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I don't want more painkillers, but maybe something different.

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I've had another attempt to discuss my pain management medication (Tramadol + anti-inflammatory) with the GP, and have come away with no solutions.

The first time, with my regular GP, I asked for my pain meds to be reviewed, as I was finding that exercising in the gym was causing me too much pain, and that it was important for me to keep exercising, as I really need to lose weight and increase my fitness if I want to be able to work again and not end up with obesity-related illness(es).

Her suggestion was that I start taking a weight-loss drug. However, as weight-loss medication is incompatible with my anti-depressant (where the main side-effect is weight-gain!!), she said I should talk to my psychiatrist about changing my anti-depressant.

Apart from her having missed my point, I have no intention of changing my anti-depressant, as the last time I did that I got incredibly sick, and I'm still reeling from the fall-out from that time, not least of which was having to withdraw from my final teaching prac*.

When I had to go back to the GP today for a new script for both Tramadol and my thyroid replacement meds, I mentioned it again. This was with a different doctor, but one I've seen several times, and all of the doctors in my medical centre can access all my records**.

His suggestion was that I stop taking so many Tramadol (I take 100mg SR twice a day) and increase my anti-inflammatory dose. I didn't have the heart to tell him I've tried this, and it doesn't help, and besides, after his explanation of what Tramadol is (I know, I've been on it for years, and done extensive reading about it), I got the distinct impression he thought I was just asking for more painkillers. However, I'm happy to increase my anti-inflammatory dose, and hope that will offer some extra relief.

I'm obviously not expressing myself clearly to my doctors. I don't want more painkillers, I am asking if there are different painkillers I could try, as my current regime is fine for keeping the pain at bay as long as I minimally active, but isn't allowing me to increase my activity levels.

I could just take more Tramadol, and supplement it with paracetomol***. My Tramadol prescription allows me to take up to 400mg/day, but I really try to stick to 200mg, as that amount already makes me sleepy, and if I take any more than that, I'm too sleepy to do anything but sleep. It's fine in a pinch, especially if I'm in too much pain to sleep, but not something I'm keen to do on a regular basis.

I'm also reluctant to be taking paracetomol regularly, as that then leaves me nothing to fall back on when it comes to headaches. I suppose taking paracetomol every day would prevent me from getting headaches in the first place, but if I'm already taking everything I can take, what is there left to take after that??****

Until I can find an alternative, I'll have to stick with what works for day-to-day functionality, and do what I can to lose weight through improved nutrition. That challenge is a whole nother blog post.

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*that was my first attempt at my final teaching prac.

**which is why I'm really reluctant to go to a new practice/call an after-hours GP service.

***The last time I went to buy paracetomol, the pharmacist nearly had a conniption, as the staff person had misheard my “Panamax” (500mg paracetomol) for “Nurofen Plus” (don't ask me how; I know I can speak softly sometimes, but still), which contains codeine, which I MUST NOT HAVE with Tramadol. (Apart from anything else, 100 tablets of Panamax is $2, whereas 30 tablets of Nurofen Plus is $8.00.) The pharmacist was very relieved that it was a miscommunication.

****After the first exploratory surgery on my hip (where they drilled through my femur into my femoral head, to check for avascular necrosis) I was unable to take any additional pain medication, as I was already taking the maximum dose of whatever I was taking (can't remember the name; it was almost 20 years ago). This meant that I was effectively without any post-operative pain relief. It was agonising, and it's made me cautious about maxing out my daily painkillers.

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