Have continued with Tramadol and am finding that I need a far lower dose than is customary. I was originally prescribed 56 caplets for 2 weeks which is 4 a day or 150 mg a day and I see that the research was done on subjects taking 200 mg daily. I had intolerable sice effects at two caplets well spaced.
As with morphia earlier, I dropped the dose right down. With morphia I was prescribed 10 mg every 4-6 hours. I had to get a pediatric syrup and titrate it down to 1 mg which was still too woozy.
So my tramadol is now at 1/4 pill on waking at 6.30 with a fat and protein snack which apparently makes it last longer in the body. It doesn't hit for 2 hours, but I can feel it come in – just a slight spacing from pain. Then I am able to do quite a lot without pain for several hours. When I say without pain, I still have to be careful how I sit and how long. But I can cook, as long as I am not standing and stirring for long periods like making a sauce. I can do quite a lot on my feet, moving about or walking,
I take a second 1/4 at 1.00 pm. The half life is 6 hours, so there is still some in my system and the extra 1/4 pill extends my relief through to the evening. Though I have a vulnerable lull between 1 and 3.
Now the big problem is cutting the caplet accurately without getting wildly different pieces or half of it crumbling into dust. Going online, I can see this is a huge problem to many people.
I have to wonder why we so often can't get smaller doses of many meds. Take, for example, phenergan of which the lowest dose is 50mg (in a tiny, uncuttable pill) whereas in England you can get 10 mg OTC. Also why in the US do insurance companies often refuse to cover the lower dose pills for common meds like statins? It is especially puzzling with pain meds which have a high addiction rate. And then, the patient is blamed for getting hooked on pain killers!
To go back to my 1/4 caplet. The nasty cheap V-shaped cutter is very inaccurate. So I looked around and found an excellent Swiss designed high precision cutter which is made in the USA. (Link to pillcutter.com)
What I really liked was not only the standard of engineering, but the fact that Ken Welch who runs the site will check out any pill to see if it will split accurately and which size cutter works best with it. You can send him a sample of any unusual meds and he will cut it, check it against the various size cutters and return it to you cut so that you can see it works. On top of this, you get a money back guarantee and free world-wide shipping.
I have no connection with the company, but was so impressed with the service and the fact that Ken emailed me twice over a weekend that I want to pass this on to anyone it may help. Not only is this really useful, but anyone who gives such a high standard of service for a product made in North America and not outsourced to China really deserves mention.