Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

[Cane2theLeft]

JC, I'm sorry the TENS unit was ineffective. I have been using the lidocaine patches for years now and they are amazing for nerve pain... its like 3x as effective at numbing as ice without the discomfort, melting, etc. etc.

I do love the lidocaine patches but they serve a very specific purpose for me... I get muscle stiffness/spasm similar to what you've described and I've tried over a dozen times to put the lidocaine patches on my shoulderblade area with zero success... NSAIDs, weed, stretching exercises and massage are what I go to for that pain but it rarely gets to the point that its truly bothersome or requires personal intervention beyond my normal routines.

Please do post in this thread more and keep us updated on how you're doing and how well the treatment is working out for you.

take care, brother

 

[Unknown]

I almost never post in here, I should do it more often.


Here's my update:
TENS unit sucked my unit. When's the last time you heard someone call their dick a "unit?" Exactly. I put it on my shoulder (actually, my scapula), and it wound it tighter than its ever been, with a side of muscle spasms. I'll probably use it to shock small animals or something from now on, because its not going on my body.
So then I slapped on a lidoderm patch today and I think it did something, but it fell off twice in 6 hours and probably looked like a tampon fell out of my ass each time. I'll call it a moderate success.


Non-narcotic treatments fucking my shit up - 2, Me - 0

Sometimes narcotics, or other analgesic medications are necessary for some people. Im glad to hear that you are trying everything you can to avoid narcotics though. Cane2theleft told me before that pain pumps (narcotic pump implants) are used as a last resort for people on large doses of narcotics, but I think you might be good for this. It is extremely hard to abuse, and pain is regulated around the clock.

If narcotics are your only option, I hope you are able to control it .

 

[Unknown]

I have a question about Fentanyl.

I have been in pain management for going on 4 years and have permanent nerve damage. I am taking daily 700mg's total of neurontin (not all at once) and 8 Norco 10/325.

My tolerance has gone up alot and the medication isn't helping like it used to so now my pain doc wants to add a long acting med. I can't go any higher on the Nuerontin because it turns me into a zombie, even after all this time I get extremely tired on it. Unfortunately my insurance doesn't cover Lyrica. He is recomending adding the 25mcg Fentanyl patch. I have read about Fentanyl and I have to admit that it kind of scares the hell out of me. I hear that it's not only dangerous, but its also one of the strongest meds out there and once you go on Fentanyl there's no going up from it. I would've thought that the next logical step in the ladder of meds would be somekind of oxycontin for long acting, or even switching my Norco to percs or something else for BP? I am not an expert but I am just wondering if anyone else has had a similar experience and any advice? I trust my doc completely so am I just being paranoid???

I wouldnt worry about it too much. If a doctor decides fentanyl transdermal patches should be used, they wont be dangerous if used as prescribed. The ones you hear about ODing are the ones who inject, chew, apply a heating pad, or wear multiple patches.

I have been on 50mcg patches, and they are a great pain management tool if needed around the clock for chronic pain.

Long acting pain meds are great, because they dont produce the high and lows which occur in short acting narcotics. They produce an even level of analgesics, so pain can be controlled much easier.

"How often are you using your medication to either gain a buzz or high or are using it other than prescribed?"

Never...I only take my meds as prescribed. I have been so traumatized by past doctors labeling me as a "drug seeker" while seeking pain management that I would never risk loosing my current doc's trust and having to go through that again. I think probably most people in Pain management have some experience with the stigma attatched to taking narcotic drugs for pain wether its from a doctor, friend, family or pharmasist.

Thats part of the game unfortunately. Doctors have seen it all, and they are only trying to protect themselves, and you. The downside is that people suffer...

I moved here from a really small town in the midwest where opiod abuse is rampant among young people and every pharmacy in the city was/is getting robbed for oxy's and hydros etc.. So naturally the doctors back there assumed every person under the age of 30 was drug seeking if they came in complaining of being in pain. Legitimate reason for pain or not, it's next to impossible to get opiods prescribed to you there, and for some of us that's unfortunately what works. Hell most of the pharmacy's don't even carry Oxy's of any kind anymore out of fear of being robbed, it's really a sad situation. I am lucky I moved and have actually found a doctor who cares about my pain management and treats me right.

I think thats why I love these boards so much, noone here judges you because everyone can relate on some level to what your going through. I don't even have any friends left that I can say the same about. No matter how hard I try to make them understand what its like to to live in constant pain, they still label me as a "druggie" just because I take opiods and can't just "live with the pain".. Now if I meet people, I just don't tell them that I am in PM.


"I work in a hospital everyday and I know what it's like to be a young chronic pain patient on heavy medication"

Amen to that.. I would give anything to not be in pain and on opiods, but at the moment that's what is working for me. I have tried alot of non-opiod meds and most had negative side effects or my insurance didn't cover them.

I wish you luck!

 

[tg.mu]

I have a q about fentanyl.

I'm in the UK and get prescribed the 75 ucg/hr Durogesic Transdermal Matrix Fentayl patch.

In the last few weeks my Doc for the first time ever gave me an instant-release strong opioid - 5mg oxynorm 3 times daily but I've gotten through all 84 in 14 days.

Anyway so now I only have the patch.... to help my pain I've added another half (37.5ucg/hr fentanyl).

Can anyone give me their 2c on whether I'd be OK adding another half so I was wearing two patches which is twice my daily recommended dose.
I used to be prescribed methadone tablets (physeptone) and would regularly take way over twice my total daily dose at once and be totally fine.

Also I took 15mg of diazepam 12 hours ago followed by another 10mg 3 hours later. And I have a very high benzo tolerance too.

Anyone with experience of fentanyl who can offer me some davice would be very welcomed by me.
Thankyou.

I'm in the same boat as you - I was on the 75 μg/h Durogesic patches too - I've recently changed to MST Continus. I'll give it a few weeks and see which is better. For BTP I get Oramorph 80 mg daily as needed. So is the patch working better than methadone? Have you been on any types of morphine. I will only be prescribed diazepam or temazepam occasionally - do you get them on repeat like the fentanyl? I don't find Oramorph much good for BTP. I'd much rather try something else, or increase my MST dose, I'd even be happy to swap Oramorph for something like temazepam on repeat.

Also, to stop yourself from taking too much of your prescription before your repeat is due, you could give the patches or any medicines you may over-use, to a close, very trustworthy friend. They could then give you enough to last you a few days at a time. If you could control yourself, they could then give you your meds weekly, and so on. This way, you won't run out two weeks early any more. Of course this friend would have to be someone really special. Failing this, you could perhaps be prescribed daily pickups like people being prescribed for addiction do (e.g. daily diamorphine or methadone) - although this may make you look like a drug abuser or addict, so may make your doctor try to get you off strong opioids. So there are pros and cons to consider for both "controlled dispensing" options I've outlined - maybe one, or another variation on this general idea, could work for you? Or if you're in a family, you could put your medicines in a very 'open' ( -- I mean a private place but somewhere 'open' instead of being clandestine, -- ) place that is seen daily, such a a family medicine cabinet. This way you may be deterred from emptying the shelf too early, leading you to taking your meds as prescribed and in front of your family or close friends.

If you have any ides for me I'd like to hear them too!

 

[dhcdavid]

Thankyou so much for your helpful suggestions tg.mu.

When the doseage i s"just right" for the my body's pain then fent is far better than methadone because fent doesn't really produce that state of depressed apathy anywhere near as much as methadone did for me.

The diazpepam was originally prescribed to try to keep me off illicit benzos after I suffered (my second in 2 years) a grand-mal tonic-clonic seizure which saw me in the E.R. in November 2008.

Now my Doc just keeps prescribing them for that same reason and because I assure him I would still like them prescribed daily to me! (And my girlfriend gives the dizepam out to me so I don't eat them all at once)

 

[sportbikesforlife]

So....5 years after hitting that tree...I'm still in pain. I've been prescribed vicoprofen 4 or 5 times from 3 different doctors at different times in the last 5 years. Mainly because my first doctor retired, second doctor was my family doctor, third doctor was because we had moved to another state. Since my ER visit last year when I was going thru the bowel obstruction, my chronic back pain has gotten alot worse both back and neck and I have major bone spurs on both heals plus damage to my siatic nerve. I'm pretty sure that the bowel obstruction was caused in part by taking too much ibuprofen. Do you people think I need/derserve more pain meds? I sure fukking do. I still have this traumadoll...but I don't want it.....

 

[MeasuredBreaths]

Hello all,

I need some help dealing with my chronic pain. Almost 2 years ago, I was helping my brother move, and I injured my back. I went to see my PCP and she gave me 60 percocet 5/325 and 60 tramadol 50mg per month, while I waited to get into the Pain Management clinic. When I went to the pain managment clinic, the doctor immediately discontinued the percocet and the tramadol without a weaning schedule, and put me on 15mg extended release morphine (2 per day), flexeril, and neurontin. I didn't take the neurontin due to how it made me feel, and recommendations from my psychiatrist to discontinue immediately (diagnosed bi-polar). I experienced no relief from the morphine or the flexeril, and went through extreme withdrawals for 4 days. I called the pain center, and was seen by a PA who at least seemed to understand that I needed something for breakthrough pain. She kept me on the morphine and flexeril, and added 120 5/325 percocet per month. They attempted a steroid injection, it only gave me about 10-20% relief for about a week. After this did not work, the PA increased the dosage on the percocet to 10/325, still 120 per month. These were working great, occasionally I would run out before the end of the month, and I would need to take some of the Tramadol my mom was being prescribed for her back to get through until my script got refilled. I had another injection after this, with similar results. They suggested pool therapy which did not help. They had me try an EMG to see if my nerves were damaged, and I could not go through with the test due to the intense pain. I went to an orthepedic surgeon on my own, not to get any other scripts, but just to find out what was wrong with my back. I was diagnosed with a bulging disc, fluid in my joints, arthritis, a pinched nerve, and degeneration in my lower back, and he recommended surgery(disc fusion of L4 and L5). I went back to the pain clinic for my monthly appt., and I couldn't get in with the PA I was seeing, so I had to go back to the original doctor. At this time, I had been being seen at the pain center for a year, and none of the therapies or solutions worked, the narcotics were the only thing that provided me relief. I asked the doctor what they planned on doing, and if they had any ideas. I was frustrated that they could not provide me any answers, and that the orthepedic surgeon was able to diagnose my problem in one office visit. The doctor got very defensive, and he told me that I was addicted to percocet, and I needed to go for fucking chemical dependency counseling. He AGAIN immediately discontinued the percocet without a weaning schedule, and gave me a 2 week weaning schedule for the morphine. It has been about 3 months since I was seen at the pain clinic, and I have had to rely on a lot of other ways to get percocet to manage my pain. Unfortunately, it looks like I won't be able to do this much longer. I am getting married in a week, and taking a 2 week honeymoon, and I want to be able to be pain-free for the most exciting time in my life. When I return from the wedding, I will likely do the surgery, but I want to be pain-free until then. My question is, does anyone have any ideas about how I can get back to the pills I was taking? I have tried going in to a couple of doctors, and they end up either calling the pain clinic(who will not see me until I go through chemical dependency treatment) or calling the pharmacy, and seeing that I have had quite a few percocet and vicodin prescriptions. All of these doctors referred me back to the pain clinic, and said I needed to get treated there. I am sick of being treated like I am trying to get high. All I want is relief. Help!

EDIT - In case it is important, I am a 25 year old female from the upper Midwest. I welcome any questions if something wasn't clear in my post. Also feel free to PM me to discuss further. It sure would be nice if I can find a doctor in my area willing to give me some relief.

 

[sweetbeatlvr]

does anyone here have any experience with using Cymbalta for chronic pain?

i have Fibromyalgia, and my doctors and i have been trying different ways to manage the pain, without having to increase the pain meds.

i have tried other different AD's in the past (per doctor's request, and despite not having depression), and have had horrible side effects: anger, extreme agitation, racy heart, no sleep, and reactive depression from all the side effects.

needless to say, i am a bit concerned about trying cymbalta, but on the other hand, it has been approved for the mangament of FM (w/ or w/out depression), so i have high hopes it may work.

my doctor also lessened my dose of hydrocodone, in the hopes of of the cymbalta working.

*any* info anyone could give me would be greatly appreciated.

 

[Desdenova]

Sweetbeatlvr,

I was given Cymbalta for undiagnosed chronic pain, and it did nothing for me. However, mine is undiagnosed, and yours is Fibromyalgia. I was evaluated for that, and it was never seriously considered as a possibility.

If it's been approved, it's had some success. Give it a try, and if it doesn't work it doesn't work. Finding the right treatment, be it medication or other therapies, can take a great deal of time

 

[sportbikesforlife]

Actually, good ol narcotic pain killers are the best and they are time tested. I am very weary of putting any of these new fangled pharmaceuticals into my body that the drug companies are coming out with these days. Side effects seem worse than the condition one is being treated for....just seems like opiates are really the best way to go when treating chronic pain.

 

[Cane2theLeft]

Narcotic analgesics are great for pain but they are NOT the best for every condition. NSAIDs and steroids are the most effective for inflammation, some skeletal muscle relaxers and benzos are best for muscle spasm, tricyclics and certain anticonvulsants are the most effective for neuropathic pain, etc

You really can't generalize ALL new medications to treat pain as being anything, they are too diverse a group. Lyrica is a godsend for neuropathic pain but has some horrific side effects in a lot of people while lidocaine patches have virtually no side effects (both of which I use on top of opioids).

In reality, no medication is very effective for chronic pain. The most effective treatments utilize a diversity of treatments including medications from various classes as well as other means to manage the pain... Physical therapy, meditation, psychotherapy, exercise, biofeedback, nerve stimulation. Etc. Etc. Etc.

 

[Desdenova]

Well, today I'm going to be calling to make an appointment with a new pain clinic

It's not that I'm unhappy with the current one, I really like the doctor and I'm sad to have to leave, but I just moved into an apartment right by my school, which is 45 minutes away

I got damn lucky too. The new doctor is not only covered by my insurance, he's at the university's hospital! (I won't say specifically what one for anonymity's sake)

I can't believe there's actually a pain management clinic on campus!

Hopefully, Percocet isn't the strongest their willing to prescribe for BTP. But even if they make me stay with it, the conveniece alone is enough

 

[Cane2theLeft]

That's great, Des that you were able to find a pain clinic on campus. The last university I was at had a decent clinic (regular clinic, not pain management) but the pharmacy there carried nothing stronger than T3's!

I'm always nervous when seeing new doctors so I hope everything works out really well for you and you are able to find a caring doctor who will listen and treat you appropriately.

Keep us posted and take care!

 

[Desdenova]

Well, shit

I called the place, and if I have my current PM doc refer me they will review my chart and decide if they want to take me as a patient

Problem is, they're taking patients but won't be seeing until sometime in August, they're restructuring or refurbishing or something I didn't catch. I would have to stay with my current clinic for the time being, but they're 45 minutes away from me (a real bitch with no car) and they don't prescribe anything stronger than Percocet for BTP

I do have another option though. There is a huge, really really nice hospital complex(really more like a mini-city) with a place they call the Center for Advanced Medicine. I've seen a neuromuscular specialist there, and was really impressed with the place. They're the medical school/hospital part of the super elite private university here. They have a pain management center there with three doctors (two of whom give prescriptions directly to the pharmacy using an internet service provided by my insurance company).

Only problem with that is, it's off campus, so I can't use our transportation services to get there. I don't have a car, and it's too far to walk. It's close enough that a cab ride would only be $10 or so.

And now, sitting here typing this, I think I've just convinced myself to take the second option. I can't put a price on adequate relief, but $10 a every 1-3 months is pretty damn reasonable

 

[Desdenova]

Hope it's ok I'm double posting. I think it is, since it's a six day interval?

Quick question for everyone...

Does anyone here have a home delivery pharmacy for their prescription insurance? Like Express Scripts? If so, do you hate it?

Cause right now, I do

 

[Cane2theLeft]

Sorry, I have a walgreens my crippled ass can even walk to if need be so I've never had to use a delivery service (or had much desire).

Why are you hating yours?

 

[Desdenova]

Well, they've had some delays with my medications

I put on my last Duragesic Friday, so it's gone now. Took my last Percocet last night

Just have to get through until tomorrow afternoon though. That's when they're supposed to be here. Although they were supposed to be here by now, so I don't know how much faith I can put in that

 

[TheDankaholic]

Well, they've had some delays with my medications

I put on my last Duragesic Friday, so it's gone now. Took my last Percocet last night

Just have to get through until tomorrow afternoon though. That's when they're supposed to be here. Although they were supposed to be here by now, so I don't know how much faith I can put in that

Thats harsh, I just had a Dr. who went on vacation so my Dilaudid RX was delayed like 4 days, & i'm suppsoed to take 4mg's 6X a day. I'm really lucky I had some random bottle of Norco's from 2 years ago laying around to get me through the breakthrough pain while I waited for my appointment yesterday. I hope they make it to you tomorrow afternoon. There's nothing worse then them being late on refilling your prescribed pain meds that you usually take on a very set schedule. It's absolutely cruel and causes a lot of pain and discomfort. I hope things look up for you hear, and before you know it, it'll be tomorrow afternoon even though i'm sure it seems so far away right now. I really feel for you.

 

[TheMatador]

Hey Desdenova,
I'm really sorry to hear about your predicament man, it is absolutely horrible being a chronic pain patient in pain without our medicine, and the fact that our pain is 'chronic' doesn't help, since it is chronic pain and most of us have been on our meds for quite some time it makes the situation go from bad to worse It is completely unnecessary pain that we go through and it makes me cringe just thinking about it and everything, some of the situations similar to yours that I have been in flash across my mind, I've been there man I'm really sorry.

I know you know all the things that are going to make your minor withdrawals better and bluelight has a wealth of info on that one subject it would take days to read, so be grateful we all have this amazing site for our use and I hope you the best with that.

Hopefully you can change your service to something besides ExpressScripts, their a giant corporation so I dont doubt it when I hear that they have fuck ups like these on the regular. It is not an option for us chronic pain patients to go without or medicine for any length of time, its unnecessary pain and sometime torture.
I would definitely look into something else, perhaps regional or local based, there are a lot more reliable companies than the mega-corp that is ExpressScripts.

Good luck man, were always here for you, you know thaat

-TheMatador

 

[Desdenova]

Thanks for you support guys, truly

My mom called me earlier (she knew what was going on) and asked if I wanted her to bring up a few Vicodin just to hold me over. I told her no. I know she needs them and I couldn't ask her to do that

She came anyways though. 30-40 minute drive. Said she was gonna bring me Porketta (one of my favorite dinners) and some 7-up and Gatorade so I could stay hydrated/ease my stomach. So she showed up and handed me 4, two for tonight and two for tomorrow morning. Luckily I can easily pay her back this weekend when I go home for the 4th

God damn I love my Mom