General Medical issues thread

[RooFlyer]

Pinot mate, Pinot!

Funny, when I go onto that, the opposite happens - I can't come off it

 

[Quickstatus]

opioid

1 of 3 mechanisms of analgesia. The other 2 mechanisms are non opiate

 

[blackcat20]

I had day surgery last week and couldn’t believe the amount of plastic waste it involved.

It is incredible just how much is "disposible" these days ! Including all the actual operating tools that they are using these days - none of them washed, and sent off to the central sterilising department like in my old days !!

I had surgery last year and was gifted the scissors from the dressing change pack, because they are thrown out otherwise. They're really decent scissors too and get a lot of use around the house.

 

[RooFlyer]

1 of 3 mechanisms of analgesia. The other 2 mechanisms are non opiate

I’m sure that’s the case but I don’t see the significance. I was just happy to get off an opioid painkiller ( or any painkiller for that matter) as soon as I could.

 

[CaptainCurtis]

I was just happy to get off an opioid painkiller ( or any painkiller for that matter) as soon as I could.

I was the same last year with my chest pain - endone is a wonderful drug, but I could not wait to come off the stuff. I was trialled on tapentadol, but couldn't function on it. My understanding is that it's predominantly used for nerve pain, but is also trialled when other painkillers aren't having the desired effect. Once I was ready to come off the endone, I was placed on tramadol for the residual pain, which worked brilliantly. Interesting how people respond differently to different drugs (and dosages).

 

[coriander]

Palexia. Was given that prescribed 50-100mg 2-4 times a day IR for an occasional but severe post-operative (hernia) pain. Didn't seem to do anything and as I read it was an opioid, I got off it after 2 days. No change to the pain straight after that, which faded over a week.

Gulp. My surgeon said there may be some "mild discomfort" following my forthcoming hernia surgery(in 22 hours but who's counting) and some post op oedema of my dangly bits.

Trepidation is my word of the day.

 

[coriander]

I found Tramadol to be useless for controlling pain in my ribcage due to drain tubes after a mitral valve repair: nurse gave me two Panadol and I was asleep painfree in about 10 minutes.

Agree about drug response variability

 

[RooFlyer]

Gulp. My surgeon said there may be some "mild discomfort" following my forthcoming hernia surgery(in 22 hours but who's counting) and some post op oedema of my dangly bits.

Trepidation is my word of the day.

Chin up. My post operative issues I was told for each was in the 1 to 0.5% chance of happening. I guess I’m just lucky. Mine was a double operation, left and right.

I got the oedema thing but it only started a couple of days after I got home. Took about a week to fully subside.

The biggest thing they didn’t prepare me for was the lack of manoeuvrability after you go home. Particularly getting in and out of bed and the like. Could be briefly painful if I wasn’t very careful and slow doing stuff. Buy a cough suppressant and a bedpan if you’re the type like me who needs to “go“ during the night. Oh and what they call “complete recovery“ seems to be different from my interpretation of that. Took much longer than what they said ( I’m 62).

 

[Quickstatus]

I don’t see the significance

Not in your specific case. But it is significant in the general sense that it is less of an opiate than a pure opiate like endone. So it has been (almost) the go to before oxycodone (given all the issues and as you have alluded to with opiates). Basically its a matter of suck it and see which is better. But yes opiates are generally best for short term use only.

predominantly used for nerve pain

No necessarily, used a lot now with acute postop pain, and in preference to oxycodone - in the first instance.

Tramadol

Tapentadol is if you like the V2 of tramadol

Trivia: the tapentadol immediate release version is not yet on the pbs.

 

[love_the_life]

Chin up. My post operative issues I was told for each was in the 1 to 0.5% chance of happening. I guess I’m just lucky. Mine was a double operation, left and right.

I got the oedema thing but it only started a couple of days after I got home. Took about a week to fully subside.

The biggest thing they didn’t prepare me for was the lack of manoeuvrability after you go home. Particularly getting in and out of bed and the like. Could be briefly painful if I wasn’t very careful and slow doing stuff. Buy a cough suppressant and a bedpan if you’re the type like me who needs to “go“ during the night. Oh and what they call “complete recovery“ seems to be different from my interpretation of that. Took much longer than what they said ( I’m 62).

Funny how the older we get, the longer it seems to take to get over things. Not a lot of value in getting older I fear.

 

[Quickstatus]

mild discomfort

For some reason the people who say they have a "high pain threshold" seem to be the ones who need more painkillers than the usual.

 

[JohnK]

For some reason the people who say they have a "high pain threshold" seem to be the ones who need more painkillers than the usual.

Wouldn't that depend on the intensity of the pain and type of pain and how much pain?

My left ribcage hurts just about where the heart is located. There's a visible bulge. Doctors saying possibly pushed out of shape by stomach. Maybe from birth. It's extremely uncomfortable and stressful as I can struggle to breathe at times.

My left shoulder/collar blade has what I can only describe as electrical pain. Very unpredictable and can last a few seconds.

Both shoulders and upper arms swollen and stiff.

Fingers/hands/wrists/forearms are swollen often and cause great discomfort.

Left hip is gone and is causing quite a few issues all around and knee is taking most of the brunt. And now the right hip has gone out in sympathy.

The pain in my lower back/pelvis is never ending. It can be so intense that I have to double over and wiggle around trying to get some relief. Uncomfortable and stressful.

Shins/calves can be extremely uncomfortable and recently foot has started similar pain.

The worst of the lot is neck pain. It's non stop. Extremely uncomfortable and last night and today have various headaches/migraines.

Each of the above conditions is different. Note there are other areas too in constant pain. Medication does very little but it's only temporary relief anyway. Occasionally 2 Panadeine Forte do nothing for the pain but it can numb the mind which is the best feeling of the lot.

Note I do not remember the last time I took any pain killers or aspirin. It is at least a week. If I am asking or taking medication you know it's last resort and I'm struggling to cope.

I consider myself to have a very high threshold to pain.

 

[coriander]

Mine was a double operation, left and right.

The biggest thing they didn’t prepare me for was the lack of manoeuvrability after you go home. Particularly getting in and out of bed and the like. Could be briefly painful if I wasn’t very careful and slow doing stuff. Buy a cough suppressant Took much longer than what they said ( I’m 62).

I'm a double as well, non Laparoscopic and have 9 years up on you.
I'm au fait with the manoeuvrability challenges (still have pain from multiple vertebral fractures if I move oddly). Bed activities... yeah well...

For some reason the people who say they have a "high pain threshold" seem to be the ones who need more painkillers than the usual.

I don't claim to have a high pain threshold, I have a drawer full of Endone, Targin boxes of many colours, and Dilaudid to prove it . As I mentioned upthread I was always amazed at how Panadol, oral or IV, would knock pain down.

Surgeons must have massively high pain thresholds, though .

My neighbour, mid 60s, said he was back to normal in 3 weeks so I guess it's a case of YMMV.

 

[RooFlyer]

Trivia: the tapentadol immediate release version is not yet on the pbs.

Interesting - that's what I got. $27 for pkt of 20.

I also have a barely used pkt of Endone

 

[Quickstatus]

$27 for pkt of 20.

As a disclaimer: I don't go to drug rep dinners. I have received a few pens in the past.
For some reason, the drug reps find it difficult to send me information without having to go to the dinner.

Sadly it still happens - under the guise of "Education"

 

[Quickstatus]

Wouldn't that depend on the intensity of the pain

No, often it is the expectation (sometimes misguided) that the pain of X is comparable to the lived experience of other pain

I don't claim to have a high pain threshold, I have a drawer full of Endone, Targin boxes of many colours, and Dilaudid to prove it

. A sobering thought that Drs are sending patients home on a multitude of S8 narcotics. Hence the move away from pure opiates like the ones above.

Surgeons must have massively high pain thresholds, though

What they are saying is that if you get anything other than mild pain, it not due to them.
The insinuation is that it must have been something you did after the op (AKA)

 

[cove]

Yes @Quickstatus while I have some narcotics in my medicine cabinet I am very, very careful with their use. I already know I have been addicted to caffeine and my dad was an alcoholic and had to totally dry out.
I would hate being addicted to any S8 narcotic.

 

[RooFlyer]

A sobering thought that Drs are sending patients home on a multitude of S8 narcotics. Hence the move away from pure opiates like the ones above.

My travel doctor asked what I had in my travel 'first aid' kit. I told him he didn't want to know! <But that's mainly for travel to some really dodgy places, like the Stans, Siberia etc>

 

[mrsterryn]

Husband has had endone for post brain surgery. It stayed in the cupboard for a couple of years.
With recent head injury he had pandeine forte
However merysdonl is his preference most of the time

 

[Quickstatus]

S8 narcotic

Stans, Siberia

The Japanese have a very strict aversion to S8 narcotics
Mrs QS broke her tibia in several places. Had to have a cast placed

The transport to hospital - no analgesia
The Dr consult - no analgesia
The application of cast with required realignment of the leg - paracetamol
The discharge meds - paracetamol
The repatriation involving cars, trains, flight, car (# to arrival into AU 5days) - paracetamol. I managed to get some ibuprofen from a chemist

I knew MrsQs was tough but never that tough.

Friends I know take oxycodone (with script) as a backup for travel to Japan

But the Japanese have a point.....

..............

pandeine forte

Trivia (but not trivial): panadeine is not available anymore
The human body is a drug manufacturing lab. The reason codeine is problematic is because the liver converts it to morphine.
But the issue of codeine only via prescription is a vexed one.