☼ Hello. mammaP checking in!

March 24, 2015

MammaP, just saw this. Wow, oh wow! I still remember the day you joined this merry band. So very happy for you! So very glad you have some doctors on your side, at least a bit! I hope you and tramadol have a very peaceful parting of the ways and that you can sleep, sleep, sleep!

March 29, 2015

Thank you everyone, I can't quite believe that I am not enslaved to those rotten beads!

Congratulations about getting off Effexor finally! Was there ever a more cautious taper? I don't think so.

Since the tramadol is causing such problems, you might be able to initially reduce it by a larger amount, say 25%. Your body is saying it doesn't want it. See how that goes, then I would plan for tapering at a lower dose.

Sending healing thoughts your way, dear mammaP.

Yay yay yay you're off the Effexor at last! I know it took longer than you wanted, but I think crawling off at the end the way you did is why you're doing so well with it, so good for you!

I'm so sorry about all the pain you're having, though, and the issues with tramadol now and having to taper off of it. You might be able to taper it faster than the ADs, who knows, I would as usual suggest caution at first until you know how your body is going to respond. I'm so sorry to hear it's making your pain worse, and that you have to deal with that all the time. I know chronic pain is just exhausting and makes everything in life harder to deal with. You're always so kind and sweet and upbeat here, I don't know how you do it.

Hugs to you MammaP and congratulations again, yay, you beat the Effexor!

Thank you for the input Alto and Rhi, I am hoping I can kick the tramadol sooner. I have cut my dose by 25% over 3 weeks making it a total of 40% reduction from the original dose and divided the dose to 3 x daily instead of 1 hit. That seems to be better but I am feeling some withdrawal. Nothing big, just light headed and dizzy with slight nausea, which is relieved when I take the tramadol and is why I spaced the dose. I am back home now and can make a liquid, the powder is soluble in water which makes it easier to get accurate doses, I was guessing before and trying to measure the powder with the capsule halves which is not ideal!

I have spoken to my doctor about the pain clinic, which I know has non drug pain methods too, but I guess she thinks I want stronger pain killers! She said that she can prescribe everything the pain clinic can prescribe but I know that is not true! I know that medical cannabis is available from the clinic and that it it much safer than all the other drugs, but it is very tightly controlled. I will see her in a week or so, she wants to see me when my pain levels are 'normal'. I have managed with just 50 - 75 mg of tramadol post surgery and the pain has been terrible but the side effects really ramped up after surgery and were worse than the pain.

It is better with the split dosing but still have side effects, just more bearable. I can't imagine how I am going to feel when I am off that too, I've been taking opiates for arthritis pain for longer than psych drugs, at least 30 years but always at low doses and never several times a day.

So far there are no withdrawals from effexor, and things are happening to my brain that I didn't expect really. I heard today that some friends have lost someone in their family and I started to cry for them. I then cried for my brother who died 2 years ago and I didn't cry, it was like he had just gone on holiday or something!

And my dad, I didn't cry for my dad either, but as he was quite abusive I didn't feel it was unusual for me not to cry. But I did today when I heard that news of my friends loss.

Also over the last few days I have been having fond memories of my mum and dad, and my late husband. All I remembered before was the abuse, but now good memories are coming through and my heart swells with love when I remember them. It is so strange. I wondered why people felt love for parents who were abusive, but for me all I could remember were the bad times, yet there were some very happy times too that had left me! Yesterday I had quite a bad day and felt ill, I was in a lot of pain and felt really sick after a sleepless painful night. I got up and started to get myself together, then later in the day it dawned on me that I didn't think of suicide for a single second! Those thoughts were always there in the background somewhere, ready to pop up when feeling ill or low. That 'I can't go on any longer' feeling. I stopped paying any attention to it a long time ago, but not to have it pop up was new. I've also been feeling creative and actually wanting to create something, or paint, strip, take apart something, beware everyone, I'm back and nothing is safe! If it stands still it will be painted or remodelled Ironically I can't do very much, but that is always when I am most creative, when it isn't possible, maybe it is psychological, only want to do it because I can't? . We will see.

I have to tell about last nights bath........or non event! I've been craving my magnesium baths but unable to get into the bath at my daughter's. When I came home yesterday it was the first thing I decided to do. I have a hydraulic bath seat, I sit on it and pull a lever which lowers the seat. When it is down it is just 2 ins high so can lay back in my lovely deep bath easily. I filled the bath, fixed the lights to low, poured in my 3 large cups of epsom salts and was so excited to be getting my 'fix'. Sat on the seat and pulled the lever. It started to slowly lower then stopped :angry: . I jiggled and tried to push it down but it would not budge and just kept coming back up again. In the end I gave up and pulled the plug, devastated that I couldn't get a bath. Would you believe it the thing started to lower as the water went down!! :unsure: :angry: . Then it hit me, I use loads of salt and can actually float in the bath, and that is what happened, the salt made the seat float with me sat on it :lol: . As it takes 45 minutes for the bath to fill I gave up but will get my bath today, just will less salt

I remembered something else my doctor said. She was asking about my drugs and I told her that I had tapered effexor over 3 years and was done with it. She said that was great, very impressive, then asked if I would recognise signs of relapse!! I think I will be educating her very soon!

March 29, 2015

So pleased for you mammap and to not have suicidal thoughts yay! Xxx

March 29, 2015

Congratulations on the end of taper. I'm glad your interests are coming back, that is reall important. Hopefully I will be joining you soon on the other side! Thanks for being there a few days ago when you talked me down from the " bridge" of just jumping off my minuscule dose.

March 29, 2015

Hi

Sorry about your bath. Sometimes, especially lately, those are the only things that get me thru the morning. I use coffee beans and milk. Milk is good for the skin and surprisingly it doesn't leave any smell. Coffee leaves the hint of a smell but it is something I really like. I put the beans on my heater to dry them out after my bath and then my room smells like coffee too! Just can't leave them on there for very long. I don't know if I could use them again. I only ever use them once.

I hope that you get your soak!

March 29, 2015

It is not a surprise to me how your feeling off the effexor and that you can now feel the good things...

I had a very long stint in wd of bad thoughts and feelings I think others here are having it... ones who did not taper ..it just ended after a long time.

I am so glad you have turned this corner Mamma better days ahead I hope. I am not so sure pot is any better then other drugs I have read some things about bad psych effects from it like anxiety and psychosis it is still a drug.

Whatever you decide I wish you a fast healing and lots of epson salt baths wonderful that you have that tub

Hope all goes well from here on... I would think if you explain to the doctor you would like to see what else the pain clinic has besides drugs she may open up to it... I have been to one. They do education not much there really meditation relaxation... time limiting all postures 15 min in any posture then change a lot of other things besides medications... tho I have to admit I was put on an antidepressant when in the pain clinic I know you will not fall for that at this point.

I wish you peace

March 30, 2015

Thank you everyone, it feels good to be rid of that drug but I'm not classing myself a success story just yet, I know that withdrawal can rear it's ugly head out of the blue. I will wait awhile before getting really excited, until my body has recovered from the trauma of surgery and see how things are then.

BTDT, the cannabis that is available only in the pain clinic has had the stuff removed that causes the 'highs' and the brain stuff. I am sure I will not qualify for it though because it is very tightly controlled. It seems crazy that opiates, anti depressants, benzo's etc etc are widely available and given out like candy when they have all that psychoactive stuff in them,and are highly addictive yet a drug with all the psychoactive stuff removed is so tightly controlled. We all know that is big pharma's doing, they can't be making a cheap relatively harmless drug available otherwise they would lose money :angry: . Not that I would take it anyway unless I did extensive research, as I will with any treatment, and will not under any circumstances be taking any psychoactive drugs! I am hoping they might have some non drug stuff, not sure what yet, they can refer me for acupuncture or massage therapy which would be better than drugs.

March 30, 2015

Thank you everyone, it feels good to be rid of that drug but I'm not classing myself a success story just yet, I know that withdrawal can rear it's ugly head out of the blue. I will wait awhile before getting really excited, until my body has recovered from the trauma of surgery and see how things are then.

BTDT, the cannabis that is available only in the pain clinic has had the stuff removed that causes the 'highs' and the brain stuff. I am sure I will not qualify for it though because it is very tightly controlled. It seems crazy that opiates, anti depressants, benzo's etc etc are widely available and given out like candy when they have all that psychoactive stuff in them,and are highly addictive yet a drug with all the psychoactive stuff removed is so tightly controlled. We all know that is big pharma's doing, they can't be making a cheap relatively harmless drug available otherwise they would lose money . Not that I would take it anyway unless I did extensive research, as I will with any treatment, and will not under any circumstances be taking any psychoactive drugs! I am hoping they might have some non drug stuff, not sure what yet, they can refer me for acupuncture or massage therapy which would be better than drugs.

They did not have pot when I was in the pain clinic so had no idea about this new improved pot it may be worth it if it works... I am just scared of everything... that is how I am now. I wonder if there is enough research out about it yet and if it too has been compromised I know hard to win over and it makes it really hard for me to make any move even after I research something then I have to try to decide if I trust the research... it is really a catch 22 like with the ppi... I know what they do... I take them anyway and hate it... but rock and hard place means I have to make a move... off my island of no drugs... to something with (hopefully) the least bad news or risk.

It may be just the thing... I don't about this new and improved pure pot and should have kept my mouth shut. Hoping your healing is going well and wishing you peace

March 30, 2015

MammaP, just so proud of you, happy for you, even though I know you still have lots going on. And so sad...that a day without SI is wonderful, and relieved by stopping the freaking medication!

March 30, 2015

Thank you everyone, it feels good to be rid of that drug but I'm not classing myself a success story just yet, I know that withdrawal can rear it's ugly head out of the blue. I will I am hoping they might have some non drug stuff, not sure what yet, they can refer me for acupuncture or massage therapy which would be better than drugs.

I'm happy to hear that acupuncture and massage may be possible for you. I have always gotten so much help from those. You may also have access to some kind of very gentle stretching type exercise or therapeutic assisted yoga, ask them about that.

In my own experience these things don't relieve pain 100% but they help, plus you can learn tricks that you can use when you need them, which gives you a bit of a sense of control, and that in itself makes pain more tolerable.

I know a number of people here who use medicinal cannabis, since it's been legal here for a while and it's not hard to get a medical card for chronic pain. Seems like the response is mixed; some people find it really helps and others find it doesn't help so much. For me, cannabis has never really helped a lot with pain, as far as actually easing the pain itself, but I've never tried the kind of special strains they've developed nowadays, with the high CBD and low THC.

Also, for arthritis, have you tried glucosamine or glucosamine with chondroitin? You may have already tried that a long time ago. I think it helps primarily when there are cartilage issues. Helps me a lot with my knees.

I so appreciate your positive attitude and the way you can always think of something positive and nurturing to say to people. I'm delighted to hear that you're getting your creative urges back, that's wonderful! As always, you're such a delight, and an inspiration. I dream of one day being able to save up enough money to go back to France for a month or two, and if I do I will definitely make it a point to come across the Channel and visit you. I would love to meet you in person!

March 30, 2015

So pleased to read you are finally off!! Congratulations....so pleased to see you are already seeing improvements.

March 31, 2015

Today is another day and I feel really, really ill. I have been feeling a little dizzy and light headed but nothing bad just very mild. Last night it ramped up and I was literally staggering to bed and holding onto things so I didn't fall. In bed any movement made my head spin and was so nauseous my stomach muscles are sore from heaving. I am still dizzy and can barely sit up, but lying down isn't any better, I have never felt this before except when I was very drunk once ). I am scared, so scared that this is withdrawal. Maybe it isn't, I have a sore tickly throat and slight cough, my sinuses feel a bit stuffed too with some pressure over the eyes. Maybe it's the tramadol. it has really started to affect me badly since the op, or maybe it's withdrawal from cutting the tramadol. I have tried thinking what would I tell everyone else? I haven't a clue! I feel dreadful, going back to bed.......

March 31, 2015

Well it actually sounds like you caught a virus and i never would think i would be wishing a virus on someone but as it a lesser of 2 evils, i hope you are just sick.... sorry to hear though.

March 31, 2015

So sorry! I think you would tell someone else to just rest, knowing this is temporary, no matter the cause, and that they should be careful to get plenty of fluids. I still remember feeling like that, so miserable. I hope it passes very quickly!

March 31, 2015

Hi mammaP, it's taken me a bit longer than expected, but I've finally got to the end of your intro. Goodness me, what year you've had! I think you've done very well under the circumstances. Relocating 600 miles, supporting ill family and friends and having an hip op is no mean feat!

I'm delighted to hear you're now off the Effexor , but sad to hear you're feeling so poorly today It does sound like a cold virus as opposed to protracted withdrawal. Fingers crossed it doesn't hang around for too long. Look after yourself!

March 31, 2015

Today is another day and I feel really, really ill. I have been feeling a little dizzy and light headed but nothing bad just very mild. Last night it ramped up and I was literally staggering to bed and holding onto things so I didn't fall. In bed any movement made my head spin and was so nauseous my stomach muscles are sore from heaving. I am still dizzy and can barely sit up, but lying down isn't any better, I have never felt this before except when I was very drunk once ). I am scared, so scared that this is withdrawal. Maybe it isn't, I have a sore tickly throat and slight cough, my sinuses feel a bit stuffed too with some pressure over the eyes. Maybe it's the tramadol. it has really started to affect me badly since the op, or maybe it's withdrawal from cutting the tramadol. I have tried thinking what would I tell everyone else? I haven't a clue! I feel dreadful, going back to bed.......

Effexor and tramadol are so close in structure I do wonder if this is not the flu which way to go from here.

Sorry if I am in the wrong line but my mind goes there automatically now rather than just wait and see.

Delayed wd from E for me was just like the flu.

Could tramadol have covered that in part or does it make it worse as it is not exactly like E? Could it be the lack of E that has made the tramadol react badly of late?

Lets hope for the flu and that it goes if you grow weary of it all is there a possible way of fracturing that one bead to get it to a lower dose?

This may sound ludicrous to others but I had a reactions way passed a year out in wd from just having some E on my finger in counting beads to help another with wd. it is very potent stuff for us afflicted.

I don't want to aggravate you Mamma but help to sort out what the next move is if you want help in that area... maybe others with ideas will come along I am sure they will if this does not pass.

I so wish you health and peace

April 2, 2015

Oh, mammaP, I'm so sorry.

I can't say for sure what's wrong. If you think it's the tramadol, how about reducing to 15mg 3 times a day -- not all at once, take 5mg off one more dose each day. See if that helps.

As for taking an SSRI to counter tramadol withdrawal, I haven't the faintest idea.

April 2, 2015

Have you thought about maybe licking an effexor bead to see what happens? Like a micro dose?

April 3, 2015

My daughter took me to the doctor yesterday and she didn't know what it is,( which was no surprise, I only went to make my girl happy ). She thinks it is the middle ear as I was sinusy and a ticcly cough. That is a possibility but I wasn't convinced, to me everything is drugs and withdrawal! Last night I took a microscopic dose of tramadol and the same this morning. The doc gave me anti emetics, stematil and that has helped some. Still dizzy and light headed but the room isn't spinning.

The research I did showed that tramadol has SSRI/SNRI and synthetic opiate. People have a hard time quitting because of the ssri. Some doctors give patients ssri's to withdraw from tram to compensate. I wouldn't mind reinstating a bead or 2 to compensate but its the opiate part that I'm not sure of. Everything I read was experiences, and generally people seemed to think cold turkey was best because of opiates addictive properties, andtapering prolongs the withdrawal. I am not convinced by that,it is what lots of people say about AD's too and we all know what nonsense that is! I did find a site with tapering schedules of up to 36 weeks but they were starting at much much higher doses, 600+ mg per day, I never had more than 100mg once a day.

Side effects have always been problematic and why I had my op, so I would not have as much pain and get off them. I never craved them and never wanted to take them to feel good, and don't crave them now. I took 2 x 50mg in the evening for about 8 years and before that codeine at night until I started reacting to it. I tapered down to 80mg about a year ago. After my op I split it into 2 doses, morning and evening but started to be very sick after taking them, within 10 minutes I was throwing up. then the doctor suggested asking my gp for a referral to pain clinic because tram was obviously affecting me badly. That was 5 weeks ago and I tapered down to 20mg 3 x day to split the doses to make it easier thinking it would be better to taper with a steady blood level, but it just makes me sick all day. It has made me even more empathetic to those here who are struggling to taper in poop out, ssri's really are evil ! I am sure I wouldn't have so much trouble if it was just the opiate.

I have no idea how I will be when they are done, I think I will cope with the opiate withdrawal. If I get SSRI withdrawal I will reinstate a bead, at least I will be able to recognise that but up to now it has been different. It is all physical, and the vertigo is very frightening. I forgot to say that the vertigo eases as the tramadol dose wears off.

I have an important meeting tonight, it is the anniversary of Christ's death and I am praying it stays away until after. I will not take it tonight, if I take it before I go I'll be too sick, and if I take it after I will not sleep, it has always been that way and why I needed to get off it. I've rambled on a bit and lunch is served!

April 3, 2015

Tramadol is not an opiate. Docs claim that it is, but it's opiate action is very weak. almost non-existant. It's main action is tricyclic, as you noted above, SSRI/SNRI. Docs give it because it is non-opiate. You'd have been better off with codeine, since your system is very sensitive to those neurotransmitters. Tramadol works by taking away your give-a-jit about your pain. It does not numb your pain like an opiate would. I would never give tramadol to someone who had been through antidepressant withdrawal (those darned docs think they are doing you a favor by keeping you away from the opiates, but opiate withdrawal lasts a week at best!)

You are more at risk of Serotonin withdrawal from tramadol than opiate withdrawal (which is less frightening, actually)

Please taper tramadol carefully - you know the drill. :huh: Treat it like a tricyclic. Or an SSRI.

I have tramadol on my "do not prescribe" list. When they threaten to prescribe it, I get all wild eyed and drool a little bit and mutter "bipolar" and they leave it out of my regimen. :blink:

Please make sure you are getting enough nutrients, too - it's hard to eat when you are sick.

{{{{{HUGS to MammaP}}}}}

April 4, 2015

PLEASE read this Mamma!

Prochlorperazine (Compazine, Stemzine, Buccastem, Stemetil, Phenotil) is a dopamine (D2) receptor antagonist that belongs to the phenothiazine class of antipsychotic agents that are used for the antiemetic treatment of nausea and vertigo. It is also a highly potent typical antipsychotic, 10–20× more potent than chlorpromazine. It is also used to treat migraine headaches.^[1] Intravenous administration can be used to treat status migrainosus.

In the UK, prochlorperazine maleate is available as Buccastem M in buccal form as an over-the-counter treatment for migraine.^[5] In this indication it blocks the chemoreceptor trigger zone (CTZ) in the brain, which is responsible for causing severe nausea and vomiting. Its over the counter (OTC) use is strictly restricted to a maximum of 2 days, because of the potentially severe side effects of prochlorperazine, which mandate supervision by a health care provider.

http://en.wikipedia.org/wiki/Prochlorperazine

April 4, 2015

She thinks it is the middle ear as I was sinusy and a ticcly cough.... would it not be more likely that an antihistamine would help for these than the drug she gave you... I don't know for sure but this old stand by I have used for dizziness nauseous

is my first line of defense if I need something like that...

Dimenhydrinate (marketed as Dramamine, Gravol and many other brand names) is an over-the-counter antiemetic used for the treatment of the symptoms of ...

‎Medical uses - ‎Recreational use - ‎Veterinary use - ‎Brand names

Kid strength... I take 1/4 of a kid dose of 15mg over the counter.

Still I don't know what is best for you Mamma I so wish I did... I know I would try to stop... the tramadol if it makes you dizzy when you take it... I quit it before but too long ago to recall.

April 4, 2015

I am in pieces over this, 3 years to get off effexor and now this. I knew tram had SNRI in it but wasn't expecting this. I think I shot myself in the foot splitting the dose but in the hospital it seemed like the best thing. I should have stayed with just the evening and tapered that. Now I feel damned whatever I do I didn't sleep all night, the room was spinning when I moved and I sat up researching tram. I do not like what I found, and really wish I could find the equivalent dose of SNRI. That is, is 100 mg dual to 20mg effexor or pristiq? I found some properties on wiki but it meant nothing to me. I am gutted, and feel so down but not specially depressed, just tired, angry, frustrated and sick. 5 weeks of split doses, is it too late to go back to 1 but lower, do I stick with this and wait to stabilise, or just chuck the flaming thins in the bin? Not really asking because I know no one has the answer, just voicing frustration. I know that c/t isn't really a sensible option and if it were someone else I would be talking them out of jumping. I have plenty of effexor and could reinstate a few beads to offset the SNRI withdrawal, but only a few beads, NO WAY could I go higher because that makes me sick too, in fact I feel that if I RI more than 2 I would react. I can't have anything, like lots of us here I am so sensitive.

April 4, 2015

Have you thought about maybe licking an effexor bead to see what happens? Like a micro dose?

The beads are coated to make them slow release CW. I could try one or 2 but don't want to do that yet, till I have it clear in my head what to do for the best.

April 4, 2015

MammaP - I don't know what your surgery was. Was it a hip replacement? (again, I thought I heard that somewhere)

Are you on any immune suppressing drugs so that the hip replacement "takes?"

I have friends with hip replacements and they have to be extra careful with infections because they could reject their own hip if it gets infected, which I understand can happen more easily with the replacement. (this is my simple, homespun version of what I've been told - not firsthand info so please check it out for yourself)

But my point of saying this IF you have an infection, it could be hazardous to you and your hip.

I know it's Easter weekend, but if you continue to suffer or get any worse, please get medical attention - it may be related to your surgery (as well as the @#*^ drug, we know about that one). Hospitals are horrible places to get infection. Hubby fought antibiotic resistant UTI after his surgery for 6 weeks (that was our Christmas!), and a further 4 weeks on a fungal infection. It's like a new way of life, this post-hospital vigilance. At least we're not visiting the GP twice a week like we were for awhile.

Please feel better, and find some peace this Easter holiday. {{{MammaP}}}

April 4, 2015

mammaP,

Could you please list every drug you have put in your mouth (and the doses) since you had the surgery? I think btdt may have hit on something when she mentioned the anti-emetic you had taken (stemzine). Because of its properties I would not take even one more dose of it.

I have been researching tramadol and I have no idea where JC got her information but it is completely different from what I have been reading.

Tramadol is a SYNTHETIC OPIOID ANALGESIC, that is, it relieves pain by its action on the central nervous system (meaning it has an effect on the nerves in the body as opposed to a local effect. An antibiotic has a local effect: as it circulates in the blood it goes to the place where germs are and it acts to kill them by some means like disrupting their cell membranes or scrambling their protein makeup (this is a simplistic explanation and may not be totally accurate so don't jump on this anyone.) Something that acts on the CNS works via receptors: it either binds to certain ones and makes it impossible for other messengers to bind to them or else it competes with messengers for sites to bind to and this has an effect in the body at the level of the nerves (the whole system as opposed to locally). This too is a simplistic explanation.

Chemicals that are not natural to the body get metabolized by the body's fluids and organs: they get changed into other compounds as a result of this (they are metabolized) and eventually peed out. Some drugs have their effects by a combination of the chemical itself AND by the metabolite too. Chemicals circulate to the liver where a lot of this metabolizing is done and you have seen mentioned several enzymes that do this (the CYP stuff, not going to look them all up right now.) Certain people don't have the proper enzymes to metabolize certain chemicals and therefore have untoward reactions to certain drugs. This causes problems.

Ok, that is the minimal background so you can see where I am coming from.

Your body was used to a certain level of tramadol (which is mentioned only a few places as having a WEAK serotonin and norepinephrine reuptake inhibition) as a result of the type of chemical it is. It is weak as opposed to something like effexor which really blocks the serotonin and norepinephrine receptors so those chemical messengers that shuttle between the nerve cells cannot cross the gap and complete their connections, they instead stay in the gap between the cells longer (but they eventually do get taken up). For whatever reason we were given them to take, this is what they do. I don't want to get into an explanation here.

So effexor mainly blocks S & N, tramadol does it a little and not as a main feature of its chemical makeup. Tramadol and its metabolite mainly competes for a receptor in the brain that is thought to modulate your response to pain, your ability to process it (how much it is painful, where it is coming from, etc). That's how pain meds work: they fiddle with the brain's response to a pain signal from somewhere in the body. The chemical does nothing to remove the pain (surgery attempts to do that) but just modulates your brain's response to it. If the pain is not sensed, you feel ok. But moving the affected part around (instead of not doing that because it is painful to do so) still produces the pain messenger chemicals but your brain does not process them until the drug wears off and the receptors are active again.

Are you with me so far?

So adding an anesthetic into your system caused an effect which is unknown. You had an inhaled gas I assume? It has to get cleared out of your system And here's what may be happening: it may be clearing very slowly because of your age and lifelong drug burden on your liver. The tram has to clear too and your body is still reconfiguring itself from the effexor jump. I also saw mention that tram comes in an extended release formulation and if you are using that one and breaking it up you may be getting too much too quickly.

I would be careful assuming that this is all ssri related simply because tram is such a weak reuptake inhibitor. I would instead look at this as a problem taking an opioid. Their side effects ARE dizziness and nausea (I'd have to look up why that is, it is probably a side effect of competition for receptors). If that is your main problem it may be happening because of the additive CNS effects: anesthesia + pain med and this not getting cleared from the liver yet.

So what to do to help? Instead of putting all the focus on ssri's and such, do what is necessary to help the liver clear this stuff out. Drink more than the usual amount of water and move your body. Even if you are mostly bedridden you can do this. Move your arms, your hands, stand up, sit down, move move move. It makes the blood circulate. And adding more fluid DILUTES the concentration of these metabolites in the body. They have a less noticeable effect.

I see JC has added a reply while I was typing. She is right about checking for an infection but adding fluids and moving will help with this too.

This is just my suggestion but I would go back to the tram dosing you were doing before surgery but increase your fluids a lot. You were taking it a bedtime, right? So if you get dizzy and nauseous you at least won't have to try to walk around for daytime activities.

The other suggestion is to just stop taking it and see if you can cope with the pain and side effects. They may actually turn out to be milder than you think if you keep your mind from dwelling on ssri withdrawal stuff and opioid wd stuff.

I don't think you should take the antiemetic at all. And I would make sure you are getting enough food. I have always found that eating something takes nausea away for me.

I think this will take some time to resolve and I hope my clumsy explanations might help a bit for you to see what might be going on and what you might do. Unless you have a gut feeling otherwise, I think if you do nothing but increase fluids and exercise by moving and stop messing with the tramadol this will clear up in the sense that you will heal from the effects that the surgery had on your whole system. If you can find a way to dose it so you are not feeling ill (maybe stopping it without tapering is actually a good idea) I think your body will lead you to a resolution (which will be healing).

April 4, 2015

Thanks Jan, yes it was a hip replacement. I was at the doctors and she didn't think it was anything to do with the op, but I do know that other infections can attack the joint. We don't get the immuno thingy's here in the UK, I've had 3 joints replaced and didn't have the drugs for any of them. I'm hoping that it is a bug but at the same time anxious about the hip if it is. If the hip gets infected it has to be removed and replaced again. I haven't taken anything today, the very thought of the pills makes me feel sick, I need to get over that because it will not help a jot. Had a really bad night, took 20mg tram at 5, went out and felt ill, had to lean on my sticks so I didn't fall over. Didn't sleep a single minute, restless legs were awful and head spinning. I haven't taken anything today and will not take another stemetil. It's strange because when I got out of the hospital I actually felt good, in pain but I remember being outside and thinking that everything looked so clear and fresh, and my brain felt good. Ha, that didn't last long, lol.

CW thanks for that explanation, it makes sense. I've been researching and found a few answers here, http://www.tramadolfacts.com/

Now for the hospital, I had my hip replaced but didn't have a general anaesthetic, I had an epidural and nerve block, with sedation. It went well, I woke up near the end and could feel them working on me. It was not unpleasant or frightening, they had told me it might happen but I had said I didn't want the general and wanted as few drugs as possible so was prepared. I couldn't feel a thing, just hear them and feel some movement. I felt fine, no hangover, nothing. My shoulders were very painful because of how I was laid but that was it. I was sat up drinking decaff tea and biscuits in no time, chatting to my daughter who had stayed.

The epidural wore off and they gave me tramadol, but it takes 2.5 to 3 hours to work, so was in a great deal of pain. I have reacted to all the other pain relief and they suggested pethidine. ( Can't remember the american name ) I googled it and there was a major interaction with tramadol so I refused, then 6 hours after the tramadol accepted the pethidine because the pain was off the scale, but the tramadol should have been out of my system then, or so I thought! . I had told them repeatedly that I have reactions so they gave me a 'mini' dose. Within minutes I was projectile vomiting, sweating profusely so the sheets were soaked, shivering uncontrollably and couldn't speak. I was frightened because I was not in control of anything, and couldn't move my tongue to speak, it was like it was paralyzed. Then I slept for a few hours. After that I had 50mg tramaol 2 x day and it made me very sick, every dose I had cyclazine injections to prevent vomiting. That is when the dose was split into 2, and that is all the pain relief I had for 4 more days until I was discharged and cut the tramadol into 3 doses, lowering them to 20mg each. Prior to hospital I was taking 80 mg in the evening, only once a day because of the side effects. I can't drive after taking it, can't find words, appear drunk, if I take it at bedtime I have restless legs and can't sleep at all. Even taking it in the evening (6pm) it leaves me with a hangover in the morning, so I had only a few hours in the afternoon when I could drive, before taking it again.

I've been taking it like this for about 7 years, can't remember exactly. Before that it was codeine but that was making me ill and tramadol was the only other drug the gp could prescribe, I'd been through all of them and had reactions. I have had 1 x 500 paracetamol (tylenol) maybe 4 times in total since discharge. I can't take any more because that seems to build up in my liver too, I can feel it. Hope it's not too random and you can understand it all!

Just to add that I'm not sure what sedation was used, they did say but can't remember, think it was a benzo.

April 4, 2015

MP,

Do you think you can cope with the level of pain if you omit the tram? Can you do it without worrying about ssri and opioid wd as I mentioned above? I know this may sound weird but cold turkey is very uncomfortable but one does not usually expire from it. This may be one case where tapering is prolonging the agony but only you know for sure.

The way you are describing it above, the tram was really making you sick, more than it ever had because of all the work the liver has had to do. The nausea was (I think) partly because it has that effect anyway and partly maybe your body trying to throw it off? As in, the liver was or is not able to produce the enzymes necessary to metabolize it (and everything else). Un metabolized stuff often makes us feel sick.

You were given a long acting benzo and maybe some kind of drug to produce amnesia (like versed maybe) that produced a level of near but not quite unconsciousness like a general would. The nerve block kept the pain from being felt and waking you up. If you woke up you would tense all your muscles and they would not be able to do the replacement. And you'd no doubt be vocal about it.

Ok, so your liver has had to clear ALL of those drugs, your whole system environment was changed because of their necessary use.

Different receptors being occupied or blocked, systemwide unknown effects.

Pethidine (I know it better as demerol) is known to cause nausea so I am not surprised you barfed and had the other reactions, it is really a strong drug. The cyclizine maybe did not work too well either in that it may have calmed the nausea but added a effect to the liver. Cyclizine (meclizine, used a lot for motion sickness because it is less drowsy producing than dramamine) is an antihistamine and ssri use and antihistamines seem not to work well together. The 5HT receptor thing again. All this drug reaction stuff is receptors and enzymes and metabolites duking it out in our bodies. We feel the effects of whichever one is more dominant it seems.

What do you think you should do at this point? Whatever you do do, you need to aid your liver and kidneys in clearing these drugs and their metabolites from your body. My guess is that if you can do without meds of any kind it is worth a shot to see how your body copes. You might have well developed a higher tolerance to pain as the years have gone by and all the meds are not needed.

There will be pain in the area of the surgery as it heals but the pain that was there as a result of the degeneration of the joint is gone and the overall result might be way less pain. If you know you will have a certain level of it it might be easier to bear.

One thing I do know is that you are going to have to work really hard to keep your nutrition up. You have to feed your liver. Eat eat eat. drink drink drink. Move move move. Sit in the sun and breathe. Distract.

What are you eating?

By the way, if there are any scientists reading who wish to take exception with how I have tried to describe things, have at it. I am only trying to give a bit of insight on the whys of what is going on so mammaP can bring her intuition into play and figure out what to do. Medicine and the body is for the most part NOT magic: it is physical stuff, causes and effects, chemicals and proteins and electrolytes and minerals and stuff that reacts. Sometimes thinking about it that way can lead to insight.

April 4, 2015

Thank you CW, that all makes perfect sense. My body is telling me not to take any more drugs, the little tram I am taking is not doing anything for pain anyway and the pre op pain is much better. I had the op so I could get rid of the tram but needed it before the op. The bad hip was throwing my whole body out of line because of deformity and the surgeon assured me it would make a difference to my whole body, and it has! I still have pain but that can be managed with magnesium baths, but now I am at my daughter's again and can't get into her bath . Right now I am vegetarian but only out of respect for my daughter and her lifestyle. She is very good though and cooks good well balanced meals. My body feels like it needs to recover and like it needs a detox but I am so scared of ssri withdrawal, especially after tapering for 3 years!

April 4, 2015

Well, you are going to have to let your fear of 'ssri wd' take a temporary hike because it is going to make you miserable, fearful and talk you into doing something you shouldn't.

You might want to take a vaycay from reading parts of the board if you cannot control worry, you know what I mean.

Let the detox from the tram begin and see what it is like. I am pretty sure it won't cause any irreversible harm. If you have any doubts of this, well look at how many members this site has. Everybody is at some stage or another and all are hanging in there. We don't like what it feels like but we are managing. Lots of people have gone ct for various reasons.

I have a feeling you will manage too. Maybe it's time to listen to the body voice instead of the head voice all of the time? (I am not saying you do this though, it is only a suggestion.)

Oh, what do I know anyway. You are your own best doc or nurse and nothing goes by the book all of the time anyway. All trial and error.

April 4, 2015

Hope you feel better soon xx

April 4, 2015

Thanks Jan, yes it was a hip replacement. I was at the doctors and she didn't think it was anything to do with the op, but I do know that other infections can attack the joint. We don't get the immuno thingy's here in the UK, I've had 3 joints replaced and didn't have the drugs for any of them. I'm hoping that it is a bug but at the same time anxious about the hip if it is. If the hip gets infected it has to be removed and replaced again. I haven't taken anything today, the very thought of the pills makes me feel sick, I need to get over that because it will not help a jot. Had a really bad night, took 20mg tram at 5, went out and felt ill, had to lean on my sticks so I didn't fall over. Didn't sleep a single minute, restless legs were awful and head spinning. I haven't taken anything today and will not take another stemetil. It's strange because when I got out of the hospital I actually felt good, in pain but I remember being outside and thinking that everything looked so clear and fresh, and my brain felt good. Ha, that didn't last long, lol.

CW thanks for that explanation, it makes sense. I've been researching and found a few answers here, http://www.tramadolfacts.com/

Now for the hospital, I had my hip replaced but didn't have a general anaesthetic, I had an epidural and nerve block, with sedation. It went well, I woke up near the end and could feel them working on me. It was not unpleasant or frightening, they had told me it might happen but I had said I didn't want the general and wanted as few drugs as possible so was prepared. I couldn't feel a thing, just hear them and feel some movement. I felt fine, no hangover, nothing. My shoulders were very painful because of how I was laid but that was it. I was sat up drinking decaff tea and biscuits in no time, chatting to my daughter who had stayed.

The epidural wore off and they gave me tramadol, but it takes 2.5 to 3 hours to work, so was in a great deal of pain. I have reacted to all the other pain relief and they suggested pethidine. ( Can't remember the american name ) I googled it and there was a major interaction with tramadol so I refused, then 6 hours after the tramadol accepted the pethidine because the pain was off the scale, but the tramadol should have been out of my system then, or so I thought! . I had told them repeatedly that I have reactions so they gave me a 'mini' dose. Within minutes I was projectile vomiting, sweating profusely so the sheets were soaked, shivering uncontrollably and couldn't speak. I was frightened because I was not in control of anything, and couldn't move my tongue to speak, it was like it was paralyzed. Then I slept for a few hours. After that I had 50mg tramaol 2 x day and it made me very sick, every dose I had cyclazine injections to prevent vomiting. That is when the dose was split into 2, and that is all the pain relief I had for 4 more days until I was discharged and cut the tramadol into 3 doses, lowering them to 20mg each. Prior to hospital I was taking 80 mg in the evening, only once a day because of the side effects. I can't drive after taking it, can't find words, appear drunk, if I take it at bedtime I have restless legs and can't sleep at all. Even taking it in the evening (6pm) it leaves me with a hangover in the morning, so I had only a few hours in the afternoon when I could drive, before taking it again.

I've been taking it like this for about 7 years, can't remember exactly. Before that it was codeine but that was making me ill and tramadol was the only other drug the gp could prescribe, I'd been through all of them and had reactions. I have had 1 x 500 paracetamol (tylenol) maybe 4 times in total since discharge. I can't take any more because that seems to build up in my liver too, I can feel it. Hope it's not too random and you can understand it all!

Just to add that I'm not sure what sedation was used, they did say but can't remember, think it was a benzo.

I know how that feeling of not being able to talk from a drug reaction and I will put my money on that reaction to pethidine causing a change in your system now... to some extent at least. I have had this before and it takes time to calm down.

As for reacting to the tramadol after the surgery most likely a drug itneractions from the other meds you were given... just another guess. As of the feeling of dizzy to the extent you are I had that big time with E wd and it was helped by electrolyte replacements. I am not sure if they have checked this but adding a baby drink electrolyte is harmless if you don't need it .. then it won't help you but won't hurt you either.

As for the pethidine my search did not come up as it being demeral at all... I got this.

http://en.wikipedia.org/wiki/Pethidine

Compared with morphine, pethidine was thought to be safer, carry a lower risk of addiction, and to be superior in treating the pain associated with biliary spasm or renal colic due to its putative anticholinergic effects.^[3] These were later discovered to be all myths, and it carried an at least equal risk of addiction, possessed no advantageous effects on biliary spasm or renal colic compared to other opioids, and due to its toxic metabolite, norpethidine, was more toxic than other opioids, especially during long-term use.^[3]The norpethidine metabolite was found to have serotonergic effects, so pethidine could, unlike most opioids, contribute to serotonin syndrome.^[3]^[4]

Pethidine Tramadol and cyclezine .... are all listed together in this article as interactions causing serotonin syndrome - seizures.

http://www.medsafe.govt.nz/profs/PUArticles/TramSerious.htm

"Three other patients developed seizures when tramadol was given intravenously following, or with, pethidine and/or cyclizine. "

"To reduce the likelihood of serotonin syndrome occurring, avoid co-prescribing tramadol with the medicines listed in Table 1, if possible. Tramadol is contraindicated in patients who are taking monoamine oxidase inhibitors or who have taken them within the last 14 days.¹ Prescribers also need to be aware that co-prescription of tramadol with tricyclic antidepressants, selective serotonin re-uptake inhibitors and antipsychotics can lower the seizure threshold.¹ Prescribers should bear in mind the potential risks of serotonin syndrome and seizures when making a clinical decision to use tramadol."

So then the doc throws an AP at you for nausea when there are so many alternatives... just stupid. I am mad now... I will go away as I am not helpful in this state.

April 4, 2015

• pethidine

http://reference.medscape.com/drug-interactionchecker

Serious - Use Alternative

tramadol + meperidine
tramadol, meperidine. Other (see comment). Possible serious or life-threatening interaction. Monitor closely. Use alternatives if available. Comment: Tramadol may reinitiate opiate dependence in pts. previously addicted to other opiates; it may also provoke withdrawal Sx. in pts. who are currently opiate dependent.

Significant - Monitor Closely

cyclizine + prochlorperazine
cyclizine decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Significant interaction possible, monitor closely.
cyclizine + prochlorperazine
cyclizine decreases levels of prochlorperazine by pharmacodynamic antagonism. Significant interaction possible, monitor closely.
prochlorperazine + cyclizine
prochlorperazine increases effects of cyclizine by pharmacodynamic synergism. Significant interaction possible, monitor closely. Additive anticholinergic effects, possible hypoglycemia.
meperidine + tramadol
meperidine and tramadol both increase serotonin levels. Potential for dangerous interaction. Use with caution and monitor closely.
cyclizine + meperidine
cyclizine and meperidine both increase sedation. Potential for interaction, monitor.
cyclizine + tramadol
cyclizine and tramadol both increase sedation. Potential for interaction, monitor.
cyclizine + prochlorperazine
cyclizine and prochlorperazine both increase sedation. Potential for interaction, monitor.
meperidine + tramadol
meperidine and tramadol both increase sedation. Potential for interaction, monitor.
meperidine + prochlorperazine
meperidine and prochlorperazine both increase sedation. Potential for interaction, monitor.
tramadol + prochlorperazine
tramadol and prochlorperazine both increase sedation. Potential for interaction, monitor.

There are very good reasons you feel the way you do. On top of all this our brains are not the same as the ordinary person until this fact is recognized we are put at risk we just are... in my humble opinion. Our brains are changed after years of Antidepressant use and our reactions to medications are different in many cases

At this point if I were to suggest anything at all it would be to go home with help who will cook and feed you meat... and anything else you care to eat. Try an electrolyte replacement the baby one is all I can tolerate once my cart is upset like yours is.

The reason I say go home is the bath tub is there.

I don't know if you can swing all that or not but if you could it is my best idea. As for the tramadol I would try not to take any at all I know big words from the one not in pain. An even lower dose would be the next option back to the normal dosing you did before surgery but lower... if you can stand it. Your off kilter now cause of the other drugs and tramadol is not your friend or it would not be making you sick.

I am not at my best will try to get at my best and take another look later... if you can't do anything else try to get some baby elecytrolyte replacement to try.

I wish you peace Mamma

April 5, 2015

http://www.cfp.ca/content/54/7/988.full

" One cause of delirium with neurological hyperexcitability is metabolite-mediated opiate toxicity, which can occur with rapid escalation of opioid doses, high opioid doses, or low opioid doses in patients with renal failure. Opiate toxicity is most likely caused by meperidine and morphine but can be seen with all opioid agents.20 Anticholinergic toxicity is differentiated by presence of skin colour changes (red as a beet), dry mouth (dry as a bone), and constipation or absence of bowel sounds .4,19"

In the above article the topic of discussion is SS serotonin syndrome... I know before people go off on me think of this... we have changed this system in our brains possibly by long term SSRI/SNRI use and I think it possible to trip up our systems with much less medication than it would take to cause the same symptoms in a person who had never taken an AD. The fact that the tramadol still causes symptoms makes me think this too... along with my own personal experience with reactions of drugs... I have to add with my liver being not healthy most likely changes how I react to drugs also.

I can't be a scientist I am way to old and stupid what I have to add is experience and not the good kind.

First thing I think of when I have been hit with a reaction is water... drink it and get in it.. the skin is the largest organ in the body and the last line of defense to any reaction if the body is trying to purge something and is overwhelmed the skin will be used as a cleaning agent... to help the body soak the skin. Plain water is better than nothing sometimes I use plain water before I attempt ES bath sometimes not. Drink the water too... as much as you can. We are mostly water... replaces our fluids cleans our bodies.

Generally water is safe... first do no harm. Water wait.

The issue of dizziness has been debilitating to me... if your too dizzy to walk self care plummets even getting to a bath is impossible I have been there... I have crawled.. but lets not go there. I dont know all the things in those baby electrolyte drinks I tried making my own and did not have the same results there is something else in there that helped me. If your too dizzy stay in bed.

They talk about drugs to treat it... and we are not sure you even have this... keep that in mind.

The antihistamine cyproheptadine, which is also a 5-HT_2A inhibitor, should be considered in moderate cases and is recommended in severe cases, despite a lack of randomized controlled trial evidence (level II evidence). It is available only as an oral preparation; the initial dose is 12 mg; the dosage is then adjusted to 2 mg every 2 hours until symptoms improve.21,22

Not sure what this drug in exactly but an antihistamine I mentioned above

Dimenhydrinate is primarily used to treat nausea, vomiting, and dizziness caused by motion sickness.^[1] Dimenhydrinate has also been found to aid in the treatment of ear congestion.

Would be the first thing I would try IF I were to try anything to treat the dizziness. Just me we may not be the same. Very very low dose of anything.... I would take 1/4 of a child dose which would be 3mg an adult dose is 50mg ... some otc pills have much higher doses be very careful to check the dose. I have seen them as high as 100mg per pill.

There are likely other systems involved most of this is coming from the gut instincts and experience.... it may be completely wrong for you if we have nothing in common other than drug use.. or our drug use may have leveled the field and we have more in common then we know.

It is all chance at this point. Time again Mamma is going to be a factor as always ...if the tramadol is needed for pain and the systems has been sensitised by the reaction it is possible you could use the antihistamine to treat the dizziness to get just enough of what you need.. maybe.... to get thru this ... to the place where you say bye to tramadol.

Reactions like this can take 6wks - 3 months for the worst of it to pass but if you still need to take one drug ... and another to treat the side effects of the heightened sensitivity of the system now.. you may find it changes up rather quickly.... as the drug to treat the new side effect could work with one dose and from there it would be a dance of getting the levels right.

Everything low and slow..

and I have to say this even tho I know you know it others who read this later may not.. I am not a doctor this is my own experience... playing with any of these medications should be done after you talk to your doctor... these are suggestions things I have done talk to your doctor to see if they may be right for you...

I wish you peace.

April 5, 2015

I hope some smarter people take a look at what I wrote some who may understand why all this would be as i don't understand it well I am at this moment challenged by a reaction to prednisone but did my best Mamma I hope there is something useful in there but it may well be dribble.

peace

April 5, 2015

How is it going today, MP?

☼ Hello. mammaP checking in!

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