When paracetamol and ibuprofen won't cut it

[Myusernameismud]

Not about periods!

DS10 has a torsion of appendix testis (essentially a little twisted bit on one of his balls). He's seen a urologist who advised there's no treatment, just regular pain relief until it clears up. Which is fine, but there are some points during the day when the pain relief just doesn't touch it and he's crying in agony. The urologist said it could go on for 'a few weeks'.

AIBU to feel ridiculously helpless when he's in pain? As adults we would either put up with it, or take something stronger like codeine or visit a pharmacist/dr for really bad pain. But for a 10 year old, there's nothing else available. So they just have to put up with it.

I know there are worse problems to have, believe me I know. But as a mother, your first instinct is to protect and help your child and when you can't do that, it leaves you feeling helpless. I do everything I can to comfort him, cuddles, the softest pyjamas, his favourite foods and no requirements to do anything strenuous. But beyond that, it's just a case of hugging him while he sobs. It's shit, and as adults we wouldn't put up with it.

That sounds horrible. I would go back to the doctor. How can there be nothing else available? Obviously the dose might be different but strong pain killers aren't contraindicated for children, especially 10 year olds. Some of them can be near to adult size. I mean what about children who break bones or have surgery. They have pain killers.

Visit your local pharmacy first there may be a low dose of something else he is allowed to take. How about a dose of antihistamine might make him sleepy ? Hope he's better soon.

I'd go back to the Dr, there might be something else he can get on prescription. He shouldn't have to suffer through that pain. Poor thing (and poor you - must be horrible to watch)

They prescribed dihydrocodeine for my 5 year old when she had a horrendous ear infection after getting grommets. It was a small dose as a liquid. She'd been screaming in agony and paracetamol and ibuprofen were doing absolutely nothing. So there is stuff out there. Hope he gets something, it's awful seeing them in pain.

Go back to GP for alternative / additional painkillers!

Dihydrocodeine is licensed for use in that age for moderate to severe pain.

We have this too. My 13 year old has frequent ear infections and nothing beyond those two is ever considered. I've witnessed hours of screaming and self injury ( he has profound learning difficulties and doesn't have a clue what is happening to him). It's horrible to watch.

Is there a pain clinic at your hospital that you could be referred to?

I found diclofenac really effective for post birth after pains, as another alternative pain killer. No idea if it’s suitable for your poor son but it’s maybe one to ask about.

Oh and if it’s affecting his sleep, his schoolwork and his ability to socialise with friends or siblings then you should mention that.

I had no idea dihydrocodeine was licenced for kids. The urologist was very adamant that P&I is all he would need for pain relief. But isn't pain subjective? Some people cope better. I'll admit my pain threshold is pretty low, but I know plenty of people who can cope better with pain of varying degrees.

When he's taken both, he seems fine, can carry on as normal. But they wear off long before he can take another dose and they've advised not to take ibuprofen more than 3 times a day.

Waiting for a call back from the GP, the pharmacist has said anything else will be prescription only, but there are slow release painkillers available so maybe that's an option.

sleepy that must be horrible to watch. Ear infections are hard enough to cope with when you're able to understand what's causing it. Your poor DS.

Not instead of talking about other options but its amazing what a heat (or ice) pack can do and a long hot bath or shower. They are my go to things to try.

Heat pack for muscular and ligaments, cold for throbbing pain and inflammation, sometimes trial and error sometimes alternating both. im not sure which your DS' issue fits into.

Oh and sleep music (with sleep headphones to help sleep)

Are you staggering the paracetamol and ibuprofen rather than giving them together so he’s getting something regularly rather than having to get on top of the pain again? And as a pp said heat can really help, like a wheatie bag. We use them a lot in hospital for pain. If he’s really struggling though then I would contact your GP as anything else will be in prescription.

Suggest you start with the pharmacist and then back to the doctor if there is nothing stronger available without a prescription. Children under 12 shouldn't take co-dydramol without a prescription, if I remember correctly.

Yy to staggering the paracetamol and ibuprofen. Alternate every four hours round the clock. Keep a written record of what he's taken when so you dont lose track.

If your child is on the tall/large side and on the cusp of a dosage increase ask the GP whether the larger dose is appropriate. Make sure you know DS' weight.

IAmwonderwoman I asked whether they should be staggered, but the urologist said they work best together '1+1=3 with P&I' were his exact words. Still waiting for the GP to call back, but hopefully they'll be able to suggest other options. We've done just about everything else suggested, he's wearing tight pants to keep it supported and a cool pack on it when it's particularly sore. It's quite hot and swollen, so the heat pack would exacerbate it.
Sleep music is a good shout, he's been listening to an audio book at bedtime to distract him, but I have a feeling David Walliams excitable narrating is keeping him awake!

DS is quite small for his age, on 9th percentile for height and weight so I'm guessing a higher dose is unlikely.

Paracetamol and ibuprofen do work better when taken together.

Definitely go to the GP and ask about additional pain relief though. Post spinal surgery my daughter would have liquid codeine in the house to take when P&I didn’t quite cut it.

I'd give him a normal dose of both depending on his weight. If he is a fairly solid, tall boy then does he normally take 2 tablets for headaches? If he does then I'd give him 2 of each. They don't interact in any way so you won't overdose him like that.

It’s better to stagger them so you’re giving something regularly rather than leaving a big gap. Getting back on top of the pain is hard. When we send children home we advise staggering pain relief.

My DD had her tonsils out when she was 7. When she came around she screamed the house down. I was really worried and they said, oh we had better give her some pain relief.

Apparently they thought the 5 ml of calpol they gave her before the operation might be enough. .

They sent her home with some strong painkilling liquid (sorry I can't remember what it was), and told me to give her a much higher dose than recommended of P and I when the painkilling liquid was finished.
They recommended the dose of an over 10 year old for her and she was on the 5th centile as a 7 year old.

There are definitely stronger medicines DC can have. Maybe ask your GP for something.

9th centile 10 year old almost certainly won’t weigh enough for an adult dose!

Please don’t increase the dose above what is prescribed.

Just to add, codeine is no longer given to under 12s.

Liquid codeine Yes this is what DD had as a PP mentioned. The GP also prescribed a longer course of this as she had an infection a week after the tonsils were taken out.