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

[Tripman]

Thanks for all the replies back to me about Lyrica for nerve pain guys .

The "nerve" part of it as someone put it is the thing that drives me to distraction, the regular pain i can manage with other medications but the nerve stuff has just been unmanagable. I'm booked in to go see my doctor on Monday next week so will have a discussion with her about lyrica (She has mentioned it as a future option in the past).

Wish me luck .

 

[Felonious Monk]

Have u looked at gluten ?
What about diet changes- I saw u mentioned that- how has that come along? Total elimination diet then slowly add one thing at a time. There has to be an answer. How did you feel when taking the benzos?

Yeah, they did the celiac blood test but I came back negative. I've definitely experienced benefits from altering my diet though (and listening to my body better).

I've been trying to progressively cut out more and more of the processed foods I used to eat, especially wheat and corn based ones. It's definitely helped. I never have a problem eating chicken and rice (in many different forms too! japanese, indian, mexican, home-coooked... haha, as long as it's mild too, I can't do spicy). I do alright with fruits and vegetables most of the time and do well with green juice (I have a juicer). Once I have my own place this will be easier too (to complete this progressive change I've been making), as my gf has really bad eating habits as well (in a totally different way), so we've had many-a-clash over food, and it doesn't help with my issues.

Never really had the patience do a total elimination diet properly (or had anyone explain it to me well, I saw a nutriontionist but she was terrible, I educated her and I don't consider myself as having much knowledge...). I'd consider it though, I'm on a pretty basic diet (lots of liquid protein as well as smoothies some days).

I agree. There's definitely an answer, and I kinda think I'm getting there, even if the Drs aren't helping. Overall I feel better than I did 6-8 months ago (right around and before I started working again and had been unemployed a while). And I predict that 1-2 months post moving into a place by myself I'll see more functional improvement as well.

When I was on benzos was a very different time. I'd been really depressed, which is what had been the kicker that had first bumped my dose up (plus me using bars on my own for overwhelming anxiety). Overall I wasn't as good managing my emotions and wasn't nearly as mature as I am now (honestly in about a 6 month period which coincided with benzo use I had a lot for self-examination through LSD and matured a lot, self-actualized you might say, as it started something I'm still living today).

But as it relates to food... I hadn't gotten sick yet, I had occasional low-level IBS-esque issues at that time, but there was one specific point which I got very sick and went to the hospital for dehydration relating to GI symptoms and since then have never really been 100% again... (and that was over 36 months ago at this point)

 

[JackiePeyton]

I ran into something called Post Infectious IBS. It may be of interest
http://cid.oxfordjournals.org/content/46/4/594.full

The 4 Step, 12 Week Elimination Diet for IBS
Make a list of the foods which you think may worsen your IBS. If you aren't certain which foods bother you, start your list with fiber, chocolate, coffee, and nuts.
One at a time, eliminate a food on this list from your diet for about 12 weeks to see if you notice improvement.
If you do not notice improvement after 12 weeks, begin eating that food again and try eliminating the next food on your list.
Begin your elimination diet with fiber.

Here is the full link
http://www.aboutibs.org/site/treatment/diet/12-week-elimination-diet

I don't know what is going on with your relationship, but it does sound as though this is an area of trouble for you. I hope you can get this somehow sorted out.

A low dose Klonopin may be good to have around. Just tell the doctors you don't want a whole bunch.

 

[Harrisment]

I actually made a typo, which you just made me realize... its hydromorphone I take, not oxymorphone. sry bout that.

Anyway, I'm not exactly sure what you mean by "stop working". But I assume you mean, if my tolerance becomes to high to the point where the fent and Dilaudid aren't effective enough.

But, my doctors have NEVER talked to me about what they would do if the meds I'm on stopped working for me. I'm guessing they would try other meds. I don't really know for sure. I do know that there isn't any surgery or procedure that would benefit me. I've already tried(earlier on in my pain management) different types of injections into my spine... which didn't help at all.
So I guess that kinda leaves me with a big question mark when it comes to the issue of..."if my pain meds stop working". Kinda scary.

I'm curious why surgery isn't an option. I have pretty severe degerative discs, which I've managed for years with opioids and injections. My doctors now want me to try a double fusion surgery, but it scares the hell out of me. I've been on narcotics for years thou (currently Opana ER 20x2 and Opana IR 10mg x 4). The doctors just think I'm at the end of the road medication wise, so I need to have surgery. I'm terrified of ending up worse off though.

 

[JackiePeyton]

research your surgeon

 

[Harrisment]

research your surgeon

Thanks JP. I am pretty comfortable with my surgeon, as I've seen him for years to get injections and for pain management, until he eventually sent me to a PM doc. He is recognized in my area as one of the top spine surgeons around. Previously he actually advised me to hold off on surgery for as long as I can stand it, as I'm still fairly young (mid 30's now, but issues started in my mid 20's). That was back when I was just taking a couple of hydrocodone per day though, so the surgery option is now starting to sound like more of a necessity. The main issue is that my PM doc just doesn't want to continue prescribing me the opiates, as it's not sustainable in his opinion. I do agree with him on that for the most part. I just wish there was something besides a double fusion I could do, as I've heard so many horror stories about that surgery and patients ending up worse than they were before. The intradiscal injections (steroid injected directly into the degenerative discs) used to provide a good bit of relief for months at a time, but now those only last for a couple weeks at best. Other than that, I've tried just about everything else over the years: physical therapy, disc decompression sessions, and even PRP injections not too long ago. It's very frustrating and quite frankly, I'm scared as hell.

 

[JsinDubya]

I thought I would give my two cents about methadone for pain Managment. While methadone seemed to work pretty well for my pain I have as of recent tapered down and switched to opana ER and hydrocodones (norco ir). I have a slight heart condition (on top of everything else) that was discovered during a recent EKG so to avoid any complications my PMD had me taper down and switched me over. It's been almost two weeks since the switch and it has been absolutely horrible! For starters the withdrawls kicked in about 24hrs after my last methadone dose and not the typical opiate withdrawls it was crazy unbearable . I've been on opiates for 17yrs and in that time I've been thru my share of withdrawls both purposely and unintended. The opana ER would not digest properly not sure if it's bc of the make up of the pills fillers or a combo of withdrawls causing my chrons&ulcers flaring up and the pills fillers, but they would pass straight thru me. The norcos are not doing much as I still feel pretty crappy/Wd and the pain is at a very high level. I've read that it takes a few weeks for the methadone withdrawls to subside completely. I understand that this medication is extremely cheap and somewhat works for PM. But what's surprising to me is how intense the withdrawls are when switching, it's as if the meds I'm on now are having such a little effect on the withdrawls let alone any pain relief. It's very difficult, I would never recommend taking methadone for PM.

 

[Harrisment]

I thought I would give my two cents about methadone for pain Managment. While methadone seemed to work pretty well for my pain I have as of recent tapered down and switched to opana ER and hydrocodones (norco ir). I have a slight heart condition (on top of everything else) that was discovered during a recent EKG so to avoid any complications my PMD had me taper down and switched me over. It's been almost two weeks since the switch and it has been absolutely horrible! For starters the withdrawls kicked in about 24hrs after my last methadone dose and not the typical opiate withdrawls it was crazy unbearable . I've been on opiates for 17yrs and in that time I've been thru my share of withdrawls both purposely and unintended. The opana ER would not digest properly not sure if it's bc of the make up of the pills fillers or a combo of withdrawls causing my chrons&ulcers flaring up and the pills fillers, but they would pass straight thru me. The norcos are not doing much as I still feel pretty crappy/Wd and the pain is at a very high level. I've read that it takes a few weeks for the methadone withdrawls to subside completely. I understand that this medication is extremely cheap and somewhat works for PM. But what's surprising to me is how intense the withdrawls are when switching, it's as if the meds I'm on now are having such a little effect on the withdrawls let alone any pain relief. It's very difficult, I would never recommend taking methadone for PM.

Yeah, I've heard similar stories about Methadone. It seems that due to its long half life, withdrawals from methadone last a ridiculously long time.

As for your W/D's, I really think this is 100% because you have the brand name Endo Opana's. Opana is fairly weak as is when taken orally, and that new formulation from Endo has just about made them worthless. I'm also prescribed Opana ER, but I get the generics. Both Actavis and Global make a generic, and they are both based on the old formula, which are much easier to crush. I know you are hesitant to snort pills, but I can tell you that is likely the only way you are going to get relief with Opana ER. The bioavailability of Opana (oxymorphone) when taken orally is 10%, while it is closer to 50% when snorted. It makes a huge difference. I've tried to take them orally a few times, and just like you they won't even keep me out of w/d's when swallowed. My advice is that if you want to stay on the Opana, then call around to local mom and pop pharmacies, and find a place that has the generics. Even if they don't carry them, they can order them for you and have them there the next day. Also, as many other of us have found out the hard way, avoid the big chain pharmacies like CVS and Walgreens. They are generally very difficult to deal with as a chronic pain patient, and you will be far more likely to find a compassionate pharmacist at one of the smaller mom and pop places.

Good luck!

 

[Windsor]

Hi.. Pain management nurse for 6 years. Methadone is a nasty molecule. We write it for patients that have no insurance, because it's cheap, or patient's that have good EKG's and are stable on it for a long time.

While stepping from Methadone to Hydromorphone ER--with only HC for BT--you might need a benzo for 10-15 days, to stop the Myclonic jerks. They will fade, but they really do suck.Give the Hydromorphone some time-- It's a slow release, as I am sure you know. They Hydrocodone will hit your receptors, but if you are new to HC after Methadone, it most likely causes a Euphoria effect.

Try a couple beers, or see if your Dr. will give you a benzo. Something like Klonapin 0.5 mg to be taken 1 hour before bed for about 4-5 days should help

 

[xtcgrrrl]

I'm killing myself tonight. I took an extreme amount of etizolam, lots of booze, and some Lyrica thrown in for good measure. Lots of it. My husband says I can't come back for a long, long time and he's restricting how much I can see my kids, my girls never and my baby son only on alternate weekends, I've been inseparatable from my son before this happened. I can't take it. I wrote a suicide note apologizing to everybody, but my life is hell on earth right now and I'm no longer afraid of death, I welcome it becuz then everything will be over for me. I don't believe in an afterlife becuz we are just animals after all so I'll just cease to exist. I'm ok with that, cuz I hate myself. I've been in pain for so long and I just want it to stop, and soon it'll be over and I won't suffer anymore. I'm sorry guys. Goodbye.

 

[Windsor]

I don't know how much Methadone you were on, or how much Exalgo ER you are now on...so cannot speak to the conversion, but Exalgo will work. You are used to the immediate release of Methadone, which has a nice 'punch" followed by a good extended pain relief. Give it time..Exalgo will release slowly and hit your receptors.

You mentioned you were taking HC for BT pain--Where you taking this with the Methadone? Or is HC new for you?

 

[Windsor]

Hey there Xtcgrrl-

Not sure what etizolam is...is that Zolpidem? I am sorry to hear you are suffering. Suffering is hard, and I see, from your post, there have been restrictions on you seeing your children?

Perhaps you should get strong, think about what brought you to this situation with your children, and fix it?

 

[xtcgrrrl]

What brought me to this situation was that my MIL was abusing me and she finally sent me to the hospital and I reported the abuse. They opened an ACS (child protection services) case against her becuz she hit me in front of my children, after that my husband, who should have married his mom, banned me from the house.

 

[Windsor]

You have been on here since August____? and have 255 posts? Wow...That is over 20 per day. That must be really hard with working 8-9 hours a day

Don't give up! You are obviously working very hard, and want your children..so work on it.

 

[xtcgrrrl]

Breathing is shallow now and seeing things that are not there. If not for autocorrect on my phone I'd be unintelligible

 

[Windsor]

I see. so--you've been banned from the house, where your abusive boyfriend lives with his mother, and your children are living there?

 

[xtcgrrrl]

Taking more etizolam to answer your question it's like a benzo but I'm finally not afraid anymore and I want to make sure this sticks

 

[Windsor]

Well, if your breathing is shallow, you should get someone in your household to call 911

 

[xtcgrrrl]

He's my husband not my boyfriend and it's his mom that is physically abusive but we live with her or at least we did now I'm at my parents and I don't want to be banned for that long I just want to give up

 

[xtcgrrrl]

I'm so tired of being in pain every day and this thing with my kids is the last straw