Chronic Pain - Med Issues

[runninghigh]

Hey BL friends, I have rheumatoid arthritis (2.5 years now). It's an autoimmune disease...my immune system is damaging my joints. It's a painful disease, especially in the morning - swelling and stiffness for hours. I am under 35 (1 of the youngest in the waiting room at the doctor's office). I have been an athlete during my life (gymnastics for 10 years) and now long distance running. I have tried many medications (1 gave me a blood clot after an IV infusion).

I am on pain medications - fent patch 25mcg/hr (I'd like to be on 50) and hydrocodone 7.5mg, 4X a day (it's weak as hell). I was on MS Contin 15mg (every 12 hours) and oxycodone 10mg, 4X a day (better than the hydro). The MS Contin didn't help and caused severe constipation. I always run out of my meds early and it's frustrating. Should I tell the doctor I'm having problems in the morning and would like to switch back to the oxycodone? Any other suggestions? I'm also on Enbrel (an immunosuppressant). It weakens the immune system, so my joints can have a break...but I get sick easier and have a higher risk for serious infections, cancer too.

I obviously hit the street when I run out...or I end up sick and crazy. We have a safe for the meds, but I always sneak in...when my pain isn't managed. I still run long distance too (5-20 miles each run). I qualified for this past Boston Marathon while going through this, but missed the race because of an RA flare and med complications got in the way of training.

Any suggestions for other meds? My doctor is pretty understanding, but doesn't know my tolerance. Thanks.

 

[Bearlove]

Moved from homeless to HL as there is quite a bit of pain management discussion in here. I hope you find the information your looking for.

Good luck.

 

[runninghigh]

Thanks...anyone with advice? This is a really stressful situation and I'd love to hear something.

 

[DixiChik]

Hey RH...Just want to say that I empathyze with your arthritic pain. I don't have much to offer. I admire that you are able to continue running! I find it painful to even go up and down stairs. I have more wrong than right with my health and I'm new here too. I somehow got placed in the "Dark Side" forum. Ironic somehow, as I thought I was seeking fellow chronic pain peeps.

Arthritis (osteo/rheumatoid) cause severe spine/joint pain for me. I've tried epidural/facet injections in spine (no) I get Synvisc One in both knees to replace cartilage/ease bone grinding on bone pain. (successful to delay TKR, but vomit in mouth painful)

I have taken Mobic for years. I have been interested in the biologics, but both my doctor and I fear the repercussions on my obliterated immune system. I am currently battling an epic case of SHINGLES virus in my eye/face. It's been a whole year now of anti-viral cycles along with steroid drops for eye and ear. I had to start a low dose of Neurontin for the PHN pain. It feels like a colony of fire ants in my eye, face and scalp. SO...this battle has trumped the goal of PM success.

I have been through several trials of opiates since enrolling in January 2014. I have nothing good to report. I tried MS Contin (no) Oxycodone (?) Fentanyl (no) and back to Oxycodone. The Oxycodone does not really lessen my pain, but changes my perception and lifts my mood. I am prescribed 15 mg 3xday, but I don't take the full dose out of fear. I break them into 1/4s trying to keep a steady serum level in my bloodstream. My PM says I needed extended release, but I can't afford those. I've read that OxyContin is no longer an effective CP med due to it's abuse-proof design. I don't know personally because I've never tried original or modified version.

My post is rambling, though I don't mean to do so. Diclofenac 75 mg helped with inflammation and pain, but not good for GI long term if taken daily. I need it daily. I am offered some powerful opiates based on my well-documented medical issues. I am afraid I'll build tolerance and become addicted to larger doses. I can easily see where the Oxycodone can make me actually want to wake up every day. I feel like my former self when I take it...upbeat and productive, even though the pain is still there.

I understand and can relate to your stress. I'm almost 54, but have been living (existing) with chronic pain most of my adult life. I'm worn out from the literal daily grind. I just have no desire to continue this existence. I want to feel better...to feel something besides pain, sadness and anger. I have a great husband of 35 years. We have a good life, but I'd rather be dead (truly) than to exist this way any longer. My husband says "Baby, take the meds so you can feel better". But I've read too many horror stories of addiction resulting from PM plans.

Crazy, huh? My existence is a horror story. I need guidance to avoid the pitfalls of PM. I just had genetic testing for metabolism of meds because I'm not responding as the "norm". The results showed I'm not processing the Oxycodone, so I need closer dosing intervals (4xday) My PM will only prescribe max of 100 per month. It's not magic, it's math. I would need 120 per month to take them every 4 hours. Yet another reason I fear dependence/tolerance/addiction.

All of this babble just to say I have no answers...just MORE QUESTIONS. Sorry! 8(

 

[runninghigh]

It's okay...so I'm not alone.