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

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BananasAndOranges said:
Not trying to score. I have been to several doctors and it gets worse when I get sick. They have all said meh or whatever. Its annoying.
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I know the feeling man. Every time I step foot in the doc's office they treat me like I'm a drug seeker. Because I'm young, and I have piercings. Why do they need to treat me like that? It's not right or fair. I'd rather just go score if they're gonna treat me like shit anyway. :X
 
Well after 14 months since my initial injury I finally will see a pain management doctor this Friday. Could be my saving grace as the 7.5 vicodin I have been on for the 14 months doesn't even touch the pain, and my ortho doesn't seem to have any interest in upping my dose/switching my meds. I even asked if it was normal for the medicine to lose its effectiveness overtime(even though I knew the answer) and he just replied "yeah" and wrote me the same script as usual.

I'm hoping for Oxy 10's, or at least percocet 10/325. I am sick of having to take more vicodin than I am scripted for just to cover the pain, which in turn leads me to running out before I can refill.
 
michael said:
toradol did nothing for me. neither did mobic or lodine, for that matter.
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toradol is great if you add it to a morphine/hydromorphone/oxymorphone

this may help a few patients here who are already on it and need a bit more analgesic
 
Just a: "what would you do in my shoes" type question...

Hey all...I know, I'm quite new here but, please feel free to read/reply to my introduction post if you feel so inclined! =D

Anyway ~ I'm going to give you some of my background but I promise to make it as brief as possible though not to forget important information that will eventually help answer my question (or so I assume).

May 2006/October 2006: 4 total low back surgeries. First two in May consisting of L3-L4 laminectomy & discectomy. Removed 8mm herniation that was causing me urinary incontinence. Second two surgeries in October consisted of L3-L4 discectomy (again) and some procedure to remove excess build-up of scar tissue from previous surgeries.

December 2006: After months upon months of God awful rediculor nerve pain...damn near deabilitating, surgeon diagnoses me with Failed Back Syndrome (with or without the word: "Surgery" placed before "Syndrome"). A week later I'm placed in Pain Management. Sweet. Found the right combo of meds. w00t!!!

FAST FORWARD QUITE A BIT

May 2010: I no longer see any Pain Management specialists because I moved from that state back at the end of 2008. Things are MUCH different in Illinois versus North Carolina when it comes to DEA controlled substance monitoring. I can tell you one thing...there has GOT TO BE a shitload of people in this state who suffer from chronic pain because with all these reporting procedures and governmental "Big Brother'ing" going on, no doctor is willing to trade his license to practice medicine so a single patient can live a somewhat normal live.

**Went off on a rant...I apologize 8) Now for some shitty news...

June 2010: Have surgery to remove substantially enlarged lymph node from right axilla (armpit). I'm going to list all the information I think you should know in actual list form below:​



*DIAGNOSIS/DATE: Nodular Sclerosing Hodgkin's Lymphoma/June 19th.
*STAGING: 4B Agressive
*MASS BIOPSY RESULTS: 7cm (roughly the size of a softball) malignant tumor infiltrated with living & mummified t-cell lymphocytes
*CHEMOTHERAPY REGIMENT: bi-monthly (every other Wednesday) administered @ Cancer Treatment Institute inside local hospital for a preliminary period of 4 months (8 treatments). Have completed 4 up to now.
*CHEMOTHERAPY DRUG COMBINATION: "ABVD" Description of acronym and list of each chemo drug seperate is supplied here.
*PROGNOSIS: >60% chance of complete non-cancerous recovery
*RADIATION: To begin at unknown level when chemo is finished.


I have a PET-CT scan today (Thursday) to check my progress since I've finished exactly half of my set chemo schedule. These results will show exactly where I'm at, if the chemo is working as well as if there needs to be changes to my regiment, if the Lymphoma is still aggressive, if any other Lymph Nodes are affected as well as any organs and more importantly, the blood stream. Have a PFT (Pulmonary Function Test) & Heart Scan on Friday to see how well those are holding up against chemo as well. I'm kinda nervous! :|

So, you are probably asking yourself - "where the hell is this guy's question come into play?" LOL - I know ~ thank you for your patience and for sticking with this for this long already. Here is my issue -

Even though between the time I left North Carolina and had to move back to Illinois (a move to Missouri was between them) I was experiencing low back pain, I found that I was better off dealing with it the best I could without medication. I was unable to find relief from OTC meds, steroid injections, heat/cold, physical therapy/chiro assistance and just general excercise. I honestly thought the fact that between December 2008 and now I have lost over 100lbs (alittle with exercise, a lot due to Lymphoma) but eh, the back doesn't seem to care. My back pain has increased 10-fold since I started chemotherapy. I do not know if there is a connected between the two but side-effects listed for a few of the chemo drugs show pain and swelling in the hands and feet as possible. Though I can state with almost 100% certainy that the pain I'm experiencing now is identical to the pain I would experience before I started chemo, just much, much worse.

After mentioning my concerns and pain control troubles to my oncologist, he seemed rather unsympathetic as well as downright stand-offish. I mean, I haven't caused this guy any trouble nor have I asked for anything other than anti-nausea meds so I'm not sure why a doctor who specializes in the treatment of cancer and cancer related effects would deny me some sort...hell...ANY sort of pain relief. I would NEVER demand anything and would be happy to leave the decision of what to prescribe up to him.

Simply: I'm in pain...I have cancer....oncologist could give a dead rat's ass, so I'm quite stuck.

QUESTION: If you were in my shoes, how would you handle this situation? What things would you do to have your voice heard and your ailments treated properly?

THANK YOU FOR READING/RESPONDING ~ IT IS GREATLY APPRECIATED!!! ​
​
<3​
 
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I'm just throwing this out there for ya, man...


...But, I wouldn't walk into a doctors office spouting off different narcotics, dosages, or that you're even taking them. Because the doctor is going to be like "well, he's buying them off of the street, what a drug seeker." It's fucked up, but that's how they think/work.

You're going to have to jump through a lot of hoops to start pain management. Because they might not even start you off on narcotics. You'll have to go get an MRI/X-Ray, and probably an array of other tests, just to prove that there's something legitimately wrong with you. I'm not saying there ISN'T something wrong with you, but the doctor's going to wanna make sure you have a legit problem before prescribing you potent narcotics, just so he can cover his ass.

I would go into the doctors office with the attitude of "I'll do whatever is necessary to help solve the problems of my pain." Whether it's injections, physical therapy, whatever. And he'll probably want to try various non-narcotic medications, only turning to opiates/oids as a "last result" type of thing.

It's a long process, man. And it's a hard/aggravating/annoying/frustrating process at that. So just prepare yourself to jump through all kinds of hoops.

Just do whatever it is the doctor thinks is "best," even if you think you know better. Because honestly, there COULD be things that help your pain, besides the narcotics you THINK you need.

Anyways, good luck man.

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Now playing: Atmosphere - Like Today
via FoxyTunes
 
@ Receptor Bound...

...I'd find another oncologist, honestly. You're paying them for their services. If you're not finding the treatment, of even the options of pain relief, I would just find a new doctor.

Good luck though, man. I hope shit gets better for you.

sorry about the double post.

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Now playing: Atmosphere - Nothing But Sunshine
via FoxyTunes
 
Law said:
I'm just throwing this out there for ya, man...


...But, I wouldn't walk into a doctors office spouting off different narcotics, dosages, or that you're even taking them. Because the doctor is going to be like "well, he's buying them off of the street, what a drug seeker." It's fucked up, but that's how they think/work.

You're going to have to jump through a lot of hoops to start pain management. Because they might not even start you off on narcotics. You'll have to go get an MRI/X-Ray, and probably an array of other tests, just to prove that there's something legitimately wrong with you. I'm not saying there ISN'T something wrong with you, but the doctor's going to wanna make sure you have a legit problem before prescribing you potent narcotics, just so he can cover his ass.

I would go into the doctors office with the attitude of "I'll do whatever is necessary to help solve the problems of my pain." Whether it's injections, physical therapy, whatever. And he'll probably want to try various non-narcotic medications, only turning to opiates/oids as a "last result" type of thing.

It's a long process, man. And it's a hard/aggravating/annoying/frustrating process at that. So just prepare yourself to jump through all kinds of hoops.

Just do whatever it is the doctor thinks is "best," even if you think you know better. Because honestly, there COULD be things that help your pain, besides the narcotics you THINK you need.

Anyways, good luck man.


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Now playing: Atmosphere - Like Today
via FoxyTunes
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sorry...
 
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Hello my name is Kyle and I'm 20 years old and have been suffering from chronic pain for a little over a year now. First off I would like to say I read every page of this thread, and I feel deeply for you all and hope you get the adequate relief many of us need to continue our lives.

I should say, I am addicted to poppy pods, because my pain has gone untreated for so long I wanted to kill myself. Poppies have really helped me get through the past year, except I want to be legal and quit having to hide the fact that I self medicate. And I'm having a hell of a time getting off of the pods...

My chronic pain is in my hands and neck mainly. I get sharp and shooting pains in hands, all the way through my forearms some times. My neck gets burning pains, and sharp pain so bad I can't get out of bed a lot of times. To add to the list, both of my knees have started hurting a lot as well.

I have been to three different doctors, I've taken MRIs, XRAYs, carpal tunnel tests, blood work for everything. So far they have no clue what is hurting me.

I've tried neurontin, naproxen, other anti-inflammitories. Prednisone, clinoril, and not one of these medications has helped.

My current doctor has put me on tramadol, which definitely helps a bit. The problem is it messes with my emotions, causes depression, gives me headaches, and I just generally don't feel like myself on the medication.

To make matters worst, I just got fired from my job 3 days ago. My boss got tired of me being in pain... So now I'm at risk of losing my health insurance. And I'm to the point where if I'm not on medication, then I can't work at all. So how in the world am I supposed to live without insurance, not being able to work?

My question is, should I ask my doctor straight up if I could try hydrocodone? I know it helps obviously, and I had a 2 week prescription a year ago. I just can't continue to live like this. I've had to taper the poppies for months now because of the shortage, and my life is fucked without some sort of painkiller to get me through the day, much less being able to work even 15 hours a week.

I just don't understand why so many of us have to go untreated for so long. I'm not looking to get high at all. I just want to live my life like a normal person. I am tired of waking up and crying, and not being able to sleep because of pain.
 
So of course he takes me off tramadol and gives me some bullshit NSAID called Mobic. I wanted LESS side effects not MORE. I've taken 4 different nsaids, and not a second of relief.

Well I guess I might as well file for disability. I can't work until I find a doctor who isn't a dumb shithead.
 
Hey all, I have been dealing with PM drs since around '95 and most of what I have read here is true. For the guys who have been self medicating and now want to get into the system, nobody has lied to you here. My recommendation for you is to try to think like the doctors: first thing to do is to get into a doctor run drug treatment program. (I never said this was going to be easy.) They will want to know how you got started taking opiates and you can tell them your story HONESTLY. They will probably initiate drug stoppage, BUT let them refer you to a pain management doctor/clinic. The PM guys will take learning of your drug use much better when it comes from a drug treatment doctor. It says, "this guy/girl is trying to do the right thing."

There is still a chance that any particular PM doc may never want to Rx you opiates, but it's the only chance you have while telling the truth. From that point, you may have to do like the rest of us and start the search for a doctor with some compassion. BUT, if you lie and they get the idea you are trying to blow smoke up their ass, you'll never get anywhere.

Now, the reason for this thread: I have been on Methadone since '97 - a model patient so said the PMC docs. They started me on 15mg/day and I titrated my self back to 5mg a day within a year. They then transitioned me to my primary care dr because of the heat they were getting from the DEA for total number of scripts from the clinic. I went till 2008 when my primary started me on 10mg & Hydrocodone 7.5 w/APAP for break through in addition to the naproxen/mobic I had been taking as my pain got worse and an old cervical injury started acting up. A year later she changed me to 5mg Oxycodone as break through wasn't controlled and took me off of all NSAIDs as my liver numbers were getting bad.

I should mention that my pain was held to tolerable as I had to be 100% for my high pressure job as a sales engineer w/ a large 3 letter acronym computer company. Aug. 2005 I went into major depression triggered by my mom's death, but with chronic pain and a number of other things as factors and I went on a leave of absence. Had a heart attack in May 2007 and they retired me. Got screwed out of ANY company disability and just recently went on SS disability.

When I recently told my primary that the 10mg of methadone in the morning wasn't doing it and I was taking PRN meds regularly, she said that she wouldn't make any further changes, so we agreed that I should go to a PM doc and she referred me. He started out telling me he didn't want to add any methadone and "you know, 1mg of methadone equals 10mg of morphine, so you are taking a lot." To which, not to my credit, I became somewhat unglued and told him that was a ridiculous statement. Next appointment he says, "All of the major pain clinics in the area are phasing out the writing of methadone scripts and, therefore, so am I." The alternative? ER morphine or fentanyl patches. Does this make sense to anyone out there?????

-begin rant-
My issue right now is that I am fairly pissed at the recreational drug users, in addition to PM doctors. It seems that many naive opiate buzz heads get a hold of methadone, not knowing that there is little to no buzz with it, and keep taking it until they die. Joy dopers are the big reason that those of us with legitimate need for opiates are having such a hard time getting treated!! Methadone works for me and there is no incentive for abuse! BUT, now I can't get it anymore, but I can get drugs with much greater risk of addiction!
-end rant-

Regards,
SeaDoc (see recent intro for further background)
 
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Law said:
@ Receptor Bound...

...I'd find another oncologist, honestly. You're paying them for their services. If you're not finding the treatment, of even the options of pain relief, I would just find a new doctor.

Good luck though, man. I hope shit gets better for you.

sorry about the double post.

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Now playing: Atmosphere - Nothing But Sunshine
via FoxyTunes
Click to expand...


Thanks Law for the response. I appreciate you taking the time. I've given a lot of thought towards replacing my oncologist but at this point in time (just about halfway through my treatment) I believe it's just too late.

It'll get better though - just gotta get through this for now!

Thanks again,
R*B
 
Wow ihatepipes I hope that goes well.

I am having the exact same problem. Have pain in both my hands, my neck, and both my knees. I'm hurting somewhere constantly 24/7 without opiods.

I'm hopelessly addicted to poppy pods. Even with the shortage that been going on I haven't found time to taper.

Please do update us on how the visit goes. I've wondered about finding a doctor and just telling the truth from the begining. But the fact is it's been so hard for me to find a doctor willing to prescribe me opiods without me admitting to an addiction. (I haven't found one) I'm afraid to even try.

Good luck.
 
Okay, I'm new but I posted in the intro thread and I (like all of us have been) am in a bind. I have chronic pain from several skate injuries from when i was a pro skater, and am prescribed 180 10mg Opana's per month.

I got a full month's fill before this vacation I'm on. about 3 weeks into the vacation I decided to extend it since I'm having a blast with the woman of my dreams, well I am in a different state as home, so I call my PM doctor and tell her that I need her to write a refill and that my mother will come pick it up, fill it and mail it to me... no response.
Fast forward 1 week and I'm not out of pain meds so I'm totally fucked - I call my orthopod who says he would prescribe me something over state lines but it would break my PM contract (by the way I don't recall ever signing a fucking contract), suggests I call my PM doctor. So I do and I actually get through to her (miraculous) and she just flat out tells me there's nothing she can do, when I know she could call in a C3 or something. Oh by the way, it's her last day at the practice, so i feel like she just doesn't give a fuck.
Then I call my primary care doctor and he says he would but he's not licensed to write over state lines.
So long story short, I ended up refilling a really old tramadol script that I happened to remember was in Walgreen's database. So I'm stuck with a drug that is 1/10,000th as potent as what I'm used to taking. Fucking great.
Basically what I'm asking is what can I do to potentiate it as much as possible? I know about all the inhibitors and GFJ, benadryl, meclazine, tagamet, etc...
My question is, since tramadol is converted into M-1 by my liver, should I not wait until after I have dosed to take all these inhibitors? planning on like 800mg tagamet, 100mg benadryl, 100mg meclazine, and a litre of white grapefruit juice.
SO... BEFORE OR AFTER? I want the tramadol to turn into M1, and then i want that M1 to stay in my system for as long as possible. what do ya'll think?

thanks, stay up - even when it seems like doctors hate us, gotta remember they are just watching their own asses, as shitty as they may be.
 
2 things, 1. Tram goes up in oral BA after it is in your system (useful info to have when deciding how to dose) and 2. since you're dosing with something very weak compared to what you normally use, it is likely you'll consider going over the 400mg safe daily dose. So if you have some sort of anticonvulsant handy, I'd suggest taking that as well.
 
well i took 4 pregabalin (lyrica) and 4 valium (10's) about 3 minutes after just to make sure. actually just took all this shit since no one had responded.

but the question still lingers- before or after for the enhancers?
 
littlegirlblue,

How you doing girl?? Haven't seen you on here in a while. Are your doctors taking a little better care of you??

SeaDoc
 
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