Fao Sqad Please.

[ladybirder]

Hi Sqad, need your advice please re painkillers. I had my lung cancer op by VATS in Guy's on 13 Dec and came home on 18th with the following to control the pain.
I have Paracetamol 500mg caplets take two tablets four times a day, Dihydrocodeine 30mg tablets take one tablet every 4 - 6 hours, Morphine Oral Solution 10mg/5ml take 5mls to 10mls four times a day.
Mostly just two of the Paracetamol have been enough to control my pain with the occasional one x Dihydrocodeine in between doses. I think I have overtired myself in the last couple of days and this dosage is not enough to control the pain anymore. So my question is could you advise what would be the best combination safe dosage to take that is a bit stronger than what I am already taking. I've no idea which I can mix with what and don't want to end up in hospital again.
Thank you. xx

[Sqad]

Hi! ladybirder.
You seem to have done very well.......Guys has a good history of thoracic surgery.
You pain plan has many combinations to offer....but in your particular case,1,000mgms four times a day should be seen as a maximum for the moment.
I would stick at the paracetamol dose and increase tour dihydrocodeine dose to 60mgms as and when required up to 8 tablets a day in between the paracetamol .
Juggle with the doses of dihydrocodeine that keeps your comfortable from your pain.
That would be my advice for this stage.....but can be reviewed if inadequate.

[ladybirder]

Thank you sqad, I'm due to take my next dose at 1pm so I shall do as you say.
One other thing, those horrid tight stockings they put on your legs were killing me and making my legs swell so I took them off. Should I have done that>. Aren't they to prevent DVT?
Tom Routledge did my op, terrific guy, do you know him?

[Sqad]

"Tom Routledge did my op, terrific guy, do you know him?"

LOL...LOL he wouldn't have been born ladybirder but thanks for the unintended compliment.
I was in the era of Russell Brock ..BUT..one of my mates was Mike Tynan who was professor of Paediatric Cardiology at Guys and even he retired some 20 years ago....;'-)

Yes......start your new regime at 1pm....then juggle with the combination.

Yes.....remove your stockings and yes, they are to prevent DVT's but make sure that you move about a bit more and if you get pain or selling leg below the knee, then pop them on again.

[TonyV]

lady my partner has the stockings, she does'nt like wearing them but they do help blood circulation, maybe you need a different size that are not so constrickave your local pharmacy will be able to measure you/

[ladybirder]

Lol perhaps I should have said "Do you know of him?" but as it's made you chuckle that's good;-).
When I'm sitting I do wriggle my legs and feet so I shall keep doing that.
Thanks Tony, they were OK when I first had them but then my legs swelled up so I think perhaps they were too small. I'm seeing a nurse tomorrow so I'll get her to check the size and then if as sqad says I do need to use them again at least they won't hurt as much. Got enough damned pain with out my legs as well.

[rowanwitch]

Can I add don't be afraid of the morphine sulphate use it to get the pain under control again, you probably only need one dose but it's much easier to maintain pain control than regain it.

[Theland]

Best wishes Ladybirder.

[woofgang]

and if you do hike the dihydrocodeine or the morphine sulphate then make sure you up your wet fibre intake....either more fruit and veg or something like fybogel. Dry fibre (wholemeal stuff) can be used instead but if you do that them up your fluid intake....think of what happens to a bowl of allbran and milk if left uneaten, it sets like concrete!!

[Theland]

I take Zapain, is that not also codeine?

[Mamyalynne]

Zapain is Paracetamol/Codeine combination.

[Theland]

Cheers Mamya.

[ladybirder]

Thank you everyone.
I'm afraid my pain is the same as when I left hospital 8 days ago. I thought it would have lessened by now although it is only in two places. So am going to take some Morphine shortly for the first time and see if that helps. I took my last tablets 3 hours ago so I imagine I'll be OK to take 10mls Morphine shortly?

[Mamyalynne]

That gap will be fine LB, it's been prescribed for break through pain.

Keep in touch with your medics if you get no relief in a few days time.

[ladybirder]

Thank you, just taken it. Hope for some relief soon.

[Mamyalynne]

If you can get a restful night that's a big help.x

[ladybirder]

That would be lovely. One wound is dehisced (new word to me) and that's the worst, ie most painful. I can see it's been bleeding since it was dressed on Monday but it's not due to be dressed again until this coming Monday. I'm wondering if I should go to a clinic at the hospital tomorrow or wait until Monday.

[Mamyalynne]

See how you feel in the morning about it, don't hesitate if you think it needs changing.

[ladybirder]

Good idea M, will do.

[ladybirder]

I went to the NHS Walk-in Centre this morning to get the last of my wounds redressed. Nurse told me off for leaving it too long and said as soon as I saw it was bleeding I should have come in. Got to go back again on Sunday. It's going to take weeks to heal apparently, it's clean but still wide open. Sigh!

[TonyV]

Well lady will just take time to heal, just keep up with appointments and any meds you are prescribed.