MST and Oramorph

[Mistee]

Hey guys,

I'm having a bad flare up of DDD, my back went last night when I was getting up from the settee to go to bed - excruciating pain and unable to straighten up.

I already take MST, gabapentin, amitriptyline and paracetamol for pain and managed to get an appointment at my GP surgery this morning. I was hoping to get oramorph and maybe diazapam to get me through this episode (as I've had in the past) but the locum I saw today refused and would only give me ibuprofen gel and told me to phone the self referral line for physio. She said oramorph may help initially but will make me more dependant on MST in the long run so giving it to me would do me no favours, instead she gave a prescription for ibuprofen gel and told me to call the self referral physio number!

I'm pretty peeved to say the least right now, I've never heard of oramorph affecting MST dependancy? Is this actually a thing? I've been prescribed it for years to help. With flare ups and at my last meds review at the pharmacy, they recommended I get oramorph added to my repeat prescription so I've always got it for break through pain...

I've put the ibuprofen gel on my back as well as I can manage and surprise, surprise it's not made any difference at all so far. As for the physio referral - we'll that's completely pointless, I turned that down explaining I called them on 8 Feb after slipping on the ice and partially tearing ligaments and cartilage in my knee and the first appointment they were able to give me is in the middle of May!

[johnsmith]

What is "DDD"? You need to get the referral. It may be pointless as you say. However, you have an appointment to discuss issues. You need this. You need to gain the knowledge to manage your condition. You cannot gain this knowledge by taking pain killers.

[Mistee in reply to johnsmith]

Degenerative Disc Disease. I've been managing this condition for 10+ years and have already seen physios and pain teams many, many times. They all just agree that I'm doing the right thing on my own and recommend using oramorph for break through pain which is why Im annoyed that I couldn't get it today.

I might have known, I always have problems with locums. Last time I saw one he took it upon himself to decide I was on too many medications and refused to prescribe anything until I'd had a full medical review with my usual GP. Despite the fact my meds were being managed by my pain team at the time. My usual GP was also annoyed by this.

[johnsmith in reply to Mistee]

Thanks for the email. See a McTimony chiropractor. Tight muscle fibres surrounding disks will impede blood supply and starve bone of nutrient. This is a theory I subscribe to. This is worth investigating. Another thing to consider is possible infection. Medics consider full blown infection because it is obvious. They ignore minor hard to notice ones. Explore with the doctor a course of antibiotic such as erythromycin. Google "erythromycin antiinflamatory"

example academic.oup.com/jac/articl...

ncbi.nlm.nih.gov/pubmed/298...

I know from my own experience that erythromycin is an extremely good antiinflamatory.

[Mistee in reply to johnsmith]

Thanks, I'll look into the timony chiropractor although I doubt I can afford it 😖 oddly enough my muscles don't feel particularly tender to the touch yet I still can't straighten up or move a great deal for the pain. Super frustrating and I've only just returned to work last week after 7weeks off recovering a knee injury so I've got no choice but to get myself into work on Friday (I'm part time) regardless of how much it hurts or how difficult it is to move around

[JakeFromLondon]

Tramadol is a good option as an opioid. It also has SSRI properties for nerve based pain. It’s cheap and doctors are more likely to prescribe it.

[Mistee in reply to JakeFromLondon]

Thanks, I was on tramadol for quite a few years before progressing MST but as I've managed to lose a few stone over theast 2 years and haven't had a major flare up in the last few years, I've been considering going back to my pain nurse to see if stepping back down to tramadol is a possibility. I don't think people with chronic pain conditions tend to go backwards with medication but I've felt like I've been managing quite well...until last night!!

I'm mostly just amazed to hear a medical professional tell me that oramorph would lead to needing a higher dose of mst in the long term when litterally every medical professional I've seen in the last 10yrs at least has prescribed it in situations like this. I don't get it often and only asked for 1 bottle to help get me through this episode. The ibuprofen gel has made no difference whatsoever 😩

[JakeFromLondon in reply to Mistee]

I still use tramadol and I require OxyContin too. Tramadol has always been consistent for my back pain. Beyond the capsules that last 4-6 hours. I found there was a tramadol pill (marol) by Teva that lasts 12 hours. I have both and the oxycodone. Each has a place. Good luck with your search. Trust your gut feeling.

[Hidden]

Hi Mistee.

I'm on MST's, Pregabelin, Naproxen and Paracetamol (as well as other, non-connected meds) for donkey's years, with Oramorph for break-through pain, although nothing seems to work and I can now barely stand! I recently went to my doctor as life is unbearable, expecting to be sent for X-rays to see if there is more recent spinal collapse? I was told that "The (local) hospital has told us not to refer anyone for X-rays any more."????? Instead, the doctors have to now refer people for physiotherapy, and it will be up to the Physio whether he/she refers you for X-ray!!!! I couldn't believe this rubbish!

I was 'lucky' to get an appointment with the Physio within 2 weeks, and hobbled in to see a young lady who began listening to my health-history as she was preparing the examination couch (not height-adjustable). I said "I'm sorry, but there's no way I can even get ON that!", so she immediately referred me on to (yet another) Physio! It's now 3 weeks later, and I have that appointment coming up this week....

I can't believe that people are being made to suffer this way - prolonging the agony whilst providing so little treatment - and they wonder why so many people become addicted to pain killers, or commit suicide??? Yet what can we do unless we have private health care, in which case we could have an appointment tomorrow....?

It makes me soooooooooo angry that I worked (and paid into the NHS) for most of my adult working life, yet when I need care the most, I'm being left to suffer! 😡🤬😡🤬😡🤬

[JakeFromLondon in reply to Hidden]

I don’t think you’re unreasonable to want better support but think you’re not doing enough to get what you need. You’re going to have to write letters to MPs. Get an advocate right to a pain charity. If need be they will get you a lawyer. To really get the care that you deserve you have got to get extra help to support you and you will get the outcome you deserve it just got to put the work in. What’s happening is terrible but you’ve also got to stop complaining so much about everything. You don’t want to irritate people and they won’t help you. Only mention the most serious breaches of your care and explain how this has caused you ‘harm’ not inconvenience. If you do that, if you get the right support behind you, reach out to charities local ombudsman, councilmen, whatever you’ve got to do. These people are in these powerful positions to help people like YOU. Good luck.

[Hidden in reply to JakeFromLondon]

Thanks Jake, but it seems that things have (eventually) begun to progress without my having to involve bringing in the big guns? - The Physio I saw took all my (long) medical history, and immediately asked if I was available to see the most senior Physio the following day? I almost kissed him!!

After a few more questions with the 'top bod' on Tuesday, and a few simple tests for things like reflexes and sensitivity (lack of!), I'm now waiting for an appointment for an MRI scan! I've been saying lots of prayers since... 👼🙏

[JakeFromLondon in reply to Hidden]

It’s good news for you. I think you could of had this scan ages ago? Lol. I know my DR wanted that done before he would give me strong pain relief. We couldn’t see anything anyway. Just remember, MRI does give out lots of false positives. I’ve decided to have another as it’s been four half years now. Whatever your results just keep in mind it’s a combination of tests / tools that help to build a picture. Beyond that, I would always get a second opinion if the results point to an outcome that requires anything invasive. Let me know how you do. 😎

[Hidden in reply to JakeFromLondon]

Hi Jake. I almost get the feeling that I have another 'slipped disc' which will show up on MRI? At least there's a chance of them seeing what the problem could be, whereas merely dosing me with opiates isn't going to cure anything? I have all my fingers very tightly crossed. 🤞🤞🤞🤞🤞

Watch this space.....

Good luck with them getting you sorted out to. 👌

[trimmso]

Dear Mistee I have no offer of a solution for you except empathy as I know how cold hearted and single-minded the NHS can be