Re: Re: Kens update - Sciatic Pain..

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Thanks Cam, I think it is time for me to research taking Meds.... I have put it off as long as possible but feel it may offer me a little more mobility (or at least I hope so)... and to buy me some time until I find out what my options are (surgery or the current "live with it").. Ken.cammaltby <cammaltby@...> wrote: What worked for me was ice and rest.... and ultimately surgery...nothing else touched it. Sorry you are having that by-product of your family day. Cam

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Ditto again.

Bonnie

[ ] Re: Kens update - Sciatic Pain..

Ditto!Drugs, ice, and rest is the best combination I've found for a day of over-doing!kam>> What worked for me was ice and rest.... and ultimately > surgery...nothing else touched it. Sorry you are having that by-> product of your family day. Cam>

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Which Meds do you all prefer?Bonnie <bonnie@...> wrote: Ditto again. Bonnie [ ] Re: Kens update - Sciatic Pain.. Ditto!Drugs, ice, and rest is the best combination I've found for a day of over-doing!kam>> What worked for me was ice and rest.... and ultimately > surgery...nothing else touched it. Sorry you are having that by-> product of your family day. Cam>

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Generally speaking, for the sciatic kinds of pain, across here you would be prescribed an NSAID, probably diclofenac initially (perhaps as arthrotec or one of the other brands that has a stomach protector), and a paracetamol (acetominophen) & codeine combination - co-proxamol (325mg paracetamol/32.5mg dextropropoxyphene) is no longer prescribed and may actually have been withdrawn due to a supposed increase in suicides (although it was unclear last time I read about it as to whether this could be affected by other factors such as misprescription). That leaves co-codamol (500mg paracetamol/8mg codeine phosphate) and co-dydramol (500mg paracetamol/10mg dihydrocedeine tartrate), before they move you onto the bigger guns such as tramadol, and pure codeine phosphate or dihydrocodeine tartrate. The former is generally then prescribed as either 15 or 30mg tablets, the latter they don't tend to prescribe unless they have specific reason not to give codeine phosphate.

My experience of it has been that diclofenac was great initially, then over time just not so good, like I developed a tolerance. Purely anecdotally I would say that most people I have known who have been on diclofenac for any length of time have found similar tolerance issues, but usually not as bad as mine - although I suspect that for me it was partly change of the *type* of pain that stopped it working so well.

Similarly when I was on co-proxamol originally, it worked well just as it had after my first surgery. Gradually it stopped seeming to work, and now all it does is make me feel a bit odd and leave the pain there - admittedly I feel just odd enough to care a bit less, but that's not really the desired effect! Codeine phosphate works at higher doses (30mg and up), but bungs me up a bit and makes me sleepy, basic 8/500 co-codamol don't really do anything - they'll help a mild headache and that's about it. Co-dydramol have been great - I've been taking them over the last 4 years and find them fantastic for your everyday stuff, and for me they don't get in the way of thinking for work.

Something to remember is that you don't have to think in terms of taking enough painkillers to be totally pain free or anything - just knocking the edges off can make you feel so much better. Also, if you're not sleeping well, you may find just to take (for example) a low dose of slow-release diclofenac twice a day to give background pain control and help with the inflammation (which of course will help nerve pain by settling them a little), and a couple of codyramol at night will help you tremendously, and actually might give you more energy and ability to do things than treating the pain on more of a symptomatic basis of waiting until it's bad then trying to catch up with it.

Hope that makes some kind of sense, and of course it is just my thoughts and experiences ;o)

titch-- Something unknown is doing we don't know what

[Guest guest]

Hi titch ~ Thanks for the insights!! I think I will need to read this a few times to get it to sink in... Ken.oojackapivvy <oojackapivvy@...> wrote: Generally speaking, for the sciatic kinds of pain, across here you would be prescribed an NSAID, probably diclofenac initially (perhaps as arthrotec or one of the other brands that has a stomach protector), and a paracetamol (acetominophen) & codeine combination - co-proxamol (325mg paracetamol/32.5mg dextropropoxyphene) is no longer prescribed and may actually have been withdrawn due to a supposed increase in suicides (although it was unclear last time I read about it as to whether this could be affected by other factors such as misprescription). That leaves co-codamol (500mg paracetamol/8mg codeine phosphate) and co-dydramol (500mg paracetamol/10mg dihydrocedeine

tartrate), before they move you onto the bigger guns such as tramadol, and pure codeine phosphate or dihydrocodeine tartrate. The former is generally then prescribed as either 15 or 30mg tablets, the latter they don't tend to prescribe unless they have specific reason not to give codeine phosphate. My experience of it has been that diclofenac was great initially, then over time just not so good, like I developed a tolerance. Purely anecdotally I would say that most people I have known who have been on diclofenac for any length of time have found similar tolerance issues, but usually not as bad as mine - although I suspect that for me it was partly change of the *type* of pain that stopped it working so well. Similarly when I was on co-proxamol originally, it worked well just as it had after my first surgery. Gradually it stopped seeming to work, and now all it does is make me feel a bit odd and

leave the pain there - admittedly I feel just odd enough to care a bit less, but that's not really the desired effect! Codeine phosphate works at higher doses (30mg and up), but bungs me up a bit and makes me sleepy, basic 8/500 co-codamol don't really do anything - they'll help a mild headache and that's about it. Co-dydramol have been great - I've been taking them over the last 4 years and find them fantastic for your everyday stuff, and for me they don't get in the way of thinking for work. Something to remember is that you don't have to think in terms of taking enough painkillers to be totally pain free or anything - just knocking the edges off can make you feel so much better. Also, if you're not sleeping well, you may find just to take (for example) a low dose of slow-release diclofenac twice a day to give background pain control and help with the inflammation (which of course will help nerve pain by settling them a

little), and a couple of codyramol at night will help you tremendously, and actually might give you more energy and ability to do things than treating the pain on more of a symptomatic basis of waiting until it's bad then trying to catch up with it. Hope that makes some kind of sense, and of course it is just my thoughts and experiences ;o) titch-- Something unknown is doing we don't know what

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That's why I always try to state quantities and generic names ;o) Although if anything it's more restrictive here than the US, so I'd find it fairly surprising if we have painkillers you do not. One difference I've found in a few minutes looking is that it seems not uncommon to have opiod/aspirin combos - we've just recently got our first one across here which is Nurofen plus, but until then a doctor would have had to prescribe the NSAID and the codeine separately to each other.

I've just checked and it appears that an equivalent to co-dydramol is available: http://www.saintfranciscare.com/111408.cfm (although it doesn't seem to state quantities). Although the quantities seem different (approx twice the amount of dextropropoxyphene to paracetamol), the brand Darvocet seems to be the equivalent to co-proxamol. I'm pretty sure diclofenac is available, and I believe that tylenol (not sure whether 2 or 3, haven't yet found anything on quantities) is the equivalent to co-codamol. I'm pretty sure that diclofenac and diclofenac/misoprostol combos are available in the US too. Tramadol of course is branded as Ultram.

And having said all of that, prescription trends and regimes will vary from area to area, quite apart from country to country, which doesn't help much.

titch-- Something unknown is doing we don't know what

[Guest guest]

Hi,

I've been using Arthrotec for over three years. I wonder if my pain level has decreased because I've become too accustomed to it. Hmmm. I will bring this up with my pain doc on my next visit. Thanks.

About Arthrotec: It is a combination of voltaren and cytotec, voltaren being the NSAID part and cytotec being the part that is supposed to protect your stomach. When my internist first prescribed it, he said it is a very good drug that just never seemed to really catch on in this country. Well, perhaps there is a reason for that. If you read the insert, it clearly states that this drug can be very harmful to pregnant women and should not be taken by anyone who even has a chance of becoming pregnant. The warning is so explicit that I think they want anyone even on really good birth control not to take it. Not a problem for me, of course, being well past menopause.

A few months ago, I became increasingly worried about my stomach because I've been on NSAIDs for almost all of the last nine years, so I went to see a gastroenterologist, just to get his take on it all. I'm not having any stomach problems that I know of. I have been taking Nexium for a couple of years and before that Prilosec, altogether for a total of about 10 years or more because of a hiatal hernia. Well, the gastroenterologist said that between the Nexium and the Cytotec, I was doing just the right things to protect my stomach from the NSAID. He also said to regularly check the color of stool (sorry, but needed to be mentioned) and have a colonoscopy when scheduled in three years (my last one 2 years ago was normal). He said that while there's no guarantee, of course, under the circumstances he saw no reason to stop the NSAID.

Bonnie

Re: [ ] Re: Kens update - Sciatic Pain..

Generally speaking, for the sciatic kinds of pain, across here you would be prescribed an NSAID, probably diclofenac initially (perhaps as arthrotec or one of the other brands that has a stomach protector), and a paracetamol (acetominophen) & codeine combination - co-proxamol (325mg paracetamol/32.5mg dextropropoxyphene) is no longer prescribed and may actually have been withdrawn due to a supposed increase in suicides (although it was unclear last time I read about it as to whether this could be affected by other factors such as misprescription). That leaves co-codamol (500mg paracetamol/8mg codeine phosphate) and co-dydramol (500mg paracetamol/10mg dihydrocedeine tartrate), before they move you onto the bigger guns such as tramadol, and pure codeine phosphate or dihydrocodeine tartrate. The former is generally then prescribed as either 15 or 30mg tablets, the latter they don't tend to prescribe unless they have specific reason not to give codeine phosphate.

My experience of it has been that diclofenac was great initially, then over time just not so good, like I developed a tolerance. Purely anecdotally I would say that most people I have known who have been on diclofenac for any length of time have found similar tolerance issues, but usually not as bad as mine - although I suspect that for me it was partly change of the *type* of pain that stopped it working so well.

Similarly when I was on co-proxamol originally, it worked well just as it had after my first surgery. Gradually it stopped seeming to work, and now all it does is make me feel a bit odd and leave the pain there - admittedly I feel just odd enough to care a bit less, but that's not really the desired effect! Codeine phosphate works at higher doses (30mg and up), but bungs me up a bit and makes me sleepy, basic 8/500 co-codamol don't really do anything - they'll help a mild headache and that's about it. Co-dydramol have been great - I've been taking them over the last 4 years and find them fantastic for your everyday stuff, and for me they don't get in the way of thinking for work.

Something to remember is that you don't have to think in terms of taking enough painkillers to be totally pain free or anything - just knocking the edges off can make you feel so much better. Also, if you're not sleeping well, you may find just to take (for example) a low dose of slow-release diclofenac twice a day to give background pain control and help with the inflammation (which of course will help nerve pain by settling them a little), and a couple of codyramol at night will help you tremendously, and actually might give you more energy and ability to do things than treating the pain on more of a symptomatic basis of waiting until it's bad then trying to catch up with it.

Hope that makes some kind of sense, and of course it is just my thoughts and experiences ;o)

titch-- Something unknown is doing we don't know what