Warning on NSAIDS.

I can't take NSAIDs due to stomach issues. Tylenol does absolutely "0" for my pain. So, what to do? I've tried most of the "woo-woo" alternatives, none of which have worked for me. Level 5-7+ pain on a daily basis can't be healthy and absolutely limits enjoyment of life.

I can no longer do a lot physically although I try to stay as active as possible. I take a low dose of a mild opiate in the late afternoon (driving done for the day). It helps considerably, but docs are understandably reluctant about prescribing with the DEA and others breathing down their necks. In our area the "opioid crisis" is occurring largely among late teens, 20 and 30-somethings using fentanyl and meth. It's not 85+ Y/Os trying to live with/manage chronic pain. I'm well aware of the risks (including falls, which have not occurred so far). I accept them. It's a trade-off as is almost everything about old age.

I think a competent older adult should be able to sign a waiver acknowledging that they have been thoroughly informed about the dangers of certain drugs, Rx and OTC--and then be allowed to take them if they help manage medical issues. IMO, pain is definitely a medical issue. It affects functionality and quality of life.

My mother literally ate at least eight aspirins a day from the time she was old enough to take them herself until she was about 75 when she finally burned a hole in her stomach. She blamed her need for them on being "a little stiff" from having rheumatic fever at five years old. Once she was hospitalized with internal bleeding, she was told never to take aspirin again. She switched to Tylenol, which didn't do anything (surprise!), and suddenly she was able to tolerate her pain with no help.

Go figure.

notgoodenough,
you ask what the alternative is. It may be anything from TAKING NOTHING to TAKING IT BUT KNOWING THE SIDE EFFECTS AND LIMITING INTAKE.

I meant this as a warning. Many with serious stomach and bowel issues take NSAIDS not knowing how very dangerous they are SPECIFICALLY to that issue. They can kill. Then you don't have to worry about what's causing the pain anymore, but............

Many think that, because they are sold over the counter they are benign. As a friend said "My hubby thinks is one is good, 10 must be great". Then there's my friend that thinks voltarin cream is body wash. Nope, it's an NSAID and is absorbed through the skin.

For me, I take nothing. I am 81. (Rare motrin for headache). I have the usual bone and joint and you name it issue. I don't find I am a lot worse off than when I used NSAIDS as my drug of choice and gobbled up quite a few of them.

Pain is little explored. And our tolerance and manner of handling pain little understood. Pain clinics are the stop for many and often a good stop.

So point is, there isn't always a choice. But the side effects need to be known. They aren't Good N' Plenties. They are medications with serious side effects.

Every medication OTC or RX has a health risk. I would rather suffer than take NSAIDS. I had a terrible stomach problem with Naproxin. Some of the crap Dr's prescribe can be worse than narcotics but they'll willingly write a script for it. Remember Celebrex? I took that for menstrual cramps years ago. They pulled it due to 'heart problems'
I'm sorry about your friends Alva.

Alva,

Yes, we do tend to feel that anything OTC is safe.

Awhile back my labs showed decline in my kidney function. The very first thing that my doctor told me was to not to take Advil, Motrin or Aleve. I was told to take Tylenol instead.

You know what I think about sometimes. I asked my doctor if I should take any vitamins or supplements. She said, “I want you to eat healthy and you will get everything that you need from a plant based diet.” The only thing that she told me to take was vitamin D.

So many people spend tons of money on vitamins and supplements. I wonder how many people are taking too many of them. Can too many cause any harm?

Keep in mind that NSAIDS are also in cream / ointment form and while they will not directly effect the stomach lining they still enter your system. I would check with a doctor or better yet a pharmacist on interactions and potential problems. (does anyone read the "black box" warnings?)
I use Tylenol or a generic as well as Aleve but I am more apt to reach for a lidocaine patch for my knee if I get no help from the oral meds rather than take another round of Tylenol or Aleve.

While I appreciate the warning, I can't help but ask, so what's the alternative?

I don't know about where you live, Alva, but I can tell you that here, on the East Coast, an hour north of NYC, barring someone actively dying or having had MAJOR surgery, it is virtually impossible to get a prescription for pain medication. Between the hyper-sensitivity about addiction and doctors being wary of lawsuits, none of them want to even consider it. To the point that the last time my husband was in the ER for a kidney stone attack, the FIRST THING the attending physician told him was "I'm not even going to consider giving you a prescription for pain killers, so don't even ask." My husband replied "I don't need painkillers, just give me the flomax. This ain't my first rodeo with these." This doctor *automatically* assumed my husband was there trying to get pain meds.

And we can shake our fists to the sky and lament the fact that people who are in constant chronic pain are being denied access to these prescriptions, but that won't change what I wrote. And Every. Single. Day. I see commercials on TV talking about "Are you addicted to pain killers? Sue your doctor!!" I can't even blame the medical professionals for being gun shy.

So what other choice is there? Take the Advil for some relief, or be in constant pain? Which is also not great for your overall health, either. My husband has used Advil as his "go to" for pain - and he is often in some sort of pain, given his various health issues - because 1) it works and 2) there's really no alternative.

They can also cause kidney damage too.

Tylenol causes liver damage. I take Advil when I need to. All these medications tell you on the label not to take over a certain amount a day or over a certain number of days.

Good old fashioned aspirin has been causing problems for over a century. And acetaminophen isn't benign either, if you like to have a little tipple it should never be your pain reliever.

So true Alva! I have this argument with FIL every week . He’s irate that he can no longer have Motrin since we put him in AL , because of history of multiple GI bleeds and his colon is not working well at all , diverticulitis , slow peristalsis , along with frequent impaction. He was also on low dose aspirin so should not have been taking NSAIDS.


Like many people he thinks any over the counter drug is safe regardless . Many people ( especially elderly ) die each year from taking over the counter meds they should not take, either because of medical conditions they have , or other meds they are on , or taking large doses .
Thank you for bringing this up .

I taught my children and still remind them of the possible dangers of taking even some over the counter meds at the same time . Plus the fact that some combo meds like cold cough meds have Tylenol or Motrin in them already . My adult children still call me up sometimes to check before they take more than one med for colds, stomach bugs etc .

Great words of wisdom from who better than a retired RN. Thanks Alva.

I hear you Alva. There have been warnings out of one kind or another for Nsaids for quite a while.

Despite this kind of warning in 2016, Nsaids continue to be prescribed at the same rate according to the article quoted below from Br J Gen Pract. 2016 Apr; 66(645): 172–173.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

NSAIDs affect the cardiovascular, GI, renal, and respiratory systems.

Older people have a higher baseline risk of cardiovascular events, GI bleeds, and impaired renal function, all of which are further increased by NSAIDs.

deaths from NSAIDs remain very high: more deaths than from road traffic accidents and twice as many deaths as from asthma or cervical cancer.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809680/

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I take them occasionally but not for more than a few days at a time. My understanding is that aspirin is a safer alternative for cardiovascular risks but I know it too is hard on the gut, and the kidneys and increases the chances of bleeding.

I'm sorry about your friend. Mother never took any Nsaids or other pain killers in a routine basis. She said going for a walk helped her to feel better. Once she was institutionalized they gave her only Tylenol for pain.