AIBU to expecto better than paracetamol in hospital for a kidney stone attack?

[LobeliaSackville]

I'm annoyed with my (lack of) treatment after being admitted to hospital with a kidney stone.

At 6pm on a Friday evening I was suddenly struck with atrocious pain in my right flank. It came in waves and lasted for about 25 mins each wave. I was hunched over on the floor moaning and vomiting. This happened 3 times before DH called 111, and a doctor phoned back and sent me to the out of hours GP. I had a total of 4 waves of attacks before seeing the OOH GP. He was sure it was a kidney stone and sent me with a letter to A&E.

I waited from 9 until 12:30 without any pain relief - I didn't take anything (after vomiting up coco-damol during the second attack) as I didn't want anything in my system to interfere with what they might give me.

I was sent for a CT scan and had another attack whilst waiting for the results and had to ask a staff member if I could go into one of the cubicles with curtains so I didn't make a spectacle of myself. Somehow no one knew where I was when the doctor came looking for me and I had to chase him down in the middle of the attack to tell him I hadn't gone home.

The CT scan found two small stones, and I was admitted overnight to the surgical assessment ward. At this point I was finally offered paracetamol tablets, at 2am. Jee, thanks. They didn't do anything for the pain.

I barely got any sleep as a consultant came and woke me up at 4am to tell me I had stones on the scan (which I already knew) and the night staff were chatting loudly in the corridor.

At 8am a nurse came in to take my stats and gave me paracetamol tablets again, which did nothing. I said the pain was bad but I wasn't offered anything stronger.

I saw a urology consultant at noon who told me he was discharging me as I had likely passed the stone by then and to come back if the other stone causes an attack.

AIBU unreasonable to think I'd be better off staying at home next time? They didn't actually offer me any treatment and I don't know why I had to stay overnight.

At least I have coco-damol at home...

I was given diclofenac by GP which did nothing, antibiotics, and then codeine by OOH who said I should be in hospital. So glad I didn't go!

I keep nurophen plus in now just in case.

I find paracetamol only works for anything if you take it before the pain starts.

That's terrible. I've had two attacks (in 18 years), and both times was prescribed strong painkillers - I didn't need them the first time, the second time the doctor got some out of their drug cabinet and I took them while still in her office. I'm not in the UK btw

YANBU.

I was offered diclofenac suppositories and IV pain relief.

I was sent home and GP prescribed tramadol whilst I waited for surgery for one of the stones. It took a year! In that time the stone doubled in size and was 5cm!

Apparently I was told stones only cause pain when they are on the move?

Keep an eye on them and try and see if GP can prescribe something if the pain persists.

I was given paracetamol after my c section. No thanks. I'm never one to complain normally but found the only way to get decent pain relief was to become that patient and keep pressing the buzzer until I got morphine.

@Lullibyebye same, was just coming on to say this. Spinal, baby, then paracetamol. Unfortunately I wasn't that patient and thought that was normal, second I was same as your,

You!

Dreadful. I was given morphine in a&e when I had gallstones. Brilliant stuff. When I went in with gallstones a different time I had already had paracetamol so couldn't have morphine so I was given diclophinac suppositories which were effective but not as fun! Paracetamol is not enough!

From experience a&e don’t like to give much more than paracetamol (and IV paracetamol is rare) and then when you’re admitted you need to ask for something stronger. As previous posters have said I have no idea how people without capacity manage in hospital now, you need to be on top of everything that’s happening which is fairly difficult when you’re unwell enough to be in hospital. I now take my own painkillers to a&e given wait times and how long it takes for them even to give you paracetamol sometimes

Yanbu

I was given a suppository when I first arrived then later some morphine. And then to Take home with me some codeine and muscle relaxant to help pass the stone when I had one

Panadol every 8 hours day two after a c section in Brunei. I was crying like a baby.

I think it's modern day policy now? Back 10 years ago I was given morphine for pelvic cramps.

This is very poor. Kidney stones are known to be one of the worst pains EVER. I can't believe how dismissive they were. Please complain.

I was given two paracetamol after a Caesarean. 5 hours later I was refused 2 more because “I wasnt due the next dose”, 6 hours later I was refused because there was only one nurse on the ward and they needed 2 to dispense.

This was 30 years ago.

Whilst it certainly sounds like the OP could have been given some stronger analgesia, diclofenac is what I would have expected, it's absolutely not true that IV paracetamol is more effective than oral. It's the same drug, at the same dose. The therapeutic dose for paracetamol is about 2g and it takes 24-36hours to get there with regular dosing.

There are lots of studies on the benefits of each analgesia:
https://emj.bmj.com/content/35/3/179
"Conclusions Overall, there was a small but clinically significant decrease in pain in each group. No superiority was demonstrated in this trial with intravenous paracetamol compared with oral paracetamol in terms of efficacy of analgesia and no difference in length of stay, patient satisfaction, need for rescue analgesia or side effects."

I have to say that iv paracetamol is well superior to oral. It makes no sense. But it's absolutely true!

DH was given Oramorph for the pain. He finally managed to pass the stone.

Well at least you don't lose iv paracetamol if you throw up. I've been given oral painkillers in hospital vomited later and seen the whole, undigested tablets in the bowl, but then not been allowed anything else because I've "already had the maximum dose". Surely an iv dose must be more reliable and quicker as you're not having to wait for it to be absorbed?

YANBU, I had stones in my last pregnancy and was given gas and air and IV morphine to help

Paracetamol would have done nothing

Me too ! i declined as pretty useless for me ,i felt it was offered as a fob off / placebo.

Absolutely ridiculous.

Renal colic should be treated with IV Morphine until pain is under control. I would make a formal complaint to the hospital but given that the NHS is fucking abysmal it wouldn't make any difference.

This is why I've packed my own painkillers in my hospital bag this time round. I had to ask three times for painkillers after having DD and it took about 5 hours for them to bring any

@MrsAvocet Yep that's pretty much the only real benefit of iv paracetamol over oral, definitely far superior in the vomiting patient!!

The not having to wait for it to be absorbed is what makes some people think that it will work better than something given orally but that's just not the case in paracetamol.

Treatment for pain is an odd one that we always seem to get wrong, despite it being one of the main reasons for people seeking help. It's the short attacks/exacerbations that should be hit hard with stronger analgesia that we know will only be issued over a short period which should reduce the chance of developing into chronic pain. Obviously when pain is chronic and the cause isn't going to be cured then the treatment plans shouldn't often involve those 'strong' pain killers as this isn't effective either.

Stronger meds need to be prescribed by a doctor. So one needs to be free to come and see you. Whenever I've been in theres always been a wait to get one. At the very least they should prescribe you liquid paracetamol though. It does seem more effective.

I've never worked on a ward (im pre-hospital), it's a shame to think someone was left writhing on the bed in pain when they can choose to take it away. I do worry it's just coming down to massive staffing issues where they either don't have capacity to monitor so many patients being given morphine and the like, or just too far down the list for the Dr to get to and prescribe in the first place... There must be some reason.

Yep I had intravenous paracetamol for an abscess (whilst waiting for the op to drain it) years ago and it was so much more effective than the tablets, I couldn't believe it. Needed morphine as well though as the paracetamol was not enough on its own.

OP's experience sounds awful - I know a couple of people who have had kidney stone issues and been offered morphine straight away, no way would paracetamol have done any good.

I once had to have a tumour removed from my tongue as a day patient. The surgery involved a wide excision and the wound went all the way across my tongue from one side to the other. The surgery was of course totally painless because of the local anaesthetic - indeed I drove myself home.

But ...... did anyone stop to think ahead and wonder what the pain might be like when the local wore off? Did they heck! I was home by that point, but, as you will know, the tongue is heaving with nerve endings and the pain was beyond description. I lay drooling, unable to swallow my own spit (as I could not move my tongue), and weeping with the pain. Luckily my OH was a GP and he was able to administer an injection of a strong painkiller - but he was on duty and doing evening surgery and I was in this dreadful pain for at least 5 hours. I could not have phoned anyone as I could not speak!

That is what I call poor care.