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  • BDD Moderators: Keif’ Richards

Complex Regional Pain Syndrome (CRPS)

T

The Grey Madness

Greenlighter
Joined
Aug 2, 2010
Messages
4
Gidday all -

First time for me here.

I have been diagnosed with CRPS for nearly a year after x2 fights with 2 different prisoners in the course of work (I'm a Forensic Psych Nurse in Prison) within a 2 week period. I have been in pain ++++ at times for well over a year as it takes so long to diagnose CRPS due to exclusionary criteria prior to getting to the diagnosis itself. I can't use NASIDs as I have Irritable Bowel Syndrome (IBS). I was eventually put on Gabapentin 300mgs x2 TDS (3 x a day) = 1800 mgs daily - I tried this in combination with tramadol though after 3+ months I have minimized the gabapentin and ceased it as no real theraputic benifit - I ceased the gabapentin last Thursday so less than a week ago and I have felt like shite for that period, finally feeling more awake today - I was in bed until 1900 hours yesterday and all days nauseous and fatigued.

Has anyone else felt this on the withdrawal of gapapentine?

I also ceased the tramadol as I was doubling the max recommended dose to 800mgs daily with no real pain relief - luckily none of the nauesea some people associate with tramadol - the only days I felt a lengthy reduction in pain was when I mixed the medication with alcohol. I don't drink everyday - not anymore, used to drink 6-8 cans a night and 2 bottles of whiskey a week - I'm sure if I went back to this I wouldn't feel much.

Has anyone got any thoughts of a medication regieme that worked for them or others with a diagnosis of CRPS? The physio has worked ++ well for Range of Motion etc but pain kicks in +++ easy down left side of face, left shoulder and arm hand.

Currently only on venlafaxine 75mgs SR x4 nocte as well as stemitil for the nausea currently in force as well as when it accompanies the pain when it is +++. OH - and 10mgs diazepam nocte to keep the excitory neurons dampened in order to try and reduce a hop, skip, and a jump back to copious amounts of alcohol. AND codiene phosphate PRN for IBS pain.

Any thoughts would be appreciated - not a lot of medication emphasis so far from clinicians apart from what I have already typed above, I remain off work due to the injuries, am sick of the pain and restricted function, work are going to allow me back to work for x2 hours x2 a week as last time at x4 hours the pain kicked in +++ - it's not a money problem as I am covered by ACC (NZ insurance for public and as injured at work all is paid for).

Cheers.


The Grey Madness
 
The next logical step up, I'd imagine, would be Vicodin (Hydromorphone) or Percocet (Oxycodone). Trouble is, both these drugs have recreational potential, and depending on where you live, these aren't words you want to say to your doctor, as he'll think you're a drug seeker.

You do mention you're on codeine now - What dose? Maybe try upping the codeine dose - Codeine works great for lots of people and the abuse potential is limited.

Definitely don't go back to drinking - Not a good long-term solution.
 
^Vicodin is Hydrocodone, Dilaudid is Hydromorphone...

With that said. You might want to consider some other medication options such as a long acting opiate and a short acting for breakthrough pain. Currently I am on the Fentanyl Patch for long acting (not suggesting this drug to you) and Roxicodone 15mg for breakthrough pain. Since you will be in pain for a long period of time I don't reccomend drugs with APAP (Tylenol) in them because of the threat of liver damage.

Talk to your dr about OxyContin for a long acting then Roxicodone for breakthrough.. Or there is Hydromorphone (Dilaudid) which is a short acting.. There are all kinds of options for you.

Also instead of Neurontin have you considered Lyrica instead? You have many options, and I am sure many people on BL would be glad to help you.

Talk to your dr about better medication. It is important to be your own advocate. Are you in Pain Management or being seen by a Primary? Perhaps a referral to Pain Management would benefit you. Tramadol is junk... you need something stronger!!

I wish you the best of luck!
 
Thanks for these suggestions - yes I am under Pain specialists and i have arrogant I have e-mailed him research articles, some on ketamine infusion though only to highlight the reality of different pharmacological approaches, don't really feel like having horse tranqs in the system - being a Forensic Psych Nurse I have not have much exposure to pain conditions unless I am in it or someone under me is, even our medical does not deal with many cases of CRPS (if any - over 9 years there I have not had the suggestion we have one or pharmacological issues with a prisoner with this diagnosis. I will E-mail these suggestions to the pain specialists - they know not to raise medication abuse to me otherwise they recieve a tiraid of abuse or a type that is non debateable in nature due to my personality and unflinching belief in obtaining pain relief to get back to prison - strange but true, bring me prison back, I miss the action.

Cheers

The Grey Madness
 
Grrrrr you work at a prison and your here at a drug site asking advice of those that you very well could be charged with guarding and psych evaluating? I've spent most my life in Prison, and I think thats really fucked up you have the nerve to come here for help when a good percentage of the people on this site probably have been or will wind up in prison. FUCK OFF
 
bpayne said:
Grrrrr you work at a prison and your here at a drug site asking advice of those that you very well could be charged with guarding and psych evaluating? I've spent most my life in Prison, and I think thats really fucked up you have the nerve to come here for help when a good percentage of the people on this site probably have been or will wind up in prison. FUCK OFF
Click to expand...

Quit being rude for no reason whatsoever. Her questions are certainly more welcome here than posts that serve no intent but to harass others.

If you don't like going to jail, you could always not break the law (or at least not get caught doing it.) It isn't anyone in the prison systems fault that you broke the law and got caught doing it. Grow up.
 
The Grey Madness said:
Gidday all -

First time for me here.

I have been diagnosed with CRPS for nearly a year after x2 fights with 2 different prisoners in the course of work (I'm a Forensic Psych Nurse in Prison) within a 2 week period. I have been in pain ++++ at times for well over a year as it takes so long to diagnose CRPS due to exclusionary criteria prior to getting to the diagnosis itself. I can't use NASIDs as I have Irritable Bowel Syndrome (IBS). I was eventually put on Gabapentin 300mgs x2 TDS (3 x a day) = 1800 mgs daily - I tried this in combination with tramadol though after 3+ months I have minimized the gabapentin and ceased it as no real theraputic benifit - I ceased the gabapentin last Thursday so less than a week ago and I have felt like shite for that period, finally feeling more awake today - I was in bed until 1900 hours yesterday and all days nauseous and fatigued.

Has anyone else felt this on the withdrawal of gapapentine?

I also ceased the tramadol as I was doubling the max recommended dose to 800mgs daily with no real pain relief - luckily none of the nauesea some people associate with tramadol - the only days I felt a lengthy reduction in pain was when I mixed the medication with alcohol. I don't drink everyday - not anymore, used to drink 6-8 cans a night and 2 bottles of whiskey a week - I'm sure if I went back to this I wouldn't feel much.

Has anyone got any thoughts of a medication regieme that worked for them or others with a diagnosis of CRPS? The physio has worked ++ well for Range of Motion etc but pain kicks in +++ easy down left side of face, left shoulder and arm hand.

Currently only on venlafaxine 75mgs SR x4 nocte as well as stemitil for the nausea currently in force as well as when it accompanies the pain when it is +++. OH - and 10mgs diazepam nocte to keep the excitory neurons dampened in order to try and reduce a hop, skip, and a jump back to copious amounts of alcohol. AND codiene phosphate PRN for IBS pain.

Any thoughts would be appreciated - not a lot of medication emphasis so far from clinicians apart from what I have already typed above, I remain off work due to the injuries, am sick of the pain and restricted function, work are going to allow me back to work for x2 hours x2 a week as last time at x4 hours the pain kicked in +++ - it's not a money problem as I am covered by ACC (NZ insurance for public and as injured at work all is paid for).

Cheers.


The Grey Madness
Click to expand...

You tried Gabapentin which wasn't effective (wasn't for me as well, I have chronic nerve pain), however have you tried Pregabalin (lyrica)? It was more effective for me, but still needed to be paired with other pain medications. I use tramadol and hydrocodone. I'm not sure what your level of pain is, but imo I'd try hydrocodone before oxycodone. You have to look at it as a lifetime treating this condition. If you jump quickly to some of the most potent pain relieves, you don't leave yourself a lot of wiggle room down the road when you've built up a heft tolerance. Maybe a combination of hydrocodone and muscle relaxers? I don't know. And if hydrocodone doesn't work, then move up the ladder to something stronger.

Good luck in your search.
 
Again thanks for all the advice, as for bpayne - is that really the best you can do? I have no interest other than to gain medical information about my real condition and if you knew your law you'd be more relaxed than your current usage appears able to achieve. Besides - those in your position I have done years of positive service for - but go ahead and tar all those with the only brush you appear able to hold. You truely have no idea and would find (should you ever be in a NZ prison) that the medical department works within legislation laid by the Government (like any health professionals in first world countries) that ensures we work towards the best possible outcome on health standards, give commensurate care to that in the community all whilst being non-judgemental and not told what to do by the custodial component of prison. Surprisingly I am not a she and would gladly meet you in the car park to talk about any issues you appear not able to cope with. I have never held the past drug use (for example) against someone coming into prison and frankly fail to see what it would achieve. Thanks for showing me your character though.
 
bpayne said:
Blah, blah, blah...
Click to expand...

Now that was just pathetic mate. Get a grip :|

The Grey Madness - I think upping your dose of Codeine is a good idea, but you'll likely get to the point where they'll want to try you on a different Opiate altogether.
They'll likely try you on Morphine (Instant or Extended release). The unfortunate thing about Morphine is that the oral Bio-Availability isn't that good so the dose has to be quite large.

Something that might be worth trying out is Buprenorphine:
  • It doesn't have too much in the way of abuse potential (atleast I found this)
  • It last a long time so you only need to take it once a day
  • It's powerful (you'd likely only need 0.5 or 1mg)

One thing though is that you wouldn't be able to take Codeine anymore, but to be honest it wouldn't be needed if you were to go on Buprenorphine.
 
Cheers Monstanoodle - will research buprenorphine re my condition.

Thanks for the infomation and support.

Madness
 
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