Last week hit a wall of pain and coping. My back bad, but everything was intensified by my husband's birthday. Friends were throwing a birthday lunch for him. A lovely idea, but my heart sank. How could I sit through it? How could I manage it so as not to put a damper on the day?
Serendipitously, we had a friend round for drinks. She was telling me how tramadol made her pain bearable and gave her a semblance of her life back. Interesting as my experience with it was not good: dopey, confused and not much pain relief.
Then she said she took it first thing with food and it seemed to give relief all day. I has been told to take it to give me a four hour window so I could go out, see a friend etc. It patently didn't work for that. I was really confused, had to think carefully and laboriously, watch my words and felt as if behind a shiny glass wall. I also didn't feel like me and was nervous of crossing a road.
I had taken it on an empty stomach as that's how the timing worked out to get my window and certainly had not got workable pain relief. Now I decided to give it another go. My prescription told me to take one caplet every 4 – 6 hours and that I could refill in 14 days, so the expectation appeared to be that I would be taking 4 caplets a day.
So now, with the lunch hurdle coming at me like a runaway train, I decided to try again, but take it like my friend. I took 1/2 a 37.5 mg. caplet with breakfast and, to my amazement, was more or less pain-free 14 hours later. A bit light headed, but not too woozy. It took about two hours to kick in.
Have kept to this regimen for 5 days now, but very puzzled at why such different results, till after a lot of googling, I turned up gold: a comment from a user forum that when she took tramadol with a meal that is high fat/protein, the effect was stronger and lasted longer.
Aha, I thought, that explains the different effect. Admittedly only one user and she seemed to want to get high!
Then I found http://pain.emedtv.com/ where it explained that most people are recommended to start slowly with 1/2 tablet, increasing by 1/2 every 3 days. And that starting with the full dose increases the risk of “bothersome and intolerable side effects.” Exactly what I had.
I wonder if there are other people out there who are taking more tramadol than they need, suffering debilitating side effects or who have stopped taking it in despair. Are there others who are timing it incorrectly, expecting it to work like normal pain killers. I would take it half an hour before I needed my pain-free window, have no relief because it takes so long to kick in, so by the time it did work, I had stressed my back and the pain was there for the day, too well set in for tramadol to touch. Also by the time I hit the maximum relief period, it was hours later and I had gone to bed.
Why didn't the pain specialist know to start me gently, why didn't he tell me to take it with food? Why did his prescription imply that it worked for 4-6 hours when both I and my friend found an early morning dose lasts all day, but that it is very slow taking effect? Why, yet again, do the experts not know their area of expertise?
I hope this entry may help others trying tramadol.