Naproxen and bleeding

[z's playa]

Happy snow day day everyone Well I tried to pm someone about this but I was rejected. Here's the problem. When do you say enough Naproxen and NSAIDS, and prescribe narcotics for pain?

I've been pretty much an invalid for 1 week (LBP) and I've been taking Naproxen for the whole time. I've also been taking something for my stomach to prevent GI upset. The thing is, I've started to cough up blood and get awful stomach cramps. Especially when I eat or drink anything. I went to the doctors. My regular doc was not available so I saw a resident. He told me they do not prescribe narcotics and to take more Naproxen with Cytotec. I may not be a nurse yet, but it seems to me there is a major glitch in the way things are operated at this so called teaching facility. I can't believe they're teaching residents..period!

I also only just heard that my MRI from a year ago came back positive for a slipped disc. What are the chances of my running into real complications from this choice of treatment?

I've made up my mind. I am definately going into pain management as soon as I graduate!

Thanks

[llg, PhD, RN]

I wouldn't fool around with GI bleeding and Naproxin. Granted, he was in his mid-60's at the time and was pre-disposed to intestinal bleeding due to a structural defect -- but I still wouldn't fool around with it.

If you truely have a slipped disc (which your MRI seems to say), then I would be talking to my orthopedist about long term management that did not involve and NSAID.

Just my $.02,

llg

[Dave ARNP]

We prescribe narcotics after we have tried an adquate round of non-narcotic threapy at theraputic doses.

As for what this resident told you, it's bullsh*t. Get a second, third or fourth opinion.

Also, a year on a MRI? I don't even wanna know what they were doing :)

Dave

[Dave ARNP]

Just hit me that he gave you cytotec.

By your post I couldn't tell if you were male or female.

So I'll give you the spill just incase you're female.

If you plan on taking cytotec and are female, you HAVE to be using a contraceptive. Cytotec is used in the termination of pregnancy and will cause a spontaneous abortion if taking during pregnancy.

Just something you need to be aware of.

Dave

[z's playa]

Dave:

Whaaat? I need to look into this more. For all he knew, I was TRYING to get pregnant! Now if I wasn't pissed before...I'm fuming now!

what is with these people; giving stuff with no warning. By the way. How much blood coughed up is ok? And for how long is it ok to bleed? And I can't believe I'm asking this:chuckle (laughing nervously)

[Dave ARNP]

Cytotec is class X during pregnancy and is classified as an abortifactant.

A big, and I mean a BIG nono

If nothing else that resident needs to be slapped. Tell me he's not doing his medicine rotation section of Ob/Gyn!

Anyway, just thought the warning was worth passing on.

Also, the amount of bleeding is that is OK is dependant on your dx and presentation. I would be very afraid to give you an estimate without knowing more.

I will say, that if anytime you feel like a trip to ER is needed, by all means GO! A GI bleed CANNOT be played around with and is a VERY SERIOUS issue!

Dave