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Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

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^As long as you aren't looking to abuse your medication (which I assume you aren't), single daily administration makes it easier... you are less likely to miss doses or dose late and so it is easier to establish and maintain constant levels of morphine in your bloodstream. If you don't have breakthrough pain, that alone should be sufficient, but generally people who take 12, 24 or 72 hour formulations require some form of BT pain medication, like a short-acting (4-6 hour) agent.
 
That will be something I mention to my doctor today. I'm going in about a couple of weeks early to make mention that my meds are NOT working like they used to. I can feel needle prickling in the legs and feet along with throbbing pain in my lower back at the L5 disc.
 
anybody have anything to say about MSIR?"morphine sulfate instant release" i was just prescibed them for BT pain yesterday. I have the 15mg tabs. Has it woked well for BT pain for anyone here??thanks
 
KittyIsShopping said:
I used to use fentanyl, I had the huge patches and it made me throw up 24/7. It did control the pain, but the side effects were a serious threat to my overall health.
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You could use Fenergan to help with the nausea. That way you control the pain and take away the nausea. I know what its like with back pain I flipped to cars in one month and have lower back and neck issues and I am about to start with the blocks in my spine again, and the roxi 30mg, they work I just hate how they wear off. I mean one 1st I feel like I can do anything w/o pain meds and then it wears off and I am stuck in bed again. Altough I dislike being put under for the block its worth it to me to get the pain out of my back if just for a week or so. So anyways yea try that.
 
Suggestions...

KittyIsShopping said:
This thread is for all your questions on chronic and acute pain management with emphasis on the first. Do make sure to post a question , You can ask other for an opinion on what meds would work for you , dosage , side-effects , comparing different medications etc. -BB










I'm new to the forum and have done a thorough search but can't find any answers. I have graduated to 100mgs of morphine, 75 mgs of oxycodone and 60 mgs of baclofen every 4 or 5 hours to try and control my pain. It BARELY takes the edge off. I wake up every 20-30 minutes in horrific pain and have to reposition myself. (I take 45 mgs of temazapam and smoke a joint before bed) My scripts are all legal and I have serious pain issues due to a shattered back.
I'm afraid to up the dose because at the level I'm currently taking, I get serious problems swallowing and slurring of my words although I don't get any sort of high at all from it. Shitting is also a MAJOR issue. Or non-issue since I never do it lol. I have parachuted the oc and plunged the morphine, it doesn't seem to make a difference.:| I'm thinking of changing my 30mg oxy to 4mg dilaudid and try those again to see if I can get a handle on this monster. Is that a good/bad idea? Oh I also get a spinal block once a month or so (takes the edge off for about 3 days, hardly worth the anesthesia risks as they knock me out to do it)

I'm over it!! What should I do?
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I really understood your frustration as I've been there. I too have chronic pain and after going through so many potent opioid drugs that barely touched my pain I was put onto Methadone with Ketamine for breakthrough pain. Have you considered these meds?
I take a fairly heavy dose of 290mgs each day, divided to half in the morning and half in the evening. I take the Ketamine as a nasal spray throughout the day to manage. Some days are better than others in term of the pain but at least these drugs have got my pain to a level where I can function as a person!
I would recommend giving it a go, especially given the terrible state you are in with your pain. Maybe you need a second opinion from another pain doctor?
Also do swap from the oxy to dilaudid - it's a much better/effective drug
I do hope you get some relief...and soon. I remember only too well how devastating it is to have uncontrolled pain, it gets in your head and just about drives you mad. My thoughts are with you.
 
in a month span I get
#20 percocet 7.5/325
8 mg dilaudid daily.

For severe burn caused by a car accident.

I have been on demerol, flexeril, ketorolac, tylenol w/codeine before this.
none helped, especically the latter 3.
then i got dilaudid as it's good for severe pain, according to my pain mgt doctor, and he gave me the percocets for breakthrough pain.
I'm on a good combo, I'm not oversedated, i'm comfortable, and i'm pain free.
 
"it gets in your head and just about drives you mad" Is the perfect way to describe pain.

Sometimes my pain is so bad i just don't know what to do with myself. Although, right now my pain is very well managed-- oxy/fent/soma. I have times when it isn't though. It's like a toothache that just nags at you.

Pain is like another entity inside your own body. And sometimes he just won't leave you alone and than other times the medicine quiets/calms him down. Does that make sense?

Rpg
 
Chronic Pain, Where to go From Here?

I'm a 19 year old male with a chronic pain problem. About a year ago, I received an operation for a rather complicated inguinal hernia (a pretty bad one). The recovery process took about a month, but after that I felt perfectly fine. Fast forward from there about a month and the same pain came back. It was excruciating. It felt like someone was ripping me open from my scrotum to my waistline. I've been bouncing around from doctor to doctor, and the general consensus seems to be that I have damaged nerves from the surgical procedure. I have been given a TENS (transcutaneous electrical neurostimulation system), which did nothing. I have tried acupuncture, but that is expensive and relieves the pain slightly for about a day. I have tried hypnosis/self-hypnosis, and that just makes me less anxious about my pain. I have tried nerve blocks, which are only minimally effective and alleviate the pain for only a couple hours. I have tried several non-narcotic "nerve pain" drugs like Lyrica, Neurontin, Elavil, and Cymbalta, which all either do nothing or make me feel depressed (namely the Elavil).

Thus far the only thing that has helped me has been narcotic pain relievers, and my doctor is going to cut me off from them at the end of the month. He says that drug dependence is no way to live (yet he has no problem with me taking Klonopin three times a day for god knows how long8)).

Where do I go from here. Am I just going to have to live with this pain? It's beginning to make me depressed and I don't know where to turn.
 
I would go to him and tell him "If you aren't capable of treating me for my pain condition, I will find another doctor." Try to get an appointment with a pain management doctor. Thats what I ended up doing. Doctors arent really good with treating pain, unless thats their field. Trust me, it will work out.
 
Find a different GP or ask to be referred to a pain management specialist. Drug dependence sucks, but chronic pain makes it difficult if not impossible to simply FUNCTION.

He's also clearly an idiot doctor. Benzo dependence is far more detrimental and just downright dangerous than narcotics.
 
^^^
You don't know for sure if hes an idiot or not. Maybe pain management isn't their scope of practice. A lot of doctors who aren't in PM aren't really comfortable with prescribing narcotics, just because their not familiar with chronic pain. Its like a shrink prescribing antibiotics for a kidney infection.
 
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Even though your doctor has a point that it is not a great way to live, he also should understand the fact that when people have chronic pain, and have tried many things to manage it like you have, that sometimes narcotics are the only thing to turn to for relief. I would find a diff doc and/or get into a pain clinic. If your pain is legit you should have no problem finding a doctor who will treat your pain, there are some good compassionate docs out there still.:\
 
Fuck, I went through my GP, then my kidney doctor, then a pain management doc (who refused to treat me), to a second PM doc. From what I hear, its normal to already go through a bunch of docs before you find the right one.
 
Well my GP is the one that has been prescribing me the narcotic pain medication and is cutting me off, I also forgot to mention that he wrote on my chart to not prescribe me narcotics in case I see a different doctor at the same practice (that just seemed like he didn't trust me or something). I have seen 3 different pain specialists and they have all told me that they don't prescribe opiods/opiates at their practices, it's probably a regional thing (I live near LA).

EDIT: I think also part of the problem is that the ultrasounds and CT scans I've gotten pretty much confirm it's a nerve issue. I've had 2 different doctors tell me that opiates do not relieve pain that originates from damaged nerves. I don't know how true that is, seeing as how the Dilaudid I've been taking for the past couple months has been working pretty well at controlling my pain to the point where I can be functional.

EDIT 2: I have a medicinal marijuana license (I live in CA), but I live with my parents. My mom said she'd rather have me smoke pot than take pills, but my dad is skeptical of the efficacy of marijuana for pain. Indica strains usually make the pain "numb" instead of reduced (but hell, that's better than pain). That, plus marijuana ends up being rather expensive when you add it all up. A months supply of my pain meds used to be $10 under my insurance, but a gram of decent cannabis is $20-$30 at the medical dispensaries and that'd last me probably a few days. Is it worth asking about Cesamet or will they laugh at me? (I know it's off-label used for nerve pain)
 
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william1985 said:
^^^
You don't know for sure if hes an idiot or not. Maybe pain management isn't their scope of practice. A lot of doctors who are in PM aren't really comfortable with prescribing narcotics, just because their not familiar with chronic pain. Its like a shrink prescribing antibiotics for a kidney infection.
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I dunno, I think any GP should be aware of the risk and extent of dependency for commonly prescribed classes of drugs.

In any case, your pharmacist should DEFINITELY be aware of these issues. You might even try having him/her call up your doctor to discuss it.

My doctor is the opposite. He prescribes me 300+ 4mg hydromorphone a year (for infrequent kidney stones at that), but is really hesistant when prescribing benzos. He'll only give me 5-6 at a time and to use only as needed - which doesn't bug me at all because the last thing I want is a benzo dependency.
 
^^^
Keep looking. GPs are pain doctors. They will on script narcotics for a short time. Look online for a pain doctor in your area.
 
Merging Geist89's chronic pain question into the Pain Management mega thread.
 
Geist89 said:
I'm a 19 year old male with a chronic pain problem. About a year ago, I received an operation for a rather complicated inguinal hernia (a pretty bad one). The recovery process took about a month, but after that I felt perfectly fine. Fast forward from there about a month and the same pain came back. It was excruciating. It felt like someone was ripping me open from my scrotum to my waistline. I've been bouncing around from doctor to doctor, and the general consensus seems to be that I have damaged nerves from the surgical procedure. I have been given a TENS (transcutaneous electrical neurostimulation system), which did nothing. I have tried acupuncture, but that is expensive and relieves the pain slightly for about a day. I have tried hypnosis/self-hypnosis, and that just makes me less anxious about my pain. I have tried nerve blocks, which are only minimally effective and alleviate the pain for only a couple hours. I have tried several non-narcotic "nerve pain" drugs like Lyrica, Neurontin, Elavil, and Cymbalta, which all either do nothing or make me feel depressed (namely the Elavil).

Thus far the only thing that has helped me has been narcotic pain relievers, and my doctor is going to cut me off from them at the end of the month. He says that drug dependence is no way to live (yet he has no problem with me taking Klonopin three times a day for god knows how long8)).

Where do I go from here. Am I just going to have to live with this pain? It's beginning to make me depressed and I don't know where to turn.
Click to expand...

It's sucks to be there man, I hope you can work things out. I'm was kind of in you're situation only the painkillers I was using weren't prescribed to me :\ But all the Drs I went to would never give me anything but NSAIDS and Neurontin which did shit for my pain. I'm only a couple years older than you, and our young age is a great disadvantage to us when it comes to trying to get narcotic medication for legitimate pain. I just ended up kicking the pills I was taking and getting on suboxone and that has worked fine for my pain so far.
 
william1985 said:
^^^
You don't know for sure if hes an idiot or not. Maybe pain management isn't their scope of practice. A lot of doctors who aren't in PM aren't really comfortable with prescribing narcotics, just because their not familiar with chronic pain. Its like a shrink prescribing antibiotics for a kidney infection.
Click to expand...

If pain management isn't his forte he shouldn't have tried to unsuccessfully treat it and then cut him off. He should have sent him to someone capable. Your analogy is better suited to a shrink cutting him off his antibiotics for a kidney infection.

(Unless the guy is clearly faking it)
 
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Please help!

HELP! ok my girlfriend has a thyroid condition and they keep BS'n on meds because her hormones are fluctuating so much (one appt there normal the next she has graves disease) she currently lost her insurance so can only afford one more appt. she throws up every morning and at work and has horrible back pain at work, so my question is if we go in there and demand medication is there a good combo for nausea/pain relief, I was thinking of just straight up asking for tramadol or darvocet if they dont offer anything stronger and say my moms a nurse and told me to ask for that, because im not goin in there and having her ask for vicodin (shes only 18 ) but if they offered that it would be great! but i also need a good anti-nauseant, shes currently on a low dose of a beta blocker called atenolol to help with her heart beat and some other symptoms. thanks!!!!
 
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