Medical & HealthNews and debate about medical and health issues as they relate to aircrews and aviation. Any information gleaned from this forum MUST be backed up by consulting your state-registered health professional or AME.
Following a really bad accident (ladder collapsing at home) I have had a lengthy period off work and am still not fit to fly due to massive damage to my left arm. After 7 ops to try and sort the problem things are beginning to pick up. During the whole gig I was prescribed tramadol after each op (pain relief in hospital was morphine drip) and that resulted in being on this drug for 9 months at up too 400 mg per day.
The whole experience was awful and I was wondering if anyone else out there can furnish me with any details as to their personal experience having being on this drug for a while.
It's a drug which is "high up" on the pain ladder, and overused generally by hospital doctors.
I should imagine that after 9months, you've developed some degree of tolerance and dependence. Be careful about withdrawing its use suddenly, seek the help of your prescriber.
How's the pain now, and have you tried anything else to control it?
I was prescribed it following an open gall bladder op (my gall bladder had ruptured) followed a couple of weeks post-op by a pleural effusion. Going from two capcules 4x per day to mostly not taking it simply happened naturally for me, but I wasn't taking it for the amount of time that you have been. As it was time to cut the dose I simply tended to forget to take the pills - I was taking it with a couple of paracetemol, and at one point in time an ibuprofen as well.
The one problem I might have had was restless legs - taking one tramadol before bed time fixed them so I could sleep, but the problem seems to have faded away.
The important question right now is how much pain do you have now? And does the pain break through before the next dose is due? If you have no pain you will probably be able to gradually reduce the dose, hopefully with no problems.
But UKLocations advice to talk to your doctor(s) and to not suddenly stop are good.
Thanks for your advice, guys, the problems are really quite horrible. You are right perhaps because the effect of the drug seems to be less in terms of pain relief. I was abruptly taken off tramadol a couple of weeks ago after 9 months, and put on to volterol and I feel ghastly. I can only descibe it of being totally outside myself. I have panic attacks, sweats, mood changes, feeling totally restless, headaches, just cannot sleep and feel just awful. I wish I had never been prescibed this drug as I think perhaps I have now developed an addiction. I will take your advice and go and see my GP.
It does sound like you're having withdrawal symptoms.
One light at the end of the tunnel is that it's likely that your symptoms should be short lived, and at this stage (after a couple of weeks), should be on "their way out."
Take the advice of your GP, it is important to control your pain, but I'd be a little wary of stepping back up the pain ladder.
Thank you for your advice. I've seen my GP today and the upshot is that she believes that I do have classic withdrawal symtoms from tramadol. (the volterol switch was initiated by a hospital doctor by the way). As a result I have now been put back on tramadol as pain relief to be monitored weekly and a plan produced to taper back the dose over a period of 4 months.
A word of warning to pilots and others out there. Tramadol in my opinion is a nasty number and you should avoid it at all costs. I had to have 7 surgical interventions over 6 months so in some ways was not in control of what was happenning to me. My GP has explained that tramadol is highly addictive and should never be taken over an extended period. Having taken 2 x 50mg this morning I feel a whole lot better in myself, but now have the painful knowledge that my body now needs this drug (a dependency) and I will have to be careful over the next few months. Not what I need as I try to get a shattered arm back up to speed!
If anyone out there has had similar experience and is reading this I would be grateful if you could offer your thoughts. I have to say I'm rather frightened at the moment.
Sounds like you're in good hands, it's understandable being frightened, but it's unlikely you will come to any physical harm due to the medication. Tailing off slowly, and having some understanding of why you feel like you do is the way forward.
I can understand your antipathy to Tramadol given your current problems, but would say to anyone who needs it to control pain to take it. Good pain control is a really important part of recovering from accidents or illness - without it one isn't active enough, and it's hard to sleep.
I also suspect you might be unlucky in getting physical addiction to it, but I'm sure that you will come out the other side just fine.
BTW is the Volerol controling your pain? Don't be tempted to exceed the dose if it isn't as it can cause the same stomach problems as ibuprofen. Suspect you can add paracetemol if necessary. It's a brand name for Diclofenac.
(and I'm so glad I hate ladders and don't use them!)
The replacement drug was dicloflex 50 mg. I obviously was not on it for any length of time before going back on tramadol, the only effect I noted was feeling slightly nauseated.
Today I feel a whole lot better in myself but I do feel rather dejected (depressed).
All I can say to others out there is DO NOT TAKE TRAMADOL. It is ghastly stuff even if it does take pain away, long term use is BAD news. I have does some digging on the net and Sweden has reclassified this drug in May this year. Something is not quite right with this stuff.
Tramadol is a trade name for a drug that is derived from morphine, and as such has many of the associated problems. However, when properly controlled by a competent doctor it can be an invaluable tool in the recovery from painful surgical procedures. To suggest it should NEVER be used is dangerous.
As noted above, proper pain control aids in a speedy recovery.
As with any morphine based product a dependence can occur, however this need not necessarily be a problem as long as the prescribing authority manages the drug properly.
I am currently on a high dosage of Tramadol following a thoracotamy and surgery to replace my aortic valve, and without the powerful painkiller being available I would not be able to sleep at all, and my movement would be severely restricted. Obviously I am aware of the issues and intend to manage my use and reduce it as soon as I'm able, but I will not forego it and suffer more pain than is necessary.
Thank you everyone who has commented. I think I need to stress that this prescribed drug was taken as directed. I can see that some people do abuse drugs but I did not. I had no idea that it has an effect that is really horrible.
Check out the link that I have found and you will see what I mean. It is of no consolation that others have unwittingly run into the same problem. It has recently (may) been restricted in Sweden.
I agree with Matt here. Managed pain relief is very important post operatively. I had my spleen out last week and for a couple of days I was on morphine through a subcutaneous line, then Tramadol for a day and then Paracetemol. Luckily my surgery was all key hole and within 4 days I didn't need any pain relief at all.
There are various reasons for using pain relief other than just patient comfort, one of the main reason for me was because my belly had been operated on, it made it hard to breathe deeply, so I was advised to take the painkillers to ensure that I breathed deeply enough to stop potential problems like chest infections etc.
I have no experience of long term pain relief and I feel for anyone who has to live with constant pain, just my short experiences are enough to tell me that powerful pain killers need to be managed very carefully, especially when it comes time to stop using them.
Good luck with getting over all the surgery and pain. It must have been a year to forget. But I found short term use of tramadol to be greatly beneficial.
Having broke my back in 2 places and using morphine while in hospital. I was given Tramadol as my pain relief for use at home, it is Fantastic stuff,and will remove the pain. if you have to use this to remove the pain then you will know what pain is, not whinging people who have a little ache in their backs etc. I found the side effects were instead of making you drowsy like some medicines i was fully alert in the middle of the night, some times getting up and being very active at 1am etc.
use it . I found it totally non addictive and stop using stright away.
A while ago I posted some detail on tramadol after I had taken it at max dose for 9 months following an accident at home following a ladder collapsing.
I offer this thread on another site for those of you who may be prescribed this drug. The effects for me were totally catastrophic and I ended up losing my beautiful wife Helen because of the wretched stuff. It is a very good pain killer but take it for a long period in all innocence and then try and stop......Tramadol (list of experiences about)
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I'm sorry to hear about the results of you taking this drug. I posted a lot about Valium and all the related drugs on this forum some years ago. The results for many have been very serious, and the rate at which this stuff was pumped out in the 70s was totally bewildering.
The rage reaction was so severe in some patients, that I've no doubt that some people went to jail because of this prescribed drug.
One young GP ended up shouting at me to take the stuff...and to "stop worrying about your body!" I had a huge gallstone, and a bladder that was so bad that the surgeon had rather a lot to say about the delay. That young doctor was finally struck off for life, though I hasten to add that it was nothing to do with my case. He'd been mainlining himself, and therefore probably didn't think Valium was much of an issue. Sad that.
Thank you for your reply and also for the PM's that I have had from well wishers; it is very moving. May I just stress that I truly believe that though this drug is undoubtedly a very good pain killer it does come at a price, and for me that price was terrible and has left me devastated. The effects of it are for some of us(see the links) are profound and insideous and should not be underestimated. When it was too late for Helen and I, completely by chance I was placed in the hands of a locum doctor who had USA experience of tramadol/ultram/zydol call it what you will, who at once recognised my symptoms and started me on the road to recovery. I have never been any good at reading the fecking manual (its in my Irish genes)and had I done so perhaps I would have recognised the cues. At the time tramadol was not even on the radar as a causal factor for either of us. But when you are in a whole heap of pain it is almost impossible to be objective about what you are doing. Naturally I have done a heap of research now, and frankly this drug is horrifying, and it turns out that some of us, me included, have low tolerence to any opoid drug in any event.
I just offer my experience not only to patients, but to patients spouses, partners, sons and daughters, friends and colleagues that if someone is on this stuff for a period (more that 3 months) then you can end up hooked and it is definitely mind bending stuff and just please please take care, and look at the links that have been posted.
Back in 2005 I had a major motorcycle crash where I ended up with three open fractures in my right arm ( radius, ulna and humerus ) which necessitated 7 hours of surgery and a foundry's worth of titanium and screws.
I had post operative morphine via a pump and then was prescribed tramadol orally as well as numerous other tablets to deal with issues associated to the crash. I was made aware early of the long term dependency issues with tramadol and when discharged to recover at home decided that I would take control over when I would take the tablets and immediately reduced them.
Within 6 hours I was on the ceiling with pain, unable to get comfortable and was close to doing anything to relieve what I was enduring. My wife restored my dose of tramadol to that which was prescribed and the management of pain once again became tolerable. I never again missed taking one of those tablets when it was prescribed but was fortunate to have the total support of my GP / AME who phased their use out as soon as they identified that there were other options available.
Tramadol was reduced out of my treatment over a period of six weeks and I never consciously noticed the reduction within myself. It was 18 months before I returned to flying status by which time I was taking no prescription medication.
Yes I agree that tramadol is a strong pain killer but if you are prescribed it then best you be taking it as your body needs the relief that it brings.
If you have this drug prescribed, talk to your GP and express how much concern you have over its use but be assured that they are aware that as soon as you can instigate a reduction programme under their supervision then they will support you through it.
I would have been unable to get through my recovery without it but did not rely on it for a long period of time ( 11 weeks in total ).
It was an essential part of my treatment but I have to thank all of the medical staff who supported me in every way to give me an arm that looks a bit odd but works in every way that it should.
I had an accident at work in September 2006, which left me with a torn ACL, a torn MCL and a torn Meniscus in my knee. I have had 3 operations and a heap of titanium, a lot of very hard rehab and unbelievable pain in the last 2 years, but it has been managable because I took the tramadol thatcwas prescribed to me. I believe that if I had not had such a powerful painkiller, I could not have put so much effort into the rehab after my ACL reconstruction, which would have ment that me knee may not have completely straightened or been as strong as it was before the accident.
I have stopped taking tramadol 4 months ago after being on it almost constently since September 2006. I had no problems coming of it, but I think that everybody reacts to different drugs in different ways, some people can become addicted to things alot easier than others.
My advice to people is to take tramadol if you need it to control your pain, but be aware of what the early signs of dependence are, (starting to get a knot in your stomach, getting irritable, sweating or shaking etc if you are late taking your tablets, not in pain or in much reduced pain but still feeling you need to take your tablets), and see your GP if you notice any signs, or have any worries or concerns.
I think tramadol is a very effective painkiller, and I would have no hesitation using it again if it was needed.
Tramadol
