Pain relief for home use? Tramadol ain't cutting it.

[Chocolatedeficitdisorder]

Hi

I'm an almost 50yr old overweight female. I was diagnosed with gallstones a few years ago but I refused surgery as the attacks weren't very regular and I didn't want to take time off work.

Over the past 6 months the attacks have become more regular and far more painful, although they are very short in that they last less than an hour. The pain is excrutiating and I'm unable to talk when it's at it's peak and I often have suffer from nausea and become very, very hot during an episode. Sometimes I vomit.

A few months ago I asked my Gp to refer me to the surgeons to discuss having my Gallbladder out. I eventually saw the surgeon who referred me for an MRCP. My LFT's from that day were very deranged with my ALT and ALP both in the low 200s and my GGTs above 700.

Bloods taken the day after an attack earlier this week show my levels climbing even higher, now ALT and ALP are almost 300 and my GGTs are above 1000.

I'm still having attacks several times a week and feel awful for a day or two afterwards. I take Tramadol 50mg 4 times a day to help with the attacks when they arrive, but I still feel horrible pain when they happen and would like something stronger to help with the pain at the time. My Gp just said that she didn't want to move me onto Morphine, just that she would try to hurry the surgeon along with a date.

Is there a better combination of drugs I could try? I'm taking Paracetamol alongside the Tramadol, but I would love something that was fast-acting and could take at the beginning of an attack that would prevent me becoming a snivelling wreck (sometimes a snivelling wreck sat in a car by the roadside). What would a reasonable Gp offer me?

No idea what is appropriate for gallstones but I used to take Tramadol in liquid format, which is faster acting than the tablets. You could try asking for that? You should be able to take a higher dose too, the max dose of Tramadol is 400mg a day.

I now have Oxycodone in liquid format which is pretty effective. But if the docs don't want to move you to morphine you probably wouldn't get that prescribed either

I hope you can get an op date soon

I would say that the only thing stronger would be morphine so I understand why your gp is hesitant but you could always ask for a SMALL bottle of oramorph for occasional breakthrough pain?

Are you also taking buscopan?

I do have Buscopan and was taking it faithfully, but I can't say it made a bit of difference. Now it's 50mg Tramadol and 2 Paracetamol, 8am, 1pm, 6pm and 11pm. when an attack comes along I immediately take another Tramadol but suffer from the pain until it goes away itself or the extra Tramadol kicks in 30 mins later. It's a very, very long 30 mins and often I've vomitted and the Tramadol is probably lost anyway.

My pain specialist believed that tramadol caused by gallbladder problems and every time I took it, it exacerbated my pain. I think you need to keep going back to your doctor. I’m on morphine for another condition, and that didn’t exacerbate things - you’d only need it until you’ve recovered from the surgery which hopefully they’ll do quite quickly with the problems you’re having.

For a different sort of pain (back) but I have found naproxen in addition to opiate pain relief to be really effective. It's a non steriodial anti inflammatory like ibuprofen but stronger and longer lasting.

I was given it because codeine wasn't cutting it for me and gp was reluctant to give me tramadol due to young child but it's made a huge difference to the pain levels

Can you have coedine or cocodamol instead of just paracetamol for break through pain?

To be honest I take morphine and a nerve action pain killer called pregabalin twice a day for arthritis throughout my body but when I get intense pain attacks because of muscle spasm they don't touch it either. There's no magic pain relief (outside of gas and air I suppose or that mad 'green whistle' they have on Bondi Rescue and I swear they only distract not remove pain) that can cut irregularly appearing pain. I wish I'd known that because I spent years chasing the elusive 'pain killer' and I don't think it exists. It must be absolutely horrible to have frequent pain attacks from your gall stones, I would keep pushing for it to be removed ASAP, squeaky wheel and all that.

Codeine isn't a good idea for gallbladder pain...it can cause worse pain due to sphincter of oddi dysfunction

Ten years ago I had similar symptoms, attacks and deranged LFTs but no gallstones were found. The Consultant reckoned it was Sphincter of Oddi dysfunction but the attacks lessened and I didn't need treatment. I remember at the time being told that codeine-based drugs weren't a good idea. Now I do seem to have gallstones, and probably stones in the common bile duct too. Wherever the pain is orginating - it bloody hurts.

Thanks for the ideas folk, there are a few drugs I hadn't really thought of (am an ex RMN, but haven't nursed for many years). I'll hopefully hear from the surgeon soon, but if not, or if the attacks are really bad this week I think I'll go back to the Gp and dig my heels in about getting something stronger.