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Original poster

Amitriptyline - advice about dose - any Drs or pharmacists?

53 replies

Blu · 08/07/2008 11:42

DS's consultant has put him on Amitryptyline as a drug to modify his perception of pain. He is undergoing bone-lengthening, and has been waking at night in pain, and also finding it painful to keep his leg as straight as he needs to while he is in his wheelchair. She advised that this would help him sleep and possibly enable us to reduce the other painkilling drugs he is taking - codeine sulphate, paracetamol and ibroprufen.

He has the first dose last night, and did indeed sleep through, but it was no hep to our getting ay sleep as he shouted and yelled in his sleep fo hours, on and off. (he has no recollection of bad dreams this morning) he was very hard to wake this morning, and went back to sleep after breakfast.

I have looked on the instructions and he seems to be on a v high dose.

It is a solution of 25mg/5ml, and he has been prescribed 5.5 ml. He weighs about 17gk and is almost 7.

I a wondering about reducing the dose?

OP posts:
tissy · 08/07/2008 18:45

Blu, how often is he stretching?

It may be possible to alter the timings a bit, so that he stretches less in the evening, and more in the morning, or possibly to slow down the rate of lengthening a bit. It sounds like he's going too fast....when are you seeing the Consultant again?

Original poster
Blu · 08/07/2008 18:47

Have just explained to DS - as understated an calmly as possible - why he has ben feeling grggy an poorly all day...and now do feel quit tearful and shaken.

Th pharmacist is Spanish and has difficulty understanding some English. I had to write Ds's name on a bit of paper before he could understand what it was, and then he couldn't understand - even though I told him twice, that in a hyphenated surname the name before the hyphen IS the surname - he eventualy found the prescription, when I picked it up, simpley made out to FirstName SecondPartOfHyphenated name.

Also, every other time I have had to collect something later (it had to be ordered) I have been given a receipt, and had to produce it on collection. He did not give DP a receipt nor did he ask for one when I went back to collect it, or ask for any proof of identity - basically he could have been handing the bottle to anyone.

That isn't right, is it?

OP posts:
Original poster
Blu · 08/07/2008 18:52

Tissy - 1mm a day - BUT we have been told to leave it for a day if the pain increases. Mostly the regular drugs do control the discomfort, and we tend t give lengtheing a rest every three or four days.

I have realised that a drawback with the TSF is that, unlike an Illzarov, lengthening can only happen in whole mm's rather than half turns possible with an Illzarov.

We are 23mm through a planned 5cm!!

OP posts:
tissy · 08/07/2008 18:57

ahh.... I'm a bit of a luddite with frames; was "brought up" with Ilizarov, and can't see what the fuss with TSF is about. You see if he had an old-fashioned frame I would have said 3 x quarter turns a day, rather than 4, but that's not much help to you .

Sounds like you're doing all the right things, I assume he's doing stretches for his hamstrings as well?

Original poster
Blu · 08/07/2008 19:03

Yes, he's doing very well with his hamstring stetches..his physio this morning was very hapy with him.
We see his consutant once a week for x ray and she checks his progress.I also have the mobile number of the specialist nurse for any crises (like today), and the odd rogue pharmacist aside, I feel very wel suported.

You can see my assorted ramblings about all this on my blog - or Blug! nd I intend to write a concise sensible case-study fo STEPS fr the benefit of other parents.

OP posts:
Original poster
Blu · 08/07/2008 19:33

Well, here's a turn up for the books!

I just had the pharmacist, in person, on the doorstep!!!

Mortified, completely admitting it is his mistake, come to make sure DS is Ok and advising us not to give him more for 3-4 days, asking for his GP's name and address so he can give her a report, bringing the correct label for the bottle, and a small dispensing syringe for 1.5 ml doses!!!

OP posts:
tissy · 08/07/2008 19:37
Smile
herbietea · 08/07/2008 20:05

This reply has been deleted

Message withdrawn

Original poster
Blu · 08/07/2008 21:32

We're off to A&E.
Nurse just rang and said consultant has asked for DS to have an ECG to be on safe side, or she won' rest easy.
Nurse is on hol, too...and co-ordinating all this from her mobile.

Update later...wish us luck.

OP posts:
batters · 08/07/2008 21:37

This reply has been deleted

Message withdrawn at poster's request.

Marina · 08/07/2008 21:37

Oh FFS blu, what a totally unnecessary worry for you all
At least the pharmacist had the conscience to come and see you in person
Really hoping all is well for you and BoyBlu XXX

Marina · 08/07/2008 21:39

But could not help LOLing slightly in passing at a Spanish person of all nationalities being dazed and confused about English hyphenated surnames

iBundle · 08/07/2008 21:43

oh blu, am so glad to hear this. and impressed that pharmacist pitched up (albeit prob after professional advice). wishing you v boring results from ECG, and a peaceful night, xxxx

ummadam · 08/07/2008 22:04

glad to hear they are dragging you in for an ECG - boring and annoying for you but now we can rest easy as well (not that I've been anxiously checking MN for updates.. no not me!)

Hope all comes up clear and you all get a good night sleep!

Original poster
Blu · 09/07/2008 00:05

A&E very helpful and thorough, and thankfully the ECG gave them no cause for concern at all. Poor DS was quite distressed because he was in bed by the time the nurse rang and told us to go - but he's OK and quite philosophical about it now. And I'm glad that the consultant was mindd to take no risks.

But bloody hell- what a close shave. The Dr in A&E said he could have had a seizure - and that would have happene within 6 hours of having had the excess dose. S that would have been in the night before I had realised there was any problem. I only started checking all this because I was a bit about DS being so sleepy.

Our nurse is a star. I rang the number she gave me when DS was in the first couple of days after the op - and didn't realise that was her personal mobile.

Thanks everyone...for your expert views, experience and good wishes respecytively.

off to bed!

OP posts:
Montmorency · 09/07/2008 06:31

Blu, what an awful mistake to make. I am so glad that your DS's ECG went well, and hope that he had a settled night.

batters · 09/07/2008 08:18

This reply has been deleted

Message withdrawn at poster's request.

SueW · 09/07/2008 08:40

Oh blu Thank goodness you were on the ball and queried it and that your cons and her sec are so helpful.

Marina · 09/07/2008 09:41

Oh thank goodness. You were all on my mind last thing last night and first thing this morning XXX

Original poster
Blu · 09/07/2008 10:31

wel, we did all sleep well - DS had the most undisturbed night for ages - did not wake for painkillers. He is very perky and cgheerful this a.m and busy devising gruesome vengance on the phrmacist.

Meanwhile, his consultant rang us this morning to see how he is, and has spoken the pai managemnt conultnt - she wants us to go back in this morning, be checked by p-m con, for them to chk tht the dread bottle is not also made up with as adult mixture with alcohol in it, and to make a statment about wht happened.

SO...another half day at the hospital, another urgent e mail t work cancelling my meeings - but another big round of applause and thanks fo our team at the hospital - I a so re-asured that they have paid so much professional attention to this, and with personal care and cocern, to - his conultant is capable of being a really formidable oman - but she sounded as wrought as i did this morning about DS and said sh had been awak at night worrying about what had happened.

Thank you MN for being alongside me...I re-read my Op last night an realised that had i not een fo MN I ight well have simply experimented with half the dose - still way too high! Although was v unhappy about it b the - MN helped me implement my instincts.

Off to the hospital....

Streatham Mn-ers, I will tip you off as to a certain chemist to avoid. (but this is goin to some officil process, and i don't ant to go public or involve MN in a libel case).
Dispensing, it seem, is not as simple as ABC...

OP posts:
Original poster
Blu · 09/07/2008 10:31

wel, we did all sleep well - DS had the most undisturbed night for ages - did not wake for painkillers. He is very perky and cgheerful this a.m and busy devising gruesome vengance on the phrmacist.

Meanwhile, his consultant rang us this morning to see how he is, and has spoken the pai managemnt conultnt - she wants us to go back in this morning, be checked by p-m con, for them to chk tht the dread bottle is not also made up with as adult mixture with alcohol in it, and to make a statment about wht happened.

SO...another half day at the hospital, another urgent e mail t work cancelling my meeings - but another big round of applause and thanks fo our team at the hospital - I a so re-asured that they have paid so much professional attention to this, and with personal care and cocern, to - his conultant is capable of being a really formidable oman - but she sounded as wrought as i did this morning about DS and said sh had been awak at night worrying about what had happened.

Thank you MN for being alongside me...I re-read my Op last night an realised that had i not een fo MN I ight well have simply experimented with half the dose - still way too high! Although was v unhappy about it b the - MN helped me implement my instincts.

Off to the hospital....

Streatham Mn-ers, I will tip you off as to a certain chemist to avoid. (but this is goin to some officil process, and i don't ant to go public or involve MN in a libel case).
Dispensing, it seem, is not as simple as ABC...

OP posts:
Original poster
Blu · 09/07/2008 10:31

wel, we did all sleep well - DS had the most undisturbed night for ages - did not wake for painkillers. He is very perky and cgheerful this a.m and busy devising gruesome vengance on the phrmacist.

Meanwhile, his consultant rang us this morning to see how he is, and has spoken the pai managemnt conultnt - she wants us to go back in this morning, be checked by p-m con, for them to chk tht the dread bottle is not also made up with as adult mixture with alcohol in it, and to make a statment about wht happened.

SO...another half day at the hospital, another urgent e mail t work cancelling my meeings - but another big round of applause and thanks fo our team at the hospital - I a so re-asured that they have paid so much professional attention to this, and with personal care and cocern, to - his conultant is capable of being a really formidable oman - but she sounded as wrought as i did this morning about DS and said sh had been awak at night worrying about what had happened.

Thank you MN for being alongside me...I re-read my Op last night an realised that had i not een fo MN I ight well have simply experimented with half the dose - still way too high! Although was v unhappy about it b the - MN helped me implement my instincts.

Off to the hospital....

Streatham Mn-ers, I will tip you off as to a certain chemist to avoid. (but this is goin to some officil process, and i don't ant to go public or involve MN in a libel case).
Dispensing, it seem, is not as simple as ABC...

OP posts:
batters · 09/07/2008 10:46

This reply has been deleted

Message withdrawn at poster's request.

Original poster
Blu · 11/07/2008 15:21

The official follow-up is vey thorough.

Th pharmacist called agin to see how Ds was and report that he has told our GP of the incident. Then his area manager rang and asked for a full statement of what had happened. We have also been caled by someone senior in the pharmacy dept at the hospital - also writing a full report because the original prescription came from the hospital. They asked for DS's reactions in great detail, and also everything each member of the hospital staff and said and done when I contacted them - they wanted to record it and ensure that they had all responded correctly to a possible and then confirmed drug error. (they had!).

We are waiting for a response from the pharmacy.

OP posts:
Saggarmakersbottomknocker · 14/07/2008 18:41

Blu - only just seen this after reading the blog. What a shocker. Glad that it's sorted now and that the pharmacist eventually held his hand up to it.

I think it shakes you quite a bit doesn't it? dd got a 10x heparin dose whilst in ITU as a baby (badly written prescription) I really lost faith for a while and I still meticulously check her prescriptions. It could have ended very badly.

Good to hear that BoyBlu has been his usual stoical self