Saturday, 4 July 2020

2020 07 04 Treatment Advice Note

 DEPARTMENT OF OBSTETRICS Consultant:WrJ Hughes WormdeRay Tel: Secretary: 01905 Donna 760150 Seymour IE Endometriosis Specialist Nurse: Corinne Shore Email: Newtown Road Worcester WR5 1DD Tel No: 01905 763333

NHS No: 6106007306 Hospital No: 4440496393

Our Ref: JH/CS/DS/MB Date: 08/07/2020 Dictated: 04/07/2020

Private & Confidential Mrs Emma Jane Goode 35 Archer Road Redditch Worcs Worcestershire B98 8DN 

Dear Mrs Goode 

It was lovely to talk to you and | am sorry to hear that you are struggling. | am writing to go over what we discussed today. You have stated that you are in constant pain which is affecting your daily life and this is mainly a 2/3 pain, but when the pain is at its worst it is 3/3 despite analgesia. You describe the pain as being on the right side of your abdomen and across your pelvic area, but stated that it does not radiate down your legs. The pain is sharp and stabbing in nature. You feel that the pain gets worse before and during your period and you regularly have to take up to 7 Tramadol tablets a day. You state that you are unable to have intercourse at present due to the pain. You are also suffering with pain on opening your bowels but deny any constipation and you open your bowels regularly. You have no pain on passing urine

You are currently taking Paracetamol and Tramadol. We have discussed the concerns regarding Tramadol addiction and you are full aware of this. You are going to monitor your bowels while taking Tramadol to prevent constipation. You have previously had Ibuprofen and | cannot think of any reason why you are unable to take any non-steroidal anti-inflammatory drugs and we have discussed trialling Naproxen and | have included a treatment advice letter for you to take to your GP. | advise that you take this medication on a fully stomach and your GP may wish to give you a stomach protector such as Omeprazole to take with this once daily. if this is not effective you can also trial Amitriptyline but we have discussed that you are first going to trial the Naproxen as a first treatment choice. You are taking the combined oral contraceptive pill and are happy to continue with this at present.

| have enclosed a diet information sheet for you that you can follow and please if you have any concerns don’t hesitate to contact us again.

Yours sincerely
Checked but notsigned 
Corrine Shore Endometriosis Specialist Nurse