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Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

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Thanks for the words of support. And it was way out of the normal for oral surgeon to Rx me that much. The only reason he did so was it took more than 3x the anesthetic to put me under and I told him that I had an extremely high tolerance to all CNS depressants. Most people get 5mg hydrocodone to take 4-6x daily at most for extraction.

I also had an impacted tooth that had to be blasted into four pieces and dug out as well, so that probably had something to do with it.
 
A similar thing happened to me with one of my wisdom teeth. The gum just wouldnt numb and he ended up giving me 5 shots of local and it still wasn't numb....he went ahead anyway andvlike you the tooth broke and had to be pulled a piece at a time......it was a fucking nightmare!!!!. Technically there shouldn't be cross tollerence between opiates and "caine" type anesthetics but there seems to be. My dentist says its genetic for me as im of dutch/Scandinavian extraction with pale skin and red/blonde hairand he said people of that "race" have a ggenetically lower pain tollerance..........ive absolutely no idea if thats true or not though
 
I was referring to the meperidine he used to sedate me. Most oral surgeons use midazolam+fentanyl to put the patient under, but this guy was old school.
 
Ok so I quit my job today because of a bunch of reasons, I am not gonna go into that. So obviously my health insurance is gonna get canceled. I am in pain management with my physiologists APRN at my local hospital. Have been with her since November. I only see her in office visits once every 3 months. She does do random urine test, not all the time though. I only get 1 script a month an thats 120 perc 10's. I am scared to get dismissed. What if I pay cash at the office visit and cash at the pharmacy? my script is do in 2 weeks, will I be able to still have a co pay of $10 or by then will the pharmacy make me pay cash? So what are you guy's thoughts?
 
percojerk said:
Ok so I quit my job today because of a bunch of reasons, I am not gonna go into that. So obviously my health insurance is gonna get canceled. I am in pain management with my physiologists APRN at my local hospital. Have been with her since November. I only see her in office visits once every 3 months. She does do random urine test, not all the time though. I only get 1 script a month an thats 120 perc 10's. I am scared to get dismissed. What if I pay cash at the office visit and cash at the pharmacy? my script is do in 2 weeks, will I be able to still have a co pay of $10 or by then will the pharmacy make me pay cash? So what are you guy's thoughts?
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Consider this......: http://www.dol.gov/dol/topic/health-plans/cobra.htm
 
percojerk said:
Ok so I quit my job today because of a bunch of reasons, I am not gonna go into that. So obviously my health insurance is gonna get canceled. I am in pain management with my physiologists APRN at my local hospital. Have been with her since November. I only see her in office visits once every 3 months. She does do random urine test, not all the time though. I only get 1 script a month an thats 120 perc 10's. I am scared to get dismissed. What if I pay cash at the office visit and cash at the pharmacy? my script is do in 2 weeks, will I be able to still have a co pay of $10 or by then will the pharmacy make me pay cash? So what are you guy's thoughts?
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If you can pay cash then you can absolutely still see her. You don't need insurance to receive medical care. If you discuss it with her she might even cut you a deal on the fees, since they'll be getting it in cash instead of having to wait for insurance reimbursement.

Hard to say if your insurance will even be cancelled by that time. Many jobs give you 4-6 weeks when you leave, but I'm not sure if the situation changes since you quit.
 
Thanks guys. Worst case I pay cash for office vist like 150 say every 3 months. But not sure on the script though.
 
Percocet shouldn't be too bad at the pharmacy, seeing as it's generic, but I'm not certain. It won't be as cheap as other stuff (antibiotics, etc) since it is a controlled substance.

If the cost of medication becomes an issue I would discuss changing to something less expensive with your Dr. Percocet will be one of cheapest though, only methadone would definitely be cheaper.
 
Yea I would definitely not be considering methadone. Does $380 sound like a lot for my script? ? Thats a quote I just got from 1 pharmacy. Lol
 
Yeah, you can pay cash at the doc of course, if you have the money. I have been, due to losing my insurance due to a fuckup, but it is rather expensive. I know we don't discuss prices on here but the morphine 15 IRs are considered to be equianalgesic to your current dose of oxy(and DIRT cheap), although that would be a CII script. Hopefully they'll work with you on that. You can call and ask the cash price at the pharmacy for medications, and shop around if needed, some pharmacies are far cheaper than others. Depending on the doctor and your pain contract you'd probably have to notify them of the change. At least that's how it works where I live.
 
Yea if I remember correctly, I can only use 1 pharmacy. I do have another job lined up, however health benefits wont be available until 120 days.
 
Hi guys, I'm pretty depressed. I snooped through my MIL's emails and texts and I realized that she only sees me as some addict junkie, not a person in real pain. I shouldn't care about her opinion of me, but it means that while I'm living here I'm never going to be treated with respect. A junkie is all she sees and it doesn't matter HOW much pain I'm in, she will never think that it's ok for me to take painkillers.

It's been nearly a month since my last pain clinic kicked me out due to the insurance issues (which are now fixed BTW) but I haven't been able to get to another clinic because my FIL insists that he has to go too and he will just slam me as being a junkie looking for a fix and I won't get any help. I'm trying to make a new appointment and go to it covertly, but I'm so pissed that I have to be treated this way. Even if I get a new script for pain meds from this new place, I'll have to drive nearly a half hour away to get it filled, because otherwise my in-laws will hear about it (yes, the pharmacy I've been using reports on me to my in-laws and they've called every pharmacy nearby to tell them NOT to fill my scripts. I might be going to get psychiatric help from a hospital that's a little far away but still in Brooklyn, and maybe I could fill my scripts at the hospital pharmacy? Or would they be even stricter? I haven't filled a narcotic script in nearly 2 months, so there's no way they can tell me that "it's not time yet" or maybe they'll tell me they're "out of stock" of that particular medicine (yeah right, a HOSPITAL pharmacy being out of 5 mg oxy?! REALLY.)

I'm just sad and depressed that nobody, not even my parents, understand my pain. I hate having to hide my drugs all the time. I hate having to order them off the internet then be careful to intercept the package first to make sure no one opens my mail without my permission. I REALLY hate that no one sees or acknowledges the work I do to remain steady on my medicine, take it only as prescribed, and to do as much for my children as I can. All I get is "you're not doing enough." I love my children and I do as much for them as I can. Yes, I can't drive to pick them up from school. And I can't walk them to karate class because the walk would be too much for me; physically, I probably COULD do it if I pushed myself, but it would take everything out of me and cause me to need pain medicine of some sort afterwards and then I'd be lying down, too sick to get up and go to eat dinner (not a big deal because I barely eat these days anyway, the pain takes away my appetite) and too much in pain to help with baths and pjs and reading them a book.

I already feel like a failure as a mother. I don't need the other people in my life treating me like I'm dirt under their shoe.
 
I know how you feel sweety , I feel like a burden on my family and my son is now becoming aware that I'm not like his friends' mums and it really upsets him but I've tried everything they can throw at me and I'm still not the mother that I used to be and probably never will be and I hate it that my illness upsets my family so much
 
xtcgrrrl said:
Hi guys, I'm pretty depressed. I snooped through my MIL's emails and texts and I realized that she only sees me as some addict junkie, not a person in real pain. I shouldn't care about her opinion of me, but it means that while I'm living here I'm never going to be treated with respect. A junkie is all she sees and it doesn't matter HOW much pain I'm in, she will never think that it's ok for me to take painkillers.

It's been nearly a month since my last pain clinic kicked me out due to the insurance issues (which are now fixed BTW) but I haven't been able to get to another clinic because my FIL insists that he has to go too and he will just slam me as being a junkie looking for a fix and I won't get any help. I'm trying to make a new appointment and go to it covertly, but I'm so pissed that I have to be treated this way. Even if I get a new script for pain meds from this new place, I'll have to drive nearly a half hour away to get it filled, because otherwise my in-laws will hear about it (yes, the pharmacy I've been using reports on me to my in-laws and they've called every pharmacy nearby to tell them NOT to fill my scripts. I might be going to get psychiatric help from a hospital that's a little far away but still in Brooklyn, and maybe I could fill my scripts at the hospital pharmacy? Or would they be even stricter? I haven't filled a narcotic script in nearly 2 months, so there's no way they can tell me that "it's not time yet" or maybe they'll tell me they're "out of stock" of that particular medicine (yeah right, a HOSPITAL pharmacy being out of 5 mg oxy?! REALLY.)

I'm just sad and depressed that nobody, not even my parents, understand my pain. I hate having to hide my drugs all the time. I hate having to order them off the internet then be careful to intercept the package first to make sure no one opens my mail without my permission. I REALLY hate that no one sees or acknowledges the work I do to remain steady on my medicine, take it only as prescribed, and to do as much for my children as I can. All I get is "you're not doing enough." I love my children and I do as much for them as I can. Yes, I can't drive to pick them up from school. And I can't walk them to karate class because the walk would be too much for me; physically, I probably COULD do it if I pushed myself, but it would take everything out of me and cause me to need pain medicine of some sort afterwards and then I'd be lying down, too sick to get up and go to eat dinner (not a big deal because I barely eat these days anyway, the pain takes away my appetite) and too much in pain to help with baths and pjs and reading them a book.

I already feel like a failure as a mother. I don't need the other people in my life treating me like I'm dirt under their shoe.
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xtcgrrrl, I'm so sorry to hear what you are going through. As if it isn't hard enough to deal with pain, having to deal with Dr's that don't take you seriously and meddling inlaws must make you feel like crap. :( My main point to one part of your post: (excuse my caps here but I need to drive this home) IT IS AGAINST THE LAW FOR PHARMACIES TO GIVE OUT PERSONAL/PRESCRIPTION INFORMATION TO ANYONE THAT IS NOT YOU! ie: Your inlaws A: have a huge set to even ask the pharmacy B: The pharmacy could be sued BIG TIME for revealing your records. I'm not trying to upset you more than you already are but when I read that they call in to bully the pharmacies to not fill your scripts, and the fact that the pharmacies actually listen to them and won't fill??? That's bizarre! They have no right over your medication. The ONLY individual that can or cannot dictate your prescriptions is your Physician. ONLY your physician.
Sorry for the long winded rant but my eyes popped out of my head when I read that. There is no reason in the world you have to order your meds online (that actually scares me for you because you don't know for sure what you are getting). One more point. If you bring your script in to fill and the pharmacy says "we are out of stock" tell them to order more and that you will be back in a day or two. (speaking from experience). They can get it re-stocked within a day, or two days max.

Please don't beat yourself up. You are doing the best you can under the circumstances. And if it helps at all, I understand your pain. Mine is a long drawn out story that I won't get into just yet but, I believe you and I believe that you are doing your best to maintain. Please try and stay strong. And if you want to talk further please feel free to private message me.
 
In the uk if they dont have what you want in stock they will get it same day.....kost pharmacys taie 2 deliveries per day and are registered with both the major uk distributors (alliance healthcare and allied pharmacies.....if we in the small uk can get any drug...controlled or not within 4-6 hours (assuming they dont have it in stock theee and then...which they usually do) then a pharmacist in the states (the richest country in the world) saying they cant get it..or it willltake 2 days is utter bullshit....if they tell you this tgen its a rouse t oo not fill your script for some ulterior reason.....most probably due to pressure from tge fucking rediculous DEA.....end of rant!
 
This withdrawal is killing me I'm so unwell, the crps with wd on top is just nightmarish. Hope everyone is having a better time than me
 
I have chronic pancreatitis. It's fucking painful. I had acute pancreatitis when I was 8 (fucking painful shit too) which they thought was from an injury to my abdomen. It was back then they discovered my gallstones, but decided against taking my gallbladder out. I was only 8 so I had no say in the matter. After that one attack I went almost 15 years without pain... I had a normal life. Fast forward to my 23rd birthday. I was doing well in life (had already graduated university) and then I start getting attacks again. I almost died, I was going in to liver and pancreatic failure when I was in the ER. I had a serious infection going on and my common bile duct was inflamed. High white blood cell count, extremely high lipase and amalyse. A normal lipase level is between 10-140...mine was well over 4000! I had a doctor tell me he was surprised I was still walking around with a level that high. Anyhow they took my gallbladder that night and did some repairs to my bile duct. However my pancreas levels took over a month to calm the fuck down.
 
Hello all, I am managing a chronic pain condition resulting from musculoskeletal and nervous system pathology. I am currently taking tramadol, with oxycodone for breakthrough pain. One issue I have is trying to alleviate/tolerate pain while maintaining my cognitive function. I work in technology sales, and it requires me to be very alert. For nerve pain I have tried gabapentin and pregabalin, love their efficacy toward pain control, but find I am not sharp enough to handle my workloads and grasp new information effectively. I intentionally under medicate my pain to retain cognitive functional ability. My pain doctor has suggested a shift from tramadol to a buprenorphine pain patch, I have yet to make the shift due to an imposed "step therapy" mandated by my insurance company, but the transition will be soon. From reading other threads here, I have seen that some use tramadol or tapentadol for BT pain, due to the fact that these medications aren't exactly analgesically opiate driven, and as such do retain some pain relieving qualities? Because I am naive to painkiller medication, can anyone speak with experience to what works, what they have experienced, and/or what they find helps them in a situation such as this? Brandon
 
I personally would advise against the BuTrans patches. They did not help me in the least and coming off of them was no picnic. I don't know what to tell you to try out if you're trying to steer clear of your classic opioid medications (apart from the oxycodone). They recently came out with ZoHydro (Hydrocodone bitartrate extended release) in the US, which isn't as potent as morphine or oxycodone; the drawback to these is how goddamned expensive they are. As far as treating the pain goes though. Morphine sulfate extended release has always done me the best, but this might have you passing out/getting sick if you're new to pain medications. What dose of oxycodone are you on exactly, because I've never heard of it being used for breakthrough for someone whose main medication is tramadol. That seems a bit backwards to me. What doses of tramadol and oxycodone do you take? I'm assuming your tramadol is of the extended release variety?

I've never gotten this way, but some people actually get more "dopey" from GABA precursors like pregabalin and gabapentin than they do from benzodiazepines. Have you ever taken alprazolam (Xanax), diazepam (Valium) or clonazepam (Klonopin), and, if so, how do they do you? These could be useful for nerve pain and as a muscle relaxant; though you need to be careful if you decide to go down this road. Benzodiazepines are worse to come off of than opioids. If you don't mind disclosing this information, what exactly are your diagnoses? Knowing these will provide for a better assessment of what kind of pain/how much pain you're going through.

Wishing you the best of luck,
Doug.
 
Hi Doug, thank you for your response. I use benzodiazepines and nonbenzodiazepines for sleep, I rotate between lunesta and temazepam. Much of my pain manifests nocturnally and stimulates me, moving me away from getting a good nights rest. I was using tramadol 50mg tablets as needed for pain during my work day, and Percocet 5/325 for breakthrough pain when needed. I just started buprenorphine, with no set pain med for breakthrough. I am like the individuals you referenced above, I get very dopey from Lyrica, but it also works very well for me. I don't need a build up either, I felt relief from the very first dose. Unfortunately, I just cannot cognitively function on it. I have a few sources of pain. I was recently diagnosed with a sports hernia, which I am further qualifying by having a series of nerve blocks performed. So far I have seen relief from an ilioinguinal nerve block, but am uncertain as to the source of ilioinguinal nerve damage. Next will be a symphisis block, to qualify a proposed adductor tenotomy. I have a CAM impingement in my hips bilaterally, with OA/spurring and a labral tear on my right side. I have bulging discs, DDD, and a tear in one of my IVD's. I also have residual pain from shingles. I also have pain that is still idiopathic in nature, they just don't know what is causing it. I have had a lot of testing done. It mostly manifests from the groin area and is mostly relieved with nerve pain meds (like Lyrica). My goal, because I have been in a chronic state of pain for the last 3 years, is to find relief that I can use in the long term. I would also like to determine whether or not I can ramp up my pain management on the weekends, as less is required of me intellectually, but also I like to do more with my family, and activity of any nature makes my pain worse. I will have to ask my doctor about the medicines above that you referenced. I also have a PM doctor that is trying to help me navigate to better medications as I make adjustments to my maintenance therapy. This was how the BuTrans patch entered the equation. The financial aspect isn't a hurdle for me, I have good insurance and have already hit my max out of pocket expense for the year. The goal is to find medications that will be effective in the long term, my doctors want to guide me to medications that are indicated for long term use. Brandon
 
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