I do, quite successfully. Do you have questions?
Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V
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I do, quite successfully. Do you have questions?
TheLostBoys
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Hello all.
I haven't been on here in quite a while. It seems like I only come here when I'm having sort of issue, but today I just stopped by to say hello and make a couple of comments.
First--while I've been doing fairly well on my current pain management medications (Topamax 25mg x3, MS Contin 15 MG ER every 8 hours, and 5mg/325 oxycodone 3x a day as needed for BT pain). I also starting using Kratom as a substitute/supplement to oxycodone last summer and have had some good success with that (but it's expensive and has taken a lot of experimenting to find strains that have the best analgesic effects.
I have noticed that I am having more breakthrough pain than I was a couple of months ago and nothing has changed with my injuries or my activities (other than I have been walking the dogs a little more often). I don't know if this is because the brand of pills (they switched to Oramorph and some generic brand of oxycodone) got switched and they are less effective (does that make ANY sense?) or if I am just becoming tolerant to the opiates. I e-mailed my doctor and asked him about rotating the breakthrough meds. I said nothing about a possible tolerance issue. I just told him that I wasn't finding enough relief from my current regimen. I tried to make it clear to him that I am not asking for a higher dosage or an increase in number of pills. I don't even know that rotating the medications will help and I've read that it can be tricky to get the correct dosages, so I might just be borrowing trouble here. We'll see. He may not want to do anything--he's a good doctor, but he likes to warn me of the dangers of tolerance and addiction.
The second thing I came here to say is that I have been doing a lot of research about my particular issues (Post-thoracotomy pain syndrome, coupled with pain from a distal pancreactomy) and I have been lurking around several pain discussion groups and boards and I just wanted to say that compared to so many of these other boards--this discussion group here on Bluelight is the BEST. You guys are the smartest, most supportive CPP group I have ever found. Even among other CPP's, there is much stigma and judgment. But, not here. So, thank you.
I hope that you are finding some relief today--whatever that means for you.
I haven't been on here in quite a while. It seems like I only come here when I'm having sort of issue, but today I just stopped by to say hello and make a couple of comments.
First--while I've been doing fairly well on my current pain management medications (Topamax 25mg x3, MS Contin 15 MG ER every 8 hours, and 5mg/325 oxycodone 3x a day as needed for BT pain). I also starting using Kratom as a substitute/supplement to oxycodone last summer and have had some good success with that (but it's expensive and has taken a lot of experimenting to find strains that have the best analgesic effects.
I have noticed that I am having more breakthrough pain than I was a couple of months ago and nothing has changed with my injuries or my activities (other than I have been walking the dogs a little more often). I don't know if this is because the brand of pills (they switched to Oramorph and some generic brand of oxycodone) got switched and they are less effective (does that make ANY sense?) or if I am just becoming tolerant to the opiates. I e-mailed my doctor and asked him about rotating the breakthrough meds. I said nothing about a possible tolerance issue. I just told him that I wasn't finding enough relief from my current regimen. I tried to make it clear to him that I am not asking for a higher dosage or an increase in number of pills. I don't even know that rotating the medications will help and I've read that it can be tricky to get the correct dosages, so I might just be borrowing trouble here. We'll see. He may not want to do anything--he's a good doctor, but he likes to warn me of the dangers of tolerance and addiction.
The second thing I came here to say is that I have been doing a lot of research about my particular issues (Post-thoracotomy pain syndrome, coupled with pain from a distal pancreactomy) and I have been lurking around several pain discussion groups and boards and I just wanted to say that compared to so many of these other boards--this discussion group here on Bluelight is the BEST. You guys are the smartest, most supportive CPP group I have ever found. Even among other CPP's, there is much stigma and judgment. But, not here. So, thank you.
I hope that you are finding some relief today--whatever that means for you.
Hello, it's me again. So, my doc got back to me. Says he doesn't want to change my short-acting pain meds. (I told you he would be worried about having to increase it again too soon and that's exactly what he said). Instead, he suggested we change up the long-acting meds. I actually hadn't thought of that, and I'm willing to try it. So, he will be switching me from 15 mg of Morphine (ER) to 30mg of Morphine (ER).
chase_in_56ace
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^If I were you I'd be eager to switch to Oxycontin 30mg. Much higher oral bioavailability. Also, if your doctor is already writing you an oxycodone Med, Why not percocet 10/325 3x a day? I understand the concern about addiction.
However, you are already on the opiods and dependent I assume. He's concerned about tolerance? Nice! So am I, but there's not much I can do about it. There's no opiates I personally can take long term as Rxd without developing some sort of issue.
In my opinion, this is clear cut. You have serious pain, you have become tolerant to the relatively low dose opiod regiment you are on, and require a dose increase. See how the increase to 30mg works out. If it doesn't, be a little assertive with the right attitude, if you catch my drift
However, you are already on the opiods and dependent I assume. He's concerned about tolerance? Nice! So am I, but there's not much I can do about it. There's no opiates I personally can take long term as Rxd without developing some sort of issue.
In my opinion, this is clear cut. You have serious pain, you have become tolerant to the relatively low dose opiod regiment you are on, and require a dose increase. See how the increase to 30mg works out. If it doesn't, be a little assertive with the right attitude, if you catch my drift
BigG
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Some doctors dont understand the difference between dependence and addiction. Admittedly the line can become blurred sometimes but as I understand it. Dependence occurs when ANYONE uses an opiate for a chronic condition over a protracted period of time whereas addiction is defined more as an unstoppable compulsion to use even when your illness doesnt really require it. Lots of studies show that when even the strongest opiates/opiods are use for genuine chronic pain conditions as prescribed, dependence will likely occur but addiction shouldn't. Of course this.very much depends on the personality type of the patient. Many of us on this forum suffer genuine and debilitating chronic pain conditions but have also battled.addiction at one time or another. Finding a doctor.who understands this situation is tough. Mine has just about goven up on me and sends my scripts directly to the phatmacy without even asking to see me. Im very much on my own. Incidentally ive just started trigger point massage on my neck and shoulder problems which is provided free as we uave a physio at work in the building. Ive only had one session and it hurt.like hell but the physio is optimistic.
chase_in_56ace
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We can't have Schedule 2 meds faxed/sent over to the Pharmacy. It has to be brought in by the patient from the pain practice. At least in Florida it's like that...
Anyway, not too stray too much... dependence and tolerance are as previously stated, inevitable. The human body is incredibly efficient at adaptation on all levels and quickly Changes structure around powerful opiates. One must find a balance between the strength of the meds and frequency of dosages. I find that as long as my doses increase subtly and I don't double up and abuse my meds, I'm usually in the clear.
England, curious as to where it's legal for doctors to fax such high tier narcotics..
Anyway, not too stray too much... dependence and tolerance are as previously stated, inevitable. The human body is incredibly efficient at adaptation on all levels and quickly Changes structure around powerful opiates. One must find a balance between the strength of the meds and frequency of dosages. I find that as long as my doses increase subtly and I don't double up and abuse my meds, I'm usually in the clear.
England, curious as to where it's legal for doctors to fax such high tier narcotics..
BigG
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In the Uk the pharmacist sends someone round to the surgery to pick your script up for you (any script.....doesnt matter what its for) makes it up and its there waiting for you. Im in and out in under 2 minutes as the pharmacist knows me and knows I turn up at 9:00am every Saturday morning. She has the drugs packed in a paper bag, hands me then and Im out the door. I have no contact with the doctors surgery at all, the pharmacist will even phone the surgery to ask if theyve done my script yet and as I say send someone round to pick it up..they will even deliver it to your door. As ive said before, laws in the Uk arnt like they are in the states. Things are nowhere near as strict. We can get away with stuff thats unheard of in the US. The main reason for this id that while prescription drug abuse is a problem in the UK it has yet to reach tge epidemic proportions that it has in the US and so hasnt attracted the attention of law enforcement to the same degree..... Plus we dont have a fucked up organization like the DEA trying to stop genuine pain patients receiving the treatment and drugs the need and deserve. Whos to say that things wont change in the future though.
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I'm new here. I'm looking for some help. So here's our story. My husband is currently using H for pain relief. I believe he may have a problem with addiction. Although he says he doesn't have a problem he still uses everyday. If he doesn't use he can barely walk due to knee pain. And in order for him to be able to go to work he has to use. He had surgery April 15, 2014. He had a torn cartilage removed and arthritis scraped. It was a simple laparoscopic procedure. I have told him I wanted him to stop using. He says he would like to stop using. But he can't because of the pain. So I have been researching different ways to help him and manage his pain without using H. A friend of mine told me about suboxone. As I read about this drug it seems that there are a lot of different uses. Some say it helps with pain and others say it doesn't. So my question is, is it possible to switch from H to suboxone and will it actually help with pain. Thanks for reading.
Is there anything that will help with pain management after using H? Now that there is a tolerance and there isn't much more that is as strong or stronger than H. Because H is so strong I'm afraid that nothing will help with the pain. Are the chances of managing pain without using H even possible? Any suggestions?
Is there anything that will help with pain management after using H? Now that there is a tolerance and there isn't much more that is as strong or stronger than H. Because H is so strong I'm afraid that nothing will help with the pain. Are the chances of managing pain without using H even possible? Any suggestions?
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Responding to the person who asked about Kratom for pain. It really depends on what your opiate tolerance is. Right now I take 10 grams of poppy every day to manage my pain, and I use Kratom to boost it a little. Personally I would rather be using natural substances than paying homage to Big Pharma although I wouldn't turn down oxy if I could get it.
Kratom, by itself, is only useful for pain if 1) your pain is NOT terrible and 2) you have a low opiate tolerance. Otherwise I'd recommend poppy. I'm drinking a nice batch of poppy seed tea right now because I ran out of pods and I can't get more until Wednesday, but luckily I've saved all my seeds and I have a LOT of them so I should be fine. Plus I have a ton of Kratom. So no WD for me, YAY! Although the BEST YAY would be...no more pain, WITHOUT substances!!!!!!!!!
Kratom, by itself, is only useful for pain if 1) your pain is NOT terrible and 2) you have a low opiate tolerance. Otherwise I'd recommend poppy. I'm drinking a nice batch of poppy seed tea right now because I ran out of pods and I can't get more until Wednesday, but luckily I've saved all my seeds and I have a LOT of them so I should be fine. Plus I have a ton of Kratom. So no WD for me, YAY! Although the BEST YAY would be...no more pain, WITHOUT substances!!!!!!!!!
Rybee
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** Really Need Input Before Thursday **
Guys and Gals, the 100mg Dosulepin I'm taking to help manage the nerve pain is just making me so drowsy. Amitriptyline once induced genuine psychosis many years back so I was hesitant to try Dosulepin in the first place - and I'll never take Amitriptyline again. Similarly when I tried Gabapentin and Pregabalin for migraine prophylaxis in the past they just left me my cognitively constipated, I just can't function on them. Furthermore, I've been mistreated on SSRIs/SNRIs for my previous depression and promised myself that I would never touch them again with a bargepole. So I don't want to try them for long-term pain relief either.
So, Gabapentin/Pregabalin/TCAs/SSRIs/SNRIs out of the question... what other kind of nerve blocking agents are available to use? I used to try things like Sodium Valporate for migraine prophylaxis (though with no luck - though that's not to say it wont work for my back, it just didn't work for my migraines). My pain doc does not like opiates, hence why he wants me off of the Oxy and Morphine, and wants me to rely on the Dosulepin.
I just can't hack the dose (100mg). I'm a drowsy mess and I've suffered bouts of what I'd call short term amnesia. I really struggle to recall simple things that I've done in previous days... I'm not talking to the extent that I have no recollection of events, but I really have to put a lot of thought into what I was doning and I find it quite embarrassing.
My pain doc is going to review my Dosulepin and switch me to Tapentadol so I'd like to be as up to speed with alternatives as possible!
Guys and Gals, the 100mg Dosulepin I'm taking to help manage the nerve pain is just making me so drowsy. Amitriptyline once induced genuine psychosis many years back so I was hesitant to try Dosulepin in the first place - and I'll never take Amitriptyline again. Similarly when I tried Gabapentin and Pregabalin for migraine prophylaxis in the past they just left me my cognitively constipated, I just can't function on them. Furthermore, I've been mistreated on SSRIs/SNRIs for my previous depression and promised myself that I would never touch them again with a bargepole. So I don't want to try them for long-term pain relief either.
So, Gabapentin/Pregabalin/TCAs/SSRIs/SNRIs out of the question... what other kind of nerve blocking agents are available to use? I used to try things like Sodium Valporate for migraine prophylaxis (though with no luck - though that's not to say it wont work for my back, it just didn't work for my migraines). My pain doc does not like opiates, hence why he wants me off of the Oxy and Morphine, and wants me to rely on the Dosulepin.
I just can't hack the dose (100mg). I'm a drowsy mess and I've suffered bouts of what I'd call short term amnesia. I really struggle to recall simple things that I've done in previous days... I'm not talking to the extent that I have no recollection of events, but I really have to put a lot of thought into what I was doning and I find it quite embarrassing.
My pain doc is going to review my Dosulepin and switch me to Tapentadol so I'd like to be as up to speed with alternatives as possible!
Rybee
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Yes of course there are. What kind of pain is it? There are many non opiate based drugs that are used for pain management such as TCAs/SSRIs/SNRIs/Pregabalin/Gabapentin etc... As well as NSAID's and steroid drugs too.
Even Methadone is really good for some types of pain. Plus there's Fentanyl and Oxycodone... obviously the doses would be high but you've still got options.
Even Methadone is really good for some types of pain. Plus there's Fentanyl and Oxycodone... obviously the doses would be high but you've still got options.
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Ive been prescribed tapentadol er for a while now, it doesnt seem to have any effect on me, i have quite a high tollerance. as i cant find a way to prep these to shoot i decieded to give plugging a go. i didnt expect but bot was i wrong, 100mg er has given me a very europhic nod (not unlike 50mcg 25mcg fentynal extracted and iv'd completely to my surprise!!! Just thought id throw in my 2 cents (haha even know i should say 2 pennies as im from the uk). I would highly recomend it as the oral biovaibility seems rather low. i used to be a big tramadol lover, but for me the way forward is to plug tapents. also reminds me of my fave Oxycontin, unfortunatly i cant get them where i live anymore....even typing this is makining me crave them lol ....Oxy, those were the days...
HatsuneMiku
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Changing The dose/frequency on my (PP) pain pump
Recently I had a major surgery after spending a few days at the hospital I was sent home with a caretaker my family hired To help me recover. The pain I am feeling is quite excessive even with the 80 percocet I was given to take 1-2 every 6-hours as needed. The dose is 5-325 which is pretty weak. Luckily, I was also given Pain Pump that I can press a button on to dose myself with morphine. The pump has some built in safety features and my nurse wont raise the dose or frequency. This is upsetting however, I would like to know if any of you with experience with these could tell me how to get more out of it more often. My pain levels and general well being appreciate the answers. As a side note I also take Phenergan for nausea(25mg) with percs in the morning, I take 10mg ambien everynight for the last 2 years, And I drink a large amount of coffee and Advil daily.
My opiate usage has been about 30mg-50mg hydrocodone daily for last two months before my surgery which got me pretty high as I took it at a single dose once a day. After my surgery I was put on a 25microgram fentanyl patch for 2 days then my nurse removed that and put me on the pain pump. My question is can I override the machine to get more morphine out of it or set it up so I can dose more often. On average day I take 5-8 percs a day 1 phenergan and 1 ambien, and up to 5mg of morphine and hour before the lockout kicks in. I have only used 45mg max in a single day. I Would much rather have a larger dose at one time and take less during the day. For eample, 3 15mg doses spread throughout the day. This is a good example of exactly what my pump looks like. I know there is some code to adjust the box the my nurse knows. Surely there is a way to brute force this box password by connecting my laptop to it
or is there an easier way to adjust the frequency.
Thanks for your time and consideration and remember to always have a backup plan and not drive while using.
Recently I had a major surgery after spending a few days at the hospital I was sent home with a caretaker my family hired To help me recover. The pain I am feeling is quite excessive even with the 80 percocet I was given to take 1-2 every 6-hours as needed. The dose is 5-325 which is pretty weak. Luckily, I was also given Pain Pump that I can press a button on to dose myself with morphine. The pump has some built in safety features and my nurse wont raise the dose or frequency. This is upsetting however, I would like to know if any of you with experience with these could tell me how to get more out of it more often. My pain levels and general well being appreciate the answers. As a side note I also take Phenergan for nausea(25mg) with percs in the morning, I take 10mg ambien everynight for the last 2 years, And I drink a large amount of coffee and Advil daily.
My opiate usage has been about 30mg-50mg hydrocodone daily for last two months before my surgery which got me pretty high as I took it at a single dose once a day. After my surgery I was put on a 25microgram fentanyl patch for 2 days then my nurse removed that and put me on the pain pump. My question is can I override the machine to get more morphine out of it or set it up so I can dose more often. On average day I take 5-8 percs a day 1 phenergan and 1 ambien, and up to 5mg of morphine and hour before the lockout kicks in. I have only used 45mg max in a single day. I Would much rather have a larger dose at one time and take less during the day. For eample, 3 15mg doses spread throughout the day. This is a good example of exactly what my pump looks like. I know there is some code to adjust the box the my nurse knows. Surely there is a way to brute force this box password by connecting my laptop to it
Thanks for your time and consideration and remember to always have a backup plan and not drive while using.
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hi guys, I wanted to update you on my situation. I've switched from pods to seeds, seeing as pods are selling at rip-off prices right now on my backup site and my favored site is out of stock (but I'll be watching closely for when they do come back into stock.) In the meantime, before my seeds arrived, I was using Imodium (loperamide) to manage my WD and it even worked a tiny bit for my pain. I was using 5 pills (10 mg) a day and now I'm tapering that down and trying the seeds, which so far have been disappointing in terms of pain relief. They're no where near as strong as pods, not even the ones I got which were stated SPECIFICALLY to be unwashed. They do help a little, but I'm going to combine the weak tea I get from them with Kratom for the time being (I have TONS of Kratom, it's always been a tool in my plan to eventually get clean.) I'm making Kratom pills right now (and BTW I read on another thread somewhere that capsules contain dangerous hormones and are carcinogens...not true for these capsules. They're all vegetarian caps and all natural.)
I'm seeing a new GP tomorrow, I am hoping he will prescribe me Neurontin. (Actually, I'm hoping for Lyrica, but on a first visit I'm not going to ask for a controlled substance. Neurontin is just as good as long as he prescribes what I was taking before, which is 600 mg 3 times a day.) I've found that opiates don't seem to work on my joint/muscle pain, which is another indication that I may have fibromalyia, which I won't have confirmed until I see the rheumatologist on Monday. Probably not even confirmed then, because I've read that a diagnosis of fibro is only given after a process of elimination (when they test you for a host of other things, and none of them are what you have.) But the pressure point test administered by my NS seemed to be indicative of it, and I'm sure the doctor I'm seeing Monday will repeat the test (not looking forward to it, it's painful beyond belief. I almost passed out when my NS did it the first time.) I just wanted to ask you guys, does Neurontin sound like a good choice for me? I know it's for nerve pain but I read that it can be very effective with fibro. I have a very difficult weekend coming up (we're taking the kids to a Renaissance Faire in NJ and there will be a lot of walking and not much sitting and I'm not sure I can handle it but I have to try, my kids LOVED it last year and I'm NOT missing it, it's going to be fun, except I'll be in excruciating pain the whole way! Plus there's the hour drive to NJ which always wrecks havoc on my back. I'm going to bring my massage pillow, which has an adapter to plug into the car, and my TENS machine, which is light and portable, and use both to minimize the pain. And I hope my neurologist fills my prescription for Reglan so I have something for the nausea I always get...I get car sick SO EASILY!)
Anyway, I'm just hoping that he'll trust me enough to write me a script the first visit. Of course, I'm going to come clean with him about everything...if you can't trust your doctor, then...I'll tell him about the back problem, the addiction, the poppy, the etizolam, the bipolar and anxiety disorder, and the pain that might possibly be fibro. I looked up this guy on the internet before I switched to him and he got a 4 star rating on a healthgrades site, and one comment left by a person said that he took his wife to three different GPs and paid out of pocket because they didn't have insurance and they couldn't help his wife, he brought her to this doctor and he not only didn't make them pay but he adjusted her medicine and found out exactly what was wrong with her and she's a new woman now. So now they have insurance and they go see him because they know they can trust him to get it right. So maybe this will be the doctor who will find out WTF is wrong with me?! I'm hopeful. Only problem is I have to bring my son as I will be all alone in the house with him. So I have to go in the morning before his nap.
I'm crossing all my fingers and toes that this is the doctor that I've been looking for, the one who's going to actually help me! Wish me luck everybody!!!!!!!!!!!
I'm seeing a new GP tomorrow, I am hoping he will prescribe me Neurontin. (Actually, I'm hoping for Lyrica, but on a first visit I'm not going to ask for a controlled substance. Neurontin is just as good as long as he prescribes what I was taking before, which is 600 mg 3 times a day.) I've found that opiates don't seem to work on my joint/muscle pain, which is another indication that I may have fibromalyia, which I won't have confirmed until I see the rheumatologist on Monday. Probably not even confirmed then, because I've read that a diagnosis of fibro is only given after a process of elimination (when they test you for a host of other things, and none of them are what you have.) But the pressure point test administered by my NS seemed to be indicative of it, and I'm sure the doctor I'm seeing Monday will repeat the test (not looking forward to it, it's painful beyond belief. I almost passed out when my NS did it the first time.) I just wanted to ask you guys, does Neurontin sound like a good choice for me? I know it's for nerve pain but I read that it can be very effective with fibro. I have a very difficult weekend coming up (we're taking the kids to a Renaissance Faire in NJ and there will be a lot of walking and not much sitting and I'm not sure I can handle it but I have to try, my kids LOVED it last year and I'm NOT missing it, it's going to be fun, except I'll be in excruciating pain the whole way! Plus there's the hour drive to NJ which always wrecks havoc on my back. I'm going to bring my massage pillow, which has an adapter to plug into the car, and my TENS machine, which is light and portable, and use both to minimize the pain. And I hope my neurologist fills my prescription for Reglan so I have something for the nausea I always get...I get car sick SO EASILY!)
Anyway, I'm just hoping that he'll trust me enough to write me a script the first visit. Of course, I'm going to come clean with him about everything...if you can't trust your doctor, then...I'll tell him about the back problem, the addiction, the poppy, the etizolam, the bipolar and anxiety disorder, and the pain that might possibly be fibro. I looked up this guy on the internet before I switched to him and he got a 4 star rating on a healthgrades site, and one comment left by a person said that he took his wife to three different GPs and paid out of pocket because they didn't have insurance and they couldn't help his wife, he brought her to this doctor and he not only didn't make them pay but he adjusted her medicine and found out exactly what was wrong with her and she's a new woman now. So now they have insurance and they go see him because they know they can trust him to get it right. So maybe this will be the doctor who will find out WTF is wrong with me?! I'm hopeful. Only problem is I have to bring my son as I will be all alone in the house with him. So I have to go in the morning before his nap.
I'm crossing all my fingers and toes that this is the doctor that I've been looking for, the one who's going to actually help me! Wish me luck everybody!!!!!!!!!!!
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Hi all, another update from me. Saw the RHEUMATOLOGIST today, not my GP, but he did the pressure point exam again and it hurt. A lot. OFFICIALLY diagnosed me with fibromyalgia and saod I may be in pain for a long time. Fuck. He gave me Neurontin today though, 90 600 mg pills with 3 refills and said to see him again in 3 months. Also recommended aquatherapy which I'm going to try to set up tomorrow. I'm also going to see if I can force myself to go to at least one Tai Chi class a week. He said you have to retrain the brain and the nerves that light touch or ordinary movement should not hurt as much as I'm hurting. At least he doesn't think it's all in my head! He told me that the brains of people with fibro are actually physically different, they're ACTUALLY experiencing pain, but there is a psychological aspect to it as well, that people with fibro tend to have high stress levels and depression and anxiety as well. Sounds a lot like me. The Neurontin takes a long time to kick in but I started taking it at 6:30 and it's now 8:30 and I DO feel better. It's not that the aches and pains are gone; just that I feel happier and more functional. I guess the laundry will get done tonight after all. Just one quick question....I posted it in the Neurontin Megathread, but I'm going to ask again here: I know Aleve helps with the analgesia of gabapentin. I have prescription generic naproxen, 500 mg. Will taking one or two of these help with my pain? Let me know, THANKS!
hermione danger
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Any naproxen sodium will do. It's all the same.
In your last post you said you were going to come clean to him about everything. Did you? I have an appointment with a rheumatologist soon, too, and I'm not sure how much to share. Like you said, if you can't trust your doctor who can you trust? But I take kratom and I'm a little uneasy about admitting that to a doctor. I don't even know why. Just feels weird to admit to buying this random, unregulated substance online.
In your last post you said you were going to come clean to him about everything. Did you? I have an appointment with a rheumatologist soon, too, and I'm not sure how much to share. Like you said, if you can't trust your doctor who can you trust? But I take kratom and I'm a little uneasy about admitting that to a doctor. I don't even know why. Just feels weird to admit to buying this random, unregulated substance online.
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