Pain Narcotics that are LEAST likely to cause nausea and vomiting?

Hello,

I am a 50-year-old female with no history of kidney stone disease. My parents nor grandparents have ever had a stone but my older brother had one stone about 20 years ago. I am in excellent health, eat a well balanced/healthy diet and exercise regularly.

Last month I began to experience some back pain. I have a chronic back spasm condition that acts up about 1-2 times a year so I tend to be hyper alert to any back discomfort. That said, I have had no spasms since November (knock on wood). I got up on a Wednesday morning and felt a back ache that I’d equate to menstrual cramping backaches. (I am peri-menopausal and get my period very sporadically). I popped a few Advil and went to work and used my heating pad off and on the remainder of the day which made things feel better.

That evening I ate a regular dinner but felt some stomach discomfort that night but nothing major. Felt like indigestion. (I also have Irritable Bowel Syndrome so my stomach can act up for no apparent reason.) I went to bed that night and slept fine. Woke up Thursday morning and went to the bathroom and began to feel the cramping again but this time it was more intense and seemed to move from my lower left flank area around to my abdomen area. I have to admit I don’t recall the details as now it’s a bit of a blur but the pain was more intense and felt different and scary vs. menstrual cramps. I didn’t know where it was coming from but it was not stopping and I got scared so I drove myself to the ER.

I described my symptoms and they immediately said ‘kidney stone’. The pain became more intense but I was not screaming in excruciating pain the way some people describe when passing a stone. They did the usual testing – blood/urine and catscan. They got me on fluids and gave me Touridol and said they would give me Dilaudin. I told them I get very nauseated from Percoset, always throw up from Codeine and definitely throw up from Vicodin. They gave me Zofran for nausea and half a dose of Dilaudin and the pain continued so they gave me the other half dose of Dilaudin. I had not eaten since night before – and did not feel nauseated. The catscan showed an UNOBSTRUCTED 7mm stone in the upper pole of my left kidney. The ER doctor came to see me and wasn’t sure of the cause of my pain and wanted to send me home but I wanted to see a urologist. They sent me to an observation floor and it did not take long for the Dialudin to wear off and the pain came back and I can recall crying. Instead of splitting up my dose they gave me the entire dose at once and the pain subsided but not long after I started to get very nauseated. They were pumping me with fluids and sent me for an ultra sound of my abdomen which showed nothing – it was a miracle I did not vomit all over the technician. I returned to my room still feeling like I wanted to vomit and spaced out from the Dilaudin when a Urologist visited me. He asked me where my pain was – and I likely didn’t point to the correct area in my back and he said well that stone is not causing your issue – I don’t know what is! I asked about removing the stone and he said he did not recommend it – that either procedure (laser or ESWL) would cause me MORE pain then I was in at the moment.

When my nausea finally subsided once the dilaudin wore off – my pain continued and all I wanted was the Touradol. I refused more narcotics. They offered to try morphine or tramidol but I said no. I was only allowed Touradol every 6 hours and after 2 hours on it the pain would return in waves – starting in the flank and move around to my abdomen. It was worse when I urinated. Never felt anything like it before. They also saw microscopic blood in my urine but no stone was ever seen.

I was discharged the following day (Friday) and pain continued that night 2 hours into another Touradol dose.

I won’t continue with kidney stone story as this is really about anticipating future pain and management of it. I am not sure if I will aggressively go in and have the stone removed OR wait for it to move at which point I know I will be in excruciating pain and have to have emergency surgery given size of stone.

My concern is like many others I can’t seem to tolerate opioids – they make me so sick. They also gave me Reglan along with Zofran in hospital to combat nausea of Dilaudin but I did not help. Anyone try ANY other pain meds that don’t make them sick to their stomach? What about any other successful anti-nausea meds? I’ve heard Phenergan might be worth a try? As I said I’ve never tried morphine before or tramadol. But I find I want to be prepared in case that 7mm stone starts to move OR if I have the lithotripsy and am in pain afterwards.

My doc mentioned a drug called Nucynta ER but I’ve read that is not very strong and can also cause nausea/vomiting.

I’m just so scared of future pain and not being able to take anything for it. 

Thanks for any feedback!

Hi Izzy and Welcome to the forum, you know allot of times when people have problem with nausea and vomiting from pain medications, it is from the dosage amount. Sometimes if your started out on a lower dosage and then slowly weaned upward to an effective dose, you often don't have the problem with the nausea and vomiting. But then that doesn't do much to give immediate relief to your pain either! Also if they don't think it is the kidney stone that is causing all your pain, have they checked out your back? Could you have pulled a muscle in your back or even have a nerve in your spine being pinched? A nerve impingement in your thoracic spine can give you similar spasms and pain. Just a thought and maybe something to consider.

I do wish you well!

White Beard

There again, its a matter of what a person can tolerate. In the past we have had folks come through here that were on Nucnyta & felt they had adequate pain control. On the other hand we have also had people say alone it did not work well but did when another pain med was added to the mix. There is no way of knowing how anyone will react to the medications since its an individual thing.

Good luck.