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Recovery My journey starts today (hydromorphone)

Please be careful with how much pregabalin you are taking. It can lower your seizure threshold in sensitive individuals or when taken in doses of over 600mg at a time. It would be a horrible idea to take heroin 600mg+ doses at this time, as it sounds like your struggling with benzo withdrawal a bit?

The flailing bothers me. It doesn't sound like the stereotypical grand mal type of shakes at all, but that doesn't mean it isn't some other form of seizure. There are many. I am not trying to scare you, but if at all possible you would do best to make an appointment with your GP or some kind of medical professional you feel comfortable/safe disclosing the fact you are going through opioid/benzo withdrawal with (though you don't need to go into specifics). Ideally it would be someone who knows what they're doing when it comes to seizures/neurological issues as opposed to just a GP (though getting check out by anyone at this point would be helpful).

I am glad to hear you have decided to split up your alprazolam dose. It is a shitty medication to use for detoxing from serve opioid or benzo habits, but it certainly beats nothing. Half life is way to short for it to really compete in effectiveness with diazepam or clonazepam.

Damn, so you jumped off at 90mg hydromorphine?! Or the equivalent dose of hydromorphone to 90mg oxycodone? Either way, although particularly the former, holy shit dude!

I wasn't wrong when I said you would still be very much justified in thinking of yourself as among the strongest in the world. Few people are able to do what you're doing with as much success as you are. I mean, anyone can do it, it's just that most seem to take the easier roads of putting it off or trying to ignore it or handing off their problems to some "professional."

More bravos are in order I believe.

Insomnia is a bitch. I found that going out walking around, especially going on a gentle night hike or bike ride, in the middle of the night when I couldn't sleep at 1 or 2am was very helpful in managing the insomnia. Much easier than just sitting there and watching Netflix or something. Eventually I found that my most productive parts of the day were the super early morning, when the rest of my world was still asleep and I could go about my work undisturbed. So you can take that shitty insomnia and turn it into something useful, even while in w/d.
 
Toothpaste,

Yes I jumped at 90mg hydromorphone. I was on my way out of I didn't just man the fuck up and do it.

The jolting and flailing feels like it's starting to subside a little. But I won't know until I actually doze off. That's when it gets severe. As soon as I can physical step outside I will go get looked at.

As I said, I don't have a heavy benzo dependency. Only .25mg clonazepam daily. I have still been taking it along with the xanax.

And thanks for the good words man, this truly feels like the fight off my life!
 
Damn, jumping off at 90mg of hydromorphone, hardly a walk in the park. I am sure you understand (or do you?) that your habit when you jump off was quite significant. It is only natural to have an absolutely shitty time with withdrawals as you have been. But it will end, you will get through it if you just keep plugging along. It is merely a matter of time (both the blessing and the curse of opioid withdrawal, LOL).

Now that I think of it, it really just sounds like severe RLS. Do you have access to any gabapentin? There are other medication you can take like ropinirole used specifically to treat RLS. I would highly recommend seeing a doctor to give them a try.

As another mentioned, hot water baths and aerobic exercise (can be as simple as walking for an hour or something) will also help a lot with RLS. I normally experience RLS not only in the legs, but in my arm, even my neck, as well as my legs. I also find that something with camphor and menthol, specifically Tiger Balm, helps almost more than any med does.

I would agree with you, but perhaps this is just the beginning of the true fight for your life ;) Keep it up brother!
 
Thank you for the tips brother! I'll see if the wife is up for a trip to the drug store.

Yes, over been an addict a long time, I know my habit was potentially lethal. And I know jumping off at that is probably not the safest idea.

But when I look into my baby girls beautiful little eyes (10 months) old, I can almost hear her say daddy please stop taking drugs..... Day 6 of withdrawal she for the first time ever crawled on me, hugged my neck and said daddy.... Man did I cry?
 
I've been following this a bit, and wanted to at offer this up, as a clinician and as a fellow brain injury survivor -

If you were going for inpatient intensive monitoring, then I'd say quit everything at once; if you're staying home, use what you have to get you through it. As a survivor of brain trauma, you are more sensitive to the dangers of sudden changes in blood pressure, neuron misfires, and electric nerve activity - doubly so if you have a history of seizures.

Were I you, I'd not worry so much about the Kratom at this juncture. If it helps with your withdrawals and reduces your low-volume seizure activities, then it's a good thing. If those symptoms escalate, though, you need an inpatient support program. Withdrawals can be very dangerous to us brain injures folk, so while what you are doing is admirable it also carries some potentially serious risks.

If the kratom and a reasonable dose of your prescribed antianxiety meds is keeping you safe, then keep taking them. Once you are TOTALLY stabilized - I'd honestly say at least 14 and preferably 30 days after you are out of withdrawals from the Dilaudid - then do a second detox. I know no one wants to detox twice, but this is the advice I'd give any patient who asked me. Now, being that I don't know you and haven't seen you, this does not replace the advice of a clinician who is seeing you in person. And, as always, if you experience any symptoms that frighten you, go to the ER or your primary care physician. Detoxing from a powerful medication like Dilaudid came present a medical emergency, especially for someone who has experienced neurological trauma. You're doing great and I'm really proud of and for you, even if I don't know you; I also want everyone who embarks on something this huge to be as safe as possible. There is no shame in seeking help, if you need it. ❤️️❤️️❤️️❤️️❤️️
 
pembroke said:
i've been following this a bit, and wanted to at offer this up, as a clinician and as a fellow brain injury survivor -

if you were going for inpatient intensive monitoring, then i'd say quit everything at once; if you're staying home, use what you have to get you through it. As a survivor of brain trauma, you are more sensitive to the dangers of sudden changes in blood pressure, neuron misfires, and electric nerve activity - doubly so if you have a history of seizures.

Were i you, i'd not worry so much about the kratom at this juncture. If it helps with your withdrawals and reduces your low-volume seizure activities, then it's a good thing. If those symptoms escalate, though, you need an inpatient support program. Withdrawals can be very dangerous to us brain injures folk, so while what you are doing is admirable it also carries some potentially serious risks.

If the kratom and a reasonable dose of your prescribed antianxiety meds is keeping you safe, then keep taking them. Once you are totally stabilized - i'd honestly say at least 14 and preferably 30 days after you are out of withdrawals from the dilaudid - then do a second detox. I know no one wants to detox twice, but this is the advice i'd give any patient who asked me. Now, being that i don't know you and haven't seen you, this does not replace the advice of a clinician who is seeing you in person. And, as always, if you experience any symptoms that frighten you, go to the er or your primary care physician. Detoxing from a powerful medication like dilaudid came present a medical emergency, especially for someone who has experienced neurological trauma. You're doing great and i'm really proud of and for you, even if i don't know you; i also want everyone who embarks on something this huge to be as safe as possible. There is no shame in seeking help, if you need it. ❤️️❤️️❤️️❤️️❤️️
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^+2

I'm glad you mentioned what you did about not worrying about the kratom for now if it is beneficial. I was going to mention that earlier, got distracted, and totally forgot. Thank you :)

Of course benzo detoxes are another kind of beast than opioid detoxes tend to be, but I wouldn't worry too much about the second (or third) detox. I don't think Six will end up taking or using enough kratom during this process for him to really suffer the kind of acute withdrawal someone would if they'd been consuming significant quantities of it for 6-12 months, though he'll probably feel something when you stop taking it. Just that it won't be anything nearly as bad as the hydromorphone (it will be like the difference between night and day).

Benzo withdrawal, Six will really want to work with a doctor on that one it at all possible. Ideally with something like diazepam. But I couldn't agree more: no sense in worrying about this now. One thing at time is the way to success with all this jazz.
 
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Just read the last bit from u/toothpastedog... I hadn't realized you were taking lyrica. I had seen where you were asking about it, but I didn't realize you actually got it. I concur with u/toothpastedog - be careful with that one.

Are you taking any other medications (Phenobarbital or Keppra, for example, for seizures)? If you're taking seizure medication and still experiencing pseudoseizure activity, then you definitely see your neurologist to help keep you safe during this time. If you have a medical team that you feel supported by, be honest with them. They won't judge you. It is not uncommon for someone to become dependant on pain medication following an injury, and any clinician would support you in your decision to stop taking those medications. I wish you luck.
 
Again, awesome advice :)

Glad to have you aboard Pem. What do you think of valproic acid for controlling seizure issues?
 
Pembroke, man thank you so much for your concern and guidance..I appreciate it more then you know. I have not suffered a seizure in several years now and have been off of dilantin at least 5 years.. Seize free. Otherwise I don't think I would have attempted this on my own. I have been taking slightly more kratom today and it's helping for sure... Maybe I will use it for a few weeks. It can't be anything like coming off the dilaudid I wouldn't think?

I pretty much dropped that nasty xanax shit today and substituted with my clonazepam. I just assumed the xanax would be of more help as if never touched it. I certainly feel a little more stable today. Still no sleep.

Should I be concerned about sleep deprivation because of my brain injury?
 
toothpastedog said:
Again, awesome advice :)

Glad to have you aboard Pem. What do you think of valproic acid for controlling seizure issues?
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Well, the main thing is "is it prescribed to you?" Some people have positive results from depakote / valproate, but it should be taken under the supervision of a neurologist. I've primarily seen it used with positive effect when it's given to dual diagnosis folks with seizures and a psychiatric condition such as bipolar disorder or depression with psychotic features. It shouldn't be taken casually.
 
Sixxam said:
Should I be concerned about sleep deprivation because of my brain injury?
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In short, Yes.

Lack of sleep is very taxing on a healthy brain - it's estimated that a healthy brain, deprived of one day of sleep, is as unsafe on the road as someone with a BAC above the legal limit. 17 hours after waking up, a healthy brain makes judgement calls with a delay that is the rough equivalent of a person with a BAC of .05%. Lack of sleep over the course of several days can cause seizures in a healthy brain. You are not starting with a healthy brain.

When we're talking about a brain that has had trauma, and even more so a brain that has caused seizure activity in the past, all of those things are heightened as compared to a brain that is otherwise unremarkable. For example, if someone who is well-managed on antiseizure medication goes for 24° without sleeping, that single night of sleeplessness can lead to the emergence of breakthrough seizures. And, remember, in this case, were talking about someone who is on medication - one day without sleep is enough to override the positive effects of that medication. And a study in 2014 found that going without sleep for more than 4 days can cause irreversible brain damage - brain damage which occurs in an exponentially greater amount in half the time when studies included people with existing brain trauma.

The limb flailing, whether we're referencing RLS or full flailing, are both related to misfiring electrical impulses through the nerves. Both are considered psedoseizure activity, and the fact that you are having these symptoms is potentially alarming in a patient with a history of seizures. If you continue to feel safe and successful at home with the supports you have in place, that's great; I don't have any intention to frighten you or discourage you from what you are doing. What I am saying, though, is that if you begin to have symptoms that are alarming or frightening to you, it is important that you get your medical team on board. Perhaps there is a non-opioid, non-benzo sleep aid that will work well for you. I can think of several options, but the best option - particularly if you continue to not sleep tonight - is for your doctor who is familiar with you and your history make that decision with you. Prolonged lack of sleep can have potentially long-lasting, negative impacts on the brain of an already brain injured person.

Hope that helps. And being that you've made it 6 days, perhaps you will be able to sleep now. You have some difficult days ahead, but you are on the downslope as far as physical symptoms are concerned. Good luck to you, and lots of hugs. ?
 
Pembroke said:
Hope that helps. And being that you've made it 6 days, perhaps you will be able to sleep now. You have some difficult days ahead, but you are on the downslope as far as physical symptoms are concerned.
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It is good to stay cognizient of that reality, that Six is his way to getting on out acute withdrawal each day now, hour by hour by this point.

Of course, that is a huge dose of hydromorphone to be coming off of, but by the end of week 1 much of the physical symptoms of acute opioid withdrawal should begin to rapidly resolve. Some of them will linger, but you should begin to notice so significant improvements.
 
toothpastedog said:
It is good to stay cognizient of that reality, that Six is his way to getting on out acute withdrawal each day now, hour by hour by this point.

Of course, that is a huge dose of hydromorphone to be coming off of, but by the end of week 1 much of the physical symptoms of acute opioid withdrawal should begin to rapidly resolve. Some of them will linger, but you should begin to notice so significant improvements.
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Yep. The worst that's to come are the wave or rebound craving - but that's no light thing. The rebound cravings can be crazy intense, worse than what you experience whilst actively using. Also not meant to be discouraging, but this being the first time you've dropped such a huge dose, it's important that you be prepared and have lots of support and activities of distraction planned. But you can do it for sure if you've gone through six days of this alone!

How severe is your lingering pain (back pain iirc?), and do you have a plan in place for that? Our bodies are sneaky, manipulative assholes with stuff like this. You may find that your pain increases sharply in 10-14 days. It will be uncomfortable and you must have some sort of treatment plan in place because, though it will feel like your injuries have gotten significantly worse and it may feel unbearable, it is your body tricking you. What happens is that when you fail to succumb to the cravings, your brain is going to try to signal your body that you have a physical need for the drugs - and hence the temporary increase in pain. It can be brutal, but it will pass... and your friends here at blue light will be here to support you through it. You may find the red vein or white Kratom to be useful during this time, or you may wish to speak with your doctor to come up with a plan and some non-narcotic medication.

A quick way to tell if the increase in pain is due to your injuries or if it's your brain trying to get you to take drugs: take a mega dose of Imodium. It sounds crazy, but it's true. Imodium binds to opiate receptors in your gut and, while it does not cause euphoria, it will stop symptoms of psychological (and some physical) withdrawal cold. If you take several Imodium and the pain subsides, then it is your brain trying to trick you into taking that sweet Dilaudid. If the pain remains, then you need to visit some options for pain control. Fortunately, there are many non-opioid options for spinal pain.

Anyway. That was long, and again I don't mean to discourage. It is important that you be prepared for what lies ahead if you are to overcome it, and I'm sure you will. ?
 
Wow, thanks for all of your insight pem.. I'm actually almost at day 9. And yes the zaps and flailing is in both arms at the same time or legs. That concerns me a little. Tonight is the first night I actually feel the static in my head starting to slow... I've had a very sharp constant bright light when my eyes are closed, there kratom helps alleviate this.

I attempted a child turkey back in June at around 30mg hydromorphone, it was similar to this one all though not as intense..I was better prepared this time with benzos and kratom. I didn't catch s wink of sleep for 12 days that time.. Unfortunately the addict in me went looking and actually found a pill in my old hiding spot in my machine shop and started the spiral again.

I remember the paws was fucking brutal, I was at around week 4-6 and that pill gave me instant clarity which I was searching for. Back down the dark road I went.

I don't have any solid plans in place for pain. I do believe I could go back on a low dose of oxy codone and use responsibly,but I truly don't want to. I'm too damn young and my wife is to damn hot to have a dead sex drive and numb mind :). And my beautiful daughter needs her pops on point. I want to try and live healthy and free.. Fuck the pain.... For now at least.

I've been on opioits since my brain injury at 18, I'm 32 now. So sobriety scares the shit outta me.. But it's time. I'll get into the story later. But I was with my grade school sweetheart my whole life until three years ago when her mental illness slowly took her. And with in six months of discovering dilaudid she was dead on the needle. I tried in every way to save her but I couldn't. It kills me inside. She died April 1st last year. I have not dealt with this yet........
 
Oddly enough, the dark hours are the only time I feel safe and OK right now. Night times my friend.

I can't even begin to express how much I appreciate all of you guys and your support. I truly hope I can over come this, stick around and really get to know you great people. Forgive my butchered spelling....I haven't slept in.... Well you know.
 
It concerns me if you're on day nine and still "flailing". That is pseudoseizure or seizure precursors, and they should not still be happening at this point. I thought you were at day six and even that was a bit on the outside edge for that particular symptom. I would advise you to see your neurologist - it is possible that your seizure activity reemerged some time ago, but your Dilaudid use was covering it.

Depending on what type of pain you have, there may be other options. You might find success with trigger point injections or nsaids. You never know what will help.

Full disclosure, I'm not "sober" myself, and don't forsee ever being totally off of pain meds. I'm fortunate in that I have a team who I can be totally honest with and who will - and have, on occasion - call me out on my bullshit. That said, there have been some occasions where I've thought my meds were increased too high or I was on the wrong thing / taking it for the wrong reason and did a "drug holiday" where I threw everything away and started from scratch; so I've been through detox. It sucks, and it sucks all the more when you're a brain injured pain patient on top of it. Ugh.
 
And I'm sorry to hear about your ex. I lost a spouse to mental illness. It's been years and I still beat myself up for it from time to time. It gets easier.
 
Well shit... I'll call tomorrow. Why am I only feeling it at the 4 hour mark after taking kratom? That's when it's starts kicking in like rls. On the bright side, I just slept an hour with the aid of kratom and lorazepam. Not much but I'll take it.. I actually feel real messed up after a little nap..
 
Shoot, I should add. Tonight would be day 9 of dilaudid. The first two nights I took 10mg oxy codone at the 48 and 72 hour mark so that may have slowed it down a little?
 
Sixxam said:
Shoot, I should add. Tonight would be day 9 of dilaudid. The first two nights I took 10mg oxy codone at the 48 and 72 hour mark so that may have slowed it down a little?
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IME it is possible but unlikely to have any affects that are as serious as those you are potentially dealing with. If what you are experiencing is in fact nothing more than RLS (which can continue for longer than a week or two to variable degrees of severity with moderate to heavier habits such as yours), then it may have exacerbated things very slightly.

TL;DR It isn't very likely, but anything is possible. I wouldn't fret about it now, just keep plugging onwards.

I am very glad to hear you'll be involving a specialist/professional of some kind! Very wise choice considering your medical history and current condition.
 
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