My Dad

[TripleSeptic]

My dad is 72, has been suffering from excruciating pain, and numbness in his left arm for about 4 weeks. He's been to his GP three times since, has been prescribed 30/500 cocodamol, then amitriptyline, and this week, tramadol. He's like an old man, in pain, drowsy, sleeping all the time. Dr wants to treat the pain as a squashed nerve, but it's not helping. My normally spritely, lively, lovely dad currently has a vastly reduced quality of life, he can't go out with his pals, drive, even struggles to walk the dog. I don't know what to do.

In Northern Ireland you can "book" an A&E appt, but I'm torn, is it A&E worthy? Might be if it's heart symptoms.

Go private? To who? I feel he needs properly assessed by a GP, someone who can tell us who to refer to. A heart specialist, someone who deals with nerve pain, a bone specialist, physio?

Please let me know your thoughts, because I want to try to help him this week, it can't go on, he's not himself at all.

I would think a physio might be able to help and try and relieve the pain or give exercises to help.

This is awful op he shouldn't be struggling to walk the dog and sleeping all the time. Yes pain meds can knock the stuffing out of people but not to this extent.

Just go back, keep going back until he either has an xray, physio referral or specialist referral. This thing some GPs do of prescribing pain meds without review or follow up isn't good enough. Does he have any other issues like breathlessness?

Assuming the GP will have ruled out other medical conditions I'd say not A&E - try a physio first, but look around to see if you can find one who has some expertise with age-related care.

I've texted a physio who really helped me and has really great reviews from elderly people and people with fibromyalgia and trapped nerves. I don't expect to hear anything back until tomorrow, but fingers crossed.

This is why gps are mostly useless imo!

They often treat the symptoms without even bothering to try and find the cause!

Can you go with him next time? Or better still (unfortunately) is there a younger man that can go with him? Because unfortunately medical misogyny often extends to ageism too

This is unacceptable for him to still be in pain for weeks and the cause not identified, plus as you say it could be a heart thing going on or a stroke and that shouldn't be ignored (I'm ex elderly care hcp)

He needs to have the cause properly identified and treated.

My brother was trying to get him to ring the Dr again tomorrow, but I'm afraid the GP will just up his meds and leave him more stoned! I agree, he should be referred on somewhere, instead of being given stronger meds when none of them have worked inside the last 4 weeks. I accept maybe he needs to give them a chance to work, but he got up at 11 today and was fast asleep again by 2.30pm, woke again at 7pm.

I don't know if they have ruled anything out, or how they can just by talking to him. He's said he'd like to be seen elsewhere, but apparently "there's not much they can do for this kind of thing" and then, covid/post-covid waiting lists

I tried to reply individually to each of you, but it didn't work. Thank you for taking the time to reply and calm my nerves 🙂

Thank you! I will ask one of my brothers to go in with him. He said he wouldn't mind hearing "you're too old and your spine is squashing X nerve and affecting Y, I see this all the time", but he's not even getting that. It's more like "take this and I'll phone you next week". To be fair to the Dr, he did phone the following week, but when it was no better, he got more drugs, then more drugs. My dad would be more inclined to have a hot whiskey and go to bed when he was a cold, than dose up with paracetamol and ibuprofen, vitamin c. He's not used to taking all these tablets and rattling when he walks, it's not his style.

@JaniieJones, no breathlessness, but THIRST. I thought diabetes, would that cause pain if untreated? Then I thought, cocodamol makes my mouth dry.

If you're going to book a private appointment, I would go to a private GP as first port of call. Get it assessed and they'll tell you who to see next.

I would get your dad to ring the GP again though and say it's no better. It's not a terrible plan to prescribe pain meds in the first instance (though not great either), but if there's no improvement then the next step is definitely see the patient! The GP won't know it's no better though, unless you ring and tell them!

He isn't taking tramadol and cocodamol is he? It is one of the other I believe. He probably needs a higher dose of nerve pain meds, so the amitrypline may need increasing or they could prescribe another like carbamazepine or gabapentin. Cocodamol does make people thirsty yes in response to your recent post.

I'm surprised with arm pain and numbness they haven't taken bloods to rule out other issues. If you have 111 in NI I'd encourage him to ring explaining he has ongoing arm pain and numbness, extreme fatigue (which may or may not be meds related but the GP should check) and see if he can see someone even a nurse practitioner surely a basic xray should be done after a weeks of pain.

No 111 here, GP during office hours, and out of hours triage/emergency GP service or a&e beyond that. That's our options. Private GP appt available in Belfast tomorrow, 30 mins for £96, I'll talk to him when he's awake tomorrow. Thanks so much

I would be careful with taking tramadol more than very short term. I got terrible withdrawal when I stopped taking them. Really bad.

I use a chiropractor now for my mulscular skeletal pain than flares up now and again. But yes, maybe a physio if that sits better with you.

Go to A and E, the more people that go the more it will pressurise GPS into seeing and physically assessing patients rather than using psychic powers through a telephone. Absolute joke. Covid was the best thing that ever happened to them. Hope your dad gets sorted.

Painkillers should mostly be a temporary measure until the cause of pain is identified and treated, it's really only in cases of known conditions but chronic pain (as I have due to disability) that they should be a regular prescription. In addition tramadol is addictive and should be closely monitored it's a heavy duty drug for most.

Personally I would not be impressed that he hasn't at the very least had an ecg and an initial stroke assessment which it sounds as if these haven't even been considered. Covid is no excuse!

These are serious conditions that respond well to early diagnosis and treatment

but THIRST. I thought diabetes, would that cause pain if untreated?

Yes -nerve pain can be a symptom too

Given his age and the symptoms in your and his shoes I'd be far from impressed with gp!

But then ime they're generally shit for anything but basic care.