Pain relief dilemma

[doggieday]

I am 85 and have extensive osteoarthritis and fibromyalgia amongst other conditions.

I also have a chronic bowel condition which puts me in hospital if I become constipated. Most of the oral meds offered by GPs for pain relief have that effect even though I am very careful to avoid it. The Rheumatologist put me on Butrans Patches 5 mg to start with and now increased to 10mg. This does take the edge off pain so, despite some side effects, I am more comfortable now.

My Gp says that, as I have discovered, the effect of the patches wears off as the body becomes accustomed to them and she is not at all happy to increase them any further.

My dilemma is that I really struggle to cope with the side effects of oral pain relief and don't want to keep trying it. I understand her point when she wants me to try them again. Do I take her advice and the risk involved or do I ask for increased patch doses which might eventually have the same problem or worse anyway?

I am unlikely to see the Rheumatologist again for a long time because of waiting list delays.

[kev60]

hi , I to suffer with pain various areas. I am on Bunov pain patches like you started on 5mcg , I am now on 30mcg having gone to 35mcg and found I became unwell and dropping to 30mcg this seems best for me. Like you say it takes the edge off. As I have abdominal problems I cannot take ibuprofen but I can tolerate paracetamol of which I take up to 8 per day also have codeine for emergencies (high pain). Speak with your doctor about upping the dose to find what works best for you. Good luck. Kevin

[doggieday in reply to kev60]

Thank you! I am such a difficult patient to prescribe for because pain relief causes side effects i find hard to deal with but it gives me confidence to hear what others find helpful!

[bookish]

Are you being given vitamin B12 injections? It is unlikely that you are absorbing well given your other conditions and risk of deficiency increases with age and depletion by other medications. If you are not supplementing any B vitamins you could ask for serum B12 and serum folate (B9) testing, plus magnesium and vit D. Those B vit tests cannot rule out a deficiency but may rule one in. Best wishes

[doggieday in reply to bookish]

No, I havent been offered anything in the way of supplements but just take a multi vitamin. I have been anaemic in the past and had a potassium deficiency but that was years ago. Thankyou for your suggestion, I will ask when I get my next appointment

[Batty1]

What type of chronic bowel problem do you have?

[doggieday in reply to Batty1]

I have Chronic Diarrhoea caused by Bile Acid Malabsorption (after Gall bladder removed). I also have Diverticular disease and the advice is that I avoid the constipation that most pain relief causes. Its a Rock and Hard Place situation!

[SouthernSally]

Can you take a prescription drug for constipation along with your oral pain meds?

[doggieday in reply to SouthernSally]

Good question! Getting the right balance is a nightmare . I have spoken to dieticians and tried all ways to find suitable pain relief that works for me. I have had years of this and its getting to be more of a problem as my pain levels increase,