to think I should have a right to pain relief?

[MadYoungCatLady]

I have just come back from the hospital. I have been in pain for over a week now. I firstly went to my GP last week, who prescribed codeine phosphate and paracetamol. I asked him for dihydrocodeine, which is what my previous doctor had given me on repeat prescription (I had last taken it 3 months ago). He said no, it had a street value and was addictive and to make do with the codeine.

By yesterday, I could take the pain no longer. I had not eaten all week. I felt sick because of it. I was awake at night and crying in DP's arms. I made an appointment with another GP. After a lengthy conversation about my anti-depressants (completely irrelevant) and what procedures I had previously had to diagnose me, she prescribed anti-bitotics for three days. For a condition I have been suffering from for about 4 years. She gave me more codeine to last me over the weekend. I asked again about dihydrocodeine. She told me she would not prescribe this as it is addictive.

By this evening, I was beside myself. Pain is getting worse. I decide to call hospital, they say come up and they will see me. I am told there to have a bath and take my codeine. I was crying in pain whilst the doctor was talking to me. I had taken codeine an hour before. They were not working.

I am 17 weeks pregnant. The doctor at the hospital told me she will not give me anything for my pain (colitis, sciatica and a UTI) because I am pregnant.

During my last pregnancy, I ended up being admitted to hospital and having morphine at 24 weeks.

I've tried to find if I have a right to pain relief but am getting nowhere.

AIBU to think there must be something they can do for me?

[JarethTheGoblinKing]

I read on here this week that codeine just doesn't work for some people, us there anything else they could prescribe instead?

[MadYoungCatLady]

They are refusing point blank. I just don't know what to do. I can't carry on like this for another 5 months. I'm pretty much in pain everyday. If I had of known that I would move to an area that just look at you like an incubator rather than a person I am not sure I would have gotten pregnant in the first place :(

[JarethTheGoblinKing]

Can you see another doctor/consultant about other ways to manage the pain?

[LineRunner]

I think that's a bloody good question about whether a person has a right to pain relief. For any condition.

I had an injury once and couldn't get proper pain relief from the hospital that treated me. I ended up washing down Volterol with booze which was daft and unnecessary but I was beside myself with pain.

[Fernier]

That's awful. I don't know what else to say but Yanbu to expect them to at least try a bit harder. Sorry don't know anything about the conditions you mention but is there no chance of them actually treating you rather than telling you to sod of?

[OpusProSerenus]

Codeine it is metablised by the body into Morphine but around 10% of the population are unable to do this so it has no effect, you may be one of these people. It is important that you go back and ask for another opinion on this.

BTW if you are a non-metaboliser then some other opiates will not work either so make sure the doctor is aware of the possibility.

[worraliberty]

Are there any dangers to the baby?

[MadYoungCatLady]

I had a colonoscopy 3 years ago, which showed colitis throughout the colon. I was then given steroids and some other specialised tablet, and the dihydrocdeine for the pain. The steroids really helped. However, I still ended up back in A&E a while after they finished, and the doctor decided to run another test, which funnily enough showed the inflamation had gone down... so he decided the first diagnosis was wrong, rather than put 2 and 2 together and realise the steroids had done their job!
I asked for a second opinion, it just didnt sit right that this was unspecified abdo pain and IBS. My second opinion came in the form of sitting in a room with a doctor who told me I was constipated .

[MadYoungCatLady]

No-one knows, thats what irritates me the most. If they could say "studies have shown it causes this" I'd be less upset. But they can't say this as they just don't know. It also irritates me that they are not thinking "what are the dangers to the mother if she doesn't have it".

[FabbyChic]

I am really sorry, but they are doing the right thing, as you have been on this drug for so long it is possible that your body has become used to you taking it, that in turn makes you feel in less pain.

It is possible that some of your pain is psychosematic, caused purely because you are not taking the medication you WANT to take.

Coupled with your mental health they have done the right thing.

Im sorry you are in pain, but you are going to have to find an alternative pain relief that is not so addictive, taking it for the amount of time you have is dangerous, the addiction and levels your body comands is not unlike being a heroin addict. It's lethal and long term use can kill you.

[FabbyChic]

Look, I understand your frustration, but you cannot take the medication you want whilst pregnant your child could die, become addicted.

They are doing what is right.

If your health is such that you cannot take certain medication because you are pregnant, maybe you should really have considered not getting pregnant until your medical health was at a place that you could carry your child without them having to be born a drug addict, even if that drug is a pain killer.

I know it is harsh, but the truth of the matter is you are pregnant and you will be harming your unborn child if you take such a strong medication.

Doctors are not idiots.

[Energumene]

First off, I know some Trusts have Colitis Nurses you can turn to when you have a flare-up. Does yours, and can he/she be contacted to fight your corner? Secondly, if you get nowhere with that, get in touch with the PALS office on Monday morning and talk to them about the situation.

The docs may still not be happy to stick you on dihydrocodeine, for the reasons they've already given. After all, the colitis and sciatica could last throughout the pregnancy and if so there's a risk of your baby becoming dependent - probably their main concern. But there may be alternatives they could try: it may simply be they have to be a bit more creative in how they treat you, but that should be their problem, not yours. Hell, they wouldn't give me the hard stuff during pregnancy, but they did give me acupuncture on the NHS, and that was brilliant.

As to the original question of a right to pain relief... I don't know about that, but I do believe you have a right to appropriate treatment, and so far I can't say I'm convinced you've had that.

[michelleseashell]

No you are not being unreasonable. I had dihydracodeine when I was pregnant. The hospital gave it to me happily but I had to talk my doctor into it. It was ridiculous though- I needed it. I couldn't eat or speak because I was in such terrible pain. So when I say talk, I mean write her into it!

You pay your national insurance. I'd see another doctor. What's the problem anyway? Codeine is addictive too and they've given you that!

Is it co-codamol or codeine you're on? If it doesn't have paracetamol with it, you could try buying something over the counter with dihydracodeine in like paramol or solpadeine to take with your codeine. Just as a temporary solution.

[worraliberty]

No-one knows, thats what irritates me the most. If they could say "studies have shown it causes this" I'd be less upset. But they can't say this as they just don't know. It also irritates me that they are not thinking "what are the dangers to the mother if she doesn't have it"

Yes but surely if they don't know, it's best they err on the side of caution?

I know you're in a lot of pain and that's shit for you, but if there was any chance of you suffering through it rather than putting your unborn baby at possible risk...is that not worth it?

You had to have morphine during your last pregnancy. Did that not ring any alarm bells re getting pregnant again?

[michelleseashell]

The consultant at my hospital told me that opiates don't cause any malformations or defects, but can cause a baby to be born addicted, the level of addiction depending on the dose and the frequency it is taken.

So surely they just need to adjust the dose and the frequency as happened with me? I took dihydracodeine from 32-37 weeks and then low does of codeine for the last few weeks. Baby is absolutely fine! And I didn't suffer unnecessarily.

[LordOfTheFlies]

I had an RTA half way through DD pregnancy. The GP would only give me paracetamol because anything else would cause the blood vessels in the placenta to reduce their blood flow

I had constant backpain for the rest of the pregnancy.
I already had a toddler.
I worked full-time until a six weeks before until I couldn't stand the pain.
It wasn't about my right to pain relief. It was about this baby who had survived a car crash.Her right to continue this pregnancy unharmed because I chose to have her.

I think the wording of your title is a bit .Its more is there anything more that can be done for you, not your right.

Have you considered acupuncture? Works for some.

[michelleseashell]

I also had a very healthy placenta, to let you know my experiences. My baby is perfectly alright, a "picture of health" to quote my health visitors.

[Tyr]

Codeine is addictive too. Dyhidrocodeine is a semi synthetic version and no more addictive, Your doctor is refusing it simply because you asked for it which indicates a taste for it. Perish the thought that you might enjoy the pain relief
Long term use of it will not kill you, It causes constipation and you will develop a tolerance - that is all.
DHC is available as a slow release format which lasts 12 hours. This is a better way of managing pain.

[ifancyashandy]

Where do you live? Are you able to ask to be referred to St Marks Hospital, attached to the Northwick Park Hospital in Harrow (London suburb)? It's the bowel hospital in the UK and thus premier for treatment of colitis. They must have managed the resulting pain for pregnant women before. If you can physical access it, you have a right to ask to be referred.

[iscream]

Is this what you are looking for?

From[[http://www.action-on-pain.co.uk/can-you-feel-my-pain.php Bill of Rights
Five rights of people affected by chronic pain]]

The five rights have been developed by Patient advocacy groups and citizen organisations representing people affected by pain from across Europe, in partnership with Pfizer.

Right to be Understood

For chronic pain to be understood and accepted as a condition by:
the general public
employers (with appropriate changes made to encourage continued working)
Right of Access to Information

To be provided with accurate and improved information about their chronic pain
Right to Professional Support

To have access to healthcare professionals who have been adequately trained and fully understand chronic pain; specifically how to diagnose and appropriately manage the condition to limit it worsening
Right to Early Intervention and Optimal Pain Management

Access to healthcare professionals who can help identify the best possible pain management and support for each patient at the earliest possible stage
Right of Pain Relief as a Fundamental Human Right

Declare 'The Relief of Pain' a fundamental human right echoing the core principles set out by of ISAP, EFIC and the WHO at a conference in Geneva on 11th October 2004

Later this year, we hope to have collected significant support for the Rights, which will be presented alongside the launch of a European wide report that aims to drive recognition of the personal, social and economic impact of chronic pain on the European population - promoting change to ensure the right patient receives the right management and treatment at the right time.

The five rights have been developed by Patient advocacy groups and citizen organisations representing people affected by pain from across Europe, in partnership with Pfizer.

[MadYoungCatLady]

I'm not after something in particular- I just want to be out of pain.
I had morphine during my first pregnancy for kidney stones - totally unrelated to the problems I have now.

The problem is not that I decided to have another child (is this a human right?) but that I moved to a new area and my GP does not agree with my old GP. If I had known this, I would not have moved, rather than not get pregnant. It seems different doctors see things very differently.

If a woman needs pain medication, are you saying she should not be allowed to get pregnant Fabby? My conditions will not improve. I would still like a life though. Its a bit unclear from your response if you think all disabled people should not have children? And why on earth would my child be a drug addict if I am given stronger pain relief for when I have flare ups? I shall bear in mind the next time I am crying in agony that it may all be in my head, gosh I should have come to you not a GP in the first place! I am in pain. I am asking for help, not judgemental bollocks. Thank you anyway.

Lordoftheflies sorry to hear about the crash, what a horrific thing to go through. I hope no permanent damage was done to you :(

Iscream I think that is exactly the sort of thing I am looking for. Thank you.

[MissusTulip]

Madyoungcatlady - good luck, I hope you get sorted soon. Codeine and DHC can be used safely in pregnancy (trust me, I'm a doctor, and I've got mad SPD so need to use it too sometimes!). It is safest in 2nd trimester, use in third trimester can be associated with baby being sedated in womb (not moving about much etc) and if used in run up to birth, it can lead to baby having withdrawal side effects after birth. This means an irritable or drowsy baby. It's not life threatening to baby (in terms of long term physical or psychological damage), it definitely does not compare to babies born to mums addicted to crack or heroin, unless you are using massive doses not recommended by a health care professional - then it will compare to heroin.

The only pain killers which can damage the blood supply in the placenta are non-steroidal anti-inflammatories like ibuprofen or volterol, so dunno where your GP got their info from Lordofthelies? Maybe just too busy to look it up in their drug info like the BNF? Really the best thing would be to insist that they find and treat whatever is causing the pain - eg if ur having another flare-up of colitis, treat that and the pain should be sorted?

The suggestions about asking for referral to a colitis clinic and trying alternatives like acupuncture are good - I've found acupuncture really good for pain management with SPD, better than pain killers, but needs to be someone trained to treat pregnant women, and they may not treat certain areas that would overlap with colitis areas as they may overlap with womb areas (I honestly have no idea other than from my own treatment).

If you see a psychiatrist on a regular basis (you mentioned antidepressants) and they're supportive / helpful, it might be an idea to ask fr their support in clarifying with GP that ur not an addict and the pain is worsening any existing mental health difficulties. Or look into complaints procedures at your GP surgery - sometimes even raising the issue will make the practice sit up and take notice without you having to go through the whole process?

Gosh fabby, harsh. I can say hand on heart as a doctor that some doctors are idiots and do not know what they are doing. I have worked alongside some complete idiots, along with doctors who are just too busy or stressed or humanly fallable (eg misremembering drug side effects). I'm just as guilty but I'd hope that colleagues and patients were not afraid to point out whenever that happens as that's part of the job!

[MadYoungCatLady]

Missustulip that post is of no end of comfort to me. Wish you were my doctor! I may well ask for acupuncture, it seems like its worth a try (anything is worth a try right now :( )
What you say about DHC is what I thought. I had read that the affects on the baby would be a chance of addiction is taken after 36 weeks, which would leave the baby irritable (obviously something I don't want for my baby).
I know the drs I have seen think I am just after something nice and addictive. I've got money - if I wanted something to get me high, I would buy it ffs :(
My psychiatrist is very good, but he's made a bit of boo-boo and written to my GP that I have been addicted to diazepam in the past - I did call him to ask what the hell was going on, he said he hadn't said that at all simply that he prescribes it every 2 months or so when I suffer badly from anxiety and panic attacks. Think my GP has read this wrong, but still - I'm now an addict as far as they are concerned and I'm now wondering if this is why they are refusing to help.

[BoysAreLikeDogs]

from your last post I can see why your new GP has concerns

Can you ask to be referred to a Pain Management Clinic?

[TottWriter]

Would you be able to change your GP? It seems that your current GP has had either some miscommunication or is a bit daft (wouldn't like to call that one without knowing them), so would a fresh opinion help? Are there any other surgeries near you that you could go to?