Tramadol questions

[gcman]

A couple of questions for the tramadol users. My GP put me on a starting dose of 50mg twice a day for bad PN rectal pain. It does nothing for strong pain but if I'm lucky enough to have mild pain it reduces it a bit. The effect does not happen until at least 2 or more hours after I take the dose. It is NOT the slow release version. Is this delay normal?
My rectal pain is kick started by a morning bowel motion and goes from about a 1 to a 7 in around 3 or 4 minutesand then hangs around for the rest of the day. Should I take my dose before or after I visit the toilet. I should add I'm expecting my Dr. to increase the dose and frequency to the drug makers guidelines for moderate to severe pain now that I 've tolerated the low dose ok.

[janetm2]

Gcman,
I would certainly try taking it ahead of time. I usually take it an hour before I think I will be sitting longer than normal or some activity that might aggravate my nerve. I patterned this after advice from the physiatrist I was seeing for pain that told me to take my oxycodone 1 hour before physical therapy so I could get the most out of the therapy without all the agony.
Janet

[gcman]

Thanks Janet. Makes sense. I'll give it a try and see how it goes.
My PT says he has had other PN patients with the same pain pattern so I guess there are other PN sufferers out there in the same situation as me.
Paul