MIL taking medication when she doesn't need it

My Dm was tired and lacking in appetite,and this was due to deficiency in vitamin B12. An injection every 3 months sorted it.

Just thought, you could ask your pharmacist a general question about how to use paracetamol without treading on anybody's toes. At least you'd have a definitive answer to work with after that and the pharmacist might be able to advise you how to proceed if he or she it is a matter of concern.

Although this is within the guidelines, yes, she does require a review and regular blood tests to test kidney and liver function (which I posted above).

Your MIL needs to have medicines review as soon as possible because long term use of painkillers can lead to imapired kidney function, gastrointestinal bleeds and liver damage. I'm sorry to give your this information and cause you to worry but it can be detrimental to her health in the long run and she has been on maximum dosage paracetamol every day for ten years and that is a long time. You have every right to be concerned for her.

The medication and dosage is in accordance with NICE guidelines.

1.5.1
Healthcare professionals should consider offering paracetamol for pain relief in addition to core treatments (see recommendation 1.2.5); regular dosing may be required. Paracetamol and/or topical non-steroidal anti-inflammatory drugs (NSAIDs) should be considered ahead of oral NSAIDs, cyclo-oxygenase 2 (COX-2) inhibitors or opioids.
www.nice.org.uk/guidance/cg177/chapter/1-recommendations#pharmacological-management

I worked in a surgery for ten years. One of the older GPs would prescribe all sorts of frowned upon items. Unlimited steroid inhalers, antibiotics for the slightest sniffle etc etc. As far as he was concerned what he had learned in his training in the 50s was the be all and end all. He was a much loved and venerated GP - until the s**t hit the fan as it did more and more often!

I would speak to the practice manager or another gp as he is unlikely to admit he is in the wrong and positively endangering your mil’s health.

Once you've told her of your concerns and the reasons for them, there is nothing more that you can do, unless you think she has symptoms of dementia or a similar condition. Repetition of your warnings will only annoy her and possibly damage your relationship.

I think it would be a good idea to get your MIL to a GP for a check-up and review.

The paracetamol may actually not be the cause of her tiredness and don't normally cause brain fog like opiate painkillers. However -
- the long term laxative use coupled with poor eating habits might mean she is not absorbing enough nutrition from her food
- if she is not getting out much she may have low vitamin D (I recently discovered that I was deficient)
- she may have anemia given her poor eating habits

Lots of Doctors still prescribe meds that are available over the counter, mine still prescribes Aspirin which I take along with Warfarin I've told him not to bother but he still does it, so I simply cross it off the form. I buy them for about 20p so it's daft but I need to take them so he thinks he should prescribe them. Trouble is if the prescription goes straight to the chemist from the surgery along with my Morphine etc. I can't cross it off.

It is easy enough to ask the chemist not to request any more laxatives from the surgery for the time being or tell the surgery until stocks are used up.

Paracetamol is an excellent painkiller amongst other things, when taken as prescribed.
Sorry to criticise you Stella 1949, but they are definitely NOT harmless.
Having seen a terrified Teenager, (with her distraught Mother ) 'Blue Lighted' in the middle of the night to a specialist Hospital, I can speak from experience.
This young lady thought that Paracetamol was like taking sweets, harmless.
She was admitted to hospital a few hours later with Liver failure.
She deteriorated quickly and that's when she was 'blue lighted' to a specialist hospital.
This Lass survived, but her liver had suffered long term problems. I often wonder about her .......

I think her GP needs a bit of a shake-up - I thought they were very keen on not over-prescribing these days.

How many years has she been taking (or not taking!) the laxatives?

Would it be nosy to ask how old she is paddyann?

It really does get worse.....3 months laxatives? Good grief ....Using laxatives on a regular basis means she will not be able to "go" normally. She should change her diet, rather than take laxatives. Or perhaps, prunes.

seems the GP sends her 3 months laxatives at a time ,its on one prescription thats why there are so many .She says she had problems with constipation when she had a prolapse in her late 30's early 40's and she got stuff from the gp then and just continued ordering it ever sonce.I asked her if she tried going without it and upping her fibre intake but she says she cant eat a lot of ruit and veg as "it gives her terrible wind" Honestly I'm sorry I looked in the flamin medincine cabinet now ,I just thought it might give the answer to her current health problems.She has a revitafit machine that I bought a couple of years ago for her "tired legs" but she wont use it at anything above the minimum setting so it does nothing to help.

Can’t comment on the paracetamol, but if she has boxes and boxes of laxative medicine in her cupboard then she’s obviously not using it, so maybe she could tell her GP she’s good for that for a couple of years or more!

Free up some cupboard space and save the NHS a bob or two!

I should have said I was prescribed Naproxen three years ago, then it was stopped and paracetamol recommended instead.

I know her mother had it badly in her hands and that it caused a lot of pain but MIL has always been fit as a flea she knits and crochets which I doubt she'd be able to do with arthritis
Perhaps she is able to knit and crochet because the medication keeps her arthritis from causing her pain and problems.

I only discovered them when I looked into her medicine cabinet and there are boxes and boxes of them
Most GPs these days will not prescribe paracetamol and advise patients to buy them over-the-counter as they are so cheap.

When I went to the GP with foot and knee pain I was prescribed Naproxen. However, that and other NSAIDs eg diclofenac, ibuprofen, are not routinely prescribed nowadays for joint pain. The GP surgery was in the process of stopping NSAIDs for anyone who needed pain relief and advising them to take paracetamol - my GP prescribed 8 paracetamol daily and said it was better to take them routinely as this was better for pain relief than taking them 'as required'.
This, presumably, is the latest protocol.

However, I don't do that as I am not happy about doing so.

I think your MIL's GP should be reviewing patients on a regular basis to ensure that they still need the medication as issuing repeat prescriptions without a regular check-up is not advisable.
I wonder if she should also occasionally (perhaps once a year?) be having a blood test to check liver and kidney function? Also to check for iron levels and other possible issues.

You cannot speak to the GP about this, all you can do is try to persuade her to make an appointment to discuss this with her GP and suggest you accompany her when she goes for the appointment as she may not be able to hear what the doctor says very easily.

Good luck.

i think you need to accompany her to the drs. tell her you are concerned about the amount she is taking. paracetamols are for other things than arthritis. she needs stronger tablets but the right tablets for arthritis.if concerned get a health visitor around to see her..

I would only be concerned about any of her medications if she hasn’t had them reviewed in the last year or so. Long term use of laxatives isn’t generally a good idea, but if she has boxes and boxes of them in a cabinet, it doesn’t sound as if she is taking them.

I have a general comment - we don't know whether pills do us good or harm long term. Think of all the meds which have been taken off the market when they are found to be harmful. Imo we should be careful to only take what we really cannot manage without.

DH has had back problems for many years and during this time GPs have added various prescriptions to the point that he really didn't know what was working and what wasn't. However, he was sure he needed them because they had been prescribed. We tried to get him to drop them one at a time and see if it made a difference but he wouldn't. Earlier this year he had abdominal bleeding and test showed he had multiple stomach ulcers which we believe were caused by the meds. Suddenly he decided to drop the meds one at a time and has discovered they were not working. I was pretty sure that a placebo would have worked so decided to get him an alternative, a TENS machine. He has been back for another endoscopy and the ulcers are healed. He won't be going back on the meds and has started to admit that we may have been right!

I have that dosage + dihydrocodeine + amitriptylene to manage mt pain and have had that combination since 2003 - but - I take them only when my pain levels are too great. I know that the medical profession say the pills should be taken regularly, but given the dual problems of addiction and tolerance, I at least know that I need them when I take them.

Thanks grannyactivist I'll speak to her again about me seeing the GP with her and I'll write to him about my concerns.I dont want to go behind her back and cause problems in our relationship.We have always got on exceptionally well ,I wouldn't want that to change .

Chronic – especially daily – paracetamol use is nephrotoxic, and older age, fasting and dehydration are associated with increased toxicity. Medical adviser Dr A J Bell

Paracetamol toxicity is influenced by poor nutrition so in your shoes I would suggest to your mother-in-law that she (or preferably you if she will permit it) asks for a full MOT and medicine review. When my mum was ill I asked her GP for this in a letter that included what my concerns were. The GP responded well and a number of ongoing health issues were properly addressed as a result.

You say she is as fit as a flea, so they are not doing her any harm. Paracetamol are not addictive and are not harmful, so I'd say leave her alone.