A&E refusing to give more than paracetamol when I’m in horrific pain

[Wonderingmummy]

I found out I’ve got gallstones, I need it out but I’ve been put on a waiting list. I’ve also just had a baby which can apparently trigger the attacks.

I had an attack 4 days ago, called 999. The worst pain I’ve ever been in, rolling around the floor at hospital. They refused to give me any more than paracetamol and I was just left to it. 6 hours later, it passed and I was told to go home.

I’m still thinking about it, and it’s annoyed me that more wasn’t done. Do you think I’m unreasonable to expect more? When the inevitable happens and I have another one, I already know my A&E will refuse to help and I want to advocate for myself better.

Asking for a friend… where is your A&E dept? Haha

Hi op i was originally given morphine during my first attack, by paramedics.

I was then told by my GP that they try not to prescribe oramorph to have at home if you have young children to look after.

I had paracetamol and codeine, and buscopan. And peppermint tea.

I also had to follow a very low fat diet while i waited for surgery. Are you following the diet to try and reduce attacks?

hahaha wrong

ive had gallstones. repeated excruciating attacks for 2 years, i was unable to eat anything apart from dry bread and marshmallows for 12 months. i also live with severe inflammatory arthritis, have had a burst appendix, peritonitis, multiple broken bones including a fractured spine. i know pain thanks

Wonder if men are told that about Oramorph (the looking after kids thing).

Yes i wondered the same lol. Though i was also on mat leave at the time.

Maybe you should have gone to A&E then if you had to wait two years. You might have got treated sooner! The hospital visits helped me move up the list.

I had similar to you and the pain was horrendous, A&E gave me intravenous paracetamol and it helped immediately so maybe ask for that next time? Such a relief to have it out

I understand that addicts will do whatever they can to obtain their drug of choice but that does not help those who are actually in severe pain due to a serious medical issue.
I’d hope A&E staff would have a fair bit of experience sorting out the frequent flyers from people in real pain.
(I do realise that addicts can also be in pain and need help with their addiction.)

Codeine is converted into morphine by your liver.
Codeine itself is a relatively weak opioid. It works partly because your body converts some of it into morphine, which is responsible for much of its pain-relieving effect.

999 is for emergencies. Severe pain is an emergency.

Not all gallbladder attacks are equally painful. I have gallstones and the pain isn't too bad. Other people have pain so severe they pass out.

I’d guess at 546,731 !

I had the same after having DS, you never forget the pain. I’d rather have given birth again. For mild attacks I oddly found that buscopan took the edge off. I couldn’t cope at all with the wait and ended up going private. I’m not made of money but it was worth saving for. The relief after the surgery is unreal by the way, something to look forward to!

I will say para on a drip is quite effective in the first instance in A&E, after that my experience is they ramp up based on presentation with a bit of oramorph being the last step. When you get that hit, you do get why it’s so controlled because whilst it totals the pain it’s so unnaturally quick that if you’re anything like me you do start to feel quite worried. I’m not dismissive of your pain OP, far from it, but you could be setting up for far bigger worries in the future.

It's amazing how many people turn up at A&E, often at weekend in the evenings when it's busy, with a pain, claiming morphine is the only thing that works for them. They are hoping it'll be so mad busy (which it is), that overworked and under pressure staff will prescribe it just to get rid of them. You dont have to pay in hospital pharmacies for the prescription out of hours too, if they do manage to get one. It probably worked in the past. Occasionally, it may still work in some places, but that will be vanishingly rare these days. Morphine isn't a great idea for gallbladder complaints anyway.

They also 'shop around' different A&Es to try to avoid meeting the same staff who know them...

codeine is not dihydrocodeine. Most people turn about 15% of codeine into morphine but a small group of patients can't do that and don't get such good pain relief from it. Dihydrocodeine has different active metabolites, but some is metabolised into a compound with similar punch to morphine. Codeine isn't appropriate for anyone who's breast feeding (OP hasn't said whether they are, but it would be negligent to suggest codeine without knowing that).

They probably would have given it to you if you had been there longer.

Nurses can only give paracetamol. You probably passed it before a doctor had even assessed you. You'd be lucky to have been assessed within 6 hours.

I was given oramorph after being admitted (11 hours wait) but tbh it made me so sick that I ended up in worse pain.

I was given intravenous morphine for mine so YANBU at all!!

I didn't have gallstones but something equally painful. I too was rolling around on the floor whilst throwing up. I thought I was dying and they gave me morphine immediately at A and E and stepped down to paracetamol when I regained my senses. I'm really surprised they didn't help you more, did they say why only paracetamol? It sounds traumatising OP, I hope you are feeling better now.

While diet can help some, it didn’t me. I never knew what my trigger was. Often opening my eyes and breathing would do it.

OP, morphine can cause the sphincter controlling the flow of bile into the intestine to clamp shut or spasm. If this happens while the gallstone is already blocking the bile duct it can make the pain much worse and potentially worsen the pressure inside the biliary system. Morphine also carries a much higher risk of unwanted side effects like depression of the respiratory system, nausea and constipation so it’s not the first choice in this situation. Non-steroidal anti-inflammatory drugs such as naproxen or diclofenac will target the inflammation and pain without the side effects of narcotics.

To be brutally honest, if I saw someone rolling around on the floor in the hospital I'd think they were putting it on or exaggerating for some reason, potentially to get their hands on drugs that will make them feel high, like strong pain killers. Maybe that's what the staff thought and they are trying to prevent addiction.

No, it's not unreasonable to expect proper pain management. Am I surprised this was the case? No. DS wasn't given anything stronger following brain surgery. It's horrific.

Oramorph in this situation is used to relax the blood vessels and take the load off the heart reducing it's oxygen requirements to prevent more damage. We would use morphine in acute cardiac failure. It was great stuff.

I’m in a very similar situation! 3 months pp and started having attacks at 7weeks pp. Are you breastfeeding? My GP prescribed codeine and diclofenac for pain relieve but I have some doubts around using codeine as I’m breastfeeding, so only have used it twice when I can’t get on top of the pain with diclofenac and paracetamol and a hot water bottle.

I am lucky to have private health so have surgery booked for mid November. The pain is so terrible when the attacks happen that I’m willing to take on surgery recovery with a baby and a toddler - I’d be absolutely furious if denied anything stronger than paracetamol 🤬