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Type 2 Painkillers suitable for T2 sufferers

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Angela3

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Dear ALL -I’m in desperate need of advice & guidance as I’ve received no help whatsoever from the GP. My mother-in-law is 75yrs old & T2. She wakes every night in agony - with what I can only describe as a ‘damaged nerve type pain’. She cries for hours & has begun to talk of ending her life, because she can’t take the pain any longer.
But despite telling her GP how bad the pain is - he just says
“Take paracetamol or cocodamol”
Well paracetamol doesn’t touch it & the co-codamol stopped working months ago. We can’t just leave her to suffer this way - as the GP has.
What can we safely give her?
Is DHC (DF118’s) suitable for her?
I’d appreciate any advice you can give.
Please forgive my ignorance of T2 diabetes - but I’m new to the condition. And although I am attempting to educate myself about T2, so I can care for my MIL - I really need to know about suitable pain relief NOW.

Thank-you all so much.
 
Hello and welcome to the forum.

This very much depends on your MIL treatments for Diabetes and other conditions she may have. We are not doctors so we can only speak of our own experiences. Perhaps a run down of your MIL diet and drugs may be of use. My first thoughts on reading your post was that your relative might benefit from seeing a different GP, sometimes fresh eyes can see things differently.
 
Sorry to hear this.
Waking at night in severe pain sounds very much neuropathic; a real problem.
1; check no other cause of neuropathy such as underactive thyroid or B12 deficiency; and check vitamin D status with Vit D level, calcium and renal function.
2; Optimise vit D levels since harmless and ,ay help.
3: Pick a drug and see:-
a: duloxetine seems best but introduce low eg 20 mg alternate nights and gently build up
b: pregabalin / gabapentin type drugs
c: opiates such as oxycontin or a buprenorphine patch; DF118 is not favoured in the elderly cos lots of side effects for benefit, and I would also be very wary of tramadol
It is really important to see what is happening - it is unlikely that one drug will work wonders, but does low dose help? Does higher dose cause side effects - generally sleepiness - watch out for confusoin, and also swollen ankles on gabapentin/pregabalin.
25 years ago, I thought that we could sort all these pains; now I think that with more drugs, we cn make them bearable.
It is a really nasty illness, and the renal impairment of older people makes tratment difficult
Other things like lidocaine plasters (expensive) and putting feet on cold surface eg tray help
Sounds like you need to get more expert hepl than that of GP
best wishes
PS am assuming glucose control OK - if glucose levels running high, controlling them sometimes helps the pains greatly; at end of day, can generally make the pain bearable, although often diffiuclt to abolish completely due to side effects of drugs used.
 
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Hi, I would film/record her misery and insist that you go back to the doctor with her. It may or may not be related to the diabetes. Demand action such as x-ray or scan to check the main site of pain. TENs machine may help as may painkillers but she needs a proper diagnosis first. 75 is not really considered as that old these days, she should be able to have a full independent life subject to any other medical conditions.
 
If the pain is that bad I'd say pain relief takes precedence over type2. Apart from that, you can have most pain killers without problems if you have T2.
I don't know about your part of the world, but in the Netherlands most hospitals have 'pain clinics', where they specialize in treating or coping with pain. Could she visit a specialist doctor?
 
Analgesia is specific. Depends on what the origin of the pain might be. If neuropathic in origin then effective analgesia will be different to, say, post op pain. Problem might be the prescriber - usually the GP - may not be experienced in pain control. That makes life tricky. Plus advancing age makes prescribers reluctant to consider some classes of analgesia. You could request specialist opinion. Could well be best bet. I hope you get access to best opinion.
 
Angela3 said:
Dear ALL -I’m in desperate need of advice & guidance as I’ve received no help whatsoever from the GP. My mother-in-law is 75yrs old & T2. She wakes every night in agony - with what I can only describe as a ‘damaged nerve type pain’. She cries for hours & has begun to talk of ending her life, because she can’t take the pain any longer.
But despite telling her GP how bad the pain is - he just says
“Take paracetamol or cocodamol”
Well paracetamol doesn’t touch it & the co-codamol stopped working months ago. We can’t just leave her to suffer this way - as the GP has.
What can we safely give her?
Is DHC (DF118’s) suitable for her?
I’d appreciate any advice you can give.
Please forgive my ignorance of T2 diabetes - but I’m new to the condition. And although I am attempting to educate myself about T2, so I can care for my MIL - I really need to know about suitable pain relief NOW.

Thank-you all so much.
Click to expand...

Angela - I'm so sorry your MiL is having such a tough time at the moment. As others have said, it is important she receives adequate medical help. I don't know why you have singled out DF118s as a potential option for your MiL, but I would urge against trying out medications without medical input. At the absolute, least, if you are desperate, have a discussion, in the meantime with your MiL's pharmacist, declaring everything she is taking, whether you feel it relevant or not. The pharmacist can check for interactions etc.
 
I am curious why you ask if DF118 is a suitable analgesia for your MiL? This immediately rings warning bells as it is commonly sought drug that is widely used / abused. All prescribing professionals will be aware of this risk. Certainly it is not the analgesia of choice if pain is neuropathic in origin.
 
Also, gabapentin has recently been been associated with higher directly related mortality. Clinical trials showed no benefit for suffers of complex regional pain syndrome, another neurological pain disorder. Specialist pain clinic support could be made available by the GP or via the diabetes clinic of your local hospital. I'm sorry that your GP seems so unsupportive.
 
Antje77 said:
If the pain is that bad I'd say pain relief takes precedence over type2. Apart from that, you can have most pain killers without problems if you have T2.
I don't know about your part of the world, but in the Netherlands most hospitals have 'pain clinics', where they specialize in treating or coping with pain. Could she visit a specialist doctor?
Click to expand...

We have a pain management clinic at my hospital ( it was mentioned to be at an appointment) not been too one, but I may have to because of right side back pain.
 
Go with your MIL to the GP, explain that cocodomol is not working and ask him/her what is the next step. A specialist in pain control seems like a good idea so ask for a referral if necessary. You need to be polite but insistent that they come up with a solution. Are you able to book an appointment with a different GP at the practice?
 
Just an off the wall thought - could the pain be due to low blood supply?
As an elderly woman can take it, extract of ginko biloba, the maiden hair tree could possibly get blood to the extremities.
I tried it many years ago before I was diagnosed with a failed thyroid to try to warm up my hands and feet - it did work, but women should not take it before menopause and I had to stop taking it.
 
There is reaonable evidence that gabapentin is effective in neuropathic pain, but as folk above have stated, side effects such as drowsyness are more common with advancing age.
Again, as above, 75 is not old and one would hope for a decent quality of life at this age
Totally agree with the idea of pain clinic, but there is often a long waiting list for these, so referral to diabetologist likely more practical. Unfortunately this is a common problem, so your local diabetologist should be familiar with it.
best wishes
 
Resurgam said:
Just an off the wall thought - could the pain be due to low blood supply?
As an elderly woman can take it, extract of ginko biloba, the maiden hair tree could possibly get blood to the extremities.
I tried it many years ago before I was diagnosed with a failed thyroid to try to warm up my hands and feet - it did work, but women should not take it before menopause and I had to stop taking it.
Click to expand...

A good thought, and why GP or specialist opinion required.
If it was due to chronic poor blood supply, then the pain would be mainly on walking and in the calves.
But a poor blood supply to the nerves might be why folk get neuropathy eg the work of solomon Tesfaye, although there are many other proposed mechanisms and it is probably multifactorial.
best wishes
 
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