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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19328
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Dear Doctor,please could u give me some advice ,I have a fused

Customer Question

Dear Doctor,please could u give me some advice ,I have a fused spine in 3 places ,iv had whiplash 7 times,the worst was being hit by a car on my left buttock,went up in the air ,come down on my left side ,iv had a mini stroke to my left side and I also have sciatic to my left side ,I also have ME, iv also got the condition that causes painfull joints that u get with ME ,i cant remember the name of it ,Epilepsy, Asthma, Bipolar,Depressions, just been diagnosed Diabetic ,not on medication yet ,.an Heart problems, Angina,
The pain medication that I'm on is not stopping the pain in my lower back an hip all on my left side
,I'm on 800mg Gabapentin,3 times a day for my sciatic,that dose work ,Pregabalin 100mg 3times a day ,for my Bipolar,Dihydrocodeine 60mg 4times a day ,not much help with the pain takes the EGA of it ,Paracetamol 1000mg 4 times a day ,I take this daily ,but I can't stand for long or sit ,the only relief I get is laying down ,if I go out which is not often I have to take ,Morphine Release tablets 75mg ,this still doesn't stop the pain ,it didn't even numb it ,only my brain ,LOL,
I know I'm complicated sorry ,iv never smoked or drunk alcohol,
I'm a female age 48,, I just want to be able to go out for a walk or go shopping ,iv been like this for 4 years ,I'm not getting any help from the pain Doctor ,so any advice would be very great full,
Kind Regards ,
Jacqui ,J, Essex
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Hello from JustAnswer.
It will help if you could provide some further information.
Does the dihydrocodeine tablets also contain paracetamol? If so, how many mg?
Have you previously been tried on any other preventive medicine, such as the gabapentin that you are currently taking?
Has the Pain Management doctor considered or performed any injections into the spine?
Has there been any discussion of implantable devices, such as a pump or stimulator?

Customer: replied 3 years ago.

I'm on Paracetamol 1000 mg 4 times a day ,

Iv only been on Gabapentin 800mg 4times a day

I have had the spinal injection 20years ago ,but they won't do it know ,because of my Angina .

They wanted to operate ,but then they said no cause of the Angina.

I'm overweight cause iv also got a under active thyroid.

Expert:  Dr. D. Love replied 3 years ago.
Some of the dihydrocodeine formulations also contain paracetamol, so I wanted to assure that there is not any in that drug as well.

What dose of thyroid replacement are you taking?
What was the result of your last thyroid blood tests?

Customer: replied 3 years ago.

I'm afraid I don't know my thyroid blood test results ,all my doctor said that it was just with in the limite, he also said my Gail bladder figures were high ,I told him I haven't got a Gail bladder,I'm seeing the Dibetic doctor on the 8july,

I'm in a right mess ,when I moved 5years ago my medical records went missing ,so iv not been looked after very well .

Expert:  Dr. D. Love replied 3 years ago.
Very good Thank you for the additional information.

There are several possibilities to consider to try to help relieve the chronic pain.

One of the primary interventions is to take a medicine regularly to try to prevent the pain. The gabapentin is one of the most common medicines used for this purpose. There are several other medicines that can be considered. The pregabalin is actually structurally similar to the gabapentin and also can be used for this purpose. Both the gabapentin and pregabalin are anticonvulsants and there are a few other anticonvulsants in different chemical classes that also can be used, such as carbamazepine and valproic acid.

Another class of medicines that are commonly used as preventive medicines are several different antidepressants (even in people without depression). Some of the common antidepressants used for relief of chronic pain are amitriptyline and duloxetine, and the latter is usually better tolerated with a lesser amount of side effects. In your case, though, the presence of bipolar disease complicates the use of an antidepressant for relief of chronic pain, because antidepressants may precipitate manic episodes, particularly if the bipolar disease is not well controlled. So, it would be appropriate to have a discussion with the doctor treating the bipolar disease before using an antidepressant for chronic pain.

I ask about the thyroid blood tests because optimal treatment of the hypothyroidism also impacts on the amount of pain because of carrying the excess weight.

The other options to consider would be the implantable devices that I mentioned in the request for additional information, such as a pain pump or a stimulator. If the heart disease can be stabilized, then these procedures can usually still be done, but you should discuss this issue with the doctor caring for the heart disease.

If I can provide any clarification, please let me know.