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Pernicious Anaemia Society
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Quick one on pain meds?

Today is one of those bad days depite jab the other day... only another day till my next... but when symptoms are only mildly relieved (usually im like a new man for 2 days) and the burning aches pains and breathing issues to name a few are only relieved a bit... is it wise to give in to getting pain meds? Ive got some codiene left over from when drs thought stabbing rib /phenomia / they never decided(that omade pain go to a strong discomfort, which is basically what b12 has done this time... still lots better than before jab though) theres also tramadol left from last stomache issue with hospital...or cpuld this just lower my b12 levels due to drug interactions? Normally i just bare with it but somtimes whem the jab doesnt rid all the issues every little breath thats tight or shoot up back or arms and legs drives me mad as im less fatigued due to jab so its just enough relief to make me alive enough for symptoms to really piss me off (pardon my french) .... really im asking so im less of burden to those round me who expect jab to fix everything.... of course it doesnt always which dissapoints them i think....and annoys me as somtimes it makes me like before i was really bad with this.... sorry rambling again....erm...pain meds good idea or am i possibley just lowering my b12s effectivness for short term relief? I know to expect bad days and good no matter what... its just very crushing at times... i should be grateful for what relief it does give me ... which is a great deal, just annoyimg when fog clears a bit so i notice stuff more... i dunno, im most likley just moaning... deal with it till tomorrows jab...lfrankly id like to avoid taking uneeded things.it just gets a bit mu h some days...look at that ive awnsered my own thing...sorry.. my question still stands for next time though... or maybe for others in simlar positions

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Hope your rant got it all out.your not alone I live in a constant pain and feel exhausted from the time I get up.crap isnt it...unfair,frustrating and yes feeling totally pissed off.INJECTIONS do they work ? Sometimes,briefly,hopefully.

Hopefully a better day tomorrow.

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I think this is a good question but there's no simple answer.

Taking regular painkillers can lead to dependency and in the case of headache, 'rebound' symptoms, or 'medication overuse headache'.

But not taking painkillers when needed can 'train' the body to keep on experiencing pain and may make it worse due to a stress response to the pain as well.

I think: look for the lowest dose of pain medication that helps, and take it when you really need to. Keep a record of how often you're taking it, and if it relieves your symptoms, so you can keep a check on things and show your GP if necessary in the future. NSAIDs and aspirin are likely to cause stomach issues. Codeine causes a different type of stomach issue and you can develop dependency if you use it long term continuously.

In the meantime, do some research and look for other ways to deal with pain, either herbal alternatives, supplements, through diet, or physical therapies such as massage, acupuncture, or mindfulness etc.

This is just my opinion after years of pain management. You should speak to your GP or pharmacist before making a decision.

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True however the British Pain society consensus is that opioids are effective in management of persistent long-term organic non-cancer pain.

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I didn't know that, thank you. There's been a lot of publicity recently about the problems of long term opioid use in the USA.

I'm not sure they even work for me, I take one for migraine which is a combo of paracetamol, codeine and buclizine. It works for a few hours but I'm exhausted. Then the effect wears off and the migraine usually is worse than before. Then I can take the follow up tablet which is just paracetamol and codeine but it doesn't work at all. I tried a stronger codeine tablet once, and it made the pain even worse and I felt like a zombie, could hardly move.

So opioids don't work well for everyone.

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Are you sure you are able to properly process the codeine? It's really morphine with an extra methyl group tacked on. Cytochrome p450 cyp2d6 is supposed to strip about 10%_of the methyl morphine but some people are deficient in this enzyme. Codeine on it's own cannot provide analgesia as: it cannot attach to the right receptors. Opioids are not for everyone but you would have to try multiple types to establish this. We have the opposite problem in the UK: Doctors are often opiophobic especially after Harold Shipman. Many patients suffer from inadequate or non existent management of chronic pain. The NHS removes a lot of the cash incentive to prescribe by lobbying and generics are prescribed as default. I have only known a couple of cases where oxycodone was scripted to non terminally Ill people. We have diamorphine (heroin) available when regular morphine is insufficient.

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I'm in the UK (but had read about issues in US) and yes, management of chronic pain is fairly non-existent here. I've found little help with severe uncontrollable migraine pain - it's been extremely traumatic to say the least. You begin to feel you are not considered worth helping.

And no, I'm not sure that I can process codeine. My system doesn't usually respond well to any kind of medication.

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Rant away lovely you have to release it all somehow.

So B12 has been a feature for me for the last 23 years. Never realised until this site the side effects of pain.

So having gone through lots of surgery ( back) Ive researched healthier options for pain. Tramadol puts me into fits Codiene causes lots of tummy and skin problems.

So I take turmeric. Stops all inflammation, pain & joint ache. Magnesium 250g & Vitamin B complex as the injection depleted my other B vitamins.

If I'm dipping badly with b12 I wear a B12 patch for 24hours but only for 1 day.

I guess its just a case of when the fog lifts trying other things.

Hope this helps I no longer take any phamaceutical pain relief.

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Hi just wondered how you take the turmeric I'm interested to try this thanks xx

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Mwahahahhaha!! Okay injection today has cured ALL of it :) back to old me even if it is only for a few days, doesnt change how wonderful it is to be back !!

Thank for all the advice and help anyways and ill keep it in mind and hope itll help anyone else too, ill be in a better country for drs regarding my condition and easier access to b12 sopn so thatll be good (nhs said PA is symptomless and let me get to wheelchair and loose my job stage, and i just despise them now, easier to leave UK as seems ive found drs that understand the condition abroad)

but for those inbetween days or times it doesnt quite do the job as well as it usually does i will definitley use your suggestions.... ahhh i just feel sooooo sooo much better its amazing how much can be lifted away from the right amount of treatment (sometimes...i know as i said its not always... like the other day when it only partly lifted and just made it more noticible physically due to clarity) but ahhh yay i seriously hope all if you feel as good as i do today !!! Seems all i needed was another jab (and this one was with IM needle all the way in not those tiny ones the pharmacy sometimes give me as there convinced its for heroin... i definitley notice a diffrence with bigger needle deeper (just realized that may sound rude..appologies). Others do work... but less so it seems

.... maybe due to being deep enough in muscle... i dont know ... anway woo!!! Im going to watch a french movie and go walk my friends dog in this window of being me again

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Exchange supplies exchangesupplies.org/ sells pretty much every length and gauge of needles and other injection supplies available. I have used their 23g needles for self injection when doing the IM route with good results.

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It's a difficult conundrum. Personally I'd just take the pain killers. It's doubtful the effectiveness of the b12 injection will be reduced to the point it would outweigh pain relief but its up to you.

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