Pain and Pain Medications

A "Thank God I'm Not Racing!" Party in Kona?  Say it ain't so.

Site of the 2010 TGINR party

I briefly mentioned the "Thank God I'm Not Racing Party" in Kona hosted by Competitor Magazine in my 10/4/2011 blog but as best I can tell it wasn't repeated this year.  Too bad as I think it's a terrific idea along the lines of the Underpants Run.  These are things that just seem to fit in the Hawaiian ambience but might be hard to duplicate at other race sites.  Jessi Stensland wrote on Active.com that "There's always a reason to celebrate in Kona and last year's first (hopefully annual) TGINR "Thank-God-I'm-Not-Racing" party, hosted by Competitor Magazine on the eve of the race is a perfect example. The inaugural event, held at Huggo's On The Rocks, was packed with pros, supporters and other industry folks. An open bar, buffet and baseball caps with TGINR were free for all."

Maybe if we're lucky, the TGINR party will reemerge in 2012.
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Might be you one day!

Ankle fracture weeks before "A" race Ironman

"Sickness will surely take the mind, where minds don't usually go.  Come on the amazing journey, and learn all you should know."
                                                             Tommy, The Who
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"At some point in your triathlon life, you may have some type of injury such that you're in enough pain that some sort of  pain medication is offered/requested.  So many of us are resistant to the "there's a pill for that" mentality but we're addressing situations which are out of the ordinary and by using the suggested medication, perhaps other parts of life will benefit like amount of sleep, ability to exercise, spousal relations, etc. There are many options, and if you have a general idea of what might work best for you ahead of time, then you'll be neither over nor under medicated.  Let's look at some of your choices.

Aspirin

Anacin, Ascriptin, acetylsalicylic acid and other forms of this work horse medication have been around for decades and have found wide acceptance as an analgesic in the treatment of minor pain.  Either alone or in combination with or substances such as narcotics, it's proven most effective.  It also finds use as an antipyretic (lowers temperature,) an anti-inflammatory agent and most recently as an anti platelet drug in the prevention of myocardial infarction's, strokes and blood clots in low doses. The author takes a daily baby aspirin (81 mg) for just such an indication.  It's primary negative is the occasional formation of GI ulcers or stomach bleeding.  It's one of the most commonly used medications world wide.

Acetaminophen

Tylenol, like aspirin, is an analgesic (diminishes pain) that's available without a prescription and is useful in treating minor pain and flu like symptoms.  It also finds it's way into combination drugs like narcotics for more severe pain such as post operative, obstetric, or in those with cancer pain. It is not an anti inflammatory and does not share the same side effects as aspirin. But, if inflammation is part of the presenting symptoms, then acetaminophen may not be the best choice. In chronic use or larger doses, it can be potentially fatal to liver function, and is a common cause of death in those who've taken a drug overdose.  It is quite safe when used appropriately.

Non-Steroidal Anti Inflammatory Medications

The NSAIDs, Motrin (ibuprofen), Naprosyn (naproxen),Clinoril (sulindac),Celebrex (celecoxib), etc. as they are called, can be quite useful in treating chronic or arthritic type pain as well as acute pain.  Like aspirin, NSAIDs also have the ability to lower temperature.  Their primary role in in the treatment of inflammatory conditions, the -itis's, as in tendinitis, bursitis, etc.  Once again, occasional GI distress is the major potential side effect and is reported to be less the family of drugs like Celebrex, a COX-2 inhibitor.  As with any medication, you should take it when needed but stop when you don't.

Corticosteroids

In select circumstances, these anti inflammatory agents like prednisone, Medrol Dose Packs, etc. can be quite effective over short durations.  They are not to be confused with anabolic steroids like the weight lifters have reportedly used.  You might be given these orally or as an injection into a joint or a tendon sheath.  Side effects can be elevated blood sugar in diabetics, weight gain, and adrenal suppression. Careful here.

Narcotics

Widely prescribed by the medical system, drugs like morphine, codeine, hydrocodone,etc. find a role in controlling more severe pain.  They require special licensing from the Drug Enforcement Agency to prescribe but help patients through surgery, migraines, deliveries, trauma, etc.  They should only be taken when the above options prove ineffective.  On the downside one finds the possibility of tolerance if taken for a long time, addiction, abuse, etc.

Alternatives

 In many instances, simply starting with ice and/or heat can make a big difference.  And, this list of categories is not meant to be exhaustive.  Electric stimulation, acupuncture, massage, physical therapy, etc. may play a role in your care.

In conclusion, depending on your situation, if in pain, and asked to consider one or more of the above options, work with your health delivery team to determine which of the above agents might be best for you.