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Discussion Starter · #1 ·
Hi everyone,
I'm so grateful to have found this site.

I was just given a firm diagnosis of MCTD on August 8, 08. I am still in shock.. I'll share full story later.
My really BIG urgent question is what do people take for 'pain' and imflamation if they take Coumadin/Warfarin...I take the coumadin for antiphosp/anticardiolipin+/PE's.. the doctor gave me the option of cortisone shots or PT... doctor said "that's what I offer"... Tylenol Arthritis does nothing, Plaquenil hasn't kicked in...
This doctor doesn't know me at all, I've had 2 visits, and both times she said she doesn't offer pain meds for patients on Coumadin, just cortisone shots or PT. Funny thing was, I wasn't asking for anything... and I certainly don't want cortisone shots now... (I have no drug history or drug seeking history) but that's how she made me feel, like I was asking for narcotics or something... I don't need them... I do have a PT consult this week.
I don't want to start changing doctors, this is all so new, I don't have a lot of info yet, I'm feeling like this is a 'bad way to start this long term relationship ...
What do you guys think ? I am in a lot of pain right now struggling to get through the work day and can't take anything... There has to be some options out there.. I'm going nuts here...
Anyone out there take coumadin and something for pain ???
Thank you so much...
 

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North East here too, New Jersey. Where are you located?

Welcome to the board and I am glad you found it also.

I am new to Lupus and I am sorry for your dx, it is kinda scary in the beginning.

I take Percocet and in the past have been on blood thinners and have take the Pers at the same time, no problems.

I hope you get on the right track for the pain.:wink2:
 

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Hi Blue Mist,

Welcome to the lupus site, it is nice to meet you. This site is full of good information about lupus. All the members are very friendly and helpful.

Here is post about pain medications. It is at the top of the section that says medication.

http://www.thelupussite.com/forum/showthread.php?t=48968

You might want to be referred to a pain specialists. Is the doctor that you are seeing a GP or a rheumatologist?

Being first diagnosed is a roller coaster ride of emotions. :hug:

Take care,
Lyn
 

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Discussion Starter · #5 ·
Thank you for your replies. I appreciate the support. This has been a confusing couple of months...

This doctor, who won't prescribe anything for pain is my rheum, GP referred me after positive ANA.
At my appt on Aug. 8 I felt pretty good. Then this weekend started feeling bad again... Docs said it was a 'flare' that got me to the doctor in the first place, .. OMG... Lots of stress and I'm moving in a few weeks... Now the rheum and my GP are on vacation for two weeks... This is crazy... I wonder... do you call a pain doctor on your own, or have to be referred... i'm going to make some calls in the morning... these doctors have to have someone covering for their vacations...
Thank you
 

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Frequently, a short course of prednisone will be prescribed to reduce pain and inflammation for any patient with autoimmune joint pain that can't be controlled with other measures. As far as I know, that is a very safe drug to take for someone on coumadin/warfarin. At least I've seen many people here taking both....

My doctors here have also over the years been very reluctant to prescribe any pain meds other than NSAIDs and amitriptyline/Lyrica/Neurontin/Cymbalta, etc. Basically, they will try everything before moving onto any sort of narcotic pain med. There can be some issues/interactions with most NSAIDs and controlling the INR - but this doesn't mean there are no options for pain control other than the two choices given to you thus far.

I would ask about a short trial of prednisone to get you through this flare, and then later discuss with your doctor seeing a pain management physician if the pain continues at a level that is so difficult to get through a day like it is now. Usually, you have to be referred to a pain management doctor by another doctor...

Good luck to you and welcome to the site!
 

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I am surprised that your doctor said that. I've been on coumadin for 2 1/2 years now as well as pain medication. I've never been told there was a problem. I've mostly taken dilaudid (hydromorphone). I've also have the fentenyl patch. And I have had regular morphine and 2 other shots of pain medication that I don't know what it was when I had a severe headache. No question was ever raised about pain medication. I just get my INR regualarly and if a new drug affects my blood, they adjust my coumadin. That happened recently when I had to take an anti-inflammatory for severe pericarditis. It affected my INR, but they just kept adjusting my coumadin. Now I did find out after that all anti inflammatories, other than Celebrex, will affect your platlettes. If  you  are  taking  blood thinners  and  anti-inflammatories, there  is  a  high  risk  that  they  won’t  be  able  to  stop  the  bleeding.  Therefore, I  am  taking  Celebrex.

Nutty
 

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Hi Blue Mist,

I would say that you suggest a short course of Prednisolone (Pred) when you next visit your doctor - that drug does help with pain and inflammation!

In UK with non-prescribed drugs we can take paracetamaol and ibruphen alongside each other as a double painkiller (not sure what they are called where youre from)!

Hope you feel better soon!

Lesley
 

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Discussion Starter · #9 ·
Thank you again for all replies...
I'm going to contact the covering doctors tomorrow, I felt a little better overnight, so I didn't call doc today, but I'm worse again this evening after work shift, so will put call in tomorrow.
I think my rheum doesn't want to 'start me off' immed with narcotics, which I understand, and agree, but given the fact NSAIDs are not an option with the Coumadin I guess I'm feeling a bit panicky about what I can use for right now and if I 'flare' again... this too shall pass.......:calm:
Thanks all for being out there.... that is comforting in itself...
 

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I'm in the same boat as you. I've been on "thinners" (Warfarin) for MANY years and other than Tylenol can't take anything over the counter (I MISS Advil!). When I have been given a perscripton for pain I usually get Vicodin (or the gereric). It's great painkiller for me, works wonders, but it's addictive so I don't get it often, havn't had any for about two years. I'm a bit jealous of my sister (also has Lupus/fibro) her Doc. gives her Vicodin....two pills a day! But at the same time I worry that she's addicted. When I visited her a few months back and was feeling pretty sore she wouldn't share, not a good sign. Nearly all the time I just deal with pain, I try Tylenol, but it doesn't do much.

Best Wishes,
Eric
 

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Blue*Mist;518013 said:
...
I think my rheum doesn't want to 'start me off' immed with narcotics, which I understand, and agree, but given the fact NSAIDs are not an option with the Coumadin I guess I'm feeling a bit panicky about what I can use for right now and if I 'flare' again... this too shall pass.......:calm:
Thanks all for being out there.... that is comforting in itself...
Hi Blue*Mist

I am in the same position as you. I did take indomethacin for a few weeks while I had pericarditis. It did affect my INR, but they just adjusted for that. It's the risk of bleeding and I have an ulcer on my esophagus which makes the risk real. But, they said for short term, I would be okay. They will give you something to protect your stomach if needed. I was already on Nexium, so I didn't have to take anything extra. Pantoloc is good too.

I am now taking Celebrex, which doesn't affect the platelettes like all other NSAID's. So I would ask your doctor about Celebrex as an option in case of a flare or regularly, if needed. The Celebrex doesn't seem to affect my INR, but the indomethacin did. It was the only thing that got me through the pericarditis. My prednisone went up to 80 mg and it did not work. It was the addition of NSAID that helped me get better.

Nutty
 

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Discussion Starter · #12 ·
Karol H

KAROL H... meant to tell you I'm in New Hampshire... home of perpetual presidential TV commercials and disruptive phone calls.. :rotfl: just kidding, its beautiful up here...
 
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