Analgesia (pain medication)

[Fiz]

I'm currently in absolute agony where the section of jaw bone was temporarily removed to access my wisdom tooth. For some reason now the pain is just in the last 6 hours of the day. I've taken Oramorph, 150mg SR Tramadol, 50mg Tramadol, 400mg Ibuprofen and 1g of Paracetamol. This is the most my GP says I can take but I'm still in agony and struggling not to cry.

How do you manage pain? Are some analgesics better than others? I'm at a loss to know what to do with myself and because I can't sleep because of the pain, tiredness really isn't helping.

Any suggestions? After 4 hours from this lot I can take a further 5ml of oramorph and a 50mg Tramadol but then that's it for the night. I'll go crazy with pain at this level.

[Sunny Clouds]

Here's my upside-down way of handling pain.

I don't try to ignore it.  I focus on it. 

You see, I'm a curious person and my curiosity is a big driver for me.  So ignoring it doesn't work for me.  I ask myself questions, I focus on it.  Where's the pain, what sort of pain, does it vary...

After all, it's intrusive anyway, so I try to change my relationship with it.

The thing that then helps is my scatterbrain and distractibility.  My mind drifts to other topics, and having told my subconscious that I know why this 'alarm' is going off, it jars less.  Yes, it's still bad, but it doesn't have the same feel.

It's like a fire alarm.  It goes off.  Panic stations.  Look at clock - ah, weekly fire drill.  If you feel ok, you barely notice it; if you don't, it bugs you.  If you can't reassure yourself it's a drill, the panic continues.

Ok, so you've got pain.  Your brain is saying "Help, emergency, danger!"  So you tell it that no, it's ok, it's supposed to hurt because that's to tell you to take care of it.  No, it probably won't make the pain go away, but it might take the edge off the distress.

The other thing is that whilst you're probably not supposed to touch the site of the wound, maybe see if there are any tender pressure points in nearby muscles that you can press to ease them a little.  Even if you can't, it'll focus your mind on something different.

But that's just what works for me, not necessarily for you.

Still, if worst comes to worst, you'll simply not sleep for several weeks, which will drive you mad, which won't be a problem because you're mad already...oops, well, what I meant was...er...I think I'd better go and leave you in peace.

Or maybe not peace, maybe drown out some of the pain with loud music.

 

[Sunshine Meadows]

 

It could be a dry socket http://www.nhs.uk/Conditions/Wisdom-tooth-removal/Pages/Complications.aspx

If you can get to the emergency dentist today they will pack it with fibrous material that smells of cloves and it should make a huge difference. I had two different occasions where I ended up with a dry socket after tooth extraction and once I knew that was what was causing the pain it did become easier to handle.

Sunny,

  good approach to pain that cant be ignored.
It is also interesting to think about the pain thresholds of people who are in chronic pain. Having a set of pain medication I can take when in pain that is more everyday does help but it can also hinder if it gets to the point where I am saying Why isn't it working 

[Fiz]

No it's definitely not dry socket. There's only a pin prick opening where one corner of the wisdom tooth had just poked through and having removed the jaw bone to chip the wisdom tooth out of the front of the gum, replaced the bone and sewn it all up, the blood clot is safely in place and can't really be displaced given the only hole available is pin prick,  there's no whole vacant socket like in other methods of removal. I'm in no pain during the day now and once I'm asleep pain no longer wakes me but every evening the pain is intense and I need both types of Tramadol plus Oramorph and it still takes a couple of hours to reduce enough for me to sleep. My theory, right or wrong, is that I may be doing too much in the day so I'm moving the loose jawbone which is preventing it from rejoining the surrounding jaw bone and fusing with the surrounding bone. I must try and rest more and see if that helps it heal properly. I'm thankful it's no longer 24 hour pain and just late afternoon through to evening now.

[Hurtyback]

I'm so sorry that your pain is so severe    Is there anything else you can do that might help? How about a hot water bottle or cold pack over your jaw? I'm not suggesting you should do this all day/every day but it might be something to add to your pain relief kit when it is so severe.


Are you doing anything else different in the evening? Is the pain better when you are more upright rather than lying down? In which case extra pillows might help if you can tolerate them.


I hope you are soon feeling much better xx

[ally]

Fizz, I don't think I could cope with what you're going through.  It all sounds horrendous.  Unfortunately, my tooth extraction is going to be the same as yours was.  I've got enough ongoing as it is, without inflicting more  pain on myself.  You seem to have a lot of health issues ongoing as well as your tooth.  It's bad enough coping with pain, without additional stuff being thrown at you.  Can you not go back to the dentist just to be on the safe side?  The pain sounds awful.  I really hope things improve for you soon.  Take care 

[Fiz]

I don't know why it gets so bad in the evening. It starts when I'm still up and I sleep well propped up at 45° as instructed. I am just so thankful that now once I'm asleep I stay asleep and I no longer have pain in the day, it's literally only the evening. And yesterday because I wasn't out I took the 150mg SR Tremadoc at the very first sign of pain, the 50mg Tremadoc and hour later and the oramorph an hour later and that regime seemed to manage the pain much better and I managed to sleep and not wake despite the war zone outside so I think I now have effective pain relief. I'd been to the cinema the evening before to see a street cat named Bob and the pain was well established by the time I was home so much harder to deal with. I've noticed the cheek over the broken jaw is slightly swollen this morning where it hadn't been, yesterday I ate normal food for the first time. Maybe I should stick to mousse for breakfast lunch and tea again!

[Sunny Clouds]

Just a PS to my last...

It's not accidental that doing nasty things to people's teeth and jaws is a staple of the torturer's repertoire around the world and has been for as long as there are written accounts of torture.

That won't stop the pain, but it may at least reassure you that feeling very distressed by this pain is normal.

The only other suggestion I've got is to get totally sloshed but you're probably not supposed to combine alcohol with your heavy-duty meds.

However you deal with the pain, I hope it eases soon.

 

[Fiz]

  I did actually have a can of cider last night which I think complimented my meds nicely! That would probably be my limit though. I've just eaten my first proper meal, meat, veggies, etc. I am so fed up of mousse, I'm thrilled to be back with food.