I took ultram (tramadol) years ago for back pain (I sprained my back) and it was absolutely worthless. After I got this ugliness I was scripted it again, and I took one, then another a half an hour later, then another a half an hour after that. No effect. At all. Next time I had a doc try to script it I told him to write the script out for M&Ms, as they were more effective. He seemed offended! lol...idiot. The only reason I can see you being scripted this worthless med is if it blocks your real painkiller from being eliminated from your body via the liver, say by using the same enzymes necessary to break down the real one, you know? If the doc actually thought you would get some relief from pain they should get their head examined. I have never met a single person who has actual pain that got any relief from this med. Not one. Ibuprofen is more effective. As regards the goofy woman you have to deal with, well, good luck. Some people shouldn't have certain jobs, and it sure sounds like she's in the wrong line of work. Maybe she would make a good sanitation worker, or perhaps a janitor at a mental ward?