Donna,
This is just coming off the top of my head- I need to look it up to make sure- but I think that tramadol is the generic form of Ultram (in the US), which doesn't contain acetaminophen. The tramadol that does have aceta. is called Ultracet (name brand) here and the generic name for the form with Aceta. is called tramadol/APAP. That's what I use for pain. I'm looking at my bottle right now and it says, "this medication contains acetaminophen. Taking more acetaminophen than recommended may cause serious liver problems".

Hi Donna,

Glad we can share our knowlage with you. I have had no stomach problems at all, the ultra long acting I take has no aceteminophen in it. Only the tramadol.....tramadol has no tylenol in it. tramacet has tylenol in it and it shuld not effect your BP but the tramadol may. But if you have not noticed any difference between before and after taking it then you should be able to take it. How often are you taking your bp at home???? are you monitering it or just at doc's. pain will make bp go up!!! only a little stress will do the same ! worrying about the meds will also bring up your bp!

I hope this is a good med for you it is a very good drug in my opinion.


I have info from the ultram er site...hope this is useful.

Indication
ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information
ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information




Efficacy and safety of extended-release, once-daily tramadol in chronic pain: A randomized 12-week clinical trial in osteoarthritis of the knee.

Babul N, Noveck R, Chipman H, Roth SH, Gana T, Albert K. J Pain Symptom Manage. 2004;28:59-71.


Background

• Recent guidelines from the American Pain Society recommend "tramadol alone or in combination with acetaminophen or NSAIDs at any time during the treatment of OA when NSAIDs alone produce inadequate pain relief."[1]
• The clinical efficacy of immediate-release tramadol has been established in numerous studies in chronic pain states, including cancer pain, neuropathic pain, low back pain, and osteoarthritis,[1-10] and tramadol also provides additive analgesic effects when combined with NSAIDs.[8]
• The short duration of action of immediate-release tramadol requires dosing every 4-6 hours in order to maintain relief in chronic pain.[3]

Study Overview

• Twelve-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study, involving 246 patients ≥ 18 years of age with Functional Class I-III primary OA of the knee.
• Following a washout period of 2-7 days, subjects experiencing a pain intensity VAS score of ≥40 mm in the index joint were randomized to receive either extended-release tramadol (n=124) administered once a day in the morning or placebo (n=122).
• Extended-release tramadol treatment was initiated at 100 mg daily and increased to 200 mg daily as early as Day 4 and no later than Day 8, based on tolerability of treatment.
• After the first week, further increases to 300 mg or 400 mg extended-release tramadol daily were allowed, based on the adequacy of pain relief and the tolerability of side effects.
• NSAIDs and other analgesics were not permitted during either the washout or double-blind periods, except for acetaminophen up to 2000 mg per day for reasons other than for chronic pain, if absolutely necessary, and for no more than 3 consecutive days.
• Patients returned to the clinic for efficacy and safety evaluations at Week 1, Week 2, Week 4, Week 8, and Week 12, or at early termination.
• The primary endpoint of the study was the mean change from baseline in arthritis pain intensity VAS scores averaged over the 12-week study.
• Secondary endpoints included the affects of pain on sleep parameters measured by the following Chronic Pain Sleep Inventory assessments[11]:
  • "trouble falling asleep because of pain"
  • "need for sleeping medication to help you fall asleep"
  • "been awakened by pain during the night"
  • "been awakened by pain in the morning"
  • "overall quality of your sleep"
• Patients were also asked to record their pain intensity every day in a daily diary.

Findings

• Patients taking ULTRAM ER experienced a significantly greater mean change from baseline in Arthritis Pain Intensity VAS scores averaged over 12 weeks (30.4 mm vs 17.7 mm, least squares mean difference = 12.7 mm, P<0.001).
• Treatment differences in favor of ULTRAM ER were seen as early as the first return visit at week 1, when patients were receiving either a 100 mg or 200 mg dose.
• Analysis of data from patient daily diaries showed significant separation from placebo as early as day 1.
• Differences increased over time and persisted until week 12.
• When Chronic Pain Sleep Inventory scores were averaged over Weeks 1 to 12, patients taking ULTRAM ER experienced significantly greater improvements in: trouble falling asleep due to pain (P=0.016) compared to patients taking placebo (P=0.016), awakening by pain during the night (P=0.005) and in the morning (P=0.004), and overall quality of sleep (P=0.031).

Summary

• ULTRAM ER not only reduced chronic osteoarthritis pain intensity, but also improved a variety of outcome measures on the Chronic Pain Sleep Inventory.

Yes, that was my understanding, too...that why I was wondering where the previous poster got their information about acetaminophen in both forms (tramadol/Ultram and tramadol with APAP/Ultracet). Thanks for the clarification!

Do you have a problem with stomach pain/nausea with your med? Have you found any way to minimize that?

Take care,
Donna

Victoria, we posted at the same time! Thanks so much for the info..maybe it wouldn't be a good choice with the bp issues. I had just discovered, also, that the tramadol affects blood pressure. Never had hypertension until the last 6-8 months, so I'm not used to thinking about it!

I'll talk to the doc about it...maybe my system's oversensitive to it with the stomach issues. Wonder if the ER would make a difference there.

Thanks again, though, for all the info and discussion!

Take care,
Donna

Most Common Adverse Events (%) Reported in Clinical TrialsAdverse Events100 mg QD
(N=403)200 mg QD
(N=400)300 mg QD
(N=400)Placebo
(N=406)Dizziness (excl. vertigo)1620237Nausea1523268Constipation1217214Som nolence81172Flushing81094

• ULTRAM ER is not a scheduled drug
• ULTRAM ER is not an NSAID or COX-2 inhibitor

Indication ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information







Most Common Adverse Events (%) Reported in Clinical TrialsAdverse Events100 mg QD
(N=403)200 mg QD
(N=400)300 mg QD
(N=400)Placebo
(N=406)Dizziness (excl. vertigo)1620237Nausea1523268Constipation1217214Som nolence81172Flushing81094

• ULTRAM ER is not a scheduled drug
• ULTRAM ER is not an NSAID or COX-2 inhibitor

Indication ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information






Analgesic drugs are associated with limitations that may hamper their use. NSAIDs, COX-2 inhibitors, and opioids all play an important role in chronic pain management, but can potentially inhibit successful treatment in certain patient types.


NSAIDS
NSAIDs, which are among the most widely prescribed drugs for a variety of conditions, are associated with gastrointestinal, renal, and cardiovascular-related safety concerns:

• Dyspepsia in a large proportion of patients, as well as more serious adverse events such as upper GI ulcers and bleeding[1]
• Risk for renal toxicity, especially with long-term use[1]
• In patients with a history of heart disease, use of NSAIDs has been found to increase the risk of congestive heart failure 10-fold[2]
• Black box warnings have cautioned that use of NSAIDs in patients may be associated with GI and cardiovascular risk

COX-2 Inhibitors
Although COX-2 inhibitors were developed as gastrointestinally safer alternatives to NSAIDs, their use has raised concerns with other safety issues, as evidenced by the withdrawal of rofecoxib[3]

• Like nonselective NSAIDs, COX-2 specific inhibitors can also cause renal toxicity[1]
• Black box warnings have cautioned that use of COX-2 inhibitors may be associated with GI and cardiovascular risk

Opioids
Opioids are associated with safety risks and prescribing concerns such as:

• Respiratory depression[4]
• Potential dependence/tolerance/abuse/withdrawal[5]
• Stringent regulatory requirements and potential for scrutiny may limit adequate prescribing[5]

Conservative approach to use of NSAIDs may result in suboptimal pain management
In a survey conducted among 2,000 general practitioners in the United Kingdom to determine their prescribing patterns for analgesics in patients with osteoarthritis,[6] the majority of physicians (69%) reported that their main therapeutic objective was to control pain without GI side effects. The findings of this study, however, suggest that a conservative approach to use of NSAIDs may have resulted in suboptimal pain management in patients with OA:

• 73% of physicians reported that breakthrough pain or incomplete pain relief was the most common reason for patient dissatisfaction with their pain medication.
• In contrast, only 23% of physicians reported side effects as being the main reason for patient dissatisfaction.

Reducing NSAIDs, postponing scheduled opioids
The chronic pain treatment ladder below incorporates recommendations by the American Pain Society, the American College of Rheumatology, and the World Health Organization. Patients presenting with moderate chronic pain may already have tried non-prescription analgesics for mild pain (acetaminophen or NSAIDs, such as aspirin or ibuprofen). These patients can be initiated on ULTRAM ER.



Early initiation of ULTRAM ER for the treatment of moderate to moderately severe pain can reduce the number of NSAID rotations that patients experience and provide earlier pain control.

• Use of ULTRAM ER may provide an NSAID-sparing effect
• Use of ULTRAM ER at this stage may postpone the use of scheduled opioids and their potential for dependence

If required, ULTRAM ER can be used concomitantly with drugs on the second step of the pain ladder that target the inflammatory response.
Indication
ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information
ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information



References

1. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee. Arthritis Rheum. 2000;43:1905.
2. Page J, Henry D. Consumption of NSAIDs and the development of congestive heart failure in elderly patients: an underrecognized public health problem. Arch Intern Med. 2000;160:777-784.
3. Caldwell B, Aldington S, Weatherall M, Shirtcliffe P, Beasley. Risk of cardiovascular events and celecoxib: A systematic review and meta-analysis. J R Soc Med. 2006;99:132.
4. Stephens J, Laskin B, Pashos C, Pena B, Wong J. The burden of acute postoperative pain and the potential role of the COX-2-specific inhibitors. Rheumatology. 2003;42(Suppl. 3):iii40.
5. Weinstein SM, Laux LF, Thornby JI, et al. Physicians' attitudes toward pain and the use of opioid analgesics: Results of a survey from the Texas Cancer Pain Initiative. South Med J. 2000;93:479.
6. Crichton B, Green M. GP and patient perspectives on treatment with non-steroidal anti-inflammatory drugs for the treatment of pain in osteoarthritis. Curr Med Res Opin. 2002:18;92-96.

Patients may be eligible to receive UP TO $25 off their out-of-pocket expenses for each of 3 ULTRAM ER prescriptions.

• To obtain this saving, the patient will require a valid prescription for ULTRAM ER and an ULTRAM ER Extended-Savings Card.
• The patient can take the prescription and the ULTRAM ER Extended-Savings Card to any retail pharmacy.
• Cash-paying patients will get up to $25 off their ULTRAM ER prescriptions.
• Patients with authorized 3rd-party coverage will get up to $25 off their ULTRAM ER prescriptions after a $10 out-of-pocket expense.
• Patients can use the same card a total of 3 times during the program period.
• Some eligibility restrictions apply.*
• For questions regarding the ULTRAM ER Extended-Savings Card or to obtain additional cards for your patients, please see your ULTRAM ER sales representative.

ULTRAM ER provides multiple dosing strengths and simple QD dosing. Find out more about the correct starting dose for your patients.


* Eligibility Criteria
(1) The ULTRAM ER Extended-Savings Card is not valid for patients participating in Medicaid, Medicare, or any other federal or state programs (including any state prescription drug program). (2) Card is limited to one (1) per patient for up to 3 uses and is not transferable. (3) Offer good only in the US at retail pharmacies and cannot be redeemed at government-subsidized clinics. This offer is valid in Massachusetts for cash-paying customers only (ie, those who do not have any prescription coverage). (4) Ortho-McNeil, Inc. reserves the right to rescind, revoke, or amend this offer without notice. (5) The selling, purchasing, trading, or counterfeiting of this card is prohibited by federal law, and such activities may result in imprisonment for not more than 10 years or fines not more than $250,000 or both. (6) Patients must understand and agree to comply with the terms and conditions of this offer as set forth above.
Indication ULTRAM ER is indicated for the management of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time.
Important Safety Information ULTRAM ER is contraindicated in any situation where opioids are contraindicated, including a history of anaphylactoid reactions to opioids, and in patients who have previously demonstrated hypersensitivity to tramadol.
ULTRAM ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances.
Tramadol, like other opioids used in analgesia, can be abused.
Seizures have been reported in patients receiving tramadol. The risk of seizure is increased with doses of tramadol above the recommended range.
Concomitant use of tramadol increases the seizure risk in patients taking tricyclic antidepressants, selective serotonin reuptake inhibitors, or other opioids.
Tramadol may enhance the seizure risk in patients taking MAO inhibitors, neuroleptics, or other drugs that reduce the seizure threshold.
Risk of convulsions may also increase in patients with epilepsy, those with a history of seizures, or in patients with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections).
Do not prescribe ULTRAM ER for patients who are suicidal or addiction-prone.
ULTRAM ER should be used with caution and in reduced dosages when administered to patients receiving CNS depressants such as alcohol, opioids, anesthetic agents, narcotics, phenothiazines, tranquilizers, antidepressants or sedative hypnotics. ULTRAM ER increases the risk of CNS and respiratory depression in these patients.
Administer ULTRAM ER cautiously in patients at risk for respiratory depression. In these patients nonopioid analgesics should be considered. When large doses of tramadol are administered with anesthetic medications or alcohol, respiratory depression may result. Respiratory depression should be treated as an overdose. If naloxone is to be administered, use cautiously because it may precipitate seizures.
Use ULTRAM ER cautiously in patients over 65 years of age due to the greater frequency of adverse events observed in this population.
ULTRAM ER should not be used in patients with severe renal (CrCl <30 mL/min) or hepatic (Child-Pugh Class C) impairment.
In clinical trials, the most frequently reported side effects in patients receiving ULTRAM ER and placebo, respectively, were dizziness (not vertigo, 15.9%-22.5% vs 6.9%), nausea (15.1%-25.5% vs 7.9%), constipation (12.2%-21.3% vs 4.2%), somnolence (7.3%-11.3% vs 1.7%), and flushing (7.7%-10.0% vs 4.4%).
ULTRAM ER should not be administered at a dose exceeding 300 mg per day.
Please see full Prescribing Information



http://www.medscape.com/infosite/ultramer/#question

you have to join, but it is no pay so just join and get the info!!!

hope this helps if you have more questions please feel free to email or pm me I will be happy to help you and answer what questions if I can!!

take care,
love and hugs,
Victoria

I've never had any stomach problems when taking my tramadol/APAP or taking just the plain tramadol but I don't take it every day or on a regular basis- just when I'm having enough pain that I feel like Advil or Tylenol won't help. So I'm not sure how it would effect me if I had to be on it daily. I also have high BP but haven't noticed that these meds effect it- but, I'm on BP meds so it may be that that's why I haven't noticed any difference. I didn't have high BP either until a couple of years ago and there's high BP on both sides of my family but I think the main reason mine is high is because of the 30+ lbs. I've gained since I started on Neurontin and Elavil for pain- and I really HATE those aspects of being on these kinds of meds we have to take.

red,

I too hate the aspects of elavil and lyrica and baclofen.....I find it effects the most important parts of my life....as does the pain, but it effects my relations with my boyfriend and myself....as well as the pain causing mood swings and snapping at him angry for no reason.....silly stuff but seems huge at the time, I guess I focus on the little things to try to get away from the pain and suffering....trying to refocus attention need to try to do it in a more positive way!!!

I hate the sleepyness and the fact that if I want to get pregnant I will have to come off all the meds as they effect the baby all of them!!!!!!!!!!!!!!!!!!! Damn is ever going to hurt but I suppose it will be worth it!!!! The effects are life altering but having a child when you have chronic pain may not be a good idea....have to think long and hard about this one...definatly want a child...would adopt for sure.....but the life changes..picking up child....etc....couldn't pick up a baby carrier or pull a stroller out of the trunk of my car......need I go on??????

anyhow point is I can relate and concur with your assessment of the hate we feel for the aspects of med side effects!!

take care,
Victoria

I understand Victoria- if it's not one thing it's another....I've been on my meds long enough that they don't really effect me anymore, as in they don't make me really sleepy or "goofy" . But, I only take a large dose of the Elavil at bedtime and it with my Zanaflex usually puts me out in about 30 to 45 mins. of taking it, so I'm sure if I took it during the day, especially at that high of a dose, I probably would be laid out in the middle of the floor. As far as getting pregnant is concerned, I don't know- that would definitely be something to discuss with your dr. though. My son is 26 so I had him a few years before the worst of my pain started. Your mentioning that got me to thinking though, it seems like I've read that sometimes being pregnant has helped some people as far as pain is concerned- that it seems to make it better or go away for the time being. I don't remember why- maybe it had to do with the hormones. Since I'm not in your situation as far as being in so much pain, it's hard to say how it would effect your being able to lift, carry, etc. a baby. Although I do have my own "issues" as far as pain is concerned, such as not being able to lift my upper arms backwards and out, with my elbow bent (if that makes sense) to pick something up. You read about these women who've had babies despite severe disabilities and somehow they figure out a way to do it. Just from my perspective and experience, I would say that whatever you have to go through or however you have to adapt, having a child is a wonderful thing that I wouldn't want to miss, not matter what I had to do. My son is the light of my life, as is my grandson. I have a very understanding husband who I've been married to for almost 32 yrs. Am I crabby sometimes? Oh...yes... I also get "snappy" and impatient and just plain in a bad mood. Luckily, he loves me in spite of that. We've seen each other through alot and we just accept the good with the bad. You're a strong person and have been through so much and have managed to make it through it all and I know if you decide that that's what you want to do, you'll figure out a way to do it and things have a way of working out most of the time!

Hi Red,

thanks that was nice! I agree things do have a way of working out and Marc loves me enough I know that we were only together for 3 mths when all this happened so I guess he knew what he was in for being a doctor....or not....nobody really expects an injury at work to last for five years....hmmmmm oh well...can't wait to have children I am 32 now so.....thinking and seeing babies and clothes as well as those little shoes....oohhhhhhhhh I willl find a way you are right, I always seem to find a way and if women in wheel chairs with greater disability than I can do it.....then I damn well will FIND a way!! just have to come off the drugs!

Thanks again
take care all
love and hugs red!
Victoria

You know, Victoria, nothing in life is guaranteed- things can be going along so smoothly and then can change in a heartbeat. We've had to deal with that with my husband's illnesses, which were much worse than anything I've had to deal with. He's well now (knock wood) but now it's me having all the problems. I took care of him when he was sick, and he takes care of me. I think having all the problems and pain he's had during his life has made him much more compassionate toward others pain. It sounds like you've got a good guy there- especially since he's stuck around after finding out about your injury so soon after you started dating. I think it shows the true character of a person who's willing to be there with you through thick and thin. And yes, you will find a way with a baby- knowing something depends on you totally for its needs might make you be "creative" but you'll do it without a second thought!