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Paramedics: Chronic Pain

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3 years 5 months ago #20944 by Aetherone
Aetherone replied the topic: Paramedics: Chronic Pain
In my experience, once they (and I'm lumping all medical professionals in here) discover you're already under pain treatment programs, its all hands-off and useless.

I've fronted the ED in so much pain (Spinal CRPS) that I can barely stay upright and the attending refuses to either treat or admit and recommends going to see my pain specialist.
The following user(s) said Thank You: Rye

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3 years 5 months ago #20946 by Mary
Mary replied the topic: Paramedics: Chronic Pain
That's not good Aetherone. It's obviously a few drug seekers who are making things difficult for everyone else. I wonder if you carried a letter from your pain specialist outlining your needs if it would make any difference? There must be a solution to this somewhere.

Mary

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1 year 10 months ago #24894 by Paulfromperth
Paulfromperth replied the topic: Paramedics: Chronic Pain
Hi Rye,
It is nice you recognise that there is a need of improvement.
In Perth the ambos can offer an injection, I believe it is a benzodiazepines based one. They offered me one once but I chose to go to hospital as I want monitoring for breathing and if is gets worse.
I suggestion would be to carry a 30 and 10 Toradol injection IM. As I find it is very effective, for me, and being a S4 drug you could administer. Again this would only be appropriate if it was used before and proved to be effective in that patient.
Regards Paul

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1 year 10 months ago #24895 by Paulfromperth
Paulfromperth replied the topic: Paramedics: Chronic Pain
Hi,
A useful tip. If my pain spikes out of control. Usually at least once a year. And I have to go to ED. I take a bag full of my meds, opiates. To prove I am not drug seeking, and I ask for a Toradol 30 IM injection, which is a steroid based medication used for severe post op pain, in me, it works highly effectively, and being an S4 non opiate they are quite willing to use it. The first time I went to ED they treated me like a drug seeker and I was appalled. So from then on I take my opiate medicine with me to prove I have not run out and I don't ask for any. You cannot use Toradol frequently because of stomach ulcers and bleeding but for rare use it is very good, for me. I use Toradol, your doctor can prescribe it for very severe break through pain, and for when I go on a plane flight, about once a year, or if I was going on a bus trip, longer than 4 hours. I hope this helps you and other people, remember that it might not help and everyone reacts differently to medication and pain is different in everybody. Now I have a Toradol 30 IM at home so I can use in a emergency. So my hospital trips are far less. It comes in tablet form too but it causes gut problems. Discuss with your Doctor. IM is intramuscular injection, in the butt.
Regards Paul

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1 year 10 months ago #24896 by Paulfromperth
Paulfromperth replied the topic: Paramedics: Chronic Pain
Pain letter is a great idea, I take some opiate medicine with me to prove I did not run out, and I ask for a steroid solution to the pain, then they are more receptive to me.
Regards Paul

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1 year 10 months ago #24897 by Paulfromperth
Paulfromperth replied the topic: Paramedics: Chronic Pain
Ketorolac: An Extensive History of Pain Relief
Ketorolac is a hospital-strength nonsteroidal antiinflammatory drug (NSAID) that has been available for over 20 years.1 A nonselective NSAID, ketorolac inhibits prostaglandin production by inhibiting COX-1 and COX-2.2,3 It has potent analgesic activity,4 and has been extensively studied in postoperative patients.5
POPULAR PARENTERAL ANALGESIC
Ketorolac was the first NSAID approved in the United States for parenteral use as an analgesic.5 Premarketing clinical trials involving more than 5,000 patients demonstrated that ketorolac’s analgesic efficacy was similar to that of parenteral opiates in patients undergoing general and oral surgery.5
Ketorolac is widely used intramuscularly and intravenously for moderately severe acute pain: there have been more than 500 million injections in the United States since its introduction, and nearly 40 million injections in 2010 alone.6
AN NSAID ALTERNATIVE TO OPIOIDS
Ketorolac has similar efficacy to morphine and meperidine.7 A 30-mg dose of ketorolac IM delivers pain relief equivalent to that of morphine 6 mg to 12 mg.8
In two double-blind studies of postoperative patients with moderate to severe pain, IM ketorolac injection was compared with meperidine or morphine IM, and IV ketorolac was compared with morphine administered intravenously or via patient-controlled analgesia. During the first hour, the onset of analgesic action was similar for ketorolac tromethamine and the opioids, but analgesia lasted longer with ketorolac tromethamine.7
Clinical studies have also demonstrated that combining ketorolac and opioids significantly reduces the need for morphine.9,10
KETOROLAC IS NON-NARCOTIC
As an NSAID, ketorolac does not bind to opiate receptors.8 A study to evaluate the sedative and addictive potential of ketorolac showed no withdrawal symptoms upon cessation of dosing with ketorolac 30 mg IM four times daily for 5 days.8 Ketorolac IM also has no significant adverse effects on psychomotor measurements, including reaction time, computerized driving skills, ataxia, and sedation.8

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