NHS pain relief, lack of it

[brahelper]

Ladies I have read a fair few threads on here of similar stories so thought I would post my issue even tho I am not a mum I hope you can offer opinion's.

I have numerous times in the past had fallout's with the NHS refusing to give me prescription strength painkillers for tooth ache, luckily tho in those case co codamel and ibuprofen (or naproxen) would at least take the edge off.

Well Starting Tuesday last week I started having almost constant head pain and extreme tiredness, even tho was tired I couldnt really sleep for anything more than an hour at a time. Iniotially the main problem was the sleep as headache was mild.

Then Thursday morning I managed 6 hours sleep for the first time in about 3 days, but the tiredness wasnt gone neither the headache. At about 2PM I went to try and have a nap due to the tiredness then suddenly liker a switch was flicked I had extreme headache, easily the worst pain I have ever had. I was already under naproxen as I take it for other health problems so took paracetomal but both of these had absolutely no affect.

My GP surgery refused to give me time to talk to a GP, not even over the phone, their policy? goto A&E.

According to NHS guidelines I qualified for 999 help but rang 111, and they arranged an out of hours gp appointment at my hospital. That doctor examined me and said I needed further help from A&E, after another hour wait the A&E doc seen me and then tried to transfer me to a neurologist but someone overuled him and I was to be transferred to A&E majors instead, I waited 6 hours for this transfer with no pain relief given, in absolute agony. I did observe sitting up vs lieing down the pain eased slightly but only a bit, it was still unbearable.

When I got to majors they did their usual routine (which seems the same no matter what the issue as if its scripted), which was blood tests and blood pressure tests. Was told to wait 90 mins for blood test results, still given no pain relief. After about 40 mins a doc came to see me and asked me questions, he asked the same questions at this point asked 4 times as if these people dont talk to each other. I was then finally given plain relief, but even tho I told them I had already hit the max dosage for 24 hours and it had no affect, guess what they gave me? you guessed it paracetomal and ibuprofen, one wonders what one has to do to get things like morphine. The dosage wasnt higher than over the counter stregth either was 1gram of paracetomal and 2 tablets of ibuprofen. Result no affect.

I ended up having a CT scan which was clean, and after that point (now about 6am) I heard some kind of ward manager pestering my doctor to discharge me, he didnt for another 90 mins whilst also asking me more questions and examining my head, but eventually he got overuled as she sent another doc to discharge me, she was shouting about me so everyone could here almost every 5 minutes "is he gone yet?". He then told to wait whilst he gets some powerful painkillers, I forgot the name but it wasnt the paracteomal or ibuprofen. The other doc came back to ask why I wasnt gone yet (following another shout from the manager) and I said waiting for painkillers. About 30 secs later I heard thi smanager shout "what!!! tell him to go home and take paracetomal, if he doesnt do what you say call security".

At that point I left.

Now is saturday night, pain is still severe, almost constant, and now I keep feeling faint as well. I already complained to the laison service although I expect them to backup their own colleagues.

So I left with no diagnosis other than what was ruled out with CT, and no pain relief.

The NHS is aweful.

I have been thinking given I was there on my own looking rough, unshaven etc. maybe they thought I was some kind fo addict after drugs, but if thats the case they should give people the benefit of the doubt.

[Buzzardbird]

Has migraine been ruled out?

[brahelper]

nope, there was no diagnosis, they didnt even say what had been ruled out by the CT, I am simply guessing anything life threatening was ruled out.

[Haudyerwheesht]

On a scale of 0-10 where is the pain?

The thing is if you're already on naproxen and now maxing out on paracetamol and ibuprofen they will be reluctant to give you any more pain killers for an acute headache.

Have you slept much now?

I suffer terrible migraines (though not as awful as some people get them) and find a hot water bottle on the base of my neck provides some relief and no looking at screens at all or any light.

[brahelper]

lieing down 10, sitting up after an hour or so might drop to 8-9.

If I cannot fall asleep quickly I have to get out of bed due to the pain levels.

I got no idea if its migraines or something else, because I havent been told. I have no history of migraines.

quote from a doctor

"the patient’s symptoms were initially misinterpreted—sudden onset headache, even in migraineurs, is an SAH until proved otherwise" Since they havent proven otherwise I think I have a case. I am trying to hold out until tuesday and hoping I can see my GP that day (is very hard to get appointment).

[brahelper]

in last 24 hours about 4 hours sleep In 2 separate sessions, I am soon going to go bed to try and sleep but I dont know if will succeed.

[FellOutOfBedTwice]

I get severe migraines and sumatriptan is the only thing that touches it. You can buy it over the counter. I would give that a go to be honest, at this point you're in so much pain you've got nothing to lose.

[brahelper]

"a normal clinical examination and CT (especially those reported on call by junior or non-specialist radiologists) do not exclude SAH

xanthochromia to the naked eye is an unreliable sign"

[brahelper]

thank you felloutofbedtwice will try to buy it tomorrow.

[annandale]

Sounds a horrific experience though I would assume the ct scan ruled out an SAH. Asking the same questions repeatedly is usually good practice so they can work out whether you are deteriorating but imo they should always acknowledge how annoying it is.

Have you asked to see your notes? ( I'm assuming since you are on here that you are now well again). You may find that there was a diagnosis but your care sounds bad especially if they didn't tell you what it was.

[longdays]

An SAH (sub arachnoid haemorrhage) would have been noted on your CT scan. I get migraines too and they're hideous I take cocodamol and aspirin.

Hope it gets better soon

[AugustinaDuBois]

You want morphine for a headache?

I get terrible, debilitating migraines so I have a great deal of sympathy, but seriously?

CBT and acupuncture have been a great help to me.

[Sothisishowitfeels]

I'm not really sure they did the wrong thing tbh. If someone comes it demanding addictive painkillers for something which they can't find . I'm not saying that YOU were abusing drugs but some people may be so I don't think they can just hand drugs out to anyone who asks

[Wolpertinger]

I'm not sure what they've done wrong sorry. It's unusual to get more than co-codamol or ibuprofen for toothache.

Sudden onset of extreme headache should be assessed in A+E so the advice of your GP to go to A+E rather than just have them give you painkillers was correct.

At A+E they did the right thing by giving you a CT scan to rule out the life-threatening emergency of a brain haemorrhage which is great news. They didn't do an LP but should have had a protocol as to who does and doesn't get one as this is a fairly common presentation at A+E departments.

Unfortunately you are stuck with a horrible headache. No doctor will give you morphine for a headache without knowing what sort of headache it is as that way madness and addiction lies.

You need an emergency appt with your GP or an assessment by an out of hours GP (better than A+E who have limited training in headache) as it's the bank holiday to find out what sort of headache you have - just demanding 'strong painkillers' will get you nowhere and probably get you the wrong treatment for the headache as well as make you look like you are drugseeking sadly.

[brahelper]

Hi again everyone.

So good news and bad news (and clarification),

Good news is today is a significant improvement, not had tiredness since woken up at 5am (at least not extreme amounts). Also I had no pain for 3 hours, although I have pain now it is mild.

The bad news is I couldnt get that recommended medication, chemist said was prescription only.

Regarding the NHS, if they not giving out drugs "just in case" someone might be an addict and think its preferable to leave people in insane levels of pain then thats a misguided policy. But to clarify.

I didnt demand drugs.
I initially went to out of hours GP who then reffered me to A&E.
My normal GP has no emergency appointments, if you tell them its urgent they tell you to ring 999 or goto A&E.

The NHS has a duty of care of which treating pain is one of them. Am I wrong on this?

The only time I questioned them regarding drugs is when I pointed out that paracetamol was ineffective so as such giving me more is pointless, especially as I already had plenty at home.

Its the same reason I find it stupid that certian drugs no longer get prescribed due to "fear of addiction" such as diazepam which is an amazing drug for certian conditions, I never got addicted to it. Co codamel has warnings about addiction as well, but to me the lesser evil of pain or addiction? the latter easily.

I used morphine as an example as its the only name of a hospital issued painkiller I know off, I didnt care what I was given in reality as long as it did the job.

But the remark alone means you underestimated the pain.

I have had broken bones.
Stab wounds
Tooth pain
Eye cornea abrasions (these are nasty)

None came close to the pain of these head pains. Obviously the term headache is very vague, it can vary in severity and strength.

[brahelper]

I remember another post i found which is a good example.

A doctor refused her painkillers on the basis that other patients with her diagnosis didnt need them, she rightly told the doctor they should not be issued based on diagnosis but on level of pain.

[brahelper]

Also can I ask what is an LP?

[brahelper]

to annandale thanks, I will get the notes of my GP, I do plan to look at them.

If the NHS posted a disclaimer "Note we dont treat serious pain" Then I would understand. I just dont understand why over the counter stuff should have worked, it didnt. I think i have learnt 2 issues from this.

There is the 4 hour time limit, which they are targeted to clear by, if not diagnosed by then? tough luck I guess.
They dont provide decent pain relief just incase someone is a drug addict seemingly giving drug addicts drugs is a big enough issue for them that they are prepared to leave people in agony.

Surely also they only need to check my notes to see previous visits to hospitals and if I ever got issued drugs then? very quick way to see if I am a drug seeker.

I am not alone here, lots of hits on google for people been told to survive on paracetamol (drug designed for light pains), even for things like surgery recovery.

[brahelper]

They also overdosed me as I had informed them I was already on 4g of paracetomal when arriving.

quote from packaging.

"for treating of mild to moderate pain", so doctors not using as suggested by manufacturer? or they thought I lied about level of pain.

codeine (counter version) "for treatment of acute moderate pain (when other painkillers havent worked"

To be fair I didnt try co codamel, even tho i have some here they out of date. The A&E staff didnt even suggest co codamel tho, confident paracetomal would knock it out.

I do have new co codamel now which the chemist gave when they said they couldnt give me sumatriptan

[gamerchick]

I don't think morphine would do a headache much good anyway.

OP for extreme headache get some fizzy paracetamol or fizzy co cocodamol. Put them in warm water and they work quicker. I find the fizzys far more effective than the pills for extreme head pain.

[madamginger]

Sumatriptan is absolutely NOT prescription only, you can buy it over the counter. Is brand name is migraitan and costs about £7.70 for 2 tablets

[Wolpertinger]

Sumatriptan isn't prescription only but you do have to speak to the pharmacist and demonstrate you have a diagnosis of migraine - or at least I did, they gave me a little card to show next time so I could get it again but now I have it prescription as I have clear symptoms of migraine

A+E's job is to check you don't have a life-threatening emergency which they have. Beyond that, they don't know much about the intricacies of headache diagnosis. Just handing out morphine because someone says their headache is bad would be the height of bad practice.

[brahelper]

is actually not co codamel I got here its something called migraleve, and as I have had a sudden onset of tiredness and pain am about to take one now (tiredness seems linked for sure).

I assumed chemist made mistake on the Sumatriptan but I couldnt argue with them. Also that I asked for it by that name instead of bran name could have been why.

Correction taking 2 as instructed.

[brahelper]

Wolpertinger is there no middle ground between paracetamol and morphine?

Whilst I understand the orginal reason for A&E existing is for life threatening situations (or at least for A&E majors), we have a NHS where people are forced to use A&E for other situations, due to limited GP opening hours etc. I think most out of hours GP's have very little experience as they always seem unable to do a lot of what normal GP's do and they dont have access to patient records.

Is it a unofficial situation where by there is no non life threatening emergency NHS service? I say unofficial because GPs seem to have no problem referring people to A&E for non life threatening stuff. It seems to be a game of pass the parcel where the patient is the parcel been passed around.

[MaudGonneMad]

Wolpertinger is there no middle ground between paracetamol and morphine?

Co-codamol. Which you have.

[hollinhurst84]

It depends I guess. My GP wouldn't give me anything more than cocodamol
OOH took one look and gave me rectal diazepam plus dihydrocodeine
Cocodamol is like taking a smartie for me, it does absolutely nothing
Bizarrely my dad is the same, we are both redheads and some of the studies have shown they are more resistant to anaesthetics and painkillers