Pregnancy Forums

Posted: 08 August 2008 at 12:33pm | IP Logged

Hi all I’m not sure posting this will help but I need to try and work out in my head whats going on and looking at letters isn’t helping, but writing it down does sometimes so I’m hoping it will.

I posted recently about my trip last Friday to have phototherapy. I also chatted about my medication as my doctor wasn’t sure what to do (even though she’s specialised in Gynaecological and obstetrics) she’d never heard of spd. None of the docs at my surgery has but she goes onto the net to research it etc and find out all she can from her contacts so she tries bless her.

At the hospital the doctor told me it’s a grey area…. With the amount of codeine I’m taking daily, taking morphine (slow release) wouldn’t do me any harm but probably be better for me constipation wise etc but I’d not be able to drive. Also she’s concerned and doesn’t know how it would affect my body long term. Her guidance was very hypothetical:- if your going to take it to lie in bed and take it then no it’s not a good reason to go onto it but if you need to take it to make you able to get up and about and run after your kids then that’s the right reason….

I also raised concerns about the initial meeting I had with her about the lack of sedation in future injections due to my needle phobia etc she told me due to the constrains, the fact that sedated patients should have one on one care till they have come round etc limits the amount they can admit etc and that if that was to be the plan I could be waiting up to 15mths for another course and where as if I can bite a wooden spoon then I can have it 6mths without.

I received my letter today that she has sent to my gp and I’m now confused scared and petrified to say the least.

Letter says:

I think is she is using that much codeine regularly. And that she feels the morphine would make a difference to her mobility then by all means she should go onto MST, which will probably give her much better pain relief with no increase in constipation and so on. However she understands that the reason to use morphine is for mobility rather than for being pain-free at rest. She can still continue to take paracetamol as required and on good days (when she does not feel she needs the mst) she can of course just take codeine.

( I thought that once on morphine you couldn’t chop and change the days you took it.)

I hope to get her back into clinic in about 3mths time again for a further injection of the pubic symphysis. I will ask one of my clinical nurse specialists to ring her in four weeks time, just to make sure things are still moving in the right direction. I suspect that this phototherapy will be without sedation.

Urm so does this mean at my clinic appointment (which I have though for a day I can’t do if it’s going to involve treatment as it has to take place on a Friday due to childcare and club commitments) it’s not fair it affects them too much and at the intial appointment she promised all treatment would be on a Friday.

I’m relieved I’ll get a phone call as I’m not convinced this set is working as I’m in as much pain as I was before the injections the only difference is the tenderness and bruising has gone from the injection sites…. At least by the time the nurse calls I’ll be able to say if they’re working and if it’s going to be done I thought it had to be under xray conditions! I’m going round in circles and I know I need to compile a list of questions but I can’t think straight at the moment I’m thinking is zany shaped hole…. Injections with no sedation! Silly thing is due to being sedated last time I can’t remember what the whole thing entails apart from a canula and argh cold fluding and some strange memory of biting a pillow screaming! Then the nice porter! Eek I hate not knowing.

Sorry it’s a long rant but I’m seeing my gp on Monday and my dp’s ignoring it all at the moment and has been very cold since I had them last week… he wasn’t even his usual supportive self when we where there.

Any suggestions on the questions I should ask?

Posted: 08 August 2008 at 12:48pm | IP Logged

Argh I'm on my way out so dont have much time but let me try and help.

Firstly the injections will not be done at a clinic appt - you will get an appt through soon for the next prolotherapy. They are all done under xray whether sedated or not.

As for morphine - you can chop and change to a degree - as long as you dont take a big dose every day for 10 days or so and then just stop, for example, as you will get withdrawal.

The letter does sound confusing (I have found that with her in the past too - it seems to be her way of wording things just doesnt come across well on paper.

I would call and ask if you could speak to her over the phone to go through it with you and explain exactly what she means - you can aslo tell her then that you arent noticing improvement yet. (BTW just a thought - have you used anti inflamitories since having them? As that can limit their results.)

Dont carry on being worried and scared - there just isnt any need when you can get answers at the end of the phone. I wish you were at my gp surgery as although I know your gp has tried very hard, all 3 of my gps have experience of SPD (although not as bad as ours) and are very good at getting me sorted. I very rarely come out of there deflated.

Best of luck honey and I will talk to you soon I promise.

Posted: 08 August 2008 at 1:03pm | IP Logged

Thanks for the quick reponse madz, it certainly shocked me cause initally she onlt offered me 6mths appart with the possibility of it being unsedated! So that in its self is a tad different. The reason i worried about it being done at the clinic appointment was my very first one with Dr M the nurse asked him as i was getting undressed for the examination are you injecting today!!! Well my half off trousers came back up pretty quick till i heard him say no!

As for the morphine she's recommended:

I would start her on 10mg a day bd of mst and have her use codeine for breakthrough pain.

I know it's not a large dose like what your on but if i take 10mls of oramorph i get side effects at the end of 3hrs, all the horrible shakes etc.

I haven't been on anti inflammatories now for 4weeks and am still off them.... i'm not sure if it's just because (according to the only words out of dp's mouth) 'you've gone down hill lots since you last saw her'... gee thanks babes!

Oh i'm still hoping they'll work and i'll wake up and see a difference next week but i do feel the hope is slipping.

Just thought i'd let you all know i feel so alone my dp who's been useless this last week has just called up to ask what i'm doing so i told him what in the letter get and he said thats good to having one sooner than 6mths but when i meantioned it would be without sedation, and the fact that i said i wanted sedation etc obviously didn't matter he just said yes dear, so i thanked him for the support and he just said well what can i do, i know why you want sedation and i know what she'll say so i'm stuck in the middle.... so i reliped yes dear and ended the converstation... all i want is some love and support from him. God they can be so blinkered sometimes!

Posted: 08 August 2008 at 7:05pm | IP Logged

  Oh Tsena no wonder you are confused, I would be. I wish I could offer you more help. The only thing I can think of is to write down all your concerns for your appt next week but I am sure you are already doing this. Sending you lots of luck that they can ease your pain somehow. xxxxx

Posted: 09 August 2008 at 7:49am | IP Logged

Thanks ladies i'm glad i'm not the only one left confused. That helps me a huge amount... lol makes me even feel normal

I am in the middle of trying to write a list of questions, but so far i've only got 2. At least i have a few weeks to see if i have any improvement and to think of some that don't sound tooo panic stricken!

Thanks again all

Posted: 09 August 2008 at 8:04am | IP Logged

Yes Tsena, I have to agree with everyone, this is very confusing .  I am on 15mg MST twice-daily with codine and paracetamol for breakthrough pain - and have not been told not to take the MST on good days - never heard of that one either!

I hope your questions get answered and the 'grey area' surrounding the MST is covered hunny xxxxxxxxx

Posted: 09 August 2008 at 5:00pm | IP Logged

Honey as far as your DP is concerned I understand fully. DH has been so unsupportive recently and doesnt understand when I try to talk to him. Every now and again he gets it, apologises, is great for about 10 minutes - and then goes back to useless DH!

Men - argh!!!