Misc The Pain Management Mega Thread v. 7

[LucidSDreamr]

Has any one noticed more difficulty filling scripts than before?...due to the recent 25 perecent cut in wholesaling by the dea?

My wife and are are renouncing citizenship and moving to Canada....as my scripted pain med are basically illegal and unattainable any more due to the dea....I'm forced to buy heroin in the ghetto because my script sitting at home can't be filled due to the dea.

This is no way for CP patients to live....get out of the US if you want to he allowed to have medicine

 

[DixiChik]

Yes, Lucid...This seems to be what it has come to.

I don't see any sunshine through the proverbial clouds for us chronic pain peeps!

My options for pain management meds are limited due to GI issues and costs of potential new meds (that I may tolerate). So I continue to suffer.

BTW...I just returned from my second dental appointment in a week. ($550) My dentist cut apart my porcelain crown to "confirm" I now need a root canal and a NEW porcelain crown. Jeez...I now have a tin foil molar crown, but hey! I have options...I can spend $2,000+ to save the stump/root or $3,000+ for extraction of said tooth and implant. Cherry on top is that the implant would be a slow process in stages over the next 1.5 years.

No thanks. I asked them to turn off the lights and turn up the gas mask. I'm tired of rearranging the deck chairs on the fucking Titanic.

 

[Pembroke]

Hello, hello;

I have seen some folks reference this thread, so I wanted to hop in and poke around. I'm a post aortic rupture and rhabdomyolosis / compartment syndrome patient with resultant RSD/CRPS for seven looong years. I was injured by a physician and joined BL during some med changes last year, but am settled back into my routine.

The worst thing about being injured by a physician is definitely the difficulty I have in finding care, but the best thing is that there's a fairly clear record of what happened to me. I still struggle when I'm in the situation of ending up in the ER becausey condition is poorly understood - pretty much any chronic pain patient can relate to that, I'm sure! I avoid going at all costs, because even if I were in the midst of a critical injury, one look in EPIC and I am immediately asked, "Well, what are you on all those pain meds for?" ? You don't have to be on much of anything for that crap either - way back when I was on 10mg oxycodone TID, I'd get that crap. Now that I'm on hydromorphone hp q 4°, I don't even want to deal with an ER staff's judgement and poor understanding of my vascular condition and chronic pain.

Anyway, I just figured I can't be the only person who joined BL because of medication questions and looking for some CP camaraderie, so I wanted to ? hop on over and say "Hi guys!!" ️️️

 

[Pembroke]

Hello everyone. I am very new to this forum and not a drug user. Regarding drugs, my personal and professional interest in pain management, because I have a family member living with a chronic pain and because I am a nurse. Changes I currently see in approach to pain management simply make me scared. I was born and raised in Russia, where doctors couldn't care less about the patient's comfort. I had undergone a tonsillectomy without anesthesia, and witnessed my grandparents dying of cancer in unrelieved pain. Needless to say, American healthcare felt like heavens for me... And not a surprise, pain management is my professional interest.
Now I am scared. Recently I took my mom to an ER for back pain. My mom is a senior citizen, and her diagnosis is confirmed by Xrays and MRIs. She wasn't prescribed opioids for years. Her pain was 10, she literally couldn't move. She was given toradol, steroids, and one pill of Vicodin... Yes, just one. No more. I felt like my eldely helpless mom is being treated like a drug seeker.
And at work, I see patients being undertreated for pain all the time. I am advocating for them like a bulldog, but doctors can't do much because of regulations.
I am so scared. The healthcare system is losing respect for human beings, losing empathy. We the healthcare professionals feel helpless. I always liked palliative and hospice nursing, but now I feel that only with terminal patients I can be a caring and helping nurse, because I can give them enough meds to make them comfortable.
I think that these new regulations are harmful, and the people who suffer the most are the most helpless patients. People with chronic pains and limited income. People with limited English skills. People who do unskilled labor. The elderly, especially single.
Lawmakers who pass such regulations and scream about "overuse of opioids" have the best healthcare and all the meds they need. People who suffer from their regulations have pain, fear, and suspicious attitude toward them. Unfortunately I know all to well where this road leads. And again, I am scared.
Thank you for listening.

Hey there,

I don't know if it is the same where you are, but in my state you pretty much have to get a referral to an anesthesiologist / outpatient pain management clinic once you have a dx like that in place. Perhaps you can talk to you mom's GP about setting that up?

I was born in Pskov, Russia. I got out pretty young, but I do remember some of the medical situation. I never had anything as drastic as you, but I remember having bones set without anything for pain and stitches without a topical. I was between 6-8 for that stuff, but I still remember the excruciating experiences. I also went through nursing school before becoming a physician's assistant and it is really sad how many doctors don't think pain must be treated - never mind that pain patients, left untreated, tend to die. We have a higher risk of about everything, from heart disease to fatal depression to accidents to strokes. It's no way to live! I have a very good pain management professional who treats my pain and has no problem calling me out if he has concerns, which is important to me to have that kind of relationship with a doctor. I come from a long line of alcoholics and addicts, so I need someone that I can be honest with and who can be honest with me. I honestly believe I would be dead right now if I hadn't found my pain management team. They saved my life.

 

[DixiChik]

Hey Pembroke...WELCOME to the club nobody wants to join!

Obviously, this thread has gone "radio silent".

PAIN PEEPS seem to have dispersed, myself included. I'm still here. I'm still in pain. I'm still a PEEP. How bout you?

Again, WELCOME. We all need one another.

 

[SKR]

Yeah welcome to all those I have yet to welcome and hello to all my fellow pain peeps with whom I have not whinged to in a while. Still here, haven't totally given up yet. Well done for staying alive Dixi - well done you poor dear.

 

[DixiChik]

Hey SKR...Right back atcha my friend!

Some days I DO give up, but I continue to GET up and try to make a difference. Shit gets old though, amirite?

Good to "see" you! Oh, it doesn't have to be about whining...We can share the good, the bad and the ugly. We can laugh and/or cry.

 

[NeuroNymph]

Hi, I've been reading this site ever since I started going to a pain clinic about three years ago. I've suffered from crohnic pain for much longer than that, but after the onset of new problems required a switch in doctors and more opiates than I was already on I was referred out. My biggest issue is that I seem to be undermedicated or overmedicated. Lately though I've got lower back pain, migraines, Avascular Necrosis of both hips, knees, and jaw, bone infarctions, Crohn's, endometriosis, Fibromyalgia, Tietze syndrome, polyarthralgia, and cubital tunnel syndrome. Right now I'm on fentanyl, oxymorphone, gabapentin er, promethazine, chlordiazepoxide w/ clindium, and a topical compound containing topomax and several other joint pain relievers that I have to rub on my joints multiple times daily.

The biggest problem lately is that despite a recent increase in my oxymorphone dosage for breakthrough pain, I've been having more days where the lower back and leg pain is so bad I can barely stand up or walk. With my leg pain they're constantly cramping, feeling weak or feeling so heavy with pins and needles. I'm not sure if it's just the polyarthralgia flaring up maybe because the cold weather, or if they've misdiagnosed me since they focus more on treating my pain than diagnostic testing. I felt better last November taking oxycodone ir 15 mg for breakthrough than this 20mg ir oxymorphone. I've been on the oxymorphone since Dec 4, 2016, and the pain started getting out of control again around Dec 27, 2016...which is also when the temp dropped drastically and got really rainy.

Sorry for rambling, but I'm currently miserable and have barely slept longer than two hours since the 27th. I did try taking an extra half of an oxymorphone, but it just made me super nauseated. Also, I was switched from oxycodone to oxymorphone because I had a dental abscess that had to be drained and 15mg oxycodone didn't even touch that pain. I just need consistent relief from the crohnic pain of my poor faulty body.

 

[Pembroke]

Baaaah. I keep waking up every night at this time. I can take my next dose of meds in an hour, but I really really hate automatically waking up when it's approaching the time I can have my next dose. I used to at least sleep through most of the night, which saved me one or two doses a day, but now I wake up in schedule and in excruciating pain every 3-4 hours.

A friend of mine brought over some "red" Kratom. I haven't tried it. She said it's like a natural supplement, but I'm hesitant to take ANYTHING without talking to my PM clinic. Have any of y'all tried Kratom? Is it something that would violate my Pain contract? She takes it and sleeps all night, and I'm super tempted to try some, but I obviously don't want to risk getting in big trouble. But I'm also laying here, wide awake and hurting, 3 hours after a Dilaudid HP injection and a double dose of lyrica. Whhhyyy aren't I asleeeeep?!?!? ????

 

[NeuroNymph]

Do you take any sleeping pills? If it causes a "dirty" ua then it would break my contract. At my clinic if it's not prescribed and I don't have proof and it shows up then you're gone. My friend that referred me got dismissed for testing positive for Xanax, which she hadn't been prescribed in six months. Definitely scared me when it happened. The doc ripped up her prescriptions and told her she was dismissed. I was halfway scared to be seen leaving with her that day. The nurse that checks me in still teases me about it.

 

[Pembroke]

I don't take anything for sleep because sleep has never been a problem for me until recently. I incurred a brain injury at the time of my injuries (anoxia during prolonged flatline) and until recently I was actually on 90mg Ritalin daily, literally just to stay awake. Otherwise, I'd sleep 18+ hours a day. This has cropped up rather recently and it drives me mad. I want to cry.

 

[NeuroNymph]

Sleep has been an off and on issue for me. Right now the problem is that I can't get my pain low enough to fall into a deep sleep, and when I doze off if I roll over on my left hip I'm hit with sharp pains. Also if I stretch I get intense charlie horses so bad they wake me up. I sleep in a hospital bed with pillows arranged to minimize movement, but it's not helping much lately.

I've been taking a low dose melatonin supplement that helps some, but I can't maintain deep sleep. Ambien and most sleep meds make me get up and eat or fix food, which still causes pain issues due to walking, so I stopped taking it. Maybe we do need a good cry, especially if we get that good post cry sleep.

Luckily I haven't suffered from waking when the next dose is due in a very long time. Although that'd be preferable to zero sleep, which is the boat I'm in. Why can't we just find the happy medium?

 

[gmlifer]

Baaaah. I keep waking up every night at this time. I can take my next dose of meds in an hour, but I really really hate automatically waking up when it's approaching the time I can have my next dose. I used to at least sleep through most of the night, which saved me one or two doses a day, but now I wake up in schedule and in excruciating pain every 3-4 hours.

A friend of mine brought over some "red" Kratom. I haven't tried it. She said it's like a natural supplement, but I'm hesitant to take ANYTHING without talking to my PM clinic. Have any of y'all tried Kratom? Is it something that would violate my Pain contract? She takes it and sleeps all night, and I'm super tempted to try some, but I obviously don't want to risk getting in big trouble. But I'm also laying here, wide awake and hurting, 3 hours after a Dilaudid HP injection and a double dose of lyrica. Whhhyyy aren't I asleeeeep?!?!? ????

Kratom has never shown up on test for me and I typically will take it for two weeks leading up to the appointment and even the day of the appointment. I take meang da so it wouldn't help with sleep but if you know of or successfully try a strain that does work for sleep please lmk.

 

[Pembroke]

Kratom has never shown up on test for me and I typically will take it for two weeks leading up to the appointment and even the day of the appointment. I take meang da so it wouldn't help with sleep but if you know of or successfully try a strain that does work for sleep please lmk.

The strain my friend brought is called "red vein", and it's considered to be the best one for pain relief and sleep, and it's also highly rated for withdrawal if you're off meds or trying to reduce doses. She orders it online and says that it works really well.

Thanks for the information on testing. I decided not to try it yet, but I'm going to call my pain clinic on Monday and ask about it. I really worry about the possibility of something breaking my contract to the point of obsession, because I cannot go back to the way things were before. If they okay it and I try it, I'll let you know.

 

[Pembroke]

Sleep has been an off and on issue for me. Right now the problem is that I can't get my pain low enough to fall into a deep sleep, and when I doze off if I roll over on my left hip I'm hit with sharp pains. Also if I stretch I get intense charlie horses so bad they wake me up. I sleep in a hospital bed with pillows arranged to minimize movement, but it's not helping much lately.

I've been taking a low dose melatonin supplement that helps some, but I can't maintain deep sleep. Ambien and most sleep meds make me get up and eat or fix food, which still causes pain issues due to walking, so I stopped taking it. Maybe we do need a good cry, especially if we get that good post cry sleep.

Luckily I haven't suffered from waking when the next dose is due in a very long time. Although that'd be preferable to zero sleep, which is the boat I'm in. Why can't we just find the happy medium?

I had the same problem with ambien - I once woke up surrounded by empty Taco Bell wrappers. ? Like literally surrounded, my bed was completely covered.

My GP offered to put me back on temazepam, which I had good results with many years ago, but I'm hesitant to take that now because of my pain meds and because I try not to mess with anything that ends in "-pam". Of all the drugs out there, the benzos are the ones I worry about my risk of abuse. Over the years before my injuries, I had been on Valium, klonipin, and xanax at different times, in addition to the ristoril, and it was very easy to just not deal with life on those things. I never took more than prescribed or anything like that, but I could definitely see myself using that stuff to "escape", and that's not what they're for.

Still. I really wish I could sleep. I just took my dose of pain meds again and positioned some pillows such that I'm raised but supported - so hopefully I won't tense up and lift myself more. I wonder why I'm doing that. ?

 

[kleinerkiffer]

^You should try hydroxizine, it's a first generation antihistamine and it really helped me with my sleeping problems

 

[Pembroke]

^You should try hydroxizine, it's a first generation antihistamine and it really helped me with my sleeping problems

I will try that. Thanks for suggesting!

I need to work this out for sure because I finally got to sleep... and then knocked out until about an hour ago, 12:45 my time. I live on a farm. I can't sleep this late!

 

[trunkofmycar]

Need some info into whether or not bupe is effective for pain relief? My mom is looking to make the switch from oxycodone/morphine script she currently has... But also needs pain relief for several chronic conditions.

Is bupe ever used for pain management? The long duration of sub would be good in theory, plus it's much more stable & wouldn't have her waking up from the w/d early every morning.

?

 

[Pembroke]

Need some info into whether or not bupe is effective for pain relief? My mom is looking to make the switch from oxycodone/morphine script she currently has... But also needs pain relief for several chronic conditions.

Is bupe ever used for pain management? The long duration of sub would be good in theory, plus it's much more stable & wouldn't have her waking up from the w/d early every morning.

?

The short answer is "maybe".

Suboxone or, less commonly, Subutex are used for pain management, but it is not useful for all types of pain. I was interested in it and saw the bup guy in my pain clinic - in my state not all anesthesiologists can prescribe it, as it takes a special endorsement that not all doctors hold - but he did not believe it would work for me. It was because I have a degenerative nerve condition. He also told me that, in most cases, if you are prescribed bup then you will not receive any additional meds for breakthrough pain. This is for two reasons. If it is taken as subutex, it doesn't play well with other opioids, mostly r/t respiratory distress; if it's suboxone, there is an additive in it that renders the effects of other opioids useless and can precipitate withdrawal symptoms.

Depending on the source of your mother's pain and what options are available, subutex or suboxone my be options. It is also possible that a 24 hour medication like one of the oral -contins may be an option or something like an OROS Exalgo that works for 24 hours or more, or if you wanted to go away from oral meds there are patches and scheduled injections as options. It really all depends on what causes her pain and what that pain is responsive to.

I know it's not an "absolute" answer, but I hope that helps. ?

 

[kleinerkiffer]

I will try that. Thanks for suggesting!

I need to work this out for sure because I finally got to sleep... and then knocked out until about an hour ago, 12:45 my time. I live on a farm. I can't sleep this late!

Another few options would be chamimile tea, valerian root, passion flower and melatonin