To want to take this further?

[esk1mo]

Hi all, long time lurker but have never posted (although have often thought about it). Bit of a back story here...

DP herniated a disc (L4/L5) in his spine in May 2013. He was given painkillers and told he wouldn't need an MRI unless the pain persisted for months. He was on tramadol, codeine phosphate, nefopam and gabapentin. He never went over the allocated dosage and always requested new medication when he had fully ran out (ie. not going back asking for more after 4 days as if he were addicted). Despite being in agony daily (he cried from the pain frequently) he wasn't given an MRI until October 2013.

May 2014 he underwent operation for this herniated disc. He enjoyed around 6 months pain free before it started to creep back in. Although sore, it wasn't unbearable. It become gradually worse and over the last 8 months his pain has been worse than ever before. He attended his GP to ask for medication (that he was taking in 2012) but was told she couldn't give him anything until he was given an MRI although she did sign him off work. He was given an MRI in December which showed multiple herniated discs (all at lumbar level) and that his previous L4/L5 herniated had now ruptured and spread bilaterally, affecting both sides of his body (pain down both legs, hips, glutes and ribs). He can barely walk without breaking a sweat and wincing in pain. After receiving these results the GP agreed it was very severe and referred him to a surgeon and gave him a prescription of codeine phosphate. He thanked her and assumed that while he was waiting to see his surgeon he would continue to take this medication.

This was not the case. Today he returned to see GP to request more codeine (he was given 60 pills 3 weeks ago, you can take up to 6 per day). He was denied this. The GP who saw him FELT his back muscles and said he should take an anti-inflammatory. DP said he couldnt as he they made him throw up (despite taking omeprazole too). GP told DP that there wasn't anything else he could do and he wasn't allowed to give out opiate based medication. DP told reception this and asked if he could see another GP. Reception told DP that the GP he saw is indeed allowed to prescribe pain killers, he just didn't feel necessary. DP was told to phone NHS 24 if he felt his pain was so severe.

I am fuming. Not only has he taken multiple painkillers responsibly for over a year, this was when his condition wasn't as bad as it is now. He is at the stage now where he cries because of the pain. He has wet the bed on more than one occasion because he has crowding of the cauda equina nerves (which I believe are linked to bladder and bowel?). He is still signed off work and waiting to see surgeon on the 2nd of Feb.

I want to take this further but unsure who to contact, AIBU to want to complain to someone about this? I have asked to speak to practice manager but was told he was not in until Monday and when I mentioned my DP's name they said 'in that case he has already been told what to do".

I don't want to believe it is a race issue but my DP is mixed race (half Scottish half Caribbean) and for comfort he will wear jogging bottoms some days instead of a suit or jeans to see doctor. He asked a GP previously if this was an issue and she said 'it doesn't help.' I don't believe that any form of appearance should be taken into consideration when helping a patient. I have never been in a situation like this before and I am not one to complain about things but this feels so unjust and I feel there must be someone I can write to about this? My MSP or the GMC? I must mention, I am a white female and currently on a repeat prescription from the same GP surgery for an opiate-based painkiller for a hip condition, which although will require surgery at some point, is not as serious as my DP's condition. They have no issue giving me a repeat prescription for this. AIBU?

Thank you all
Sorry for the length

Posted too soon. Empathy here as am waiting for MRI to confirm prolapsed disc (and how knackered the rest of my back is!)

Good point, he can also add neurofen plus to those and that will be a fairly hefty dose of painkiller - especially when supplemented by your meds

I get lots of relief from gabapentin, prior to that it was pregabalin. I hope they sort out his nerve pain asap. Diazepam for muscle spasms also a must ime

I completely sympathise (6 years of soinal problems including a number of operations)- I take gabapentin, tramadol and oramorph daily, amongst other things. I can only suggest a heat pad (mine is a godsend) and, as others have said, a tens machine. They do help. Hope he gets some help/relief soon.

What a horrific thread So sorry he is going through this. 14 /15 years ago i lost a lot of weight quite quickly and got gallstones as a result.

My first attack was in the July and my op for gall bladder removal was the following April.
In the meantime i had to have pain relief Each attack was worse than the last and it got to the point where i could no longer eat solid food. I was prescribed Tramadol which didnt even touch the pain and when i told them they told me to take other things such as paracetmol and Nurofen as well. Still didnt touch the pain so lots of back and forth to A and E. I had duty doctors come to my home and give me morphine injections On Xmas Eve 2002 i had an attack and was given a morphine injection at home. Next day my legs kept giving way and i couldnt stand Also passed out so spent the day in hospital.

I once saw a doc in our little local one which has now closed who prescribed me morphine pills which used to melt under the tongue. One of the docs at our practice asked me "who the hell gave you those" I couldnt remember the blokes name and wouldnt have told him if i did.

After months of hell where i considered suicide my gall bladder was removed by a very nice surgeon who i had a consultation with previously.

I know what its like to be in excrutiating pain and i hope he recovers soon OP

In my case morphine was the only thing that stopped the pain.

My dh was operated on within hours of having trouble going to the toilet with a chronic bad back. He had not become incontinent but the surgeon said it was too risky to leave . The urgent MRI showed nerve impingment. I would start to ask questions about the risk of permanent damage with incontinence and erectile dysfunction. Let them know you are aware of these risks and want it documented in his notes that you have raised this risk. Question the treatment plan. Following surgery my dh has remained on pregabalin and occasionally tramadol. Pain never completely gone and if I am honest has impacted on his and our lives as a family. Luckily he retained his bladder, bowel and erectile function with some mild trouble with urine flow and he says a change in sexual sensation. Severe back pain with nerve involvement is devastating and so debilitating, I really feel for your dh. Over the years my dh has had numerous injections into the back from the pain team, a procedure to try and destroy the nerve endings, acupuncture and physio. After surgery things are better but for us it removed the immediate danger of a life changing consequence rather than curing him.

In times gone by they handed out opiates like Candy, which saw people getting addicted, when building up a tolerance - associating the high with pain relief. I think this is the reason why they are so cautious now.

When your DP/DH goes to the hospital next week, get him to tell the consultant about all the associated issues, plus the fact the pain is consistently 8/10, but GP won't prescribe anything as she says she can't. The consultant should write out a note for the GP suggesting what level of pain relief he should be allowed up to. So depending on what time his appointment at the hospital is, make another appointment with a GP if possible.

I haven't read through all the comments, but are you going with him? If you are you can explain and back up how things have been impacted and changed since the beginning of this pain. I think the GP will feel happier knowing they've been told from a colleague to prescribe, so if they're asked why codeine was prescribed, they've got a reason.

In an ideal world this would never be an issue, but at the same time people have abused such meds & they do get sold on. Which makes life awful for patients in genuine need.

If the specialist says no, I can't see why they would, a request for a pain clinic referral might be of use. I'm really hoping the specialist is like, bloody hell no pain relief, take this to your GP. Another option if the pain gets so bad he can't move, call 111 and speak to someone, an ambulance should be sent and they'll control the pain in hospital. Wishing him a speedy recovery, although since its come back, I think it may be a long term issue.