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

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Sorry I didn't think of this last night as I was pretty tired. You should try out Elavil (Amitriptyline HCl) for the nerve pain. I have reoccuring testicular pain (it comes and goes since I had epididymitis), and amitriptyline, pregabalin, gabapentin, and benzodiazepines works wonders for it. Opioids help as well, but I have a largish tolerance to narcotic pain medications and can handle them. If you try out the amitriptyline, you may want to start out at 25mg as these are commonly used for sleep, and even 25mg can be sedating.

With the buprenorphine patches, you can take anything for breakthrough pain, because the dose is so low. Are you on the 5, 10, or 20mcg/hr patches? Have you tried lower doses of the pregabalin or gabapentin? They make pregabalin in doses as low as 50mg and gabapentin in doses as low as 100mg. You could also try Tegretol (Carbamazepine). It's GABAminergic, but does not have the sedating properties that benzodiazepines and GABA precursors have. Normal dosing is 200mg BID.
 
I have tried Amitriptyline and Trazodone, unfortunately they both give me very intense migraines. I have re-challenged them both to confirm, and even at the lowest dosages I find them intolerable. I am able to use cyclobenzaprine and it is helpful, as I understand it they are very closely related. This is a solid suggestion. I have never tried Tegretol, I will also ask my doctor about it. I am using the 5mcg patch, my pain specialist suggested this dose as I am still fairly opiate naive.
 
Well if you still feel undermedicated at that dose 1 week after starting it, ask to be moved up to the 10mcg/hr patch. When I was switched from tramadol to it, I went from 400mg tramadol to the 20mcg/hr patch and it did nothing.
 
Thank you for all of your advice, it is very much appreciated. I will be following up on these suggestions with my doctors. I may look to some of the medications you suggested and pilot them over the weekends. I didn't mention it, but much of my pain began 3 years ago when I underwent 3 months of antibiotic treatment to treat a staph. bacterial prostatitis. It was during this time I developed many of the problems that exist to this day. I think perhaps some of our issues are related, in region if nothing else.
 
My pain stems from DDD, Hyperkyphosis, Lordosis, Lumbar Stenosis (Moderate-Severe, midline and right at L4-5), Sciatica, Bulging Discs at T10-11, L2-3,L3-4, L5-S1, and a Ruptured Disc at L4-5. I've also got Peptic Ulcers as well as many other upper GI problems and the testicular pain which comes from the nerve damage in my low back and the instance of epididymitis and testicular strain. Then I also get chronic migraines (being 22 is fun for me lol). I've tried everything under the sun with the exceptions of oxymorphone, methadone, and levorphanol. Opioids/Benzodiazepines/Barbiturates work best for my conditions. Non-benzodiazepine anti-convulsants and TCA's had limited effectiveness, and SSRI's/SNRI's had no effect and resulted in horrible side-effects. I've been in severe, chronic pain for 5 years, so I know how it affects every aspect of life. I wish the best for you.

Amphetamines also help with pain, but I wouldn't suggest this to a doctor lol. They help with pain on their own as well as increasing the analgesic properties of opioid analgesics.
 
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That's rough Doug, and 22 is too young for all of that. I am sorry to hear you suffer to that extent, and I wish the best for you as well. Thanks again for your words of guidance.
 
Oh dear......you committed to unforgivable sin of using someones first name!! Certain people with a highly inflated sense of self importance on this forun get very upset about that (regardless of the fact that the person whos name you use may be absolutely fine with it) hahaha!!!
 
I implore u guys to use non-opiod pain relievers when u can even if u feel they are below u. I find a paracetamol/ibuprofen combo to be quite efficacious for even moderate pain.
But for severe pain oxycodone is amazing 120 mgs (ir) (massive tolerance) killed all the pain 15 mind post op of a recent shoulder op that was practically a shoulder reconstruction.
IV paracetamol drip is also great. For some reason this 1 g per drip apap works well, much better than orally. I'm ma take ibuprofen, apap and codeine for moderate pain now. Running very low on oxycodone.
 
I alternate my apap I will take it for a month or two then give my liver a break for a few months. The best non steroidal anti inflammatory is naproxen by far superior than any other, 500mg twice a day. You can also get topical creams with meds in, the one I use helps with muscle pain, joint pain etc I find if you hit the pain with everything you can you have a better chance of reducing the pain a little. For pain I'm on 150mcg fentanyl patch
6x 5ml/10mg oramorph for bt pain
4g of apap
1000mg naproxen
Algesal (brand name, the link has the active ingredient's name on it)
10mg diazepam
Serrapeptase (natural anti inflammatory). I've also tried amitriptyline, duloxetine, gabapentin, pregabalin for nerve pain but couldn't tolerate any of them. Also been on every opioid pain killer that's available to me in the uk.
Also for muscular ligamentary and tendon damage, vertebrae problems and others, a tens machine works wonders for it.

I've also had guanthedine nerve blocks, lumbar sympathetic nerve blocks, lidocaine patches, physio which I have done 4-6 times a day for the past 4.5 years. I wanted a spinal cord stimulator but it was 80% chance it would paralyse me,15% chance it would make the pain worse and only 5% chance of it helping the pain, as they would have had to put it in my neck it was just too dangerous and because I also have a back problem I wasn't eligible for a spinal drug pump. I've also tried mirror therapy and I use heat therapy on the areas of my body that I can still use it on which is becoming fewer every day.

Also, weed helps immensely, unfortunately we only have sativex on prescription which is a thc sublingual spray but drs very, very rarely prescribe it. So you guys in medicinal cannabis areas, take advantage.

I've been a CPP for nearly 5 years, I was only 23 when I had my accident and I had a very bright future, now most of the time I'm bed bound.
http://m.netdoctor.co.uk/aches-and-pains/medicines/algesal.html

Hope everyone is well

PS I meditate 5 times a day for 30 minutes at a time, I taught myself. And it is very helpful for my pain and psychiatric conditions (caused by the accident)
 
Whosajiggawaaa said:
I implore u guys to use non-opiod pain relievers when u can even if u feel they are below u. I find a paracetamol/ibuprofen combo to be quite efficacious for even moderate pain.
But for severe pain oxycodone is amazing 120 mgs (ir) (massive tolerance) killed all the pain 15 mind post op of a recent shoulder op that was practically a shoulder reconstruction.
IV paracetamol drip is also great. For some reason this 1 g per drip apap works well, much better than orally. I'm ma take ibuprofen, apap and codeine for moderate pain now. Running very low on oxycodone.
Click to expand...
for some this is just impossible, the last time my sciatica really flared, it flared for entire month. imagine if you will, week one: pain so bad you dont eat(when i say dont eat i mean nothing ever day for entire week), i lost 9 pounds in under 7 days, when you lie down to sleep u fall asleep and wake up WITHIN 30mins with pain so bad u want to scream but cant because u cant breath for the first few mins, ever week after that i went to the ER atleast once! each time i got injected with dilaudid and some cocktail of other things, this only relieved the pain for a few hours though. around the end of week two the ER prescribed me dilaudid to take 4-6 times a day. this relieved the pain a little. and on top of all that unbearable pain, my pain management was total shit, they did nothing to help until week 3 when the ER PA yelled at the on call doc for my pm, then they somewhat helped me(mind you i have had these episodes ever 3 month or so for over a year, along with the horrible everyday pain).
 
Hi HFA, you might consider seeing a pain psychologist. They can teach you methods to cope with your pain, and set proper expectations for yourself. I have chronic pain conditions myself, and I know how it can affect every facet of your life. Your primary care provider will probably have a suggestion for you.
 
Chronic pain has taken my life from me. I went from being a graduate in medical school with a bright future in front of me to having nothing and noone and directly or indirectly my chronic pain condition lead to everything bad that happened to me. Im fighting back tho. I mm a management accountant for the uk ambulance service and have applied to retrain as a paramedic and am going to try to get off all my meds (some of which do more harm than good) and rebuild my life............I may fail but ill go down fighting.

If I could offer one shred of advice it would be this..only use strong opiate/ opioid med if you REALLY need them as they can insidiously destroy you if used incorrectly...even by people with genuine conditions.....if you have the type of personality that leans towards addictive behaviour/ anxiety and depression then they will suck you into a hole that will be hell to escape from....im not saying this will happen to everyone and some people genuinely cant live their lives without them.....just please be carefull and PLEASE, PLEASE dont make the mistakes I have made.........god bless all......G x
 
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APAP has quit working even for mild headaches for me. Hell, even opioids don't seem to work. What do you do when heroic doses of narcotics barely touch you? Also, has anyone ever experienced strong pulsating sensations in their lumbar? It's strong enough to rock my entire body.
 
Hey guys. I'm new to this site (even though I signed up in 2012)...
Anyway, I have chronic pain.
I have a lot of random female issues (cysts, fibroids, swelling, etc.), but am too young for a hysterectomy.
I also have IBS.
So majority of my pain is in my lower abdomen, and it really sucks sometimes.
I have other areas of pain, and have recently wondered if I might have fibromyalgia, but I don't know for sure.
So the only thing that's ever really worked for me is narco's.
I've tried a few other things, like ultrams, but they mess with my stomach and make my vision blurry.
I'm also not too fond of oxy or morphine. Oxy's don't seem to help me that much for whatever reason, and morphine just makes me uncomfortable.
I got off of narco's about a year ago though thanks to having a crappy doc and then just wanting to stay "clean".
I then started using kratom more frequently, and now on the daily.
It was helping me quite a bit there for a few months, but now I honestly think that it's doing more harm than good.
I wont go into all the details of it, but I'll just say that I've been feeling sh!zzier than normal...
I've decided to go to the doctor about it tomorrow.
I'm not sure if I should even mention kratom, or what I should ask of him to do to help me.
All I know is I'm freaking miserable and I can't continue living like this.
Especially since I know that there's something out there that can help me.
I've also tried poppy tea, but that was a hit or miss, and when it hit it wasn't that great of a feeling for me.
When I first start taking narko's they do give me a little bit of a fuzzy happy feeling, but that fades and then it just helps my pain.
I need that again.
I had also been on klons for about 7 years. In November of last year I ran out over a weekend and decided to get off of them when I realized how bad the w/d's were.
I hate having to live like I'm an old lady. I usually only feel like staying home, in bed.
Eating is even a struggle at times.
I just want to live my life!
 
Rhetorical question-

Have you been treated poorly by your pain management clinic? I am not speaking of the doctor but the receptionists who have little to no training and office managers that seem to pull all the strings? Have you needed to get in touch with the doctor only to be stalled by the front office?

I have been in PM for a long time and see a trend. Trends. The Dea and Fda are cracking down with such force that you cannot even get a script filled without the pharmacy having the ic9 code on the script. You cannot travel without telling your doc's receptionist when you are leaving, where you are going, how long your stay will be, etc.

What in the fuck is going on? I know there is pressure created by the media and idiots that claim they understand pain management. Their focus seems to be making certain medications go from schedule 2 to schedule 1.

Granted there is a problem with addiction to prescription pain killers but just how bad is it and is it worth it to put people like us under constant surveillance? I am already living a sub par life and in constant depression because disability pays squat and no one will hire a cripple. They say that it is illegal for them to discriminate against someone with a disability yet how can they micromanage people who have disabilities?

A company can easily dismiss your application for a number of reasons all the true reason is not wanting to hire someone disabled. I am sick to fucking death of this. I am highly qualified for many jobs and feel like a communist sympathizer in the 50's. There is a blacklist but no one will admit to it. Where can I go to find out the truth about this discrimination that I have felt since losing my job to pain 6 years ago? I couldn't even get LTD with a 1 inch stack of doctor reports because I didn't have the money for an attorney and I didn't want to lose my job. I lost it anyway.

I now have a real life insight into what it must have been like for those discriminated against in the day. Yes, there are days when I look like I can handle anything and my meds are working. I cannot describe it but there are days when no med on the face of the earth will kill the pain in my back and I can barely make it to the bathroom or feed myself. Who can I talk to? Pain psychologists are full of shit. I am not trying to live off of the government and sit around doing nothing all day. I am too young to bear that lifestyle.

Yes I am pissed. I have many talents that are going to waste in my bed as am I. What the hell do you do?

Sorry, I had to add something to this rant. How many times have you wished that those who disbelieve the amount of pain you are experiencing every day could experience it for a few days? Actually, that wouldn't suffice because you would have to allow for the symptoms that accompany the chronic pain.

Those might be depression, malaise, nausea, and a waste of life that was given to us. Were we meant to suffer daily. Certainly we were not all placed here to be nailed to a cross.

I apologize. I am not trying to make a mockery of this illness but I just received my 100th denial for a job. I have over 300 college credits and cannot get a job working graveyard at a Best Western as a front desk liaison. I try to explain my disability to my roomates that are half my age and they do not understand and could give a shit. It was that denial and then being asked by my pain clinic about things that doctor's offices do not ask their patients. It is not their business where I go and when I intend to return. Why amI

Is there an organization that helps people like us that I am unaware of? Someone please give me some guidance.
 
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englandgz74 said:
Chronic pain has taken my life from me. I went from being a graduate in medical school with a bright future in front of me to having nothing and noone and directly or indirectly my chronic pain condition lead to everything bad that happened to me. Im fighting back tho. I mm a management accountant for the uk ambulance service and have applied to retrain as a paramedic and am going to try to get off all my meds (some of which do more harm than good) and rebuild my life............I may fail but ill go down fighting.

If I could offer one shred of advice it would be this..only use strong opiate/ opioid med if you REALLY need them as they can insidiously destroy you if used incorrectly...even by people with genuine conditions.....if you have the type of personality that leans towards addictive behaviour/ anxiety and depression then they will suck you into a hole that will be hell to escape from....im not saying this will happen to everyone and some people genuinely cant live their lives without them.....just please be carefull and PLEASE, PLEASE dont make the mistakes I have made.........god bless all......G x
Click to expand...

True advice, as always.

Mean't in my post strong opiods should be respected and feared as much as H. i don't think i can live without oxy or another strong opiod.

and Jtkm oxy has almost stopped working for me even in doses 140 mg and above I really have to do something.

A question, how the heck u guys cope with withdrawal and severe chronic pain ? The times thats happened my rifle has seemed appealing as a quick exit.
 
Although nowhere near as bad as in the us the legislation around controlled drugs in the uk has tightened up quite a bit recently......it tightened up alot after the conviction of the infamous Dr. Harold Shipman who used diamorphine from forged prescriptions to kill what was estimated to be over 400 patients (although they could only be absolutely sure of around 250 of these) over a 30 year period. He was convicted in 1998 and killed himself in prison in 2004. How he got away with it for so long is purely a matter of conjecture....but im glad he wasnt my gp!
 
Reading these posts is somewhat depressing, but it makes me feel a little better because it reminds me that I'm not the only one out here suffering.

Milagro: I have had my fair share of rude receptionists. More often than not though, the doctors have been just as rude.
I've actually wished that the nurse was the doctor at times.

I don't know what to tell you about your job hunt, but hopefully you'll find something.
I really don't think that discrimination has come all that far.
My Nana (grandmother) has polio. Her father would take her out to whip her legs with a freaking tree branch because they thought it was a curse...
I'm assuming that we're past that radical uncalled for behavior, but nothing would surprise me...

I don't know what your disability is, but I feel disabled too. I don't really appear to be, aside from being so pale, but I know how I feel.
It's a struggle every day for me to even get out of bed, and I usually get back in it.

If you find an organization, please let me know.

I don't want to "scam" doctors, but I would love to find a good one...

Just keep trying though, that's what I'm doing, and is all I know to tell you.

P.S. I'm sorry, I'm not sure how to put partial quotes in...
 
^
i just delete the text i dont want and leave the "quote" commands in at the beginning and end....not sure if theres a better way but it works for me.lol

+1 to the comment on doctors receptionists. Their the tinpot dictators of the medical world.
 
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