chat through the availability and explore other options for more adequate pain control for your mother (e.g., a referral to a pain clinic or her GP approaching a rheumatologist for advice)?
Novartis, the main manufacturer, have discontinued production as far as I can see. I don't know if there is a generic version available, but you could ask your pharmacy for dispersable diclofenac (which is the drug name, not the brand name) Otherwise your mum could ask about other dispersable anti-inflammatories?
I have some diclofenac cream to rub into my skin over painful joints, so that might be another option?
And good on you for trying to help your mum.
She tries the gel and maybe helps a little. She has tried other dispersible nsaids but they didn't work as well or they upset her throat. Not sure all she's tried but stopped naproxen. Steroid injections help but short term. Pharmacist gave her what they could but don't have any more they can give her. They've asked other locations but can't get it anymore.
Has she tried cannabis oil? Search for recent posts on this (search box top right) as some have found it helpful.
Got her a medipen and she initially thought it helped (a while ago though. Before this bad flare and losing the Voltarol) but now says doesn't feel it helps and makes her feel dizzy and sick. She's not good at taking it. She also doesn't drink very much or eat regularly in the day sometimes and I keep nagging she needs to help her body in the most basic of ways it may make her meds more effective. I don't know just desperate to help. I'll do a search on here on the CBD oil thank you
Besides recent R.A. diagnosis & treatment, I have been on anti-inflammatories for many years for osteoarthritis. They won't give Diclofenac or Voltarol any more because of concerns re- side effects. Naproxen only now - with Omeprazole to protect the digestive system. Best wishes to your Mum.
Thanks yeah she's been on them many years. Diagnosed at 17 now 59. No problems at the moment getting diclofenac (voltarol) only can't get the dispersible ones. Yes they are no longer the drug of choice become of an increase awareness of the effects particularly on your heart I believe. Naproxen is not as good for her and she takes omeprazole already it's not enough she has a problem with her throat now after years of nsaids and alsorts. Naproxen was worse on her throat. Voltarol suppositories are helping but she's grateful for all the info and having a good look in to ways she can improve things long term. It's given her a kick up the bottom to prioritise herself and find alternatives. Thank you for your message. It's been really helpful chatting to other people with RA 
Not medically trained so obviously can't advise but has your mother tried pain patches? If she has difficulty swallowing tablets and dislikes using the medipen perhaps it might be an option? A referral to the pain clinic may help identify something to help. I really hope she can get some relief very soon and consider her to be blessed with such a caring daughter. Huge hugs all round
Jan
Such a useful suggestion that might well spot on for charlie9 's mother. I know nomoreheels mentioned that she is prescribed Butrans patches and finds them helpful. Plus it seems that the dosage can be titrated rather nicely compared to some medications and their delivery systems?
Volterol suppositories are available on the NHS. I know it sounds yucky but if you're in pain and seeking a solution.
Besides, its actually a really effective way of absorbing medication.
I suggested this so she then asked her Dr. Who did prescribe them and it was great initially but stopped her going to the toilet so she's been put off as she's had bowel trouble in the past. Perhaps she should keep trying them as like you say it's a very effective way of absorbing meds. What's frustrating is I'm making suggestions and the Dr has no idea. Just goes oh yeah okay let's try that. Because she puts on her make up and smiles and hides her pain well I'm sure they don't take her very seriously. Or spend the time to actually think through a potential solution. Just throw some naproxen at her and see the next patient. It's me telling her ideas which she then takes to the gp. Thank you for your help I think she should keep trying it.
Hi some good suggestions for your mum to try ....I have one more suggestion and that is for you to go with her to her next appointment , I really empathise with your mum, putting on her makeup and smiles through it...But it's hard to fight your own corner with the Drs when you are worn down with fatigue and pain, having you with her and giving voice to support her need for better meds and maybe insisting she is referred to a pain clinic will get the ball rolling...love to your mum for still putting her lippy on...I'm just the same!
I have suggested this I don't live that nearby and have a toddler but I would like to. They also don't listen when they take blood and her veins collapse I'm sure they could try a softer angled technique. I'm a midwife and always interested in medicine. I also have fibromyalgia which stopped my medical career. I'm the same wasn't taken seriously for years because I just kept going. One day I broke down in the appointment I was then told I was depressed. Pain management is so poor in some areas. I'm absolutely up for fighting in her corner you're right I should try and get in on an appointment. Will probably annoy the Dr but you never know they might appreciate some other ideas! Thanks for your message. Mum wants me to come to next blood test to do it myself haha I can see it now daughter banned from gp surgery!
I used to get so choked up in the surgery and trying Not to burst into tears meant I was unable to express how much pain I was enduring....Hubby came in and said his piece the following time and for once my pain and fatigue was taken seriously and acted upon...
I'm on MTX and have bloods done every couple of weeks, I was told to drink lots and be cosy warm to help prevent vein collapse...your poor mum I do feel for her, is she on this site? She would benefit from knowing we are all here for her.
Kate x
She's not. She runs her own business in a cold warehouse. Always working. Which keeps her busy and distracted but also means she never makes time to look after her self and try other things. She keeps her office nice and warm but often goes out to help in the warehouse. Which annoys me that the staff out there don't do a better job so she doesn't have to! But that's a whole other story! No she's not on here. You're right my now husband came to an appointment once and listened and watched then said no this is not good enough she cant even brush her hair at the moment it hurts too much and it got taken more seriously. I am going to her appointment!! They just can't get blood from her. She is daft she doesn't drink much water I gave her a big bottle to drink last week before the appointment but she drank it afterwards (no they couldn't get anything out!) She realised afterwards she'd been daft!
It's just hard to see her struggle but also shes reluctant to try other things like the patches etc she feels the side effects very quickly and she now has a problem with itching which is driving her nuts. It's a tough time right now.
Glad your hubby had your back. It's needed sometimes if you go in crying you're a drama queen or depressed if you go in strong and as positive as you can be you clearly can't be that bad. It's a no win situation.
Hi its awful to see our loved ones in pain, but like another poster has said your mum is really lucky to have a loving caring daughter, I have five sons and although there caring and would help in any way they can its not the same is it, I actually think that GP's are good but the thing you have to remember is they are what it says on the tin, General Practitioners and have only rarely a specialist interest, mines fantastic and have great support but anything to do with my RA and all my other autoimmune diseases he is happier for me to see my rheumatologist, he knows that at least he will be better able to prescribe for me, I haven't taken any meds in the heavy duty range for years, I take supplements and lots of tumeric and other anti inflammatory herbs etc, I have learnt over the years that exercise helps and heat on some days and ice on others.
If your mums not eating properly that want help either, she needs a good balanced diet to help the body cope and heal and dehydration is the worst thing for our bodies, very dangerous
I go hydrotherapy twice a week too, the warm water really helps, I do have other problems as well which means I'm either on crutches or in wheelchair so have to keep active as much as possible as have muscle atrophy too.
Is your mum having a good social life, being down can increase pain as well I think
I am really nagging about her eating and drinking at the moment. I gave her my medical cook book I had which is fascinating and advised putting turmeric in her foods etc. I think she often feels it's just one more things she doesnt want to have to change. She eats dinner well usually. Lots of veg and fruit but usually doesn't eat lunch and I have to keep putting water infront of her. I used to work in the warehouse so I was a feeder and water supplier for her!!
I suggest saunas etc. She can't walk far but cycles well. I went with her last week and got her to choose a bike that she was much comfier on so she'd keep managing to go. She is married to a very sociable man child!! So yes she has a better social life than me but obviously is exhausted by anything socialable as well. I would say right now she is down. Trying not to be but I think needs a good cry.
I will see if I can get her to hydrotherapy. And she's thinking of seeing another specialist privately to just chat it over with someone else. I totally understand GPs are not specialists. I think as a health care professional I perhaps cared too much. I would research and it wouldn't sit right with me until we had some reassurance or solution. Atleast support if there was no solution. But having the time to do that isnt really there I do understand that. There's such a massive strain on resources and time that care is really slipping they don't have the time to sit and think of a new plan. It's just try generic drug b now it's cheap and other people find it helps. Makes me sad.
I'm lucky I'm coping fairly well at the moment with my fibro but no one really can understand what I go through except her. And so I want to show her the same empathy and compassion.
I hope you find a good solution, without one things just get worse, I do believe though that we have to be in control of our own destiny because as you say no one else knows how we feel, I am ultra independent so hate asking for or receiving help, even my physio and OT tell me off for being over zealous LOL
Good luck to you both
Well done you. I get told off for not asking as well. Very stubborn I don't like people fussing over me. But I think sometimes we should be more honest and ask. No one can understand or be on our side if they don't know we're even facing a battle. She's very interested in trying alternative ways, diet and maybe alternative specialist too. She's eating lunch and drinking water as we speak haha daughter monster has nagged. It's been good to talk about it and get some real ideas from people who understand. So thank you
Maybe you could persuade her to join the forum, that's if she has internet connection of course, yea maybe if we never ask they don't see our pain
I doubt she would but I could try. I'm a total hypocrite but yes I would say we should ask sometimes. Or atleast open up to let people be on our team. That's what I'd try to advise others anyway!!
So sad
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