Is there some reason doctors all love Tylenol? For several weeks they have been telling me to take it, and it DOES. NOTHING. Today, I got my brace off, and have been in a lot of pain,and I asked if I could take some ibuprofen, they said “sparingly” (they believe it slows bone healing), so I took two, and the pain is gone. Completely.
Why do doctors love tylenol? Do some of you get relief from it, because for me it does nothing? Why do they put it in all the narcotic pain relievers? Why not mix narcotics with ibuprofen? Why not just give the narcotics? And am I the only one who really doesn’t experience much relief from narcotics themselves? They just sort of make me feel groggy and shitty.
And since you can seriously blow out your liver easily with tylenol, why is the preferred drug of physicians? I’m serious. After the last few months, I’ve realized how much we suck at pain relief. You can go on the highly addictive narcotics, which can make you itch, sweat like a champion, and generally feel like shit, you can take tylenol, which does jack shit, or you can do nothing.
Seriously- the best pain relief out there this whole two months? My ice machine and now the advil. And I’m not trashing my doctor, who is great and has really worked with me. It just doesn’t seem like they have much to work with.
Breezeblock
I like the Advil.
Frank Chow
Greatest. Health. Care. System. Ever.
MattF
I’ve had exactly the same experience with analgesics– Tylenol does nothing, ibuprofen works. There must be some sort of individual-by-individual differences… I’m assuming that there are some people who get relief from Tylenol, just not me and not you either.
Todd
I only experience relief from Excedrin, the most excellent cocktail of Aceta, Aspirin, and Caffeine. Aspirin is relatively safe along with IB so I’m with you on that. It really is a pain that Tylenol isn’t safe with your liver.
Hatmandu
Agree 100%. Doctor told me to take tylenol when I injured my knee yet again last fall. Doesn’t do crap. Now the presciption stuff, co-tylenol, is a different story. Advil is nice, but I am a motrin man myself. Does the job, easy on the stomach.
Robin G.
I’m told Tylenol is safer, but I live by the ibuprofen. Best thing for a hangover.
No painkiller, though, fixes my headaches.
sal
Same. Advil works.
Mike Kay
What, no Oxy?
rdale
Don’t you think it’s because the Tylenol manufacturers push it on them? There’s gotta be a profit motive somewhere.
4tehlulz
Doctors love Tylenol because the liver damage it causes gives them steady business.
nathan
John, I just had knee surgery. Percocet didn’t do shit. Smoking a bowl did. But then I live in Colorado where there is a medical marijuana dispensary on every block these days.
Dollared
J&J has convinced them that there are no risks to prescribing Tylenol. No Reyes Syndrome, no bleeding, etc.
Pity that it doesn’t work.
BTW, my daughter’s pediatrician says “alternate. One metabolizes in the liver, the other in the kidneys. In bad situations, it’s OK to double up.”
DBrown
They love that not only does tylenol cause liver damage every time you use it but tylenol Inc has given endless goodie-filled/free food at lectures over the years and MD’s know that the liver is the only organ that can rapidly regrow/heal so who gives a fuck … of course, aspirine and ibuprofen are similar and tylenol isn’t. Still, money trumps good medicine … .
Redshirt
I kinda freaked out when I read about the liver damage caused by Tylenol and alcohol together.
IncandenzaH
Apparently ibuprofen and other NSAIDs do inhibit bone growth and bone healing. At least according to this article in the Boston Globe:
http://www.boston.com/news/health/articles/2009/06/22/nsaids_inhibit_bone_healing/
Mike Kay
Kuchinich recommends leaches.
Lady Sybil
From what I am told, people react very differently to pain meds. I get no relief from vicodin or codiene, but percodan works for me. Aleve did too, but then my doctor ordered me to stop using it because it interacts badly with my blood pressure medication. Tylenol must work for somebody, but I’d rather take aspirin or nothing.
Osprey
Tylenol anything never did jack for me either. I used to get crippling migraines when I was in my early teens, and the only thing that worked were 800mg Ibuprofen. I could take over that amount in mg of Tylenol (4-5 pills at a shot) and not get a hint of relief.
Advil Cold & Sinus is also a staple here for those nasty sinus pressure headaches when bad weather rolls in.
Maybe it works for others, but it’s probably used more for the placebo effect (e.g. I took a pill so I’ll feel better, regardless of the pain not going away, you’ll think about it less).
liberal
My impression is that Tylenol is great for fever, but doesn’t do shit for pain that comes from inflammation.
In addition, my impression is that there’s no way Tylenol would be approved as a new drug these days. The ratio of the lethal dose (liver poisoning) to the therapeutic dose is too low, IIRC. That’s why there’s a move afoot to get it out of combination medicines (e.g. tylenol plus antihistimine plus…), because that way someone can unwittingly take too much of it.
Could be wrong, but I figure reluctance to prescribe ibuprofen would be due to it being an NSAID, and possible associated GI distress or bleeding. Problem is that not everyone has that.
PTirebiter
I was told the same “slows bone growth” thing with my shoulder, and completely trusting my surgeon, I really tried to stick with Tylenol but it was useless. I had a much better experience with the narcotics than you, so I don’t know what to tell you. Maybe it’s just highly individualistic- I couldn’t tolerate the ice, but the hot packs worked well for me. I also experienced the seemingly random, bring me to my knees, searing pain for about 6 mos and nothing helped with that. I never got an explanation, did you?
patroclus
Personally, I’m awaiting Armando coming over here and informing us all (in 500 one-line posts) that we’re all idiots and that while he prefers codeine, he’s not actually taking a position on the issue.
TJ
Because we don’t understand pain well. We really, truly, don’t. I recall an article in Discover some time ago about analgesia–the way most of these things work is murky and idiosyncratic.
liberal
Wikipedia claims
Heh.
Rhoda
I read something on this recently.
We literally know jack shit about pain and consequently don’t know how to manage it properly. A lot of the variety in responses I remember reading is because pain is triggered in the nervous system and people react to treatment or management of pain in different ways.
The main point the writer was making was we need more research and sleep is the great healer.
CanadaGoose
An excellent solution is ibuprofen in a topical gel. You rub it on the joint that hurts and it relieves pain without having to go through your entire system. Eliminates the stomach irritation problem too.
My husband uses it on his bum knee.
It comes in various strengths. It’s only available by Rx here in Canada. But it’s over the counter in the US. (See Amazon.com)
Ed Drone
As a recent “recipient” of a cardiac “event,” I’m on blood thinners, and can only take Tylenol, since all the others are either aspirin-related or work to thin the blood, too. And that means my sore knee (don’t know the cause) and thumb (probably incipient arthritis) get less relief than I’d get from Advil or Aleve.
Once my cardio condition gets sorted out, I’m going to keep Advil and Aleve ready for when the knee blows up again.
For me, most pain relievers work, more or less, so it’s no big deal to avoid aspirin products. But if some work better, I’d like to have ’em available.
Ed
mr. whipple
The only side effect of narcotics for me is the possibility of addiction. I don’t get anything like you got, and boy do they work.
Mike Kay
Ben Roethlisberger numbs the pain with sexual assult.
Sasha
Napraxim sodium for headaches, ibuprofen for body and muscle aches, and acetaminophen when I want to donate money to a drug company.
Doctor Gonzo
Tylenol is prescribed because it doesn’t cause ulcers. Ibuprofen and similar analgesics do.
When I’ve been in pain, and I’ve popped a bunch of ibuprofen, it really starts to attack my stomach, so all I’m doing is moving the pain to my abdomen. Tylenol never does this, no matter how many I take.
That’s also probably why they mix Tylenol with narcotics: if you are going to be on them for a long period of time, and you usually are, it is easier on your stomach.
But because Tylenol is a lot harder on your liver, you should never take Tylenol for a hangover, since your liver is already taxed with eliminating the alcohol. Take ibuprofen instead.
Bill E Pilgrim
Ibuprofren can be extremely bad for your stomach.
And don’t take it habitually. Oh it works, I used to swear by it for everything, aches, the occasional headache, until I realized that my chronic gastric stuff wasn’t being helped by it. I had no idea.
licensed to kill time
Tylenol can seriously screw up your liver. I had a doctor tell me once that people who get addicted to Tylenol with codeine or Vicodin etc have the worst side effects because of the acetaminophen. If they took just the codeine or hydrocodone alone it would be far less problematic. Of course, that option doesn’t exist.
Many years ago I had an elderly dentist who prescribed codeine phosphate for dental pain. It was very difficult to get even then (I think the pharmacy had to search the dusty back shelves of the narcotic cabinets in various locations) but it worked very well. It looked like little white powdery acid tabs or saccharine tablets. I doubt if it is made anymore; there seems to be a huge reliance on combo meds.
ajr22
The tylenol 3’s get the job done, but ya for pain tylenol is a waste of time. However tylenol pm is amazing.
licensed to kill time
Oh crap, I said the farm a cee word and am in moderation.
Shalimar
My grandmother swore by tylenol when she could make her own decisions so I assume it helped her. It does nothing for me, so I take aleve when I’m in any kind of pain.
artem1s
Tylenol makes me sick to my stomach and Co-Tylenol even more so. Also, it does nothing for pain, either headache or muscle. I never buy it and have told docs repeatedly not to even suggest it. I’ve never had problems with aspirin upsetting my stomach and ibuprofen is the only thing that does any good for my sinus headaches, preferably Advil Sinus, but even Advil alone will usually work.
I think it got a big push ’cause no one was making money on aspirin anymore and was an alternate for dosing children to avoid Rhys syndrome.
Keith
I’m in the “Tylenol does squat” camp. But then, the liver issue led my family to never really keep it around the house, either. I was a big fan of ibuprofen, but after some kidney disease, all I can take for pain is aspirin (doctor tells me no Tylenol, either, which also removes all the narcotic painkillers that I’d get in a hospital)
Zifnab
I’ve had generally good experience with Tylenol for fever and upset stomach. So, there’s that.
Ash Can
@patroclus: And, if anyone questions him, spamming the thread with another 500 one-line entries insisting he never actually said what he said.
steve
Tylenol does absolutely nothing for me. I’ve never met anyone else who thinks it works, either.
The producers of Tylenol evidently have awesome marketing skills; they recovered from a product-tampering incident that would have killed off any other drug. Doctors push it constantly. I did have a doctor years ago who grudgingly admitted that plain old aspirin worked better, but it was like getting a Republican to admit that Obama wasn’t really a socialist.
TexBetsy
Most narcotics work best WITH tylenol. The combination means that you take less of the narcotic.
The Grand Panjandrum
The only thing that works for me is tequila. Funny thing is,it works for hangovers also, too.
Yawgmoth
When I was pregnant, I was told Tylenol was the only safe pain reliever for preggos. I found hot showers and hot drinks to be much more helpful.
aliasofwestgate
As was mentioned above, alternating between tylenol and ibuprofen is best. There’s not much else you can do with OTC painkillers beyond that. I respond better to ibuprofen as well, than i ever did to tylenol. The big thing is keeping away from taking 4000 mgs of tylenol a day. Going above that regularly is what causes liver damage.
With my own chronic pain issues, its all i can do to function on an RX strength NSAID on a daily basis, augumented with tylenol sparingly. NSAIDs (advil,motrin) have their own gastric dangers but it can be somewhat controlled if you take them with food. Taking them on an empty stomach is the root of a lot of GI issues.
I’m a pharmacy tech so i run across this a lot. We have to know it to explain to patients all the time. Pain is horrible, and i wish we did know more about it. It’d make things easier in managing my own pain which i dont’ think i’ll ever be rid of. Pharmacy is a science but it doesn’t claim to be an exact one, especially since everyone’s metabolism and unique body chemistry effects any drug you ingest differently than others.
TooManyJens
I had a horrible case of strep last week and while ibuprofen did nothing at all for the pain, a couple of extra strength tylenol enabled me to eat comfortably again. Everybody’s different. Also, tylenol is the only painkiller (and damn near the only drug, period) they’ll let you take while pregnant.
sparky
ibuprofen for moi, but i’m a dirty hippie. i concur with the above poster who pointed out that despite the appearance to the contrary from advertising, the health-care-industrial-complex knows precious little about pain.
and since no one else has said it yet, that means that it looks like it’s my lot to say to all you HC bill supporters (no i ain’t callin it reform no mo) are gonna be stuck with tylenol, and it sucks, and it doesn’t work and it might kill you but you have to use that because, well, another pain reliever might NEVER show up again. and yes you can only buy the brand name kind at inflated prices because, well, it being america the only thing that is guaranteed is corporate profits. also, Obama!
i hate getting the short stick on these posts….
ps: the “sober college” banner ad currently running atop this post is pretty funny in a dark way.
MattR
@nathan: Your knee still hurt, you just kept forgetting that you were in pain :)
And this just reminds me that I forgot to grab some Tylenol-1’s while I was in Canada a couple weeks ago.
cleek
aspirin, ibuprofen and naproxen sodium can be hell on your stomach.
acetaminophen is much gentler (short period, reasonable doses).
Persia
Apparently the reason they mix narcotics with Tylenol is that the drugs then magically become Schedule III drugs instead of Schedule II (or whatever it is), and they’re far easier to legally dispense. I don’t do well with narcotics or Tylenol, though.
CanadaGoose
Also you can get Diclofenac cream/gel from your doctor. It’s another very effective NSAID and it’s available by Rx in he US.
No kidney/liver de-tox. No stomach irritation.
BombIranForChrist
As someone who takes a shit-ton of Ibuprofen to help with muscle soreness / injury / malfeasance, my doctor told me that too much ibuprofen can really mess up your stomach. The same agent that reduces swelling also interferes with something that your stomach needs. She recommends I take more than the recommended dose to help with serious pain caused by inflammation, but not to take it for too long or I could have complications with my stomach.
That doesn’t explain why doctor’s still recommend Tylenol when it sometimes causes liver damage, but it could be a lesser of two evil things.
Or maybe all our doctors are high.
Bill E Pilgrim
@Ash Can: Heh.
acallidryas
I’m with you on the narcotics. I was on them for a dislocated knee once, and for a jaw surgery once, and I was miserable- went off them as soon as the pain was at a not-unbearable level. I remember wondering how anyone could get addicted to those, I hated them so much.
Comrade Dread
Tylenol? I wish.
We just transitioned from our old insurance provider to the Christian Scientists due to rising premiums.
The Pale Scot
I believe I covered that here in Feb.
https://balloon-juice.com/2010/02/02/it-would-make-no-difference/#comment-1566558
Bill E Pilgrim
@BombIranForChrist: Believe her.
Jon H
@Mike Kay: “Kuchinich recommends leaches.”
Leeches are good after surgery to reattach things. Keep the blood from pooling in the attached limb and causing problems.
Robin G.
By the way, I’m jealous of you people who can take codeine. It kills, pain, but gives me the most awful nightmares.
pablo
I’ve been out for three weeks from a foot operation. My doc gave me a morphine derivative that did the trick, but also punched me around. He gave me 60 of the suckers! I used about 10. Should I sell the rest??
Ibuprofen is my pain killer of choice, but I have to chose between them and alcohol. I better be dieing to have to take the pills!
Fwiffo
Geeze, I thought it was just me. I’m glad I’m not crazy. Well, I don’t know that last part for sure, but along with my hairless knuckles, I’m one step closer to sanity.
DBrown
Remember, an easy, simple and totally safe way to take aspirine is to disolve it in water or chew it and drink water. No danger of damage to the stomach.
Martin
Pain relievers do almost nothing for me. That’s true of injections and the whole lot. When I was a kid I eventually just waved off the shot for fillings – all it did was cause me to hurt in another place.
When I go in for surgery I have to tell them this like 10 times and insist that they check to make sure it works because I’ve woken up in the middle of procedures before.
So yeah, those little pills are just pointless.
GReynoldsCT00
Advil is the only thing that works for me when my back gets out of shape, and Advil Migraine works better for me than the fancy prescription stuff. I have to take 3 Tylenol before it’s remotely helpful for general pain relief stuff.
Kryptik
Yeah, I live and die by Advil/ibuprofin (though oddly enough, the liqui-gels don’t work well for me, compared to the straight pills). But I’m aware of some of it’s problems, like Bill E said. I only take enough to get rid of the headache, and go strict by the 4-6 hour limit.
aliasofwestgate
@pablo:
You can keep them for up to a year after they were prescribed, pablo. Otherwise, dispose of them by grinding them up and mixing them with coffee grounds or kitty litter. The FDA no longer recommends flushing them down the toilet for disposal.
Messy process, but it at least makes them less dangerous and totally useless for the most part.
John Cole
I’m a big, big fan of ice. I had my ice machine down to 39 degrees at rehab a couple weeks ago, and they were all shocked. “How can you stand it? Most people can’t take it under 50!” The whole time I’m just sitting there telling (moaning, actually) about how good it felt.
The only actual relief I think I got was from the ice machine.
cdmarine
When I was pregnant, I was told that Tylenol was the only pain reliever I could take. Something about the others affecting the fetus (obviously).
Are you pregnant, John?
beergoggles
Wow, I guess I’m really lucky that everything works for me although I find that when I hurt my back, the only thing that works is naproxen sodium. For regular aches and pains, ibuprofen does the job. I don’t take acetaminophen because of its effects on the liver.
Of course, they all pale in comparison to pot therapy. So have u tried naproxen sodium yet?
David in NY
The codeine, –codones, are WONDERFUL, and one time I thought I was dying of pneumonia (turned out a broken rib from coughing) and the codeine stuff (previously prescribed, not used, saved for this occasion) turned piercing pain into pure bliss. No side effects from that except the possibility of becoming a junkie. Extra-strength Tylenol sometimes works for headaches, but I use ibuprofen for muscles, etc.
HRA
Tylenol has never done anything for me in relieving pain. Motrin works well. Try to find Motrin now. Well, at least at my pharmacy. Aleve is what I am taking now. It takes a few hours to kick in.
Actually I do my best to wait until I can’t do it anymore.
Inoperable right knee and back hurt in two accidents are the reason for pain relief. But – hey I go to work, do household duties, garden and that’s a plus IMO.
Breth
Had wisdom teeth out a long time ago. Narcotics (Tylenol with codeine) did nothing. Rummaged around and found an ancient motrin horse-pill. Took half. Pain gone.
Athenae
Tylenol was a family joke in our house. It was well known that it didn’t work on any pain more severe than a mild headache for which you probably just needed to drink a glass of water anyway.
I used to take handfuls of ibuprofen for my headaches, which my asshole ex-doctor told me weren’t migraines because I wasn’t seeing an aura. Even the ibuprofen barely touched them. Naproxen did nothing. Excedrin made me barf. Suffered for two years like this. Finally found another doctor, who said, “Yeah, they’re migraines, what a jerkass.” Prescribed Imitrex, I take one and the headache that would have had me bedridden for three days with an ice pack in the dark melts away in 15 minutes like a fucking miracle.
I want to find out who invented Imitrex and kiss him/her. With tongue.
A.
Citizen_X
Nembutal
numbs it all,
but I prefer
alcohoooolllllll…
Butch
After my car accident the doc prescribed something along the lines of Skelaksin (guessing at spelling), which I immediately rechristened Skeletor. It did nothing to relieve the pain but made me extremely stupid (not that anyone could tell).
Bill E Pilgrim
@Kryptik:
Be really careful. It’s not like you can just buffer it like aspirin or water it down as someone said above, or you know take it with food, with ibuprofren the very property that works also thins your stomach lining.
Not good.
Tsulagi
They do, and it’s available. Last month after a 30k lb truck brought some hate, when released from the hospital was prescribed two pain meds. One was just for 800mg ibuprofen pills. The other was for generic Vicoprofen, hydrocodone, a narcotic, and ibuprofen. Worked for me.
David in NY
@pablo:
I once was prescribed strong stuff, noted above, didn’t use any of it, and was really, really glad I kept it when I got a broken rib. I think it was past its sell-by date, but it retained potency for quite some time.
lawguy
Money and publicity?
aliasofwestgate
I can barely handle Tylenol 3 with cod., any of the other narcotics? Hate me. I usually stuck in bed with nausea the entire course i’m taking them (which means i stop the course after 3 days tops.) I HATE the fuzzy head it gives me.
mr. whipple
The things that never worked for me were muscle relaxants when I had back trouble.
I’m always amazed when pro atheletes have a bout of spasms, and they get shot up and go right to playing. I sure wish I coulda got what they did, because none of the stuff I got helped me get off all fours.
J.W. Hamner
I’m no doctor, but from the talks I’ve seen people give about pain management, my understanding is that it’s basically undertreated in every situation. Presumably another casualty in the War on Drugs… doctors afraid to get in trouble for prescribing too many pain meds.
DBrown
@Persia: And you see why, right? Death if you try to take even just a little extra – the cocksuckers know how dangerous that shit was and don’t mind if the narcotic is poisoned – what fuckers! or I should say, cold blood killers.
Elise
All I need is a half of a hydrocodone and my pain is gone and I’m feeling great! I think that has tylenol in it…but whatever it has in it…that shit works like a charm!
mr. whipple
@Athenae:
Um, that was me.
cleek
@pablo:
keep em for a rainy day!
just be careful not to enjoy them if you’re looking for employment.
(appypolylogys if this is a repost. i appear to going in and out of comment limbo these days)
TexBetsy
@Butch:
Skelaxin. I used to take it but my seizure disorder caused them to remove it from the list of acceptable meds for me.
gordo
just recovering from a nasty broken leg/ankle/surgery myself. percocet did make me a bit sweaty (like john) but it sure did work well. vicodin a little less so, but waaaaaay better than OTC stuff.
of the OTC pain meds, aleve has always worked best for me. and, like john, i’ve found tylenol to be weak tea.
also — don’t discount homeopathic/herbs. arnica does work; better than tylenol for me. and a well-made comfrey poultice, warmed up, and placed right on the sore spot, will make u feel better.
but hands down, gimme my percocets, baby!
The Tim Channel
Kudos to the ‘legal’ weed commenter in Colorado just because I KNEW somebody would mention it. Tylenol is not a drug I will use, and I’m not generally that risk averse…
Enjoy.
Sloegin
Recovering now from a severe case of cellulitis (staph) that did a number on most of my right leg.
They gave me Tylenol for it, mostly (I believe) because pain monitoring was part of the diagnostic on tracking progress of the infection.
Talk about giving a dixie cup to a man dying of thirst though.
Bill E Pilgrim
@John Cole: At one point they may have you do, or may already, the hot/cold thing. Best thing ever invented. Hot as you can bear for a few minutes in the shower, then switch to cold as you can take, for a bit. Alternate a few times, ending on warm.
Nothing like it.
The hot gets blood flowing and the cold heals it. Or something. Amazing anyway, it’s a numbing effect.
The Grand Panjandrum
OT: Looks like Erick Son of Erick is firing up the troops of the RSSF and asking them to mail “back wax” to ol’ Charlie Crist down in Florida. That’s some activism we can believe in. (I couldn’t bring myself to link to Red State so I linked to it via Memeorandum. I shall leave it up to our Fearless Leader to link to them.) But it is right up there with the Great Salt Mail In they did last year.
GReynoldsCT00
@mr. whipple:
Seriously? I took Flexeril for my back. In time it cleared up my spasms and then I just kept in on hand for flare ups.
aliasofwestgate
@J.W. Hamner: Yeah. The regulation on painkillers is very strict. I know them like the back of my hand since painkillers are among the most frequently prescribed medications in this day and age. People always get hurt, and we’re there to help them get better. The Pha*maCos? I really don’t agree with a lot of their policies (like daylight robbery via drug prices). But i can’t do much about it from my spot as a minion in a retail pharmacy.
Which is why i’m all for HCR, if they can get the price controls locked in? That will improve things more than just a little on that front.
Adrienne
Yeah, Tylenol by itself does NOTHING for me. But, give me some Perc, Tylenol 3, or Fioricet (Tylenol+caffeine+butalbital) and BOOM. No more pain. Percs will have sometimes make me itch worse than a crack whore needing a fix, but at least the pain is gone!!! Never take any on an empty stomach though or you’ll feel like death.
Michael Finn
When I went to nursing school, the rule of thumb was…
Tylenol for Headaches.
Aspirin/ibuprofen for other body aches.
Acetaminophen is hell on your liver and shouldn’t be taken for anything other than major problems with your head. (I.E. the hormone that your liver releases when its stressed increases by a factor of 7.)
Aspirin’s effect on the gastrointestinal system appears to increase the bleeding but it has only been one study showing this.
Most of this is just a reminder that these pills don’t do anything for pain. They are attempts to solve the problem that is causing the pain which is mostly inflammation. They are cutting back your production of the stuff (platelets and cyclooxygenase.)
The reason that this works, generally, is that the human immune system is a real bastard. It doesn’t know when to stop, it will attack anything that it doesn’t recognize and often that is the body itself. (Seriously, your testicles have shields to prevent sperm from being destroyed by the body’s immune system.) They think we lost this ability about 70,000+ years ago. We had a number of ugly little bastards running around the planet and we needed a immune system to handle them.
Now we are stuck with a outdated immune system. Most deaths that are related to infectious diseases are not caused by the disease itself but rather the immune system going overboard and killing the patient. I.E. the 1917 Influenza that killed off most of the healthy adult population in the west.
But yeah, none of this really helps you out…
trollhattan
@John Cole #66
Have you considered a “full Zamboni?” I have no idea what that might mean but I like the sound of it.
I don’t get relief from Tylenol unless blended with codeine and even then, not so much. Advil mo betta, naproxen better still. For daughter redhead.edu it’s Tylenol for fever and Advil for pain, and they can be used simultaneously with no added risk. Very important parental tidbit.
mr. whipple
@GReynoldsCT00:
Yes. The only thing that helped me was time and rest. I can’t recall all the various meds I had over the years, just that none of ’em were worth a damn.
TexBetsy
I wish they’d legalize pot here in Texas.
Silver
The hot/cold is great.
Not good right after an injury, because for the initial swelling, you want cold…but after that, man does it work great. Much easier on something like an ankle where a bucket and a bathtub do the trick compared to a shoulder though.
Maude
I take a non-opiate and once in awhile, aspirin.
Tylenol nevr worked. Opiates make sick as a Lily.
EdTheRed
Tylenol does nothing for me. Nothing. Marijuana, otoh, works just dandy, doesn’t inhibit bone growth, won’t blow out your liver, doesn’t thin your blood, won’t cause your stomach to bleed…of course, since anyone can grow it, it’s not legal most places (coming soon to DC, though).
MattR
@mr. whipple: Of course those shots that mask the pain to allow them to keep playing are probably the reason that most of them have trouble walking by the time they are in their fifties.
4tehlulz
@The Grand Panjandrum: Why bother? Crist is down by over 30.
Pugnant
Sorry to hear the Tylenol wasn’t helping your pain, but there is indeed evidence that ibuprofen inhibits bone healing. It acts on prostaglandins which are important for healing, whereas Tylenol doesn’t do this. All else equal, I generally believe ibuprofen is more effective at pain relief, but you have to weigh that against the drawbacks.
So no, doctors do not love Tylenol any more than ibuprofen – each is more appropriate in certain circumstances. You need to be able to see how all of these things interact to be a good doctor. And these comments that we love to damage livers so we can get paid to heal them is utter conspiracy theory bullshit.
Pain is really hard to understand – we know a lot (a LOT more than “jack shit”), but not enough. It happens peripherally but is processed centrally. Because each person is unique centrally, everyone experiences pain differently. You can imagine how difficult it is therefore to set up a perfect study for each of these drugs.
Use the ibuprofen when you need to – but I agree with your docs, use it sparingly. We want you to heal properly.
Seitz
Be a man and suck it up!
Actually, I used to pop Tylenol like nobody’s business. It generally works for me, but in the last couple years, I’ve tried to eschew most over the counter pain relief and cold medications. I still take stuff for allergies in the fall (Nasal-Crom is a godsend if you start using early enough in the season).
I think the biggest motivator for me is that I like to drink, and I know that if I’m popping Tylenol, I can’t let myself drink anything. In addition to what it does to a liver, the combination also seems to double my heart rate.
Chuck Butcher
Aspirin works and nothing else does for me. Cheap and easy to make would seem to be its big drawback…
mr. whipple
@MattR:
Maybe. I dunno if masking the pain is enough. If you’ve had back spasms so bad you can’t stand, I don’t think killing pain alone would work. They must get some industrial stuff I never did.
Persia
@The Grand Panjandrum: Is this another ‘Crist is gay’ thing? Or just general Red State ickiness?
Sarcastro
I’m always amazed when pro atheletes have a bout of spasms, and they get shot up and go right to playing. I sure wish I coulda got what they did, because none of the stuff I got helped me get off all fours.
That’s intramuscular cortisol I believe. Helps the pain immensely, doesn’t help healing at all and often allows one to use muscles that should not be used. Wilt Chamberlain nearly ended his career when he ruptured a tendon after several cortisol shots.
Aqualad08
I don’t want to be “that guy,” but there’s a reason pot is still illegal….and it ain’t because it makes you eat Doritos and watch Adult Swim…
(pssst…it works…and it grows in the ground)
licensed to kill time
I think one thing that can be learned from this thread (and the others before it) is that individual reaction to side effects of pain meds and the amount of relief vary widely. So listen to your own body and do what works for you. It really doesn’t matter if someone else loves/hates medication X, Y or Z.
They sure are fun threads that fill up fast, though! We all love to talk about drugs ;-) heh heh
Ana Gama
@Michael Finn:
My mother’s doctor put her on an aspirin-a-day regime for her heart. She ended up in the hospital with bleeding ulcer.
trollhattan
@CitizenX #73
There I go again shakin’, but I ain’t got the chills
Adrienne
Damn, I’m in moderation! Here’s the post again, edited for moderated content:
Yeah, Tylenol by itself does NOTHING for me. For minor aches and pains I’m going straight to the IBU.
That said, for serious pain… give me some Percs, Tyl-3, or Fioricet (Tyl+caffeine+butalbital) and BOOM. No more pain. Percs will have sometimes make me itch worse than a crack wh0re needing a fix, but at least the pain is gone. Never take any on an empty stomach though or you’ll feel like death.
Funny story: Last year I had the WORST outer ear infection in both ears. It hurt so bad I could barely lay my head down. Touching my face would make me want to punch you in yours. After taking SIX ibu pills (1200 mg) I go to the neighborhood hospital. MISTAKE. They send me home w/ a scrip for antibiotics and tylenol. In my drug induced haze, of course I thought it just HAD to be tylenol-3’s or something. NOPE. These asshats sent me home, after I told them I took 1200 mg of ibu’s to no avail, with a scrip for 325 mg of Tylenol. I could have bought that over the damn counter. I went to another hospital where they handed over the good shit – 10 mg of perc. Never again will I go to my neighborhood hospital! Only the ritzy neighborhood or “bougie” hospitals for me :-)
MattR
@EdTheRed: And if you smoke cigarettes, smoking marijuana also decreases your chances of getting lung cancer.
@mr. whipple: Read quickly and did not realize you were focusing on spasms. Never had a back spasm, but did have one in my neck that was no fun. The meds definintely did something other than just relieve the pain.
Bill E Pilgrim
@Silver: Exactly. That’s why I say at some point, you don’t want the heat right away, only cold.
I’ve only done it in the shower, just train it on the (ankle in my case) and change every few minutes, not too long. Doesn’t have to be freezing/scalding to work, just hot and cold.
It worked such wonders I’ve done it for the back, shoulders, even just when slightly sore.
Ana Gama
OT
The Eric Massa mess just got bigger.
WaPo reports that 3 unnamed sources have claimed he is/was being investigated for groping male staff members.
Michael
OT, but here’s some wingnut welfare for Bible themed, Bible thumping producers of saccharine fucking bullshit.
http://www.freerepublic.com/focus/f-news/2467408/posts
Apparently, this particular fucking fundevangelical talibornagain stimulus package would consume pretty much the entirety of 88 million smackers in Florida tax cuts.
I’d love to kick Precourt in the teeth just for pretending that Mayberry was a real place.
Really?!?! Handing money to grinning, giggling fag-ass Christofascists to use to lobby is about job creation?
Look for movies of Confederate generals praying next to horses.
Also, movies with any o’ them ni55er themes are not allowed.
Bill E Pilgrim
@Ana Gama:
I hope to god they didn’t use those actual words.
Mar
Man up, bite down on a leather strap
mr. whipple
@Aqualad08:
Doesn’t cut it for me. I could take 3 Percodans and function, but just a bit of a doob makes me dumber than a soapdish. I really don’t know how people can go through life chronically stoned.
Mike Kay
Bayer Aspirin is evil
http://en.wikipedia.org/wiki/Bayer#Controversies
jeffro
This discussion is a fine reminder of how lucky I am to not have chronic pain, and that I should take a minute each day to appreciate that. Thanks, all, and good luck to each of you.
David in NY
@Michael:
There is a neat little movie, Misconceptions, about a gay-married upscale couple of guys from Boston who want a child and a Southern fundamentalist woman agrees to be a surrogate mother for them (twisty plot). It was filmed by a director in Florida, and it probably benefited the local (St. Pete?) economy by a half-million dollars or more. And this they want to turn away? Or have legal fights about whether it’s “family friendly” — which it is, by the way, the men want desperately to make a family, but I think that’s not what they mean.
mr. whipple
@Michael:
OMG. That’s unbelievable.
You Don't Say
I am with you on Tylenol. Does nothing for me, haven’t taken it in decades. Ibuprofin or aspirin.
Matthew C
Working in the healthcare field, I see this function-fixedness all the time. For instance, since the 70’s when an expectant mother is suspected of perhaps delivering prematurely, doctors have done a Lamellar Body Count on the mother’s amniotic fluid to try and determine if the baby’s lungs are mature enough. But the test sucks. It’s not very accurate and there are other tests are much better, yet it’s the first thing our doctors order in this situation and often wait as much as a full day before ordering the other (better) tests. Too much of medicine is done simply out of rigid, rote behaviour.
Ana Gama
@Bill E Pilgrim: umm…well…
Politico is reporting some crap that apparently went on with interns, also, too.
Randy P
@steve:
Then I guess it’s time for me to mess up everybody’s statistics. It’s my headache reliever of choice. Usually one 500 mg tablet will do it. It also seems to do a pretty effective job on fever, and we used to use it with the kids to control fever.
But I’m not talking severe, surgical-type pain. I had the codeine version prescribed for me after getting my wisdom teeth out. Only other experience I can add to this discussion is that lately I’ve been getting recurring back pain (mid-back, shoulder-blade area) that seems connected to intestinal health in a weird way. Tylenol was useless for that. But a couple of doses of prescription muscle relaxant seems to do the trick.
I forget the brand name.It’s called Skelaxin.I’ve also had several years of a chronic achilles tendonitis issue. No oral medication worked for that.
Uloborus
Quick note – the doctors I’ve lived and worked with said Tylenol is the default because it has the least dangers and doesn’t interact badly with much. This is not an absolute – welcome to the ‘everybody’s’s body is different’ side of medicine.
drunken hausfrau
I suck down Ibuprofen and/or Aspirin — NO stomach problems… I also drink LOTS of water. The IB gel is great for knees, joint problems, tendons, etc.
If you’re worried about the stomach issues, make sure to eat with the meds — or buy the buffered ones.
For a headache, try one of those neck cooling thingies/scarves — my mom has one that absorbs cold water, then you wear it around your neck — it’s like icing down your brain. Feels great!
Bill E Pilgrim
@Ana Gama: Okay yes they worded it differently ;)
Tsulagi
@Bill E Pilgrim:
That’s worked pretty well for me too. We have a hot tub and I’ve cranked the heat up. After sitting in there as long as can take it, get out and take a cold shower. The cold sucks, but within a few minutes of drying off feel pretty good and relaxed.
WereBear
@PTirebiter: You might have had nerve damage. It’s been known to heal itself that way.
You’re on your knees, going, “Well, I’m glad something’s happy.”
aliasofwestgate
@mr. whipple: body chemistry, isn’t it fun? There’s always that percentage of people that react to drugs differently from the other say…90% of the population.
Kilkee
@Redshirt: I’m with you there. I have some serious Catholic guilt over my drinking (although it helps to read BJ) so I’m convinced that one of these will kill me. I like Aleve for my various aches and pains.
Rhoda
This was really interesting to read.
I don’t know this dude or his blog; but I like that he goes hard. And I agree w/him on the CFPA thing too.
General Egali Tarian Stuck
Probly already covered upthread and I’m too lazy to read all that. But docs stay away from nsaids after surgery cause they thin your blood and inhibit healing while causing shit to bleed more. Though agreed tylenol is worthless for pain, always has been for me.
The Grand Panjandrum
@Persia: No Crist was on Fox and said something about it when asked about Rubio’s alleged misuse of a government credit card. You can read more about it here. It’s actually kind of entertaining.
Jenn
Hmm, I guess I’m in the minority — Tylenol’s always worked like a champ for me. I use aspirin and ibuprofin from time to time, though, too. Any of the 3 can have nasty side effects, so it’s not something exclusive to Tylenol. I haven’t actually done any research on those who o.d. on Tylenol to the point of having health issues, but given the number of people I’ve heard tell me that they pay absolutely no attention to the recommended dosage levels of over-the-counter drugs, it makes sense that Tylenol’s rep in the medical world would *really* cause folks to ignore dosage requirements. However, in my acquaintance, I have a couple who have done themselves damage with ibuprofin; I don’t know anyone who has with Tylenol. /anecdote
One of my biggest pet peeves, though, is all of the well-meaning purveyors of herbal medicines, pushing the stuff while saying, “it’s NATURAL, and herbal, so it’s totally safe, and won’t interact with any other medicines you might be taking.” Yeah, natural and herbal describes water hemlock, too, thanks. Not to mention that a good chunk of our medicines are distillations from plants. Whether you’re ingesting a chemical directly from a plant, or from a pill, it’s the same chemical. /rant
Randy P
Well, I see my comment #128 was idiotic, and that the consensus in the thread already was that Tylenol works OK for non-migraine headaches.
For other types of pain I actually never think of oral medication as the first line of attack. It always surprises me that’s suggested or has any effect at all, if it does. I guess my first line of attack is the heating pad or the ice. Or a hot bath.
Like I said, the Skelaxin works amazingly well for that specific issue. But that’s the only pill I take for a localized body-pain issue.
MattR
@Randy P:
Is the pain on one side of the body (kinda under the bottom of the shoulder blade) or in the middle? Do you have full range of motion in the shoulder on the side that hurts, specifically putting your arm behind you and trying to reach up to scratch your back? I am not a doctor, but that actually sounds similar to some of what I went through after I tore my rotator cuff. I did not feel any pain unless I wrenched my shoulder in a very specific way, but I would get muscle tightness/soreness in different areats nearby as the muscles tried to compensate for the tear. I doubt that is it in your case, but it was worth a shot.
Michael
mr. whipple
There is no amount of public subsidy that is too much when applied to the great and noble purpose of Wingnut Welfare.
Always adhere to the follow the following rules:
1. God is great, all wise and all powerful, and therefore will wither and die off if redneck asshole preachers can’t reach into the pockets of heathens and nonbelievers to obtain the funds necessary to proselytize about It’s insane need for constant worship, blind obedience and praise, from us It’s claymation playthings.
2. The all wise and all powerful God requires a lot of help form redneck asshole preachers and sycophantic toadies, who must be paid from money extracted from the pockets of heathens, apostates and non-believers in order to send It’s message.
3. Questioning this means that you hate Sweet Baby Jesus, America, Grandma’s behind white picket fences and the ‘Murkan flag.
Brian
Tylenol does nothing for me.
I’ve tried Naproxen twice – once it had little, if any, effect. The other time, it did wonders for getting rid of full-body muscle aches (with a cold) but gave me some amazing heart-burn than last several days past my last dose of Naproxen. Every swallow of food felt like it turned into a hot coal somewhere just north of my stomach.
Codeine makes me vomit.
Ibuprofen usually works pretty well, though.
Bill E Pilgrim
@drunken hausfrau:
At the risk of repeating: that has little effect with ibuprofren. If it’s going to damage the gastric system (and it may not) it’s not because it’s an irritant, it inhibits the protective system of the stomach.
All about it here.
mr. whipple
From Oliver Willis’ Twitter feed:
“speaking about greek financial crisis, neil cavuto has actor from big fat greek wedding on. i am not making this up.”
just. shoot. me.
CaseyL
Thank you! I agree: Tylenol does nothing for me, and I was mightily puzzled by those commercials where women claimed it was the best thing ever against labor pain. (“Mightily puzzled” meaning: shouting “It’s fncking useless!” at the TV.*)
I’ve always figured doctors loved it because J&J paid them plenty to love it.
*No, I’ve never been in labor. But I have had headaches and cramps and Tylenol was fncking useless for those pains, so how could it be any good for labor pain?
Mrs. Tarquin Biscuitbarrel
@mr. whipple: Oh, you lucky people who can take Imitrex! I started on it when you still had to inject it. All it did was make me flushed, and it gave me major heart arrhythmias that my doctor said were potentially fatal: Nice! However, I diverted every single sample tablet of Imitrex I could lay my hot little hands on to a deserving lady I knew for whom it was a MIRACLE, and who was uninsured and couldn’t afford the stuff. At the time it was $65 a dose.
But yes, doctors do underprescribe pain medication because they’re afraid of getting their licenses revoked. There are people who divert, and the doctor takes the blame. Ain’t that America.
Bill H
Ibuprofin does nothing whatever for me, in any quantity, for any kind of pain.
Aspirin works fine, but since my heart started forming clots and causing strokes and they put me on Plavix (anti-clotting medication) I can’t take Aspirin any more.
Tylenol works for a headache, but I have to take 2000mg for it to do anything, so I dare not do that very often. Fortunately, I don’t get headaches very often.
Well, migraines, but I take Axert for those. Tried Imitrex for them, but they did nothing at all. Axert melts a migraine away in ten minutes. There’s a dozen or so different things of similar nature, and they are very iniosyncratic; one has to try until one works.
dlw32
I’ve been long convinced that Tylenol is a placebo. And I don’t believe. It never helps me with any damn thing.
Advil, baby!
attica
I like the vike, but I only take a half-pill at a time. Kills the pain, doesn’t induce the fuzz. Still, it constipates me like crazy, but that I can live with.
Violet
I use aspirin, acetaminophen (Tylenol), and ibuprofen for different things. If it’s a headache not caused by muscle issues, then aspirin usually works. I’m a big fan of Excedrin because the caffeine kick really works. If I’ve only got regular aspirin, then I go with a cup of coffee too.
Ibuprofen is for muscles aches and works really well for me. Acetaminophen is for varying things – fever, headaches that won’t go away (I give it a try after the aspirin wears off), etc. But mostly I stick with the other two.
I think everyone’s body chemistry is different, which is why some medications work for some people, and others don’t.
cat48
Aspirin and Advil both are natural anti-inflammatories and blood thinners which tend to make a person bleed easier so Drs. ask people not to take them before scheduled surgeries to prevent excessive bleeding during surgery. This may interfere with the healing process, too. Tylenol does not effect the blood in this manner
I have had a few scheduled surgeries and each Dr. asked me to stop taking them 2 wks before the date of surgery. I don’t recall being told not to take them afterwards, but I did not have all the breaks involving bones you had.
p m
Not sure why this question gets framed in paranoid terms about doctors getting kickbacks from Big Tylenol. Over-the-counter analgesics are marketed directly to consumers, not doctors. No prescriptions involved, no kickbacks.
The main corruption in the OTC analgesic market is designer sub-brands and stylish re-workings (gelcaps!) that convince people that only Brand X ‘really works’ for their aches and pains. Doctors tend to roll their eyes at all that — we’re just as happy if you take the half-price generic, as long as it helps. But the placebo effect is nothing to sneeze at, so if “only Brand X” is what works for you, go ahead and buy Brand X.
The main reason why I recommend Tylenol is because of its lack of side effects and interactions. We’re taught in med school that acetaminophen and the NSAIDs (including ibuprofen) are roughly equi-analgesic. In my experience, bigger doses of ibuprofen are more potent, but that’s just my experience.
Tylenol/acetaminophen doesn’t “mess up your liver” if taken as directed (don’t exceed 4gm (4000mg) per day). It is a dangerous drug taken in massive (deliberate) overdose, but small overdoses (accidentally exceeding the limit by a pill or two once in awhile) are usually not a big deal.
NSAIDs, including Advil, tend to wear away the lining of the stomach, causing ulcers/gastritis, which can cause a GI bleed. That’s particularly dangerous in older people, especially if they’re also on baby aspirin or Plavix for cardiac disease or stroke prevention. And pregnant women should avoid NSAIDs, especially in the third trimester, since they affect a vital part of the fetal circulation. They’re fine when taken in moderation for shorter periods. I do like to recommend them for acute or occasional problems, like MSK injuries or the onset of a migraine.
Alternating or even combining acetaminophen and ibuprofen is a nice trick for short term use. I’ve seen people comfortably discharged a couple of days after minor surgery on the OTC combination instead of T#3s or what-have-you.
I find most patients dislike codeine combination analgesics because of the side effects (nausea, itching, etc), so I’ll either give them a more potent NSAID (toradol, naproxyn) or a more powerful opioid for short term use.
Disclaimers: Yes, I’m a doctor. No, this is not meant to be medical advice specific to your situation. Talk to your health care provider before making any changes in your current medication regimen.
Randy P
@mr. whipple: I guess Anthony Quinn wasn’t available.
How about Jimmy the Greek?
Maybe the producers should advertise for “Greek experts” and see who they get. And yes, I’m aware of the double entendre.
Punchy
The Kidney Transplant Lobby, co-sponsored by Tylenol and Jack Daniels.
Death Panel Truck
Empirin #3, baby. Aspirin with codeine.
Groo.
Vee.
Stuff.
Tylenol doesn’t work. Aspirin does. Even better mixed with a narcotic.
Prof. K&G
Ibuprofen makes me bleed internally. True story! I don’t take it anymore. You can become sensitive to NSAIDs very quickly – this is why doctors rarely tell you to take it.
I once had a splitting headache on a flight from Singapore to Newark (18 hours in the air!). I asked a flight attendant for a pain killer, and they gave me something that made me feel wonderful for the next 10 hours.
It wasn’t an NSAID, because I didn’t shit blood afterwards; it wasn’t tylenol, because it actually worked; and it wasn’t something like codeine, because singapore executes people for possessing codeine without a prescription. I’d really like to find out what it was.
Randy P
@MattR: Warning, TMI.
There are two symptoms that go together. One is constipation, as in I’ll realize that it’s been a couple of days. One time I had what was diagnosed as an impaction. That was fun, let me tell you.
Along with that goes this very specific back pain.
I assume there is some critical nerve involved, like the muscle spasm somehow affecting a nerve controlling the bowel, or vice versa. I haven’t figured out whether A causes B or B causes A, but empirical evidence is that they are clearly related. And at least sometimes, a couple doses of Skelaxin clears both issues up.
Bad Horse's Filly
@Butch: this plus a closed head injury and I was drunk dialing everyone I knew.
The Moar You Know
Tylenol: nothing.
Ibuprofen: fantastic, use it all the time.
Naproxen/Aleve: absolutely nothing.
opioids: even better, I get no side effects, and I’ve been told that is somewhat unusual.
weed: it’s been a long time, but weed isn’t bad. Doesn’t kill the pain, just makes you not give a fuck about it.
PTirebiter
@WereBear: Yea, it may have been a nerve. It was always the same spot and a good distance from the surgery. It was weird and awful, I have a high pain threshold but it would literally make me whimper on the floor for about five minutes.
Punchy
@Punchy: God dammit, I meant liver, not kidney.
MattR
@Randy P: Ugggh. I somehow doubt that all that is being caused by a torn rotator cuff :) And of course, now I am noticing shoulder soreness. Stupid brain. Always thinking about things.
Mark S.
@liberal:
That’s my girlfriend’s opinion on the matter is.
I had really bad sciatica one time and the only thing that worked were those Icy Hot pads that Shaq advertises for.
Origuy
My housemate has Ehlers-Danlos Syndrome, which causes her a lot of back pain, plus a spinal cord injury resulting from one of the operations she had before the EDS was diagnosed. After trying morphine and other analgesics, they put her on methadone pills. It enables her to function where nothing else does. Methadone was used for pain before its use for heroin addiction was discovered. It’s a hassle to get it dispensed and withdrawal is pretty bad.
The Wikipedia article on methadone had this interesting anecdote:
Idiots. (Italics mine.)
Dr.BDH
Wow, it took 153 comments to get to someone who actually knew something about analgesics and their side effects. Although there’s more actual information I could dispense, I have to go see patients and by the time I get back, there’ll probably be a hundred more “I like that pill, not this” comments to wade through.
So I’ll just say, how’s that Ronnie Reagan jones working out for Mr. Cole?
Tokyokie
Well, after going into anaphylactic shock the last time I took an NSAID, it’s either Tylenol or nothing for me.
slag
@p m:
This is interesting. After I finally found something that kinda sorta works on my headaches–Aleve–I went ahead and purchased the generic thinking that it would work just as well. Nothing. Nada. Zip. Then, I went back to Alleve for a while. And after Aleve started putting me in the poorhouse, I tried the generic again just to see if it would work. And now I find the generic to be no less helpful than the Aleve. What kind of effect is that? The reverse placebo?
Anya
Don’t mean to interrupt this very interesting discussion about pain killers but is anyone watching the upcoming train-wreck at Glenbeckistan? I don’t have fox news and I am interested to find out what else did naked Rahm do?
Jon Keffer
Well… different drugs for different things…
It all started with folks chewing on willow bark, which was a somewhat effective analgesic. The bayer folks figured out that the active ingredient was acetylsalicylic acid, which is where we got aspirin. Aspirin worked better, but it could cause stomach problems.
After aspirin, we came up with acetaminophen or tylenol as it’s known by brand name. It seemed to do a better job of moderating the pain and didn’t have some of the negative side effects of aspirin. But, as everyone knows, if you mix it with alcohol, it can cause problems.
Ibuprofen (Advil & Motrin) and Naproxen (Aleve) are both non-steroidal anti-inflammatory drugs (NSAID’s). NSAIDs can have some side effects as well, but if the source of your pain is due to inflammation, they can help a lot.
It sounds like in your case, even though you’re suffering from inflammation, your doctor is concerned about the NSAIDs interfering with the healing process. Might be worth having a talk with him about that.
Can’t help you much with the narcotics… I don’t know much about them and don’t have any first hand experience.
Ummm… and of course I’m not a doctor, nor do I portray one on television. You should consult your physician and your mileage may vary…
Jager
When I was a young trooper in the army, I sprained my ankle in jump school, since i was almost done and certainly didn’t want to start all over, the kindly army doc gave me APC, actually a bunch of them. They worked like magic, I had zero problems running on a well wrapped sprained ankle, did my jumps and was outta there. Aspirin plus codeine, did the trick. It either worked or I was stoned. Whatever, I got my wings. Yes, I took them the “hard way”!
The Moar You Know
Also: this country is appalling when it comes to pain medication. You’ll have doctors worrying about getting a terminal cancer patient addicted to pain meds, and DEA agents breathing down that doctor’s neck, threatening to take his license if he prescribes more than some arbitrary limit.
But they’ll give you all the antidepressants you want so you won’t be so upset about being in agony 24/7.
It’s fucking disgraceful.
twiffer
excedrin works for headaches for me. muscular pain, i go for advil. colds i tend towards day-quil/ny-quil. tylenol seems to work for my son, but he’s 2 so it’s mainly for fever.
i miss really sudafed. fucking overreaction to meth heads. i refuse to give my DL for OTC drugs because the assholes in congress decided that everyone who has a cold is faking so they can cook up meth.
but yeah, your individual biology is going to determine what works best.
RedKitten
I occasionally get migraines. If I catch it early, Tylenol can keep it from going full-blown.
But, if the migraine is already in full swing, with the puking and the light sensitivity and all that good stuff, the only thing that works for me is ibuprofen. I’m partial to Liquigels (or their generic equivalent).
Fortunately, I didn’t get any migraines while pregnant, as (like Doc p m said) ibuprofen is a no-no while preggo.
Bwah-ha-ha! If anybody had offered me a Tylenol while I was in labour, they would have very quickly found themselves experiencing Tylenol in suppository form.
Lisa @great.britain
John
Greetings from the socialist nation state of britain where I am a doctor in our evil government run health care system.
Tylenol is at the bottom of the ‘analgesic ladder’ i.e it is the weakest of the painkillers. If your pain is not controlled on tylenol alone you add something else, it’s a basic principle of pain management. For your horrific type of injury it would be totally inadequate on it’s own. It’s really rare for it to cause liver damage except in the context of an overdose, (and tylenol OD’s are very very common and where it probably gets it’s US reputation from).
Ibuprofen etc. are brilliant pain killers but they are very well known to inhibit bone healing, cause stomach ulcers and in susceptible people cause kidney failure (I am a kidney doctor and consider NSAID’s the drug of the devil) Morphine and the other opiates are good for those who can tolerate them without side effects but they can make you feel nasty (or amazing!)
Pain is really badly understood and varies so much between individuals that it defies our ability to make a drug that it is effective for everyone
Finally as a first time poster I love BJ and your commenting community John, but sadly if you were injured like this in the UK we would deem you a non-productive member of society and haul you up before a death panel.
swalker
Tylenol is the only thing that works for me. The. Only. Thing. It’s weird. It does nothing for my husband. Only Aleve works for him, which conversely does nothing for me.
Mnemosyne
Ibuprofen is always my fallback pain reliever. It knocks stuff like cramps right out and is really helpful when my carpal tunnel problems flare up. I hadn’t heard it comes in a gel, so I may have to track that down.
Excedrin knocks my migraine/sinus headaches right out, but I think that’s the only thing I take that has acetaminophen in it.
Naproxen sodium makes me vomit within a couple of days of taking it on a regular schedule which, oddly, is the exact same side effect I had with vicodin. Opiates just make me pissed off and don’t seem to do much for the actual pain. Ibuprofen was much better for that and I switched as soon as I got the thumbs-up from my surgeon.
They gave me nitrous oxide at the dentist once because I’m pretty close to being a full-blown dental phobic and that was pretty bizarre. I could still feel pain, but I didn’t care. It was like, “Oh, they’re jamming a big needle full of Novocaine into my gum. That hurts. Interesting.”
RedKitten
@Dr.BDH:
Well then, I hope you’ll accept our most profuse apologies for not being physicians, pharmacists or pharmacy technicians.
Lisa @great.britain
Oh by the way I love coming to the US on holiday (?vacation) but by far the freakiest thing about your country are those crazy pharmaceutical advertisements with drug companies insisting that their product will cure you/make you happy/make you better looking/get you a giirlfriend or boyfirend or both.
I’m glad we don’t have those here
Ash Can
@CaseyL:
@RedKitten:
Seriously. Who TF has labor pains that fucking Tylenol is effective on? I’ve got news for the broads in that commercial. That wasn’t labor, it was gas.
Mnemosyne
Oh, and I have to snicker at the “Big Tylenol” paranoia since acetaminophen has been generic for decades now. You’ll put money into Johnson & Johnson’s pocket if you buy brand-name Tylenol, but they don’t get a dime if you buy anyone else’s acetaminophen formulation.
MattR
@Mnemosyne:
fraught
Pain is an addictive.
Tylenol stays in business because of headache sufferers, back painers, feet complainers with symptoms un-x-rayable and impossible to verify.
The Other Steve
Ibuprofen in larger doses makes my gut hurt bad.
matt
To add to the random anecdotals: I made myself a bike jersey with the custom logo “nsaid fred”. To date, no one has gotten all three parts of the joke.
JGabriel
@Robin G.:
Tylenol is terrible for a hangover. Excedrin works well, despite the acetominophen in it, but the best is 2-3 Anacin (basically Excedrin w/o the Tylenol and half the caffeine) and a multivitamin.
.
R-Jud
@Mnemosyne:
I got through 21 hours of labor on nitrous oxide. It was actually lots of fun. When the contractions would settle down, I’d burst out giggling.
JGabriel
twiffer:
You can still get Sudafed in NY, but it’s behind the pharmacist counter, and you have to sign for it. The medication I miss is Actifed, which was a combo of pseudoephedrine and a pretty effective anti-histamine. Now they’ve reformulated it with an seriously ineffective decongestant and an ineffective (for me) anti-histamine.
.
LuciaMia
I’d toss a few in my backyard, to slow the squirrels down around the bird feeder.
^^^^^^^^^^^^^^^
Put me in the Advil/Motrin camp. Works good, keeping to the guidelines and always making sure you never take it on an empty stomach.
Alleve? Feh!!
^^^^^^^^^^^^^^^^
Re: Narcotics combined with Tylenol.
2 weeks ago I really sprained my elbow dealing with our last blast of a snowstorm. Lots of pain, swelling, and I couldn’t even get out to see a doctor if I wanted too. There was an old script of Endocet in the bathroom, (oxycodohne and tylenol) and desperate, I took one. Didn’t do much beyond making me feel a little spacey, and not in a fun way. What really worked was ice packs, 3 or 4 times a day. Amazing.
Dick Woodcock
If I have a good old fashioned headache, then I take X-strength Excedrin.
A sinus headache is the only time I’ll touch Tylenol (Sinus). I swear by that stuff for sinus probs.
Every other pain, except for migraines, I use Ibuprofen, although Vicodin works great for me when I can get it. I know I’ve got an iron gut, so I never have any gastric problems, which is surprising to me. I was looking for a buzz as a teen, and I took 3200 mg of Motrin (among other things) one day. My tummy was screwed for a few days after that, but no lingering effects.
Pot actually works pretty well for my migraines, if I smoke before things get too bad. I’ve never tried it until recently; I’m not in the mood to smoke when I have a headache. If I do wait too long then I have a couple of Maxalt pills that my daughter gave to me. They seem to work pretty well. I really need to get a script of my own.
KyCole
I haven’t read the comments yet, but I vote for Excendrin for the best OTC pain reliver. Of course, after I went to the dentist today for a cleaning and ended up with a temporary crown and a very sore jaw, I really recommend vodka.
Robert Waldmann
I think that tylenol is generally safer than aspirin like drugs (including aspirin). Remember Vioxx. The aspirin like drugs are messing with a very complex hormonal system and all have side effects (for example a little aspirin vastly reduces the risk of heart attacks but increases the risk of ulcers).
I think tylenol only zaps the liver only if combined with alcohol, and the alcohol gets all the blame. I htink that many doctors are totally comfortable with saying “don’t drink” and even almost comfortable if patients ignore the firm order and suffer as a result.
I have heard the semi tinfoil theory that tylenol is added to opiates to prevent abuse in the same way that benzene is added to cleaning alcohol to prevent abuse. The idea is that if you play with pills or, especially, mix pills and alcohol, you should die.
As I said, tinfoil.
ThatLeftTurnInABQ
@Robin G.:
I had to take codeine after I threw my back out during the Al Gore post-election victory celebration back in Nov 2000, and my nightmares since then have been just godawful. You wouldn’t believe how vivid…
What?
Why is everybody looking at me like that?
Mary G
I’ve had rheumatoid arthritis for 30 plus years and been through pretty much every non-narcotic pain relief there is including maybe 15-20 different prescription NSAIDs. Most of the time now I’m the same as John Cole – ice and ibuprofen are it. I buy generic ibuprofen at Costco in mass quantities and with the blessings of my rheumatologist and the horrified disapproval of the gastroenterologist who monitors me, take 3 pills – 600 mg – 4 times a day. Way over the recommended dose, every day, for years and years now. Never caused a problem. I do always have a glass of milk and/or food with it, and since Prilosec has been around I take that as another precaution.
Ibuprofen can also help control your bladder. My 86-year-old mother had all the problems of that age…using pads, Depends, and two prescriptions, but was still having trouble and getting up 4 or 5 times a night. She saw a note in the health section of the LA Times about taking two tabs of ibuprofen at night helping incontinence. The advice doctor said yes, it does help but causes stomach problems so he didn’t advise it. Mom tried it that night and it worked like a charm. Her doctor was less than thrilled but agreed that a good night’s sleep might be worth the risk, so she’s been on the Prilosec too. We are saving a fortune on Depends.
Tax Analyst
John Cole:
This is also pretty much my reaction to Codeine, Percodan, Vicodin, etc., too. I itch all over, but especially around my nose and if I’ve taken a strong dose I tend to feel nauseous. OH…they also tend to make me constipated as well.
Ronzoni Rigatoni
Tylenol is a complete fraud. Another complete fraud occurred when they forced Vioxx off the market. Outstanding pain relief, but a coupla old pfardts died and poof! Merck immediately saw tort claims and pulled it. Good goddam thing somebody gave me a coupla unused Rx’s when I had back surgery. However, buffered aspirin works for less excruciations. No stomach prollems
John Cole
@p m: I was joking about the tylenol lobby.
ajr22
Chris Mathews just called mark halperin and john heilemann superstar political writers of our generation. If this is the case, give me a IV of oxycotton because i give up.
moe99
When I was getting ct scans for the lung cancer, and when I was operated on to restore function to my paralyzed vocal cord, I was only allowed to take tylenol, pre and post. Something about bleeding irregularities iirc. And ibuprofen has always worked better for me than tylenol.
Beauzeaux
I can’t verify this but I heard somewhere recently that the formula for Tylenol predates the formula for aspirin. And the drug companies dislike aspirin because it’s not covered by a patent so anyone can make it and sell it cheaply.
Rainy
I take Aleve, Advil or Ibuprofen. They all work well. Tylenol takes forever to work. It rarely works for me at all.
mai naem
As has already been mentioned ibuprofen is really bad for your stomach. No, I don’t think it’s the lobby because my guess is that there’s way more generic acetaminophen sold than Tylenol. My parents used to use the Anacin combo of aspirin and acetaminophen. Personally I think how much you use of any pain med makes a difference because you build up a tolerance to it.
Jenn
Israel just announced, in the middle of Biden’s visit, more building in East Jerusalem.
Sigh.
http://swampland.blogs.time.com/2010/03/09/israel-embarrasses-vice-president-biden-sparks-rebuke-from-u-s/#ixzz0hiv7uKuN
Irony Abounds
I’m late to the game, so if I’m repeating anything I apologize. Tylenol does nothing for me as well, however, my wife, who suffered a blot clot in her head and incurred considerable pain, can’t take Advil because is causes headaches for her. She can’t take much aspirin because of her blood thinners. Narcotics and other heavy duty pain-killers make her ill. Tylenol actually relieves her pain pretty well.
Warren Terra
I just updated my podcasts in iTunes, and saw that the current episode of C-SPAN’s “After Words” series, in which the author of a recent book on politics or policy is interviewed for an hour by a guest host, is Mitt Romney. Now, the thing about C-SPAN, for all that it’s wonderful and I love it, is that Brian Lamb is actually rather Conservative, and the whole network is averse to confrontation (and especially to irritating the hypersensitive people on the Right). One effect of this is that the guest interviewers on After Words are nearly always politically aligned with the person they’re interviewing, and even when not so aligned they’re not going to put up any real argument, and these rules of thumb go at least double when the guest is a Conservative, because the network doesn’t want to be painted as a hotbed of Liberal Media Bias.
So, all that being said, imagine my complete lack of surprise when I found that the guest interviewer for Mitt Romney’s appearance was Professional Fluffer Of Conservatives Juan Williams.
I swear, Juan Williams should just get over with it and marry Clarence Thomas already. They’re in DC, so it’s legal now, and given that Thomas most likely hates teh ghey as much as his alter-ego Antonin Scalia does it would give him yet more self-loathing and therefore even more opportunity to sublimate his self-loathing by sticking it to the common man.
Jenn
@Beauzeaux:
Actually, aspirin is the lab form of willow-bark tea.
MikeJ
@Beauzeaux:
Aspirin – 1853, Paracetamol – 1886, but I don’t think it was widely available OTC until the 1950s.
mai naem
@ajr22: Used to like Heilleman on Morning Ho as often he was the only voice of sanity at the table. Halperin’s had a real bad influence on Heilleman and he’s turned into yet another right wing talking point stenographer. Now Halperin, I want reach through my teevee screen and slap that smug self satisfied smile off his face.
Mark S.
@Jenn:
That’s a pretty big dick move by Netanyahu.
TooManyJens
@CaseyL: They’re promoting Tylenol for labor pain? What the shit? I’ve been in labor, and the only thing that would have saved somebody from having their head ripped off for suggesting Tylenol was the fact that I wouldn’t have had the energy to do it.
gelfling545
Tylenol does nothing but make me nauseous,even tylenol with codeine. (I had someone smuggle excedrin into the hospital after I had a baby.) After hand surgery a few years ago, the doctor had me on a rotation of darvoset, tylenol and ibuprofen each 2 hours apart. I could skip the tylenol and it made no difference.If I skipped either of the others it was a foretaste of purgatory. For any kind of pain it’s ibuprofen or aspirin for me. Even loratabs or codeine don’t work and why bother with them when ibuprofen does work? I use the gel capsules and have had no stomach problems from them.
For colds, it’s the old family remedy: a cup of strong, hot tea with 1 T each of honey & lemon plus a good sized shot of Irish whiskey. Never fails.
PK
Wow! I did not know so many people had the same opinion of tylenol as I did. Tylenol does absolutely nothing for me. When I was pregnant the doctor gave me hydrocodone for my headaches and that worked wonders. Tylenol is a great fever reducer in kids though.
Ruckus
@Athenae:
Zomig works the same for me. Nasal spray, one spritz and I’m good to go. Imitrex does work, just not as well. I once was prescribed Ultrem for migraine. Worked like a charm for the head in more ways than I wanted. Hallucinations. It was like picture in picture except the picture on top was also transparent. I could see everything around me, could tell what was going on, knew what was real and what was not, the effect was startling to say the least.
But ibuprofen is my choice due to arthritis, 800mg at a time, try not more than 1600mg per day. And try like hell not to take anything at all.
snarkyspice
@Athenae:
Me too! Exact same thing – years of being told ‘that’s not migraine’ and years of taking too many painkillers and getting very little relief until I finally found a great migraine specialist who gave me an Immitrex shot in the office – as the pain started to melt away, I just started to cry. It was an overwhelming feeling to have found relief.
I feel for anyone suffering from pain they can’t get relief from. Other people just can’t understand.
Don K
My knees are majorly fucked up (doc says arthritis, bursitis, and tendonitis). I’m guessing caused by too many falls on ice trying to ski in New England at Christmas as well as numerous backpacking trips in my younger days (it’s the downhills that will kill your knees). I’ve been on 800 mg ibuprofen twice a day for years now, and it works great. Ninety tabs cost less than 6 bucks, so it doesn’t break my wallet either.
asiangrrlMN
@Athenae: I get migraines, no aura. Ibuprofen did shit for them. I would take seven capsules at one time, and nada. Tylenol, no. Excedrin, Migraine Strength actually works for me. Two capsules, maybe three if needed. However, since both you and snarkyspice mentioned Imitrex, I may mention it to my doctor.
lojasmo
As you have noted…Ibuprofen/advil slows bone healing. Most medical doctors have no problem with ibuprofen (except in the elderly, as it can exacerbate renal failure) Orthopedic surgeons HATE ibuprofen because of it’s effect on bone healing.
/RN
Ruckus
@asiangrrlMN:
When asking about Imitrex ask about Zomig as well. It’s not cheap but in the middle of a level 8-9 migraine it works for me like nothing else. I’ve been a suffer for about 40 yrs now, with bouts from several a month to a couple a year and this is the one for me.
Prof. K&G
Um, a few people seem to have some confusion on this point: “Tylenol” is acetaminophen. The Tylenol company most definitely does NOT have a patent on it, and it’s widely available in generic form, generally as “pain reliever”.
asiangrrlMN
@Ruckus: Thanks, Ruckus. I will make note of that as well. Though, I will have to suppress the desire to ask for “ZOMG!”
Jenn
@TooManyJens:
BTW, I’m not sure I’ve ever told you, but I love your webname! :-)
No Joy in Mudville
@Robert Waldmann:
Maybe. Maybe not. In Canada one can buy acetaminophen with codeine over the counter. Each tablet contains only 8mg of codeine, but it also contains 300mg of acetaminophen as well as caffeine.
I asked a Canadian pharmacist why the caffeine and he said if there were only two ingredients it would be a scheduled drug because people would find it easier to separate the acetaminophen and codeine. So, it may, in fact, be a step by step process. The first step is to combine the opiate with acetaminophen, which makes it harder to abuse and you make the drug available by prescription only. Step 2 is to allow it to be offered over the counter (with very little codeine) after adding a third ingredient that makes separating the constituents much more difficult.
I’ve spoken to a DEA agent who was retiring after many years with the agency because of how crazy the war on drugs is. Based on what he told me, tin foil hats are standard issue there.
mydailydrunk
One word: Duragesic
Beg, borrow, steal. You’re in pain – it’s allowable. We (I) won’t tell or hold it against you (unless it’s being held against your skin for a couple of days).
Jay C
@No Joy in Mudville:
Really: I suffer from mild chronic congestion, and the PITA of having to hand over ID to buy Sudafed – and sign for it (my local Rx has to keep an enormous book – for an OTC med!) reminds me of the broken attitudes in this country over “drug” issues about once a month/six weeks.
And second the many recs about alternating painkillers: Tylenol is truly near-useless, but ID and some of the other NSAIDS do mess with bone healing, and can do nasty sh*t to your insides.
A doctor once put me on (dunno what it was called: a sort of super-Ibuprofen) for a bum Achilles Tendon, and the stuff sent to me to the hospital a few weeks later with a bad case of hiccups. Seriously. They stopped chuckling, though when I started heaving up blood all over the ER floor. Not fun.
Oh, and my former Dr.’s advice when I informed him of this fiasco? “Stop taking it“.
th
I’d watch ibuprofen and the NSAIDS. Know a dialysis nurse who sees a lot of old ladies with failed kidneys who took the nsaids for arthritis.
Kib
“This ain’t Amsterdam, John. This is a sellers market. Coke is fucking dead as… dead. Heroin, it’s coming back in a big fucking way.”
The Raven
A TENS unit might be useful–or might make things hurt worse. Check with your doctor.
But, you are right: ice, anti-inflammatories, sometimes opiates, those are the best we can do. Teaching people to distract themselves, or distracting them with virtual reality technology is also sometimes effective. But that’s about it.
DougL (frmrly: Conservatively Liberal)
Because that’s the only way to make it actually do something other than attack your liver. Now you can be doped up and kill your liver at the same time!
Welcome to my world. You can thank the bogus docs who pass out prescriptions for cash and the DEA for attacking good doctors who are trying to manage patient pain as a direct result of these crappy docs. Ask your pharmacist about the DEA drug schedules, ask your doc about how troublesome it is to manage pain relief without insurance companies blowing the whistle on them for allegedly over prescribing painkillers. Our government cares more about making sure that junkies don’t get drugs, even if it interferes with good doctors helping people with their pain and suffering. We. Just. Don’t. Care. About. People. In. Pain.
Unless they are dying, then they will damn near give you all of the morphine you want. Sometimes.
Ann Marie
I take a couple of the arthritis strength Tylenol every night for my arthritis and back pain. It’s better than nothing, but not much better. I still wake up aching. When I took Advil or Aleve, even if just at night, the relief continued into part of the day. Tylenol just isn’t good for inflammation. Unfortunately, I’m not supposed to take NSAIDs because (i) acid reflux, and (ii) an allergic reaction (that might have been to the narcotics I’d also been taking, but my doctor said to stick with Tylenol). When is someone going to come up with something that gives the relief NSAIDs do without the side effects? I keep mentioning my chronic pain to my doctor and she just shrugs.
Of course, I’ll be getting a new doctor now because my current doctor wants me to pay her $1,500/year (not covered by insurance) for the privilege of using her. I already pay enough for my insurance — my firm says our premiums might be going up as much as 30% and that’s for a 1,000 plus employee firm, not on the individual market.
mcd410x
Sometimes, a doctor will tell you to take acetaminophen rather than ibuprofen after an injury like that because ibuprofen reduces swelling and you don’t always want that. swelling helps keep things, which otherwise might shift, in place.
Comrade Kevin
@mcd410x: Yes, when my mother had rotator-cuff surgery, that is what she was told by her doctor.
Interrobang
I can’t take ibuprofen; it does absolutely fuck all for me. I got wisdom teeth pulled once — 800 mg Motrins, four hours of excruciating pain until I could take something that actually works. I’m thirty-five fuckin’ years old, just give me two aspirins and a goddamn can of Coke.
DonBelacquaDelPurgatorio
Diffrerent pain relievers work in different ways on different people with different kinds of pain.
No general conclusions can be drawn from anecdotal evidence.
Tylenol works great for me on muscle pain and wound pain, not headache or toothache. Ibuprofen works as well on me for any pain as maybe Altoids. Alleve works great for me on most pain. Aspirin works well on many pains but I cannot take it. Meloxicam (Mobic) is good for joint pain.
Blahblahblah. Your mileage WILL vary. Trial and error, take what works for you.
No Joy in Mudville
@DougL (frmrly: Conservatively Liberal):
This is the American Way — or one very prominent strain of the American Way.
Better to execute a few innocent people if it increases the odds that we’ll get to kill more guilty people.
Better to assume everyone on public assistance is a lazy bum trying to cheat the system, than make sure that people don’t end up on the streets.
Rape is one of the most difficult crimes to prosecute because it can come down to he said/she said. I’ve had people say they would gladly have innocent non-rapists go to prison if it meant we could nail more actual rapists.
And in pain management the DEA is not worried at all about legitimate pain. It is far more important to the drug warriors to prevent one person from enjoying themselves on illicit opiates than it is to make sure that everyone who is suffering gets the care they need. I’ve even seen doctors who are so anti-opioids that they won’t prescribe them for anyone, under any circumstances. One doctor told me that yes, he was my doctor, but no, he would not get involved in pain management. I quizzed him and discovered that he was both opposed to opioids in general and worried about possible hassles with the government. I found a new doctor. Another doctor told me that if it was a choice between his license and me being in pain, I was going to be in pain. Of course, that was a phony choice, but it does reflect the effect that the DEA has had on medical practice.
Years ago, in a televised congressional hearing, I watched as doctors argued against the availability of heroin for terminal patients (who were in agonizing pain). Naturally, their great fear was that someone with four months to live was going to become addicted to heroin (reminds me of Paths of Glory: “Surely, you’re not going to execute a man in his condition!”). Their further argument was that we didn’t need heroin — morphine was more than adequate. As I wrote above, people respond differently to different drugs. Any doctor who thinks that morphine is the best (and adequate) choice for everyone in severe pain should turn in his or her license.
My vote for the greatest human being ever will go to the person who comes up with a pain medication that works for mild to severe pain and 1) is not an opioid, 2) does not cause heart attacks or trash your digestive system, and 3) does not cause constipation (see opioids).
No Joy in Mudville
@Jay C:
Why do I think that the drug was Indocin (indomethacin)? It’s a strong anti-inflammatory drug, but it should always be given in the lowest dose possible first, because it can have some terrible side effects and the side effects increase at higher dosages more than the relief the drug offers does. After several surgeries, I had some very serious problems and the doctor prescribed Indocin. It was unbelievable. My skin crawled. I wanted to buy a rifle and find a clock tower somewhere and just start shooting people. It nearly sent me over the edge. Later I had a friend who sustained a mild knee strain. The doctor prescribed 50mg of Indocin (25mg was the lowest dose). I told my friend to get something else. Sometimes some doctors can be careless.
On the other hand, my father was dying of cancer and had micro-metastases in his brain which caused inflammation and swelling and left him incoherent and difficult to manage. His oncologist gave him Indocin and he was coherent again within a day. That day it was a great drug.
Dave
Curious timing … I’ve been struggling the past few days, and have concluded that acetominophen /Tylenol is doing nothing more for me than upsetting my stomach (sigh). ISTR that this isn’t new behavior … I try to avoid OTC drugs so I’ve forgotten a lot of related facts I once knew. Shouldn’t have sent any money to the Tylenol conspiracy.
For now, let’s see how ibuprofin/Motrin works … better, I hope.
LiberalTarian
I was diagnosed with kidney disease last year, so no ibuprofen, aspirin or naproxen. Yay . I can take acetominophen, which does absolutely nothing. The first are nephrotoxic (kidney poison), and acetominophen hurts the liver.
So, unless I’m dying, I don’t take anything. My kidneys literally hurt (although supposedly they don’t have nerves to feel with, so go figure where the “flank pain” comes from) when I cheat and use aspirin. I dunno John. What came first–the prescription ibuprofen and naproxen they gave me a couple years ago for a twisted knee, or the kidney disease?
Lay off it as much as you can. Sorry I can’t be more encouraging, but like I said, nephrotoxic. Not a good thing.
Cathie from Canada
Sorry, I haven’t read all the comments so someone up there may have mentioned this already.
I’m not a doctor but I read up on this when I had a broken leg.
As I understand it, the difference between tylenol and asprin in terms of bone healing has to do with their effect on blood chemistry. Asprin and asprin-type drugs (called NSAIDS or non-steroidal anti-inflammatory drugs) reduce inflammation by thinning the blood, so to speak — it reduces the capacity of the blood to clot. Inflammation hurts, so this is one reason that asprin works better on this kind of pain.
Unfortunately, thinner blood doesn’t help with the recalcification mechanisms through which broken bones reunite and bone tissues heal, particularly in the earlier stages. Without a blood supply, broken bones will not heal, which is why doctors are so worried about damage to arteries and veins around broken bones.
Basically, as I understand it, bone either heals or rots — it doesn’t just stay in a neutral state. If a broken bone is not healing, it will start to die, and once bone has died it will never heal and would require more surgery, bone grafts, etc.
One of the reasons doctors won’t give you a straightforward answer when you ask them how long it will take to heal is that they actually don’t know — they have to monitor this healing process week to week and hope you don’t damage yourself again in some way in the meantime.
Your injury was a very bad one and healing is likely going to be difficult and lengthy.
When I broke my leg, it took five surgeries, an external fixator, two plates, a cast, and 19 months to heal, and my leg is now an inch shorter. But I didn’t lose it, and I can still walk just fine.
My advice — back to tylenol!
dave
The Google:
More than 30,000 cases per year of acetaminophen overdose are reported to the American Association of Poison Control Centers (Bartlett D 2004). It is a leading cause of liver failure in the Western world and the leading cause of drug-induced liver failure in the United States (Bartlett D 2004).
Although doctors tend to pooh-pooh the liver risk when talking about standard doses.
Agreed, acetaminophen doesn’t do squat for bodily pain–Ibuprofen is far superior.
bob h
With Ibuprofen, you have to fear blood clots which could cause a stroke. But, like, Tylenol, it doesn’t work very well anyway.
JKC
John- Here’s a link to some research done on NSAID’s and bone healing. There seems to be some inhibition of bone growth with stuff like ibuprofen, but I don’t get a sense that anyone knows how much there is and whether or not it’s clinically significant. Glad to hear you’re making a good recovery.
frankdawg
first rule: the plural of anecdote is not data.
interesting tidbit: Aspirin and ibuprofen and be safely taken together. The other combos, no.
I have been administered morphine on a couple of occasions and the experience has been the most pleasant of any legal pharm ever. I went from unbelievable pain to the most calm, warm and happy feeling. A guy could get addicted to that kind of happiness. Which I guess is the big drawback :)
No Joy in Mudville
I guess no matter how many times the fallacy is pointed out people will still assume that their own experiences are generalizable to others. They’re not.
I can’t say Tylenol (acetaminophen) doesn’t work; I can say it doesn’t work for me (or vice versa). I can’t say ibuprofen works; I can only say it works for me (or vice versa). That should be clear from the different experiences various commenters have had. Some people swear by acetaminophen; others swear at it.
The only way to know if something works is to try it. Other people’s opinions about the efficacy of a particular drug may or may not agree with one’s own opinion, but they are worthless as medical advice.
Some things are known: (1) alcohol and acetaminophen together are potentially dangerous, as is a significant overdose of acetaminophen by itself. I used to know someone who loved opiates and would take them in any combination he could get, which usually meant with acetaminophen. He also happened to be an alcoholic and drank to enhance the effects of the narcotics. He never had a problem with his liver. (Someday he probably will, but alcohol will be the likely villain, though the acetaminophen can’t help.) Should anyone assume from his experience that alcohol and acetaminophen together are not dangerous? It would be incredibly stupid to do so.
(2) NSAIDs have significant dangers as well. People with ulcers, digestive problems, etc. should avoid them. People with heart disease should consult a knowledgeable physician before taking NSAIDs, especially on a regular basis (aspirin is an exception since it may be prescribed for people with heart disease). Be careful, many doctors know little more than you do about side effects and drug interactions. Although the data isn’t conclusive, naproxen may (MAY) be safer for those with heart disease than ibuprofen. When an NSAID is a good therapeutic choice, a cardiologist I know recommends short term use of naproxen over ibuprofen. Years ago I took Naprosyn (naproxen) daily for severe post-surgical difficulties. Soon I was taking Zantac for a gastric ulcer. Would I tell someone not to take naproxen? No, because they might respond very differently.
Nylund
Tylenol does nothing for me but since its the only one that my ulcer-ridden guts can handle, its the only one I’m allowed to take.
So, for me, my doctor recommends it due to bleeding stomachs, but I agree, it does shit all.