Is there acetaminophen in tramadol

Very nicely done so far. Premise is reasonably believable, unlike most stories here. Your pacing is good and free of extraneous fluff.
I will say this, however: you need an editor. There are a few typo's misspellings, etc, but also a few other small issues; e.g., paracetamol would not be used by someone growing up in San Antonio, or anywhere else in the US. We all know the drug as acetaminophen. There are few more examples such as this, but the story is still rock-solid.
Thanks for the effort.

I very much enjoyed the story, a full 5 stars.
Unlike some, I've no problems with April being a little peeved at the beginning, we can all lose sight of someone's worth occasionally. If she was an ingrate, or it was Charles's grooming, is an imponderable mystery within the story.
Because you didn't make some things clear, or read your own story, or because I'm a pedant.
This was set during the Covid, yet a health centre didn't revert to the default that everything was covid and had a doctor that was free to be dispatched to June within minutes?
In appraising Dr. Satapathy, she was no older than Paul's 39 years, later on Paul is in his early 40s?
Cafés, restaurants sports centres (Paul's dojo) were all open and there is no mention of masks anywhere.
April wearing raunchy underwear for Paul. To be fair, you didn't say Paul's new job was Monday to Thursday, but you did say it was four days per week. I thought Aprils early show on Thursday morning was to prime Paul for the long weekend.
April feeding Paul sushi. No mention made of what had wasabi on it or what was dipped into soy sauce and how Paul told April his preferences. Well, I told you I was a pedant.
The drugs for June were mentioned and Tylenol was included. Tylenol is acetaminophen, which is also used in many cough medicines. Later on in the story, the alternative name for acetaminophen is used, which is paracetamol.

I like your story. Your caveat about discontinuities at the top was way too understated, they were jarring, but I get it. I've been there myself, but please remember to come back and clean up later, you're going to throw a lot of people off.
OK, big problem: Never, ever, ever take Advil and Tylenol together! Ever! Tylenol is Acetaminophen, it's a blood thinner. Advil is Ibuprofen, it's an anti-inflammatory that will also irritate your stomach lining. So between the two, you'll end up with a bleeding ulcer. I think the standard recommendation is to separate them by at least twelve hours, though I just stick to one. So unless you're TRYING to mess Hayley up even worse than she already is (bruised, battered, hung over), PLEASE stick to one or the other.
PS: Yes, this is a pet peeve. Yes, I've personally had a problem with both drugs. Google it if you don't believe me.

An IRL word of caution APAP, (acetaminophen) and alcohol are hell on your liver, short term and long term. Better to take aspirin for a hangover. Hell, by itself, APAP is hard on your liver. I used to get pain meds with APAP in them, which were yellow tablets. The APAP would make me sweat, in abnormal amounts, and non-exertiom, or cold environments.. The yellow die would come out in my perspiration as a brownish-yellow. White t-shirts I slept in during that period have stains around the collars for 2-3 that no amount of bleach or sunshine will remove.
Finally got the doc to get me on something without the APAP, and it's such an improvement in my comfort level; I'm not always sweating, or going through 3-4 shirts a day when I do anything milder active.
GeoD

There is a wife in this? No! There is a lot of fetish in this? YES! So why is this in LW? 1*

Your writing is good and the mystery is there, is there more in the future? Please let there be.

Imhapless,
There is no Vburger in McLean. There is however a Zburger in McLean with locations in MD and DC. Purely coincidental.