To wish hospitals considered pain meds someone is on before discharge.

[silvershark22]

I was in hospital for 10 nights on IV antibiotics due to an infection and have now been discharged with another week of tablets. In the hospital I was getting IV paracetamol, Morphine probably twice in evening and during the night, naprocen and IV meds for sickness. Have been discharged with Codeine 30 MG, when I have said I don't seem to get any more painreleif than on 15 mg tablets, antibiotics and only one antisickness tablet when was getting to in hospital. Obviously taking paracetamol tablets but in pain and can't sleep and have vomitted. Spoke to a pharmacist today through 111 and they said to wait for GP to open on Monday.

It’s unfortunate that the priority on preventing addiction invariably comes above the need for pain relief

Agree but I also think they have been quite lazy. Surely to stop the NSADs at the same time as all the other medication isn't helpful. I wish there was something that worked as well as IV paracetamol as I found it fantastic. Could feel it working instantly.

Really iv paracetamol. I wouldn’t have thought that. I don’t have pain but I understand your frustration with the nhs. I have a chronic circadian rhythm disorder and severe insomnia all my life and I can never get benzodiazepines or other sleeping pills long term

I found the IV paracetamol to be absolutely fantastic. Could go from feeling feverish shivery sweaty and unable to move for pain to able to flick through a magazine within minutes. It was also great as didn't leave any confusion or nausea which morphine gave.

Sorry you are having such problems. Does melatonin help?

It never used to but I suppose it could be worth trying again now that I’m not stressed like I used to be

Yes I would def give it a go. I found cbd sleep gummies to be really good, also a session in a float tank.

I'm with you on this, I was discharged after a total hip replacement with 2 oxycodone tablets and that was it. I know they have to watch for addiction but come on, two pain killers following major surgery? I was discharged the day of my surgery as well so it wasn't like I'd have the first few post op days on painkillers in hospital. I

(In the US)
I'm so sorry you are enduring such pain.

Recently my young adult child had a PE and was sent home with narcotics for the pain.

Unfortunately,(hospitalists(Again US),are only responsible while the patient is in the hospital.

I truly hope you feel better soon,the pain you are feeling can be indescribable, but hopefully will improve soon.

Personal experience and advocating for my child...Speak up, advocate for yourself and don't tolerate being dismissed by the doctors who are in charge of your care.

YANBU, but I think some could argue they over medicated you in hospital hence the issue when you get out. They should have helped you better by weaning off some of the painkillers in hospital.

It's my biggest issue with the way pain is managed after a C-section: they talk about discharge the morning after surgery when the pain meds from the spinal are still effective, women feel great so agree to go home, only to realise a few hours later when it's too late how much pain they are actually in. And they're left off managing it on their own with paracetamol and ibuprofen.

Since you weren't there and not the patient you can't judge regarding medicine and what was administered.
And having 3 sections myself, I was always sent home 2-3 days later with the appropriate amount of pain meds.

It's sad to know other countries are treating patients like this.

Hi Anaesthetist here and also have undergone many surgeries myself so have had to deal with pain relief as a patient as well. I'm very sorry to know your pain relief following discharge has not been adequate. Few options here

1. don't wait for pain to start. take the dose of paracetamol (I'm assuming 1gram unless you are under 50kg)
2. you can take codeine at the same time. now codeine doesn't work for everyone and can make you feel sick. if its working for you but making you sick - take the antisickness 30 mins before the codeine. you can also reducing the dose of codeine eg taking it every 8 hours instead of 6 or pausing if the sickness is unbearable/its not giving any relief.
3. take ibuprofen in addition to the above but ONLY after you speak to a pharmacist. I don't know your medical history so don't know if there was a reason naproxen was stopped etc.

really sorry you are going through this and hope you feel better soon

sorry meant to say take the dose of paracetamol on the door every 6 hours. and same with other pain meds, take them regularly don't wait for the previous dose to wear off.

I WAS IN QUITE SIGNIFICANT PAIN IN HOSPITAL SO DON'T THINK THEY PARTICULARLY OVERMEDICATED. WHAT I WOULD SAY THOUGH IS THAT THERE WERE TIMES WHEN I ASKED FOR PARACETAMOL BUT MY CANULA HAD FAILED AND IT WAS WRITTEN UP IN SUCH A WAY THEY COULDN'T GIVE TABLETS SO WOULD GIVE MORPHINE. GENERALLY I ONLY NEEDED THE MORPHINE AT NIGHT.

THANKS AT TT9 I HAVE BEEN TAKING THE PARACETAMOL REGULARLY AND TRY TO SPACE THE ANTISICKNESS OUT SO I HAVE HAD A DOSE HALF AN HOUR BEFORE THE MORNING ANTIBIOTICS AND PARACETAMOL. I GET A REASONABLE AMOUNT OF PAIN RELIEF FROM 15 MG OF CODEINE BUT DON'T FEEL THAT HIGHER DOSES GIVE ANY MORE RELIEF. MY GP SAID IT MAY BE THAT I AM LOW IN WHAT IT TAKES TO METABOLISE IT SO CAN ONLY PROCESS A CERTAIN AMOUNT. NOT SURE IF THIS IS A THING.

I FIND OTC PARAMOL TO BE A REALLY EFFECTIVE PAINKILLER. WILL TRY AND SPEAK TO A PHARMACIST AS I FEEL THAT SWOPPING OUT THE PARACETAMOL AND CODEINE FOR THIS WOULD BE HELPFUL AT NIGHT, DURING THE DAY JUST ON REGULAR PARACETAMOL I AM UNCOMFORTABLE BUT NOT PARTICULARLY IN PAIN, ITS ITS JUST FROM ABOUT 8 PM ONWARDS THAT THINGS FEEL TOUGH AND THAT OBVIOUSLY IMPACTS SLEEP.

I AM NOT SURE REALLY WHATS CAUSING THE NAUSIA AND OCCASIONAL VOMITTING. I WAS TWICE TESTED FOR CDIF AS HAD QUITE SIGNIFICANT LOOS STOOLS ON THE IV ANTIBIOTICS. I FIND PROCHLORPERAZNE, CYCLAZINE OR ONDANSITRON MUCH MORE EFFECTIVE THAN THE METACHLOROPHOPMIDE I HAVE BEEN DISCHARGED WITH.

SORRY TO HEAR OTHERS EXPERIENCES OF BEING DISCHARGED WITH OUT ENOUGH PAIN RELIEF.

Hospitals also need to consider giving larger courses of post-discharge meds. A week is not enough. Frequently, patients realise they run out, go to the gp, and gp haven’t received or processed the letter to find out what surgery the patient has had, and what painkillers was given.

Equally there are others with a high pain threshold and/or not in pain following an op or treatment of similar ilk, & for whom meds won't be needed.

It must be very difficult to gauge needs, as everybody's experiences will vary..

AGREE I HAVEN'T EVEN BEEN GIVEN A WEEK OF THE ANTISICKNESS TABLETS AND THINK I WILL RUN OUT TUESDAY MORNING. I DON'T WANT TO GET TO A PLACE WHERE I CAN'T KEEP ANTIBIOTICS DOWN SO SEE THESE AS THE MOST IMPORTANT. DOESN'T FEEL FAIR TO THE GP TO NEED THEM AS AN EMERGENCY.

THE OTHER THING I DIDN'T UNDERSTAND WAS THAT THEY WOULDN'T ISSUE A FIT NOTE FOR THE TIME I WAS IN HOSPITAL AND SAID SPEAK TO GP. I THOUGHT THEY ARE ABLE TO DO FOR THE TIME IN HOSPITAL.

IV paracetamol is actually pretty good. Hope you get some relief soon

YES AGREE THE IV PARACETAMOL IS INCREDIBLY GOOD.

It sounds like you've been given a reasonable prescription on discharge with codeine and oral paracetamol, if you're not managing though I'd look to your GP to review and consider whether anything should be altered. NSAID use can have some nasty side effects on your kidneys and stomach in particular so this might be why they've stopped it. i.e. it's better to be in pain over a short period then to cause a kidney injury or ulcer resulting in more significant longer term problems. Your GP maybe able to advise that it's ok to restart/put appropriate monitoring

There are lots of factors that affect how we experience pain, whilst effective analgesia is important our outlook on therapy and mood can be just if not more important. For instance there's absolutely no difference between oral and IV paracetamol in terms of how it actually relieves pain, it's the same drug and doesn't work in minutes in either instance it works over hours, from cumulative dosing which safely get you to the therapeutic dosing level which you don't reach from a single dose. There is a big psychological difference in seeing a clinician putting up a drug that runs into your vein directly or taking a tablet that you're well aware could be picked up in Morrisons. That you felt such a high level of relief in minutes is clear evidence that this came from within you, not the paracetamol.

I work as a paramedic as see this routinely, patients in severe pain sink back and relax after pushing the flush quickly reporting how much better their pain is already, when all I've given at that point is salty water. The power of the mind in getting control over pain is huge. (This isn't me trying to trick anyone which wouldn't be ethical; after placing a cannula you flush it with water to help confirm it's in the correct position and so there's no blood left in the cannula that will clot and stop it working).

There have been some really good studies between oral and IV paracetamol in patients with moderate to severe pain and there was no difference between them in terms of how they relieved the pain - patients were given trial packs with tablet and iv solution, the paracetamol was in only one and neither the doctor or patient know which, the studies looked at the patients perception of their pain and there was no difference between them.

One of the studies posted in the british medical journal:
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.
(https://emj.bmj.com/content/35/3/179)

@silvershark22 if metaclopramide not working, I would call the GP on Monday and ask for something which you know works for you. I am not sure if any are available over the counter? but definitely change anti sickness. and not bad idea to change pain relief to what you feel works

I didn't judge anything, it was a comment based on a POV a consultant shared with me. Some anaesthetists consider that patients should be left to manage with a certain level of pain in hospital rather than trying to reduce it to the maximum.
I'm not a doctor and don't have an opinion on that, i guess both have pros and cons, but sending patients home without appropriate pain meds is definitely not on, and that's what the situation OP was in.

As to C-section, I have had 2 so I also know what I'm talking about. Emergency C-section you get to stay 2-3 nights, elective C-section in my area they aim to discharged you the next day with paracetamol and ibuprofen only. The decision is generally made less than 24h after surgery.

I don’t think 30 mg codeine tablets are very strong either