I watched this programme on BBC 1 last week with increasing anxiety; almost all the drugs mentioned are those that my rheumatologist is prescribing for me.......Gabapentin, Amaltriptyline (couldn't tolerate it), Azathioprine, etc. I already take the maximum dose of Tramadol (400mg) daily in 4 hits, backed up each time with the equivalent dose of Paracetamol. I am now concerned that he is trying to reduce my steroid intake for PMR - currently at 13mg after a bad flare at 7.5mg - at any cost but that this maybe actually leading to a long term addiction. Or is it perhaps that at 70 he thinks it doesn't matter if I am permanently hooked on painkillers for the remainder of my life? I am lucky that I can tolerate Tramadol, I hear many people can't, but I started taking it 20 odd years ago for botched spinal work after all the other painkillers from 1979 onwards failed after a while, but only at a low dose then of 2 x 50mg daily until the PMR when I was put up to the max dose.
It's tough, I have to live daily a life which is tolerable which makes me think that continuing on a steroid dose that allows me to do this is the right way forward. After all I have already got two busted femurs from the Alendronic Acid.....what else is at risk?
Incidentally, I have a running prescription for "Phorpain Gel Maximum strength" which I use daily on the muscles of my arms, shoulders, knees and thighs. It can be used up to three times a day and certainly does help.
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Ida-June128
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Which is an NSAID gel (ibuprofen) and most authorities say even topical NSAIDs shouldn't be used alongside pred. I wish to goodness they could come to an agreement! I used brufen gel very occasionally (to get me out onto the ski piste I have to admit) but it never did much good, sort of smoothing the edges of the pain I suppose, so I didn't bother a lot.
I agree with you - I really would rather take my chances with a couple of mg more pred and have a minimum of medications to interact with one another. I think I am quite lucky here, when the trochanteric bursitis got impossible I had an appointment at the hospital for a check-up on the atrial fibrillation story. I asked the doctor what I could take for pain relief given the cocktail of drugs I already had and she laughed and "Not a lot!". But rang the emergency department to find out if a nice kind orthopod would give me a steroid shot for the hip pain. Done in half an hour and what a relief! And my GP would rather I took a bit more than a bit less pred - which is fine by me.
In the textbooks/papers it mentions using NSAIDs for "mild" PMR. From what I read of other's stories I'd say my first 5 years were mild - must have been, I managed without pred but it wasn't nice. But ordinary painkillers never touched the PMR pain. One lady on another forum was told by her GP to use ibuprofen when she went to him with probably PMR. Three doses of brufen later she was in A&E with a gastric bleed. She was actually fine with pred though.
That worries me as I am already taking Omeprazole for a destroyed stomach lining in the 60's due to butazoladine (no-one told me not to take those little red pills on an empty stomach) and an ulcer in the 90's. Perhaps I had better try and cut down on the gel but it does help particularly around the swelling over the busted femurs. Perhaps I have just been lucky or the Omeprazole is counteracting the ibuoprofen gel?
I suppose the omeprazole does help considerably - and of course that is something totally separate from the PMR pain. Wouldn't it be wonderful if they could find a form of pain relief that worked for everything with no side effects...
My stomache lining was also destroyed by taking Voltarol tablets when I had a bad car accident, and like you, nobody thought to tell me what would happen, or give me anything to stop that happening. I am very careful now and spread out my tablets as much as I can, and usually end up taking my Omeprazole when I get up in the middle of the night.
I'm on Omprazole 2 daily for a perforated ulcer roughly 10 years ago. Never had any problems since - that is until pred. Bad heartburn and acid reflux. GP said I can double the dose of Omeprazole until system gets used to Pred. I did this for a few days and not had any problems since.
Ida-June, at 70 you could have another 20 or 30 years ahead of you, and it would be nice not to be addicted to meds, wouldn't it? You have quite a list there. Can you discuss it with your pharmacist to find out if there is a way you can start safely cutting back, and go to your doctor armed with more information?
Ida-June, Like you I am on omeprazole. Mine is because of a hiatus hernia and gastric reflux. I take Morphine for pain from a spinal injury and was told by a Doctor that at my age it isn't the end of the world if I become addicted. I'm 64 at the end of the month. He was a locum and not my usual doctor. I forgot to order a repeat on one occasion and ended up without for a whole weekend. I was relieved to find that I wasn't showing signs of addiction. Although my pain level increased I wasn't showing any withdrawal, or climbing the walls, even after being on it for several years. Some people have what is known as an addictive personality and will become addicted to the slightest thing. Others don't become addicted at all. The very fact that you are concerned about becoming addicted would indicate that it is unlikely you will be. The signs are that you start to live from dose to dose and the dose doesn't do the job and has to keep being increased. You panic because you don't haven't your dose with you when it is due and you are perhaps 1/2 an hour late home. Obviously there are other signs too, but if what you are taking is holding your pain in check and has for a while the chances are you are not addicted.
If you are using morphine for pain - you shouldn't get addicted, it is used up on stopping the pain and if you are on the right dose you shouldn't have any left over to cause addiction. Addicts are taking it without any pain needs - so it is all sloshing around to give them a high. I still have to be convinced on that aspect - when I was given morphine for pain I felt so awful I refused another dose! I put up with the post-op pain - which to be honest was far less having the plate removed from my broken leg than when it was put in!
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