night_shade
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Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Hi all. I've looked through the posts and haven't found much on this subject. Just a brief overview...
I have a 12 year old son who sufferes from chronic ear infections. In addition, he has had corrective surgery to both eyes (incomplete muscle development) and surgery to correct a testicular torsion a few years ago.
My son sees my own primary physician (who has never given me hassles when I require pain medication.) When it comes to my child, however, it seems my doc is reluctant to prescribe anything for pain other than inbuprofen. (Except for the Adderall, which my son takes for ADD.)
Correct me if I'm wrong, men, but a testicular torsion must be one of the most painful experiences you can have.
For my son's eye surgeries, he was given Alcaine (proparacaine) drops to numb them, but got excruciating headaches for a few days post-surgery. In addition, the chronic ear infections have caused me many sleepless nights listening to my son's crying.
After much anger and frustration with his doctor/surgeons, I resorted to buying over-the-counter Paracodol (available in England without a prescription and contains 8mgs of codeine plus acetaminaphen---which is called paracetamol in the UK) every time I went to the UK. Knowing it is not legal to bring into the US, I always feared detection by Customs.
My only other choice would be to give him some of my methadone, but I feared that such a strong medication would be dangerous to a child and did not give him any.
Rarely, if I called the on-call doctor at 2AM and demanded they do something for his pain, he would get codeine syrup or Tylenol #2. Children cannot act as their own advocates or describe their pain as well as we can to our doctors. What's the most upsetting is I get the feeling that doctors think I have "over-protective mother syndrome" and am exaggerating my child's pain. NOBODY knows my child better than I do, and especially when a child has a concrete physical problem which is known to cause moderate to severe pain (like the testicular torsion--his testicle was swelled up to the size of a tangerine!,) I think narcotic pain medication are called-for.
How do you other parents deal with such situations?
Many regards-
night_shade
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Never underestimate the predictability of stupidity.
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padmakara
Member
Reged: 09/16/03
Posts: 136
Loc: Chiang Mai
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I think its funny rxlist doesn't show any drug interactions between adderall and narcotics. In the recreational drug world, this is known as a speedball. You'll want to lower any narcotic dose you give the kid cause of the adderall, that's for sure. The mix is said to be able to cause heart failure pretty easily, as John Belushi and River Phoenix found out (although they were using a strong opioid, heroin, and probably injecting it.) Although I'm sure you wouldn't be giving him that high of a dose, you should know the dangers of the mix is more than either seperated. If I were taking the drugs personally, I'd probably skip a dose or two of the adderall-- that's just me and knowing my body. not advice. Maybe this is why the doc is reluctant to give something. Methadone sounds a little strong, unless a real low dose, but isn't it known for a higher incidence of unwanted side effects than most shorter acting opiates? I'd try maybe some tyl 2 or 3. Or a third of a 10/325 hydrocodone. Well, I hope he feels better. I had ear infections and surgeries growing up, so I sympathize. Best of luck.
Edited by padmakara (09/28/03 03:26 PM)
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night_shade
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Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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A further about his ADD meds in case anyone needs it to formulate their reply...He takes Adderall 10mgs twice a day-in morning and at school. Never takes it in the evening or on weekends/holidays. He's about 5'0 and weighs 100 lbs. He's never shown any side effects such as insomnia, hyperactivity, anorexia or other common problems associated with dextroamphetamine. In addition, he's never had any withdrawal symptoms on weekends or summer vacation. He is not hyperactive, but suffers from attention deficit. He has been on Adderall for 3 years and was on Ritalin for 2 years prior to that (reached the maximum Ritalin dose, so had to go to Adderall.) He has not developed a tolerance from the Adderall, either. One last thing, this is the short-acting form of Adderall.
I didn't even think of the possibility that there would be a conflict between the Adderall and opiate medications. Can't believe that escaped my mind.
Finally, something I forgot to mention, he rode his bike from between 2 parked cars and got hit by a truck almost 2 years ago. He sustained a serious subdural hematoma with skull fracture and was in intensive care for 2 weeks. They used Nubain for pain then. The neurologist said his brain would completely heal in time (3 months after the accident, he still had the hematoma, so I'm not sure how long it takes for that to get absorbed again, but I imagine he's completely recovered by now.) I'm not sure if a previous head injury would preclude the use of narcotics for pain.
Thanks for the input.
night_shade
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Never underestimate the predictability of stupidity.
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moonbeam
Member
Reged: 05/23/03
Posts: 179
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I don't know if this will help, but my son had surgery when he was 12, and the doctor gave him hydrocodone. This was for an ingrown toenail that he had surgery for in the O.R. The first time he had this procedure, the doctor did it in her office and he didn't tolerate the procedure well because of the pain. The second time, the doctor decided to do it in the O.R. so that she could give him versed and demerol to knock him out. Both times she sent him home with a few 5mg hydrocodones.
Depending on your childs allergies, and other medications that he has taken in the past, I don't see much harm in 1/2 to 1 5mg tablet when he is in pain as long as you only give it to him when he is really in pain. Tylenol/Codeine is often prescribed to children for pain. It's probably much safer for him than methadone.
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antique
Banned
Reged: 09/01/03
Posts: 215
Loc: east coast
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If you give him tylenol/codeine or anything with acetominophen, please be sure to not exceed the maximum dose of acetominophen for a child and that includes any OTC remedies he takes that have it. Please see the thread drugs and your body chemistry if you don't know about the dangers of acetominophen. HTH.
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chevygal
Veteran
Reged: 04/28/03
Posts: 504
Loc: Way down south
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night_shade
I know how it can tear ya up when your kid is hurting. Especially from an ear ache. I have given my kids a half to a whole 5/500 before. I am not sure with your child as he is on the other medication. But as far as giving a narcotice to my kid, yeah I have and I would do agian if it was warrented.
My daughter has a problem with her neck, we have done the doctor and mri, and they said to use heat and ice and advil. Well, when she lays in her bed and is not able to sleep cause of the pain I can not sit idly by and watch her suffer and saw no harm in giving her something strong enough to make her feel better.
chevygal
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Thanks so much for the feedback!!!
It's a horrible guilt to carry when you feel impelled to do something for your child outside of medical advice.
My son has been plagued with medical problems, although we've gone through a relatively peacefil time lately.
I'm VERY allergic to codeine, so I worried about a potential hereditary allergy. He hasn't reacted to it yet, so is probably OK.
Thanks so much everyone!
night_shade
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Never underestimate the predictability of stupidity.
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catmom
Board Addict
Reged: 06/20/03
Posts: 320
Loc: Midwest
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Can't you just try discreetly asking your (hopefully) friendly neighborhood pharmacist? They are the one's who really know their stuff about drug interactions.  I seem to remember reading somewhere in pain treatment literature that people on high doses of morphine have been given amphetamines to counteract the drowsiness caused by the opiate. So, the John Belushi scare may be overblown. Just my 2 cents--hope it helps. Good luck. Kids are often treated as less than human when it comes to pain control.  And--as most of us know here, adults are often not treated much better.
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If it's not immediate, it's not gratification.
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quincy
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Reged: 11/07/02
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Loc: pacific northwest
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MY son is having some pretty heavy dental work today, root canal and crowns- things adults get pain meds for. I've asked and they won't give him anything for after. They will use nitrous oxide during the procedure, but I know that tylenol isn't going to help afterward. I have some hydro but hate to do that. Actually my mother is taking him, since I have to work and my jerk boss wouldn't let me off, and she can be a real bear. Hopefully she can get him to prescribe a few days worth of tylenol #2 or something!! My god, like they will get addicted from that!! Rediculous. Well after open heart surgery my son had at 6 months all they sent us home with was liquid tylenol with codeine. So I guess they underestimate the pain levels of children. It makes me sick.
sarah
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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I wouldn't take him to a dentist that does not believe in rxing pain meds to a child. If you can help it.
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LumbarSpasm
Or just a pain in the butt?!
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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I agree! As a pediatric RN, pain is often under-estimated, under-evaluated and under-treated...not as often in the hospital setting...but pediatricians are notorious for this. Insist that your child receive AN APPROPRIATE, mild narcotic pain med, it's not wise to utilize adult meds, as doses of the tylenol must be adjusted for body weight and development as well as the narcotic...that's why they make syrups, in pediatric doses....Screw the doc if he thinks you're an "over protective mom"! Unless your in his office every week, requesting narcotics, he's being unreasonable & heartless....and the #1 cause of chronic pain in adults is undertreated pain....you have to stop the pain impulse before there is a neuro pathway created to trasmit the signal...which if left untreated, persists, even after the anatomical condition causing the pain is corrected....you may need a new, more compassionate pediatrician...and a good place to find one is through your pharmacy...if you have a good relationship with your pharmacist, ask him if he knows of any pediatricians who have less problem prescribing judicious amounts of narcotics for post surgical pain and if required for ear infections. As long as the physician and pharmacist are aware of the adderal & dosing schedule...there is no need to worry about the aforementioned "john belushi" syndrome...he was injecting herion with LARGE amounts of cocaine & not even applicable here...good luck & 5 STARS for being a caring, attentinve mom....
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pescado1
Journeyman
Reged: 07/22/03
Posts: 86
Loc: The Southwest
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Children do not need opiates.
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"One man gathers what another man spills"
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MrB
Old Hand
Reged: 12/11/01
Posts: 488
Loc: Rhode Island
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Thanks for one of the most absurd and idiotic things I have heard in a long time.
MrB
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"I aint fallin for no banana in my tailpipe!"
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MrB
Old Hand
Reged: 12/11/01
Posts: 488
Loc: Rhode Island
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Please find a doc that will help you with your child. Do not self medicate a child under any circumstances as it could be dangerous and if someone found out, that could be kin to child abuse, in some states.
Sorry to come across a little harsh but it's our job as parentns to protect our children so please find someone who can help. There must be one somewhere in your area. How aobut a specialist or a female docotr. They seem to be the most caring. Even if it means $$ out of pocket not covered by insurance, I'm sure you would agree that it's worth it.
MrB
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"I aint fallin for no banana in my tailpipe!"
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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I hope you don't still believe that circumcision is painless. Kids feel pain.
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LumbarSpasm
Or just a pain in the butt?!
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quincy
Board Addict
Reged: 11/07/02
Posts: 333
Loc: pacific northwest
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Actually, I just talked to my son and he came through like a trooper. Didn't need anything besides some Tylenol. I was so worried!! I swear there is nothing a mother wouldn't do for her kids if they were in pain. thank God he's alright!!
Sarah 
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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REALLY! WOW! Guess all those years I spent pushing morphine for burn victims, post op open hearts, pt's with DRAINS IN THEIR BRAINS, was just for my personal pleasure.....what an interesting theory..I guess a heart rate of 180 & a B/P of 150/90 in a crying child, pulling at tubes(that were better left in place) should have been restrained physically & given tylenol....I'm so GLAD I've never practiced in that type of environment..please don't have any children or enter the medical field!
Edited by IMSUSCOT1 (09/29/03 05:40 PM)
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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THANKS AGAIN EVERYONE! IMSUSCOT1, I really appreciate the perspective on the "speedball" theory. While I have no problem being as fierce as I need to with my own doctor and go to whichever specialist I want as needed, I admit to being woefully less tenacious when it comes to my kids. I've had the same family doctor since 1997, and haven't taken the kids to pediatricians since we started going to that clinic. I have EXCELLENT health insurance which pays for everything, everywhere, without a referral. I guess it's just been easier to call the regular doctor when the kids are sick than to look up a new pediatrician, do the new patient paperwork and start a new relationship with the doctor. I'll get on this tomorrow, as I go to a specialist for my needs and my kids should probably be seeing one too!
(Ouch! Admission of parental negligence, here!)
As for the comments that do not apply, here, I just blow them off. There's always somebody who doesn't agree with me, somewhere!!! 
Many thanks again to all of you!
night_shade
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Never underestimate the predictability of stupidity.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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Don't feel guilty...the docs are pros at minimizing and making you feel like your over reacting & out of bounds...
just remember, they see your kid for 5 minutes & then get to forget him....your with him 24 hours a day & his advocate...also...nurses are generally good patient advocates & talking to the nurse before talking to the doctor may give you some back up...at least I hope that's true....stick to your guns your a great mom. & don't listent to nuthead above....who probably pulled the wings off flys as a child to see what happened
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pescado1
Journeyman
Reged: 07/22/03
Posts: 86
Loc: The Southwest
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My God, people are insane. Opiates for kids with hearaches!!!!! Broken arms and major surgeries are one thing but ear aches
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"One man gathers what another man spills"
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DrMom
Newbie
Reged: 08/28/03
Posts: 25
Loc: Great Lakes
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pescado1 it seems to me like maybe you don't have kids. If you did you would know how a parent can feel when your child hurts you hurt, their pain is your pain but worse most parents would give anything to keep their child from pain of any kind. Also when you are sleep deprived things are even harder to deal with.
night shade I am a parent and I also was a child with chronic ear infections so I can feel for both you and your son. Ear pain is probably one of the worst kinds of pain. On top of that your equilibrium is off so you feel nauseous all the time. You can't sleep because it hurts so bad to put you head down on a pillow. When I was a child I received no pain meds at all. (My mother was clueless) Yes I lived, but I lost a year of my life crying in pain, making my mother crazy, and not going to partys or playing with friends. When you hurt all the time they stop asking you over. My daughter has chronic headaches. Sometimes from the ear infection sometimes it's woman related she also get sever cramps I have on an occasion gave her a 1/2 darvocet or a 1/2 vicodin. It helped her alot. Most meds are dispensed by body weight not age so if you sons weight is half of yours or close to it you can give him half of what you would take. Thats how my doc told me to do it.
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buey
Old Hand
Reged: 01/15/03
Posts: 453
Loc: USA
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Obviously, this pescado1 never had an acute ear infection before either. I have as an adult. The pain is severe when your eardrum is bulging and close to breaking because of the pus behind it. So kids don't need opiates for this kind of pain? Why not? Are they just supposed to suffer? Why? You said it would be okay for a broken arm? As a matter of fact my husband broke his arm twice as a kid and said the shock/nausea was the worse for him and he barely had any pain at all. But he's also had ear infections that hurt 100 times more than the times he broke his arm.
I had surgery on my uretha when I was 9. I am middle aged now and still remember going through post op with nothing more than OTC pain relievers. I think at that time it was aspirin. Nobody knew about Reye Syndrome back then. I know what it is like to be a kid in pain that is so intense you just curl up in a ball and bawl your eyes out. The pain with that surgery lasted for over a week. Any adult who undergoes the procedure gets a morphine drip afterwards and a 2 week supply of hydro. But for some reason, I guess the medical profession decided that kids don't feel pain like adults. How idiotic. Just like your comments are pescado1.
My son is almost 9 and so far he's never had any condition that required anything more than Tylenol or Advil. But if he were in intense pain, I would not hesitate to break a norco in 3rds and give 1/3 to him.
Try watching your kid writhe in agony pescado1. But my bet is that you don't have any kids. With your attitude I hope you don't, anyway.
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bhamdave
Threadhead
Reged: 01/11/02
Posts: 953
Loc: U.S.A.
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Pain Control for Children
It has become recognized by the medical community that infants and children often receive inadequate treatment for pain. While parents are often better at gauging how much pain a child is in than a doctor, both parents and doctors usually underestimate a child's discomfort. (Reuters Health; July 11, 2002)
In some cases, children may experience chronic infections or other health problems which remain undiagnosed because they are unable to communicate their discomfort. Sometimes untreated chronic pain in children can lead to behavior problems, and the child may be taken to a counselor instead of a doctor. Allergies, constipation, diarrhea, digestive discomfort from food intolerance, persistent nausea, recurring ear infections, headaches, or inflamed joints may all manifest in some cases as overexcited, uncontrolled, or withdrawn behavior in children.
A scale should be used that makes sense to the child as a gauge of how much they hurt, but this may not work with infants. In the case of children who are too young to speak, the duration of their crying can be used to determine the level of pain. The goal is always to make the child as comfortable as possible without causing adverse side effects, just as in treating an adult.
A very important thing to remember, though, about pain control for young children is that their bodies react far more strongly to medication than an adult's. They are at higher risk for overdose, withdrawal, and adverse drug reactions. Central nervous system depressants often have a very pronounced effect on children, and they are more likely to experience drowsiness, delerium, clumsiness, or confusion on taking these medications.
Speak to a pediatrician before giving any medication to a child. While there are many over the counter preparations available for treating pain in young people, a doctor's advice should be sought if pain or illness continues or is frequent. Minimum necessary doses of over the counter medication should be given if you are treating your child without the advice of a doctor, though you should seek the advice of a physician when your child is ill.
Many prescription medications are not approved for children and may be dangerous for them, especially in adult doses. Dosages for children must be appropriate to their age and weight; they should not be given medication prescribed for an adult, or even for another child.
Keep all pain medications out of the reach of children when storing them, and be sure to discard out-of-date medication in such a way that children will not find it.
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AIDS
It's not YOUR problem (I hope that)
It's not MY problem (I know that)
But it is still OUR problem and WE know that!
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actonbell
Journeyman
Reged: 09/08/03
Posts: 82
Loc: Oklahoma
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To see a child suffer is one of the worst things in the world, the only thing worse is if the child is yours. Ear infections are very painful conditions. When the oldest was five he had one. He cried and cried. He tried so hard to be brave but was just in agony. When my doctor refused to order anything and told me just to give him aspirin, and of course that had no affect on the pain, my husband and I gave him 1/4 dose of codeine cough sryup we had. The relief and happiness I felt when the pain subsided to a tolerable level is indescrible. It made a believer out of me. I started insisting the doctor prescribe something if in my opinion the pain was not managable by aspirin/tylenol. And now for the grandkids if I think they need something stronger than children's ibuprofen. (Which is really a good pain med for all kinds of aches, procedures and bo-bo's, especially dental)
BUT, what we did was dangerous and we were too young and ignorant to know how dangerous. Medicating very young children is especially tricky and I really don't recomend it. But lord I do understand and sympathize with the frustration and anger that leads to it. Everytime that child moved his head a certain way he would give a little scream of pain and the sound went thru my husband and myself like a knife. To inadequately medicate suffering children is the continuing shame of the medical profession.
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All it takes to fly is to hurl yourself at the ground....and miss.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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Severe pain is severe pain...regardless of the cause....and opiates are perfectly safe for children, as long as they are prescribed and the dosing instructions are followed carefully! I understand the frustration of parents who have resorted to medicating by estimating a partial dosage of an adult medication. But I DO NOT ADVOCATE THIS, weight is NOT the only consideration...infants, toddlers & children at various stages of growth do not metabolize drugs in the same way that adults do... what I do advocate is Parents insisting physicians prescribe an appropriate pain reliever when their child needs it...If you're physician won't you need a new doc, plain & simple.
It never ceases to amaze me how adamant parents can be demanding unnecessary antibiotics, to the point anti biotics are often ineffective, but feel uncomfortable demaning their child be adequately treated for pain. And I don't blame the parents...I blame people who think that "children don't need opiates"....
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pescado1
Journeyman
Reged: 07/22/03
Posts: 86
Loc: The Southwest
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Dope em up. Everyone's seems to be a doctor here. Opiates are not the answer to everything. Kids are not able to make the rational decisions required for opiate use and their parents shouldn't be making those decisions for them. "Have I ever seen a child in pain?" Well as a matter of fact I have and its not fun, but giving them opiates for earaches and other common ailments is just plain crazy. I do have children, two to be exact and there is a reason why 99% of the world would agree with me and think it is insane to give your child opiates not to mention that if a doctor has not prescribed them it is CHILD ABUSE.
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"One man gathers what another man spills"
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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I'll concede that giving my children (aged 10 and 12--by the way, my son weighs more than I do!) methadone that is prescribed for me could defininetly constitue child abuse. BUT I NEVER DID IT!!!
My mother-in-law (who died from breast cancer) once dropped one of her 60mg MSContins on my floor during a visit. My daughter, then 2 years old, decided it looked like candy and ate it. After noticing her somnolence and drunken-like behavior, I immediately guessed what must have happened (this happened before only I found the pill--she had one of those plastic multi-day pill dispensers and dropped her pills frequently) and drove her to the Childrens' Hospital near my home. After Narcan and induced vomiting (then charcoal) and an overnight stay, I learned firsthand the dangers of opiate overdose in my child. The LAST thing I want to do is have a repeat of this!!!
However, my SON has chronic ear infections. So bad they have had to puncture the ear drum to relieve the pressure and drain the pus. He SCREAMS in pain, not just whines or complains. This DEFINITELY constitutes opiate pain medication. And still, the doctor is hesitant because of some misguided sense of reluctance to prescribe painkillers to children.
I witnessed a circumcision when my son was born. My husband and I were being led thru the room they did them in on our way to the "new parents" class. That poor baby was red-faced and screaming in that sound all parents know as the "I'm in serious pain" cry. Which dummy decided that kids and animals don't feel pain???
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Never underestimate the predictability of stupidity.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 882
Loc: usa
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Judicious use of prescribed narcotics has nothing do do with "doping them up"! You have some odd ideas...and I am sad for your children .... SO GLAD you don't work in the medical field so your warped ideas aren't imposed on other peoples children....I did NOT advocate giving any child anything OTHER THAN medication prescribed specifically for them...I'm a pediatric RN worked in PICU for close to a decade and there IS NO known advantage to suffering! No one is suggesting giving a child narcotics for every bump & bruise...were talking about pain unrelieved by the usual methods...if tylenol or ibuprophen doesn't take care of it.... narcotics are perfectly safe for infants and children if given as prescribed....And if 99% of the world agrees with you, wonder why no one spoke up here...I've not seen one reponse in agreement with you
Edited by IMSUSCOT1 (10/02/03 03:20 PM)
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chevygal
Veteran
Reged: 04/28/03
Posts: 504
Loc: Way down south
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Quote:
Kids are not able to make the rational decisions required for opiate use and their parents shouldn't be making those decisions for them.
No maybe not, but when it hurts, it hurts!! and if the parent isn't suppose to make those decisions for their OWN children, who the hell is? OMG, lets call the doctor, and in the mean time "johnny" will just have to tough it out until the doc decides or has time to call back. NOT. The origainal poster did not say she intended to "dope" her kid up for everything. But, Best if kept off the board, if my kid is in that much pain you bet your boots I will give them something to make them quit hurting. ANd I doubt seriously if it will lead to an addiction or dope them up. I have done it and I will do again if the need arises. I love my kids and I do not rely on anyone or anything to tell me what is right for them. I KNOW what is right for them, because I am their mother and I know the difference between an "owie" and "real pain" you can see it in their eyes, and you can feel it, and my job, as their mother, is to make it go away if I have the way and the means to do it. That right there is another stigma of "narcotics".
chevygal
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junebug101
Journeyman
Reged: 03/27/03
Posts: 69
Loc: NY
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Night shade I'm glad to hear you live in MN, because Children's Hospital is one of the best (my brother was a resident there). SOmeone earlier said to contact a sympathetic friend or pharmacist. I've found that friends and family are my best asset as I deal w/ pain. As an aside, I also had chronic ear infections as a kid - it's worse than the chronic pain I have now. My doctor used to prescribe (along w/ antibiotics) cough medicine w/ codeine. The cough medicine had a decongestant which helped to drain the eustacian tubes. Good luck.
PS My signature says 'Kid free and loving it but I actually love kids even though I don't have any.'
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Kid Free and Loving It!
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