Harm Reduction The Pain Management Mega Thread Version 4

[tomatalli]

Ortho is OK as are other related physical-therapy’s as it sometimes relieves the symptoms or gives temporary relief from spasm or pain but if you in fact do have an underlying muscle skeletal, spine or facet related disease it just delays the diagnosis of the original cause. But you do have to go through the steps as the hope is that Ortho will get you back to work quickly with the least cost involved, so play nice and be a good patient as sometimes its those very people who can get you further investigation of your situation.

I haven't visted or talked to an orthopedic doctor since December they did absolutely nothing for me I think I need to try and make an appointment with another one. I feel like the doctors think I am just trying to get drugs and won't listen to me that I am in immense pain.

 

[Lifeinpain]

I haven't visted or talked to an orthopedic doctor since December they did absolutely nothing for me I think I need to try and make an appointment with another one. I feel like the doctors think I am just trying to get drugs and won't listen to me that I am in immense pain.

Don’t think of each doctor as a one stop shopping! Each has their own specialties and they really don’t like going out of their specialities. Especially surgeons! As I have the best and longest relationship with my family doctor I use him for sending all referrals to Ortho and Neuro Surgeons, Pain doctors and Pain clinics and Physical-therapists. The surgeons never deal with my meds. Ever! My pain doctor does not give me scripts only my pain doc at the clinic of which my family doc repeats unless directed to do otherwise and therapists only work to keep me upright and lessen my distress. Everyone works together and each knows what the other is doing constantly. It’s a huge job managing your own health. So do a good job or get someone else to help!

 

[tentram]

^it doesn't have to be so difficult where you're basically orchestrating your life just to keep some little balance. it's going to fall apart sooner or later if it's set within.

 

[Dr Pepper]

I need some input and advice, after getting the boot (or at least being told the doc won't script me anymore) from my first PM Clinic.

So some history. 22 yrs old, chronic back pain since 16.
Turns out pelvis was injured during growth phase, causing one side to be bigger, kind of like a leg discrepancy but in the pelvis, so standing/sitting I was always uneven, uncomfortable, in pain.

Got surgery may of last year, fixed the problem by lengthening the left pelvis with a bone graft after they saw through the bone.
8 weeks later, off crutches, bone graft collapses

Then december comes, another surgery, this time didn't achieve correct symmetry or height and problem persists.

I knew things were going to be shitty once the graft collapsed, and since then i've been self medicating. Using opioids, weed, etc. Eventually, recently, it was heroin again... (went to treatment a couple years back).


Anyways, parents and therapist and myself decide pain management. Remember, im using still.

So I go to office 2 weeks ago. Give piss(fuck) since im dirty with benzo,ambien,morphine(no more 6-MAM since it was the day before), thc. I tell the doctor that i've been in treatment, and have been getting drugs illicitly because im in chronic pain, and that i need something till my final (fingers crossed) surgery.

I mention subutex, since it doesnt effect hormones much and isnt really abusable if you have a high tolerance.
He decided methadone, 5mg x2 per day would be good. I was against it, but went ahead, and was scheduled back in 2 weeks. Also to quit weed by 1 month.

Anyways, get my script, and 10mg didnt feel like anything. Ended up taking 40mg the first day. 20mg the next 2 days. Stupid fucking me.. this is where I
screwed up. Didn't even get very high, and it didn't even kill my pain.

Also gave a couple to my dog whose dying (2.5mg doses only, she was fine and pain free for a bit.) By the time 1 week expired I was out, except for 5mg for my drug screen so i had methadone in my system so they knew i wasn't diverting.

Anyways, I arrive today, after withdrawing since monday (finally felt decent today). Had an appointment with a PA. Took a long time, and this young 20 some girl know it all comes in. She is beautiful however. I tell her I only took one tablet today, and she asked why. I told her I ran out early because on of the days I took 3 pills instead of two, since i was in lots of pain. I proceed to tell her that the 10mg methadone dose is very weak considering my history, and I did my best to stick to the regimen. I also had stopped all other illicit drug use (heroin, vikes, benzos) since monday, and that was truly a feat for me.

I really wanted this PM thing to work.
Long story short, she tells the doctor that I took 3 one day instead of 2. SHe comes back telling me he will no longer prescribe me, because i didn't follow orders. WTF!?!?!?

After billing my insurance 1500$ for the first visit, plus urine testing for a couple hundo, and me being up front with these guys, and they say i can stay for counseling and for spine injections. I ask to speak to the doctor not the PA and he is "seeing patients". I stick around looking for him, and talking to some other staff i had met. Can't get ahold of him.

I decide to tell them to cancel my piss test, as i dont want to waste more $ here, and leave.
So I fucked up during my first pain management.

So now I'm going to do some actually research and find a good clinic that doesn't nickel and dime you to death. Also going to make sure my piss is clean when I go in.

How upfront should i be about my previous addiction issues? Im legitimately looking for pain relief and will follow orders to a T next time, even if it isn't helping.

Also, i have a non-related surgery on monday. Ive been scripted from this doc before, and he gave me #30 5/500 hydros.
Today I go pick up the script and low and behold, #60 10/325 norco. Although they are generic, say IP 110.

My tolerance is whack, or hydrocodone fucking blows... I CWE'd 12 pills, and plugged the solution. I think I lost some to my filter. So maybe got 80mg.. I also popped 50mg orally, no filtering, so like 1.5g apap. . So at least 120mg hydro, possible 170mg, and under 2g tylenol.

My pupils aren't even pinned very bad. Just took 25mg hydroxizine and 1mg ativan to potentiate.

Did taking a total of like 200mg methadone over a week fuck my tolerance up that bad, to where 100mg hydrocodone doesn't even put me on the map? I tried with 70mg on monday of hydro, and it was weak as fuck... Now i'll probably have to sell these pills and buy dope for any pain relief, since the doctor tossed me.

Any advice on my next pain management doc? And why is hydro so fucking weak? Thanks!

bump on info about pain management and how to go about it.. be fully honest about history?

 

[Lifeinpain]

bump on info about pain management and how to go about it.. be fully honest about history?

Just a thought and I may not know your situation at all. . . But as methadone is one of the best pain relievers and the drug of choice when in treatment could you get into a meth treatment program and relieve your pain while getting clean? Just a suggestion!

 

[Morphling]

It's really going to depend upon the doctor. Many PM specialists REALLY don't like medication non-compliance. Some are more compassionate and understanding. I would just tell him what works, in what amount.

 

[BigG]

Ive found methadone.to be.a.fantastic.pain killer for my various joint problems in the past. It has NMDA agonist properties and so acts as a antagonist to glutamate. This is as well as its strong mu receptor affinity. Admittedly the dose I was onbwould be considered highly excessive to many. Its worth thinking about tho.

 

[Lifeinpain]

It's really going to depend upon the doctor. Many PM specialists REALLY don't like medication non-compliance. Some are more compassionate and understanding. I would just tell him what works, in what amount.

Where I am. . . meth is used in pain management and much more so when the patient is younger with an abuse history.

 

[Nucynta_80]

I've been on Nucynta 75mgs (Tapendtadol) up to 3x a day for atleast 3 years (I believe early 2010), as the main pain reliever in my pain management program. I'm also prescribed Soma, as cyclobenzaprine seems to not mix well with it (seratonin effects perhaps). Anyways, the Nucynta, seems to have only built limited tolerance. In fact, when I had a minimally invasive surgical procedure on my back, I specifically ask for a few vicodins because taking 2 of the 75mg Nucyntas can be trippy and could cause a panic attack still (3 years later, lol). I'm also on 10mgs of Adderall for what seems like the beginning of time for ADD (amazingly 10mgs works well, still) and that increases Nucynta's NRI effects, so I have to becareful to tare atleast 4 hours apart or I could also get some "undesired" effects. THANKFUL, I've had zero issues with abuse from Nucynta. I cannot honestly say the same if I was on say oxycodone 10-15mgs x3 a day so I'm thankful my doc was willing to try this as a treatment option. For long term pain treatment, obviously potency, risk, and tolerance matter a lot. Nucynta = a win on all 3

 

[Chloe Indigo]

I am just saying this for the record, for my record, and piece of mind. Because when you are sick like me and have chronic pain you are indebted like slaves to the people taking care of you. Little by little they stop really hearing you and their every nuance is politely steeped with resentment. Till they explode and yell and you become tiny but the pain...the pain stays mighty. You are fully under the mercy of others, hoping, praying, wishing with all your being that someone , somewhere out there has felt your 10 out of 10, 24/7, and sees for one moment what it feels like.

 

[Dr Pepper]

I am just saying this for the record, for my record, and piece of mind. Because when you are sick like me and have chronic pain you are indebted like slaves to the people taking care of you. Little by little they stop really hearing you and their every nuance is politely steeped with resentment. Till they explode and yell and you become tiny but the pain...the pain stays mighty. You are fully under the mercy of others, hoping, praying, wishing with all your being that someone , somewhere out there has felt your 10 out of 10, 24/7, and sees for one moment what it feels like.

Damn I see this happening.. After my bone graft collapsed and failed and another messed up surgey later, my rents seem to just want to kick me out now even though I'm kind of disabled. Its the doctors fault to having me walk and start PT early. But I live with the consequences and my family has to live with me and the misery rubs off..

 

[BigG]

Peole who havejt experienced true chronic pain will never really understand whatbits like. People I work with think its rediculous that im constajtly poping pills and slapping on pain patches etc. They say stupid things like stop moajing and put up with it. I often think ifvonly they could feel thos for just 10 seconds out of the day they wouldbchange their tune but its like any kindvof human suffering. Unless uou're going Thu it urself its hard to totally empathise with others........... Well hard for some people anyway.

 

[MadWolfZX]

I hear you on medical professionals not considering chronic pain as a big deal. Perhaps when in medical school, training doctors should experience chronic pain for a short period so they have a much better perspective on this issue. Maybe some kind of harmless by pain inducing drug therapy, or at least some kind of hardware that you wear and it induces the pain mechanically. Require this to be administered for say 48 hours straight. May seem extreme to suggest the above - but in the current state of affairs with most CP patients being treated like simple 'drug seekers', a harsh solution seems needed. The doctor in training can refuse, or cancel/end the experience/lesson at any time - so this is not a forced torture but an optional one; but they should have to endure it for a full 48 Hour time window if they want the necessary credits to get their doctorate. Of course, there should be exceptions: if a doctor in training has CP of his own, or would be in medical/health risk due to existing medical problems.

I got booted from my pain medication prescribing doctor recently. There was a false positive for dilaudid; have never taken, nor even seen the drug in person. I begged for a GC-MS to show I did not take the dilaudid. They rudely rejected anything I requested, booted me from pain management prescriptions, and sent a certified letter to my residence the next day stating they will not discuss the matter in any way, shape or form.

I went through all kinds of crap to stay in compliance. I even turned down extra pain meds the hospital wanted to prescribe me when I had an accident with a fractured shoulder - with nerve pinching against it to boot. Super painful make you cry pain. If my existing chronic pain is around 7-8 in how I can tolerate it; the broken shoulder area with pinching nerves was a 9-10. But I did not want to take ANY chances that would possibly make my doctor think I was in non-compliance. Same goes for some more invasive dental procedures and a horribly painful staph infection I contracted - large, painful abscess. Perfect history of compliance for 1 year with them, and another 2 years of documented compliance in my records from my previous doctor.

With this absurd, poorly conceived Obamacare, I can't find a single doctor that prescribes for chronic pain that will accept new Medicare patients(which I am). In fact, I could not find a doctor to be my general M.D., either. I had to go to one of those emergency walk-in clinics just to get a prescription for my insulin. I also took my records, as I asked the walk-in doctor if he would prescribe pain meds. He immediately accused me of being a drug seeker - and resisted my request to read through my extensive medical history.

With no sufficient pain medication(s), my quality of life is ZERO. Can't even watch a 30 minute TV show; the pain dominates every aspect of life severely. So of course, I am now totally dependent on not so kosher medicine(s), which is a financial burden I simply can not possibly continue indefinitely.

I'm ready to find a local drug treatment center and lie and claim to be a drug addict so I can get methadone.... but I have resisted for a while - that is one black mark on my medical records that no one should have to put up with due to the forever post result of having medical professionals completely ignore any/all pains I might suffer and refuse appropriate treatment for me.

Did not mean to blow so much hot air, but reading this thread just made me have to vent/express my anger. So frustrating.

 

[Lifeinpain]

madwolfzx: what is the main difference between The Patient Protection and Affordable Care Act (PPACA) and your coverage Medicare?

If any one else knows please chip in, thanks

 

[BigG]

Wow that sounds a nightmare. You dont have to do any of that in. The uk. No drug tests, no non compliance issues andball meds are. Free. Im not saying nationalised healthcare is ideal but souds better tha the situation thevprevious poster. Describes isbnothing short of barbaric

 

[Doomed2pain]

Technically it's not free we all pay national insurance and tax for the nhs, nothing in the uk is free. And also a lot of pain management patients have to comply or they stop prescribing medication, even gp's do urine analysis to check that meds are taken correctly.

 

[BigG]

Yeah I know is not really free but what I mean is there are no up frojt costs for healthcare but obviously you pay for it with tax and NIm. Non of the pain docs ive exer seen haNBCs testedme butif u say some do then I believe u. Only talking from experience. As im sure u know not every NHS doc is. The same. Some are great andvsome are cunts.

 

[Lifeinpain]

Technically it's not free we all pay national insurance and tax for the nhs, nothing in the uk is free. And also a lot of pain management patients have to comply or they stop prescribing medication, even gp's do urine analysis to check that meds are taken correctly.

But is it Worth it? I like you enjoy Universal health Care. Canada along with every other industrialized G20 wealthy nation excluding only the US provides its citizens universal healthcare. It may not be free but free Vs.the alternative? I constantly worry for my family in the US.
#1 reason for financial ruin and for declaring bankruptcy in the US is an illness.

 

[Jktm]

Looking for opinions on best post-fusion meds for pain. I don't know if my pain will be better or worse afterwards, but fear recovery as I already require 150mg of hydrocodone (please note this amount doesn't get me high, and this isn't a goal of mine) or more for decent pain relief and am only rx'ed 300mg of tramadol/day currently. I'm trying to avoid fentanyl patches because of tolerance and the irritation patches cause me, OPs/Opana ER because of the polymers used in them (I already have stomach issues), and Dilaudid because of how short-lived they are. If someone could provide with an opinion it would be greatly appreciated.

 

[Morphling]

Looking for opinions on best post-fusion meds for pain. I don't know if my pain will be better or worse afterwards, but fear recovery as I already require 150mg of hydrocodone (please note this amount doesn't get me high, and this isn't a goal of mine) or more for decent pain relief and am only rx'ed 300mg of tramadol/day currently. I'm trying to avoid fentanyl patches because of tolerance and the irritation patches cause me, OPs/Opana ER because of the polymers used in them (I already have stomach issues), and Dilaudid because of how short-lived they are. If someone could provide with an opinion it would be greatly appreciated.

The old formulation OpanaER without the plastic matrix are available again, as generics. Dilauded is available as an ER formulation. Morphine, is of course, an option.