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9 replies

3 blockages in 4 days...Codine?

skn69skn69Member
Hi guys,
I started taking my codine, 40gms/dose, on Friday night...Sat morning I was a bit surprised when nothing came out of my pouch after my usual coffee/juice/water ...by 11am I was at the grocery store w/family and was cramping horribly but no bowel noises..ran home to empty out and ...nothing. Zip. Not even gas. I lay on my right side, drank hot tea and massaged my abdomen and finally at 5pm it started to move.
Took my codine Sat night but seemed ok if only a bit slow Sunday morning but Monday morning I was totally blocked again until 3pm...today I started to unblock around 4pm...while I am blocked I have severe cramping, nausea, a bit of vomitting and a lot of burping but nothing goes through my pouch at all. I was at work yesterday and today (1.5hrs away by public transport) terrified of a full blown blockage or my pouch suddenly letting go in class in front of 30 students...this is really unsettling and makes for a stressful day.
Do you think that it is the codine slowing things down to a full stop? If so, am I doomed to choose between pain or pouch function? The codine lets me get a full nights sleep but I can't take the risk of getting a full blown blockage that does not resolve itself...plus I am NPO when I get a blockage, makes for a really cranky teacher!
Sharon
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SpookySpookyMember
Hi Sharon,

If nothing else has changed then definitely I would suspect the codeine has slowed you down. Codeine is even prescribed as a bowel slower, so it would not surprise me in the least. You can try to increase your fluids, but maybe mention to the doctor as well as perhaps you can be prescribed something to offset the effects of the codeine. I know it's an awful feeling when you can't go, though. The cipro I took recently really thickened things up. I didn't feel constipated, but I was really straining to empty the pouch. Not a fun sensation.
Jan DollarJan DollarModerator, RN, retired
You might try halving your codeine dose, but 40mg is pretty small, especially being once daily. You probably are very sensitive, plus having a k-pouch, the constipating effects are more deleterious than with most people. Of course, halving the dose would halve the analgesic effect too. If you were taking it more often than at bedtime, I would take it only at bedtime.

This is sounding like yet another reason to get to the bottom of your pain, as it seems inflammatory and treating the inflammatory arthritis is your best bet, not treating the symptom... Can you go back on the NSAIDs at least until you get a chance to be reevaluated? If your liver and kidney function tests are good, it should be OK.

Jan Smiler
skn69skn69Member
Thanks guys, you are all right...I need to get to the bottom of the pain (yes, pun intended)...I didn't take the codine last night and my pouch was just fine this morning...but I was awake at 5am in pain...so it must be the codine stopping my intestinal function...will try to get a rdv with the rhumy but until then I am going back on the anti inflamatories...as of immediately...was working out of town today and it was really rough (and had to walk miles up and down subway tunnels, stairs etc...not fun)...will take my pills now and head for bed with a hot water bottle.
Sharon
skn69skn69Member
Darn, last night was rough. Up from the pain at 4am and couldn't find a comfortable position or back to sleep for 3hrs...this is making work difficult. There is no longer a comfortable position possible in bed...and emptying my pouch does not help much...relieves a bit of the pressure but that is it...I am making an emergency apt with my chiro until the rhumy can see me.
Sharon
Jan DollarJan DollarModerator, RN, retired
One thing I found to literally save my butt was a memory foam mattress topper. We have a sleep number bed, but even that was not good enough for me to be comfortable through the night. The memory foam softened the surface, while still being supportive. Otherwise, every body part that rested on the mattress felt bruised after an hour or so, even while taking NSAIDs. I also use a small, firm pillow to support my low back when on my side.

Hope the chiro helps.

Jan Smiler
skn69skn69Member
I gave in and called my GP in tears this morning. He will see me tomorrow to find a med that I can take that will not stop my pouch cold. He is also giving me a letter to a Rhumey and a run of 1 week prescription anti in flamatories...is there anything stronger than tylenol that does not stop intestinal motility? He is offering me anything at this point if I can take it? Do opiates or morphine help?
Thanks for the suggestions Jan, I have a matress topper but not a memory foam one, will try to get one here...been considering a waterbed at this point. I have 3 pillows under/around my body...1 heavy body pillow that I throw my leg over and hug to my for support while I sleep, 1 grain pillow that goes under the head/neck and a 2nd one under the feet. Even with all of that I can't find a comfortable position. I have added a bolster pillow under my lower back to support it too...(hubby is starting to think that I am trying to replace him pillow by pillow!).
Sharon
Jan DollarJan DollarModerator, RN, retired
Sure morphine and other opiates help, but if you get stopped by a measly 40mg of codiene, you certainly cannot take the stronger stuff. You might be able to tolerate tramadol, but it has similar side effects as the opiates, plus it can stimulate seizures if you take SSRIs or tricyclic antidepressants.

You can try any of the NSAIDs and see how you do, but they all can potentially cause liver and or kidney inflammation (they definitely will work a LOT better than Tylenol for you, and it is liver toxic too). Meloxicam would be a good choice if you are concerned about gut inflammation as it is a first generation COX-2 inhibitor, so it does not irritate the stomach and gut as much.
http://en.wikipedia.org/wiki/Meloxicam
There's Celebrex (celecoxib), but it contains sulfa, so if you are allergic, it is a no go.

Oh, and there was a definite difference with the memory foam over the regular foam topper. I have 2 inches of memory foam over 2 inches of medium density foam, and it is delightful!

Jan Smiler

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