My 81 year old mother was hit by a truck as she crossed a side street (not the street pictured here) on one of her daily long walks. She was in ICU with her pelvis broken in three place, a broken nasal spine, a broken tooth, deep bruises on her face, neck, side, and leg, and 8 rib fractures. I was stuck in another country working on a research project, but I was able to phone her physicians and nurses. The nurses insisted that my mother must not be in pain because she was not asking for any Narco, the "mildest" pain medication she had ordered. Knowing my mother, I asked if she was moving in bed or breathing deeply. Well, no, she wasn't. It did not hurt so long as she did not move, and she certainly did not want opioid pain relievers - she was already constipated enough, thank you. I persuaded the staff to switch to a carefully timed over-the-counter (OTC) pain medication regimen and after less than an hour my mother was moving in bed well and doing the deep breathing she needed to do to prevent HAPI. It really does work.
Alternating OTC dosages of acetaminophen (paracetamol) every 6hrs and ibuprofen every 6hrs (for most adults, that is 500mg and 400mg respectively), giving one or the other every 3 hours (not just "as needed") so that as one troughs the other peaks, is often VERY effective, even for post-op and trauma pain. This regimen is not overly hard on either the liver or the kidneys, and the ibuprofen can be given to coincide with meals most of the time, protecting the stomach lining. As the author of this http://www.medscape.com/viewarticle/879492 article says, "It's a myth that opioids are the most effective medications to treat severe pain. In fact, for most pain, nonopioid analgesics are equally or more effective, with less risk for harm than opioids," And this regimen does not cause the decreased quality of life that opioids cause (due to fuzzy thinking, constipation, and drowsiness). Please, give it a try!
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