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Blessed ibuprofen

When I first went to the GP complaining about difficulty swallowing, I was (mis-)diagnosed with acid reflux, and was eventually prescribed Omeprazole, a proton pump inhibitor, to try to reduce the excess acid I was supposedly producing. Actually, my stomach was causing me some pain, and the Omeprazole did help, so I suppose the tumour must have been causing my stomach to over-produce acid. However, that’s not the point of this post. Because of the acid stomach, I was told to avoid pain killers like aspirin and ibuprofen, because they can aggravate an acid stomach. Ever since then I have relied on paracetamol and morphine for pain relief. In fact, I’m on a permanent paracetamol prescription these days, so I can’t add any more, and must rely solely on morphine if the pain gets really bad.

This morning I woke up with a re-appearance of my recent back pain, except that it was a lot more severe than it had been. By the time we got to the hospital for my regular Wednesday appointment I was having considerable difficulty walking, and I could hardly sit still in my chair. I had already taken 10mg morphine, which I thought ought to be enough, but it didn’t touch the pain at all. At the hospital we got to see the consultant nice and early, and the pain and how to treat it was the main topic of conversation. I learned a lot, much of it quite a surprise to me.

First, 10mg morphine turns out to be quite a small dose. I knew that morphine is a relatively safe drug, but I’m always wary of taking more than I need, so I had somehow got the impression that 10mg was a normal dose, while 20mg was somehow exceptional, for very bad pain. That was definitely a misconception that was worth correcting.

Second, morphine, even when given as a slow-release tablet, ought to start acting in no more than about 30 minutes, so if the pain isn’t significantly reduced after that time, it makes sense to add a second dose of morphine.

Third, and most surprising, was that it is perfectly acceptable to take ibuprofen, even though I am taking Omeprazole. In fact, it seemed to be the case that I could take ibuprofen because I am taking the Omeprazole. When I found that out, I took some straight away. Within 30 minutes the pain was reducing, and after 40 minutes it was almost gone. By the time we left the hospital I was quite happy to drive, which is a huge contrast to the journey in, when I couldn’t even have conceived of driving so great a distance.

Blessed ibuprofen!

{ 12 } Comments

  1. RuthieG | 22 April 2010 at 12:25 am | Permalink

    Omeprazole – wonderful stuff. It means I can eat bacon and Marmite again ( I don’t mean together!) :D. I’ve never been told not to take ibuprofen, though.

  2. Jayne Alexander | 22 April 2010 at 9:26 am | Permalink

    I’ve just been prescribed omeprazole too! Joys of being ‘banded’. Hope all is going well Chris. I saw that programme on the Staffordshire Hoard the other day. Truly amazing. I thought of you as i was watching it cus you said you’d been to see it. I didn’t realise that so much was found. Speak soon……..Jayne x

  3. David Allsopp | 22 April 2010 at 10:23 am | Permalink

    Coincidentally I was also praising ibuprofen yesterday, for my dodgy knee.

    Googling NHS documents suggests that 30mg or higher of morphine seems to be regarded as “high dose”, requiring more care, but much higher doses do seem to be used for those who are accustomed to it and require palliative care (IANAD).

    Glad you’ve found a combination that works!

  4. icyjumbo | 22 April 2010 at 4:31 pm | Permalink

    Ruth, when I got the Omeprazole dose right it was an absolute revelation, although I hadn’t noticed that I got a particularly bad reaction from any particular food. It was just that the stomach pain went away — phew!

  5. icyjumbo | 22 April 2010 at 4:32 pm | Permalink

    Jayne, I hope the “banding” is working out well, and that the Omeprazole is not because things are proving more difficult than you hoped.

  6. icyjumbo | 22 April 2010 at 4:34 pm | Permalink

    David, I don’t know why I didn’t think to look through the NHS documentation, but it’s good to know that I’m not on a high dose of morphine. I still prefer to use the ibuprofen, though, as it seems more effective in this case, surprisingly enough.

  7. Jayne Alexander | 23 April 2010 at 9:37 pm | Permalink

    Hi chris, the banding is making progress albeit slower than i would have wished for. Apparently its common for us bandsters to need omperazole as the stomach is used to taking more food than its getting but is still producing the same amount of acid as before. It should settle down eventually. Hey i’m up to 4st 10lbs lost now and can celebrate being obese instead of morbidly obese lol.

  8. icyjumbo | 24 April 2010 at 8:23 pm | Permalink

    Jayne, wow! Nearly 5 stone. That’s amazing. You must be so proud. I got down to 11st 2lb at my lowest, but they said I should aim to put on as much weight as possible, so it’s going back up again. 12st 2lb is obese for me too 🙁

  9. Paul W | 24 April 2010 at 12:24 pm | Permalink

    I caught up with some of the DTG gang last night in Paprikas and just wanted to say hi Chris and wish you and Gillian all the very best.

  10. icyjumbo | 24 April 2010 at 8:21 pm | Permalink

    Hi Paul, and thanks for the good wishes. Hope things are going well for you now you’ve reached a grand old age…

  11. Margaret Bennet | 26 April 2010 at 1:34 am | Permalink

    As far as I recall (It was almost 16 years ago – Michael’s birthday is next week.) the only time I was given morphine, it did nothing for the pain, just made me not care as much. And sent me to sleep, so really quite similar to my response to alcohol. I’ve no idea of the dosage though. I am a recent convert to ibuprofen gel however, for a wonky elbow. Middle age has definitely hit.

  12. icyjumbo | 26 April 2010 at 6:05 pm | Permalink

    When I was in pain earlier in the treatment, the morphine was tremendously helpful, but recently it doesn’t seem to have done so much. I guess that’s because the pain is referred rather than “real”. It hurts as much as if it were real, but it’s not quite the same mechanism producing the pain. The ibuprofen is anti-inflammatory, which probably explains its effectiveness.

    Middle age is a bugger, isn’t it? Started on the bifocals or varifocals yet?