Sharon sorry to hear you are in pain. I don't have an answer for you about mixing the two.

I did want to say that my daughter takes milk thistle to help her liver clean itself out with all the crap she has to take. Dr. said the milk thistle is fine and she has been taking it for years.

Hope you feel better.

Hey Sharon

Are you talking just NSAID's over the counter stuff?

If so I had a nurse once tell me you can use them together in a staggered pattern. For example tylenol, 2 hours later ibuprofen, 2 hours tylenol, etc. You're taking each medicine every 4 hours, but you're taking something for relief every 2.

I still do this whenever my back is out, at least until i start with GI bleeds, but it does help.

I don't know the answer put I am so sorry to read that you r in pain. I hope the doctors can find the cause and fix this.

It's OK to take Tylenol and NSAIDS (e.g. Motrin) at the same time. I'm doing that right now with Celebrex, though not for GI issues. You don't have to stagger them if the too-frequent dosing drives you crazy, but staggering them could smooth out the ups and downs.

I hope you find a more definitive solution to the source of the pain than pain medicine, though.

It's fine to take both. The only reason you'd need to stagger them is to get better pain coverage while taking maximum dose. I'm sure you already know about the potential GI issues with NSAIDs and liver toxicity with Tylenol, so just be smart about dosing.

Jan

Thanks for the info guys,
I am not taking it for G.I issues directly but for the sacro-ilitis that is caused by the pouch sitting so low and all of the surgeries that have sort of given the neighbourhood chronic inflamation...I just cannot take the pain any more (can't sit in a normal chair for more than a couple of minutes, can't lay down without 5 pillows propping up various body part like hip, knee, leg etc) and even then if I move the pain is so bad that it wakes me up...there seemed to be some relief post op for a while but within weeks it comes back (adhesions building up again? I don't make many but still...or the fact that the pouch is down again and sitting way too low so when it fills it presses down on the hip)...whatever the reason I am not ready to go too strong although I am ready to accept the codine at night...will give the alternating the 2 meds a try and see if it helps...maybe 2 tyelnol 1000 at 8 pm and 2 anti-inflamatories at 11 and I'll see if I can make it through the night that way...
Sharon

Gee Sharon, are you really sure this is not inflammatory arthritis associated with IBD? What you describe sounds so much like me before I went on Humira and now Simponi. I still get a lot of SI pain, but it's a lot more manageable now. By the way, Tylenol will not do anything for the inflammation, just the pain. For me, it was like pissing in the ocean, for the effct it had. NSAIDs were much better, until I just could not take them chronically anymore- caused abdominal pain and pouchitis symptoms.

I had no defining signs or symptoms besides the long term SI pain and history of UC.

Jan

Nobody really does any indepth investigations here...my local Rhumy x-rayed the pelvis/hips/lower spine and announce that he didn't see any major problems in the hip joint (but the spine, yes) but that it was probably just chronic inflamation due to all of the surgery...I have other major problems with the region: got hit full on by a car as a pedestrian (yup, I am so lucky!) and I had 2 tumors on the lower spine that weakened the whole region and 'ate at' the scarum and coxxyx...both of those problems rendered the whole area weak, painful and full of inflamation...been seeing a chiro for years but it can't cure it, only help me at my worst and keep the region mobile...I feel better when I walk steadily or climb stairs/hills very slowly (no running)...but if I stop for any period of time the whole area just kills me...
My GP wants me on harder meds but they terrify me to death...if I start at my age, what is left for the future?
What do the meds that you take do Jan? How do they impact the pain/inflamation?
What are the longterm affects?
Thanks
Sharon

Sharon-
If your goal is pain coverage through the night, then taking both at bedtime has a better shot than staggering them. An 8 PM Tylenol dose will start to wane around midnight and be gone by 2 AM.

I take sulfasalazine and Simponi (used to take Humira). I've been on one of the biologics since 2005, and so far, no side effects. There was a recent long term study that concluded that the much feared cancer risk (mostly lymphoma) was no higher than the general public, and those with rheumatoid arthritis already were in a higher risk group because of the disease.

I went from needing to walk with a cane and not being able to sit five minutes without shifting in my seat, to being cane free, being able to walk for hours, and sit for 30 minutes or more without having to move. I also now can sleep through the night, whereas before, I was awakened by pain 3-4 times. I could not even roll over in bed, because I could not twist. I had to sit up straight to turn over.

I also take one Vicodin in the morning, and once I am up and moving about, I am pretty good. I also occasionally have to take muscle relaxers because of the stenosis in my neck, but it comes and goes.

They are beginning to think that the biologics will actually stop or slow disease progression, so I all for that. However, if NSAIDs are not working for you, the biologics may not either. I think I remember reading that they tend to be most effective in those who responded to NSAIDs, but couldn't take them. That was me. I now just take them for a couple of weeks at a time for occasional flares.

Jan

I cannot take any kinds of medication say if I get the flu or even a virus. Not even over the counter stuff like NyQuil. Everytime I do, I get diarehha, cramps, gas and so forth when all I want to do is sleep to get some rest. But going to the bathroom so often, the last thing I get is rest. I can't even take a pain killer like when I had a root canal. I have to pick my poison each time.

Rocket

Thanks Jan,
The NSAIDs work just fine for me but my GP wanted me off of them because of the danger to the kidneys...I have been on full time pain meds (tylenol) or naproxine/advil/motrin for most of the last 20yrs...the problem is that the pain is getting so bad that they barely touch it other than the prescription doses of anti inflamatories which I need to take with omopral to protect my tummy (not great for the digestive process) and even those I am not allowed to take for more than 2 weeks at a time...I can no longer sit in a chair at a restaurant or at work (fortunately I am a teacher and do not have to remain seated...I walk around the classroom constantly to keep things moving)...and turning over in bed is a nightmare...although last night was the first night on codine and I did much better...just scared of it becoming a habit...do not want to get hooked...I will make and apt with my Rhumy and look into the other options because this is just rediculous...I can barely bend over in the morning to empty out the dishwasher...hubby has to do it for me (fine, not a bad idea but still...)...this morning, after a semi painless night I realised just how bad the pain really is...once the codine wore off I could compare...wow! but I cannot allow myself to take the codine in the daytime...
Keep those ideas coming...I will do whatever it takes to ease up this pain.
Thanks all
Sharon

Yep, that really souns like inflammatory pain, where it improves with activity and does not improve with rest. I would not be surprised if your accident and surgeries only served to provide a convenient explanation for your pain, but possibly a wrong one.

Still, spondylitis is not an easy diagnosis to make.

http://www.spondylitis.org/about/as.aspx

Jan

I just followed the link and read the article..Yup, that sounds about right. I also have 18° S curve of scoliosis which leaves me looking like a bonsai tree on bad days. My pelvis is rotated forward on one side. So there is never any relief for this pain...I will print the article and take it with me to my rhumy, maybe he will listen...
Thanks Jan
Sharon

Jan,
I just saw my GP who put me back on 1 month anti inflamatories (500mg Naporine 2xs/day) and 1grm Paracetabol 3xs/day and sent me home with a letter to see a Rhumy...suggestion AS.
Been a bit better since I started the anti inflamatories and antibiotics last week (larengitis, otitis etc...cold season has hit hard)...so I will find out shorty if it is just plain old inflamation of something more...
thanks for the suggestion Jan
Sharon

Sharon, Hope your pain can be controlled or lessened with the these meds you are taking now.

Let us know how you make out with Rhumy dr.