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

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seeing pain doc soon

Let me just start off with some background info on my injuries and then ill get to my question. First off im a 21 year old male that has been in two near fatal car accidents in the last year. I had one in february of 08 and cut my face in half and broke my wrist in 3 places. I went through the windshield of my car. The second accident i had in july of 08. I was in another car wreck where the car went airborne and started flipping and i flew out of the car and hit my back on a tree trunk. I crushed my L5 verterbrae broke my pelvis in 2 places and ruptured 4 organs my stomach, liver, kidney, and bowel. Ok so its been almost 6 months since my last wreck and I'm still in a decent amount of pain. Ive done 3 months physical therapy as well as seeing a chiropractic 3 times a week. This all helps but only for a day or so at most. Well in the last month i decided i cant take the pain on a daily basis anymore. So i went to my orthopaedic dr and got a refferal to a local pain management dr. Ok so when hes telling me about what this particular dr likes to administer he starts telling me about some sort of injection that they want to try. So what does this entail and any info from a first hand experience on this procedure would be beneficial. I dont plan to go in there looking for pills but i am trying to do my research on my particular pain and what has worked for other people. I dont want to go into this ignorant and end up wasting a lot of money on something that doesnt work. Thanks for reading and any info anyone might have.
 
if its the injection I'm thinking of, its just calcium that they inject at the pressure points to try to push them apart and relieve the pain. they use those injections at my pain clinic but they are usually accompanied by pain medications. they say they use the injections so they can use less narcotics. it didn't work for me because of nerve damage.
 
nowdubnvr6 said:
Ok so when hes telling me about what this particular dr likes to administer he starts telling me about some sort of injection that they want to try. So what does this entail and any info from a first hand experience on this procedure would be beneficial. I dont plan to go in there looking for pills but i am trying to do my research on my particular pain and what has worked for other people. I dont want to go into this ignorant and end up wasting a lot of money on something that doesnt work. Thanks for reading and any info anyone might have.
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This could be epidural steroid injections.... exactly what it sounds like. They inject steroids (the most potent anti-inflammatories around) into the epidural space (the fatty space around your spine) to reduce inflammation in the area. This is beneficial in ~50% of cases which could be telling about its efficacy, or doctors frequent over-prescribing of it. I had 3 of these done and they didn't help but my ailments are far different from yours.

The second option is nerve blocks. This is where they inject local anesthetics like lidocaine around injured nerves to essentially shut off the pain from those nerves for a few days to a few months. This is most effective for neuropathic pain and I'm not sure if that is your primary concern.

I would GUESS that he is talking about epidural steroid injections but I can't know for sure. Most pain doctors have a preferred method of treatment... some LOVE surgery, some nerve blocks or steroid injection, some love narcotics, some love physical therapy and HATE drugs (usually those are the physiatrists but luckily MOST pain doctors are anesthesiologists so they are much more comfortable adequately treating pain pharmacologically).

I hope this was helpful, and I know my descriptions were brief but that was my intent, if you want to learn specifics you can search for epidural steroid injections and nerve blocks. If you have any more questions please feel free to post them here or PM/email/IM me anytime, I've been living with pain for 3 years, the last year relatively comfortably and productively and I'd really like to help.

Take care.
 
^^^^^^^^^^^^^^^^^^^^^^^^^
I agree with Cane2theLeft, that sounds just like a epidural steroid injection....i should know, ive had them
they do work great for some people, but not me as i dont get relief for very long with them:\...

ive also had a nerve block done as well but it was a miserable failure resulting in inflammation and irritation of my cervical joints

i hope it all goes well, i'll talk to you soon,

peace man
 
I appreciate the quick responses. i do remember something about epidural injections. I think that is the ones he was talking about. I do have some nerver damage as well as a result of the compression fracture in my verterbrae. Again thanks and ill be doing some more research on that. Also im kind of in a predicament with law and parents seeing as i have a felony from having prescription meds without a prescription. It wasnt to abuse them but i didnt have health insurance at the time and couldnt really afford dr visits plus the script so i bought them on the street. Do you think that could be a problem with the pain dr in terms of if the injections dont work and they need to prescribe narcotics?
 
Hey some questions for anyone who has had experience with these two medications in the same regiment ..

I just asked my doctor to switch me from trazadone (which wasnt working) to temazepam for sleep. he gave me 60# 15mg capsules to try out with 3 refills.

the reading i did over at rxlist informed me that in most patients who took it alone for sleep had a very small margin of side effects if any at all. which is why i requested it . i hate side effects , especially if i have to work the next day.

however as i started reading more and more on it . it was listed on wiki (i know) to be the apparent cause (alone and mixed) of many benzo related overdoses and hospitalizations . then reading on here that some people seem to say it sucks and others fall head over heal for these things .. whats the deal ?

i asked my doctor if it would be safe to use along side my medication for sleep when i needed it . and he said yes but i may have an additive effect on feel drugged up.

my question i guess is , if anyone else was prescribed this for sleep while on an opiate regiment where there dosing followed a few hours after taking their last dose of x narcotic .. did you get many side effects the next day or in regards to increased respitory depression ?.
 
LightTrailz said:
my question i guess is , if anyone else was prescribed this for sleep while on an opiate regiment where there dosing followed a few hours after taking their last dose of x narcotic .. did you get many side effects the next day or in regards to increased respitory depression ?.
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my dose was taken usually about 3 hours after my past pm dose of my Opana, i didn't have any side effects but that is most attributed to the fact I have been on benzos for over 2 years and have a marked tolerance, I still did keep respiratory depression in mind though because that is the biggest risk when taking this combo (even when taken as prescribed in our case) but I was fine throughout my time on temazepam. i trusted my doctor knowing about this combo and its safety and i hope you have a good doctor you are able to trust about it as well.

start out small and just take the minimum dose of temazepam that gets you to sleep, it might take a few days to find it, but you will, and hopefully it will be less than you are scripted or what you are scripted so you dont have to go up anymore, or stay on it very long for that matter. being dependent on benzos is horrible.

good luck man, hope all is well,

Peace
 
Well he wrote down i can take 1 - 2 15mg capsules but recommended to start off with 1 . is this stuff really as dangerous as some of the stuff ive been reading up on .. none of it was mentioned on rxlist previous to me asking for it .

from my charts it appears to be equal to about 5mg of valium.
 
As long as you are very tolerant to the opioids, I really don't think you have much to worry about. I was never on temazepam but I was on MScontin and then started taking 2mg of ativan a day and within a week went up to 4mg... I was on a lower dose of opioids than you are but I think that's irrelevant because I would wager we were pretty equally tolerant to our respective doses, and the 4mg of ativan is considerably stronger than 15mg of temazepam (IIRC).

I can't say with certainty or experience, just my informal knowledge and the couple pharmacology classes I've taken that I am pretty sure you'll be fine taking 15 and likely 30 but as always, work your way up slowly and be vigilant.

Also be careful about the amnestic affects, much like zolpidem you might like it, stay up and down half the bottle.... that is the only thing I'd worry about, the damn anmesia benzos cause.

Good luck, LT and I hope it works out for you.
 
Yeah i am tolerant to my medication but the last time i combined opiates with benzos was the last time i dislocated my knee and took 2mg of ativan and then 3 percocet at the hospital .. and being a benzo intolerant person that combination alone floored me to the point where i was completely unstable and about as loopey as a school child .

i am still benzo intolerant but tolerant to about 120 mg of oxycodone .. but i can still feel the effects of the medication when i take it which is what worries me and getting a cumulative form of dopedupness . and the fact of being worried it may carry over to the next day ..

see usually my normal regiment is 40mg of oxycontin in the morning at 715 am before i go to work .. i feel this dose up till about 10am which can sometimes be a challenge to stay awake if im not moving around. i take 20mg of baclofen at lunch time along with 10/650 of percocet from all the hunching over i do at my desk. i take another 10/650 around 4-5pm when i get off work . eat something then take my 40mg of oxycontin again around 8-9pm because of how late i have a chance to eat. then normally take another 20 mg of baclofen at 10-1030 as im lying in bed which is enough to make me drowsy lying down but not up and moving around . thinking i may have to cut out that last dose of baclofen and trade it for 15mg of temazepam .

its just that concerning warning ive had stamped in the back of my head about not mixing benzos and opiates .
 
I definitely understand your reservations and think you have very good, responsible attitudes about your medications. If I were you I would cut out that last baclofen at the start of the temazepam dosing. I know baclofen works on GABA but nothing more specific, do you know if there is any cross-tolerance between baclofen and benzos? That might work to your favor
 
Im not sure if baclofen (gaba-b ) would have any influence or not in regards to benzo tolerance . if so that might help . ill take a look around and see if i can find anything tomorrow .

wether or not they work on the same receptors would be key in figuring that out .
 
pain management n what would be prescribed

im 21..i have 2 pnched nerves...sciatic nerve damage..a herniated disc...and something with my spine where a vertabrae juts out...forget what it is called...i had all the tests ect done..so its all on paper to what i have....when i first went to my doctor a year ago he gave me lidacane patches..skelaxin..physical therapy...and ibuprofen800(lol)......i had some problems with opiates when i was younger.....n went to him before all this..for him to help me detox...i had nice oxy 80 habit...i am going to ask him to send me to a pain specialist.....i have since quit..but with the work i do i can barley function without pain meds..let alone sleep or be comfortable....
regular perkaset mess my stomach up with all the asprin....

is this what they will prescribe me..or if i explain that the asprin messes me uup will they dose me with something else.......

and also if i was in rehab before when i was 18 - 19 n then on suboxin....would insurance not cover me for this type of thing???

anyhelp would be apreciated.......
 
well, if you are labeled as a previous addict or have been to rehab, it might be awful hard getting into a pain mangament specialist..

I am a tad bit older than you, have 2 ruptured discs and pain management still treated me like I was there for all the wrong reasons, I gave two clean urine samples, don't smoke do anything, am a student, athlete everything, and after months they still wouldnt give me anything.....

This may be a problem for you.. But if you do get into a pain clinic, they will find what helps you best, and usually go through a bunch of differnt meds that suite your pain best.
 
percacet does not have aspirin in it.it cotains acetmenophen brand name tylenol. your skeem fails there.
 
It will be slighty hard for to find a doc. I know a couple people on PM who are on narcotics who were once addicts.
 
We're not going to give you advice on how to get the medication you want out of your doctor. The best way to do it is to work out what meds help and which ones don't, as well as exploring other options if necessary.

Merging eles215's thread into the PM Mega Thread.
 
^ I was hoping that he might be able to get some help regarding his actual pain from others in a similar situation... of course any posts that seek to assist him in getting a certain med will be removed and warnings given.
 
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