My GP has focused my pain meds entirely on morphine now – 60mg Zomorph every 12 hours, interspersed with 5 or 10ml Oramorph at need but no more than every 4 to 6 hours.
It’s a reasonably effective strategy, but with room for improvement, but he’s changed drugs so unpredictably of late I worry about relying too much upon a single drug lest the bugger changes his mind again. I’m also reluctant to discuss any problems I’m having as I have no desire to provoke him into another change – I need stability!
To that end I flirted with reintroducing Gabapentin, but at half the previous dose, just 300mg, but that wiped me out both physically and mentally.
Today the pain is totally out of control. Between 08.00 and 11.00 I’ve taken 60mg of Zomorph and 20ml of Oramorph – all to zero effect – and I’ve just added 2 tabs of Naproxen to the witches brew, but that could take a while to kick in and, until it does, I’m going to need all my self-control not to scream. And NO! I’m not a drama queen and, yes, it really is that bad.
For reasons that elude me – but probably linked to pain fog – it never even occurred to me, today, to take my Spoonie Speedball – 2 Naproxen, 60mg DHC and 2 Paracetamol – which never lets me down.
It’s now 12 minutes past noon, and I’ve taken nothing since the Naproxen at about 11.10 – and I am still in agony – nothing is working.
I am, though, getting an insight – not that it’s much help – into how people accidentally kill themselves with an overdose. OK, I’m not stupid, I know one can’t keep shovelling drugs down, but in a situation like this my memory goes to hell, and I simply can’t remember what I’ve taken.
The worst that’s happened so far is that I’ve passed out, but I took the hint and now I record everything in a Word document which I started yesterday. Nothing complicated, but it gives me an instant visual check without having to trust my memory:-
ORAMORPH RECORD, 2013.
August 19, 09.00, 5ml
August 19, 09.35, +5ml
August 19, 11.20, 10ml
This is my Oramorph record for today – you can tell, it says so. I wasn’t in too much pain so my first dose was just 5ml. Pain went through the roof, hence the following 5ml, which was useless.
Nurses came, changed dressings and, as often happens the pain went off the scale, and another 10ml went down – and this is how people accidentally die. OK, I have a safety margin – I can take up to 10ml every 4 hours – but being pushed into taking extra when a drug doesn’t perform as expected is inherently dangerous.
And now – over an hour since my last dose, the pain is finally letting up a little – just a matter of degree, nothing more, and certainly not enough for me to chalk it up as problem solved, because it’s not, by a long way.
So what is it about analgesics that makes them so unreliable (according to my GP my experience isn’t exactly unusual)? If the rest of my meds performed as badly they might well endanger my life.
Is it, perhaps, the nature of pain that makes the response to medication so apparently random, or is it yet another example of the abysmal quality control in the generic drug market, mentioned here previously?
If the latter then it’s high time the matter was addressed, as it’s been going on for far too long, as those of us unable to avoid getting sucked into the system can testify. The administration of the licensing system is far too haphazard, again, as covered previously – fortunes can be made and businesses shut down long before the inspection process kicks in, which is criminally lax and doubtless susceptible to corruption and who knows what the death rate might be from poor-quality drugs, since the Medicines and Healthcare products Regulatory Agency, to whom I’ve reported drugs which have proven to be toxic, simply doesn’t care if their response to my complaint was at all typical.