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

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Doctors always seem to know what's right for their patients but in reality, some doctors are way off on their recommendations.

I'm assuming the 1st doctor didn't want you mixing any sleeping pills with your pain meds, hence not prescribing you anything for sleep........
 
It's against our forum policy to tell you how to seek drugs from doctors, I'm going to leave this thread open but wanted to put that out there.
 
I have been diagnosed with Degenerative Disc Disease, Spinal Stenosis and osteoarthritis in my spine. I'm 33 yrs old and have been in pain management for 7 months. My old doc was prescribing 30mg oxycodone 5xday but I still couldn't sleep. After 6 months I started seeing a new doc who on the first visit cut my IR meds from 30mg 5xday to 15mg 3xday. She also gave me 15mg oxycontin er. She said she doubted if I would even need the breakthrough stuff, but its not working. The ER stuff isn't working at all and I'm having to double up on my BT meds because Ny pain isn't being controlled.

Can anyone give me advice?? Is there another med I can try that would be comparable to the oxy but effective at a lower dose?
 
It's against our forum policy to tell you how to seek drugs from doctors, I'm going to leave this thread open but wanted to put that out there.

Which is exactly what I wanted to stay away from, so my apologies to alleykat if that came off as rude.

Simply because of the nature of narcotics and the rise of Rx-drug abuse in the last decade+ the relationship between doctors and patients has changed. It just means building relationships with doctors so they can actually care for you as an individual has become all the more important.
 
hi everyone, I'm trying to self-medicate today with what little poppy I have left, some kratom (blech, I hate the taste so I avoid taking that but it's good to have on hand) and my gabapentin...seems to be working decently, I'm not in terrible pain, I was able to make a to-do list, get out of bed and do my toiletries, although in that weird way where I can't bend over at all LOL, put on makeup and get dressed with help from my husband. I'm now trying to do work at the computer. I feel optimistic and I want to thank everyone for the support on this board. I'm really glad I have no WD symptoms from opiates even though I've been taking them pretty steadily since last August. I guess I should be grateful for what I have! Doomed2pain I'm about to pm you. Thanks everyone.
 
I have been diagnosed with Degenerative Disc Disease, Spinal Stenosis and osteoarthritis in my spine. I'm 33 yrs old and have been in pain management for 7 months. My old doc was prescribing 30mg oxycodone 5xday but I still couldn't sleep. After 6 months I started seeing a new doc who on the first visit cut my IR meds from 30mg 5xday to 15mg 3xday. She also gave me 15mg oxycontin er. She said she doubted if I would even need the breakthrough stuff, but its not working. The ER stuff isn't working at all and I'm having to double up on my BT meds because Ny pain isn't being controlled.

Can anyone give me advice?? Is there another med I can try that would be comparable to the oxy but effective at a lower dose?


I think you should ask for a higher dose of the Oxycontin first before switching meds altogether.
 
good morning, how is everyone today? I had a nice soak in the tub this morning, thanks to my helpful hubby, and this cheered me up immensely. This and some Tramadol. I'm not doing so badly despite the pain. I got a back brace yesterday, and that helps too. I celebrated by feeding my 17 month old son chocolate cake for breakfast :) he loved it! And I love spoiling him so really, it's a treat for me :) I'm almost out of poppies but I've got a new order on the way so I should be feeling decently for a while despite the lack of strong prescription meds. Besides I like knowing that I can look after myself and I'm not dependent on the whims of a doctor. Feeling pretty good today!
 
Damn the DEA! They make it so hard to even get your legal medicine!
For the second month in a row Oxy IR is backordered all over, I went to 3 pharmacies after I got my script and nowhere had 10s in stock.
So I go back to my doctor and he tries to give me 3x5mg/day methadone for the month, which I wasn't having. He seemed against switching me to any of the "incredibly potent" opiates (as he put it), by which I assumed he meant Dilaudid or Opana. (Even though I suggested a super-low dose--honestly I think 4x2mg hydromorphone would have been a reasonable switch for the month).

Ended up with OP OxyContin instead of Oxy IR for the month, which I think I can deal with, I'm kinda curious to try them for pain anyway (though they're way more expensive, even with insurance). Took one at noon today and have been fairly pain-free all afternoon, and not too high either. I might actually like these...
 
Damn the DEA! They make it so hard to even get your legal medicine!
For the second month in a row Oxy IR is backordered all over, I went to 3 pharmacies after I got my script and nowhere had 10s in stock.
So I go back to my doctor and he tries to give me 3x5mg/day methadone for the month, which I wasn't having. He seemed against switching me to any of the "incredibly potent" opiates (as he put it), by which I assumed he meant Dilaudid or Opana. (Even though I suggested a super-low dose--honestly I think 4x2mg hydromorphone would have been a reasonable switch for the month).

Ended up with OP OxyContin instead of Oxy IR for the month, which I think I can deal with, I'm kinda curious to try them for pain anyway (though they're way more expensive, even with insurance). Took one at noon today and have been fairly pain-free all afternoon, and not too high either. I might actually like these...


I am not so sure it is a true backorder.

http://www.ashp.org/DrugShortages/ResolvedShortages/Bulletin.aspx?id=509

My guess is the pharmacies have reached either their own self-imposed or their wholesaler's monthly limit. Still the same effect for you I know and definitely because of DEA pressure, but trying to give you a little hope.
 
Hmm, very interesting. The thing is that this happened last month too, and it was only the 9th yesterday...
Plus one of these pharmacies is an independent operation that specifically services this pain doc, and the guy told me they order Oxy IR EVERY DAY but never get any/enough in-stock.
The other two places are CVS and Rite-Aid, who both acknowledged they'd had shortages before they did a stock check...
(in one place the lady didn't even have to use the computer to know, in the other she looked it up)
 
Hi Felonious Monk ~
The Duragesic 12mcg/hr is the typical starting dose for opiate-naive patients. For some reason, it tends to not be as habit forming as the oral opiates. I was prescribed 25mcg/hr for a forward slippage of one vertebrae over another (Pre-Op) and after a week it was increased to 50mcg/hr. Following the surgery, the Duragesic were discontinued. Got very sick and had to be re- hospitalised for WD. It was more painful than anything I've experienced.
 
Hi guys, I'm sorry to say I'm in quite a lot of pain today, both from the back (the incision) and from the sciatic nerve pain, which is the WORST. I looked it up and it seems like the pain is from one of two things: when they cut off part of your disc in a discectomy, it brings the inner part of the disc in closer contact with the nerve. The inner part of the disc is more acidic and may irritate the nerve. Also, sometimes doctors move the nerve around while doing the surgery and it may be irritated because of that as well. But...and I say this totally with gallows humor...my BUTT is KILLING me!!! Actually my whole leg feels like its on fire. I can barely walk. I finished my Percocets today, just on time - my prescription is due up to be refilled, and I have an appointment with pain management tomorrow. I just want to ask you guys, I've always been very reticent at this place to avoid being like the whack-jobs I've seen who storm in and demand hardcore pain meds like whiny babies throwing tantrums. I always said I would try to be a model patient and never "push" to get my dosage upped. Well, if I was ever going to do it, now is the time, and my friend who's also in pain management tells me that I need to be assertive about my needs, because they can't read my mind. Anyway, my question is, is there a way to be assertive without coming across like a druggie? If it turns out I walk away from the appointment with just my regular Percocet prescription, I think I'll be ok...my thinking is, SOMETHING is better than nothing right? But I'm on the 5 mg Percocet (with 325 mgs Tylenol) and I don't think bump im me to a 10 is out of the question...right? Someone else told me that pain management places can't prescribe EVERY patient the hard stuff, so they deliberately try to keep some patients on less meds so that it looks balanced. Otherwise they get shut down for being a pill mill.

I really wish there was some kind of machine that could detect your level of pain and relay it to the doctors, so they'd know how much meds to prescribe. But I guess that's not really possible, because perception of pain is a subjective thing. But I KNOW this pain is just as bad as labor, and it's worse because labor at least has an end you can look forward to. This just goes on and on...
 
Keep a 2 hourly pain check and write it down, what number on the pain scale and how the pain feels. I know every 2 hours seems a lot but it helps your dr prescribe you the kind of drugs you need, keep the diary going after the visit, it will help all of your drs, I have been doing this for 4 years. Hope this helps :) sorry to hear about you pain though sweetie
 
So ive been having serious pain for about 4 years now. After 2 years of doctors blowing me off as a young person who thinks her pain is worse than it actually was, I was diagnosed with Degenerate Disc Disease, spinal stenosis and osteoarthritis in my lower back.I attempted surgery but was still having pain. I started pain management and my doc put me on 30 Mg 5xday oxycodone. This was working grreat but I was having a hard time sleeping so I asked for an extended release med for overnight and was denied. After 6 months I started looking for a doc that would listen to my complaint of no sleep. This past month I saw this new doc for the first time. She cut me down to 15mg oxycodone 3xday and 15 Mg oxycontin er 2xday. This dose is not working for me ive been in terrible pain but the NPR who saw me said my meds aren't up for discussion. What should I do? Ive been told by a couple of people to try and get switched over to Opana IR and I might not even need the extended stuff. How do I bring this up w/o looking like a drug seeker?

I have the exact diagnoses as you and have lived in agony for 8 years now. I lost my career and live off of government scraps. I have been able to cope through proper medication and get things done that I used to sit in bed or the tub thinking "how the hell am I going to get that done?" I was young as well and I think that you may be experiencing the pain of pain management.

This country has growing malignant tumor that is full of vectors that infiltrate the right minded people that are trying to ease our pain while making it impossible to adequately treat chronic pain. I am afraid to tell people what I take for my pain because they will certainly think I am an addict, junkie, lost cause, etc. et fing cetera. I am actually taking less than I used to.

I am having a problem with navigating this site so I will go from memory, forgive me if I am wrong. You are worried that you are young? Unfortunately that is a very common feeling. Sounds like you have only been in PM for a couple of years? I started out in horrific pain that left me bedridden for weeks. I will tell you what the PM doc said to me 7 years ago when I was one year into PM. "I know you are in pain but realistically, there is only so much I can do AT THIS POINT".

I couldn't get surgery because the only spine surgeon in the area is a buffoon. Back to my doc. He was honest with me so I will be honest with you since our diagnoses are similar. Ignore me if you wish. My doc said, " you are probably going to be in debilitating pain for the remainder of your life unless there is some miracle breakthrough. I do not want to put you on hard meds like dilaudid(hydromorphone), oxycontin, opana, or a surgical morphine pump because your tolerance is going to shoot up so quickly that you will be on massive amounts of narcotics by the time you reach 50.

That scared the shit out of me. Perhaps your doctors feel the same way although it seems ridiculous that they cannot give something to help with sleep. My back is killing me at the moment, I can usually make it for an hour or so sitting but I had to volunteer today and I am spent. I just felt that since our problems are nearly the same and you are young as I was when I got the diagnoses that I might be able to help you understand how PM works.

The most important thing about PM is your doctor. You have to have a good, experienced doctor. I am sorry if I am offending the younger audience but the docs coming out of med school are completely anti-narcotic. The FDA has a lot to do with that as do the increasing OD's from opiates. Your doctor might put you through the ringer with urinalysis, pill counts, and whatever MR. DEA commands. It is sad. It is necessary.

Just know there are others, many others, out here that feel your pain and frustration. I have to lie down. One thing I can tell you as far as the pain goes, make sure you keep your core muscles( from the front of the gut to the back) Swim if you can. As for the sleep, I could probably count the amount of 8+ hours of deep sleep on my fingers and toes during the last year. Take what you can get and do not mix sleep meds with the pain meds. Oxy knocks me out so I feel for you.
 
I bet all my psych medication is the reason my pain mgt team won't budge on the opioids.

Fuck it all, I'm trying to wean myself off because this is too much to handle, jumping through all their hoops every damned month just to get my roxicodone refilled, and they won't consider ER meds yet wonder why my BT-only regime isn't perfect... I need my life back and so much is riding on me getting clean I'm just choosing to live with the pain now because nothing can amount to the pain that I've felt as a result of fighting to stay on narcotics, it has ruined my life in every way and I just give up. I know I need narcotics, but I'm taking this option off the table for myself. It's so hard to fucking taper using roxicodone too, like wtf.
 
D2P, thanks, I'll start writing things down. I did a lot of research today and it seems like I can do the surgery again, I don't have to jump straight to a fusion. I'm scared of getting a fusion because not only is that serious surgery it also means you're never going to be as flexible ever again. But I had a micro discectomy and it said on one site you can do that up to 3 times before they recommend a fusion. But another fear (yes my paranoid mind again) is that I WILL end up needing the fusion, only I'll have it years down the road, when I'm older and we all know you don't bounce back the same after you're a certain age.

Anyway why am I talking about this? Um, I'm pretty sure I re-injured myself (re herniated the disc.) Why? Well, first I admit I haven't been following the rule about "no picking up the baby" (my son) but I only did it a handful of times and I didn't bend to do it. But anyway, I was holding him and then I went to put him down and he grabbed my hair and YANKED. I lunged forward abruptly, caught by surprise, and then realized I was bent over as if I were doing a forward fold in yoga. I straightened up quickly...but...

I am in so much pain I started CRYING today. No one was here. No one saw me. It was me and Davey (my son) all day today. But I don't know who to talk to about the pain except you guys. My therapist just referred me to some other places because he's really far (in central Manhattan and I'm in Brooklyn) and it's been excruciating to try to get in to see him. I wake up in the morning (NOT rested) and sometimes I just want to lie there and scream from the pain. Just scream, except I know how that would make me look. I try not to give other people excuses to call me crazy.

It's really interesting that they want you to be able to get by on weaker pain meds because you might need the harder ones later...my pain management doctor gave me Percocet again, same dosage, but she gave me more of them so I can take a double dose if I need to. I didn't tell her I've already tried taking up to 4 at once (just once, I'm afraid of taking too much Tylenol) and it didn't do anything...so...

I'm going to try not taking any Percocet tomorrow and just using gabapentin. If it's not helping, why take it? It'll be a good test of whether it's helpful at all.

Just one question: I've googled this and didn't get a clear answer: do opiate painkillers ACTUALLY reduce pain, or do they only reduce one's PERCEPTION of pain?
 
They reduce one's perception of pain pretty sure... Because I mean, they also cause hyperalgesia with prolonged use.
 
Wow I don't believe it. oxy shortages/dea limits ? I would be royally screwed. Lucky I live in a dirt poor nation (and unlucky because Dr's aren't educated on how potent oxycodone is so is really easy to get carried away and blow ur cash and be on loperimide/high dose codeine or bupe which isn't effective for pain at all. But I digress I used to post here at that time my tolerance was just ridiculous after about a year and a half it was at 600 mg a day.

I'm now trying to taper for a final goal of 80 mg oxycontin a day (as that I deem reasonable for my REAL pain). I'm currently comfortable at 260-300 mgs. Just wished I was only prescribed OxyContin and Not OxyNorm IR 20's as well (as the latter are not good for tapering so it's taken restraint not to use them up - as atleast they'll be raising the plasma concentrations of OxyContin as I'm swallowing those whole with water now.
 
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