Confused About Medications

[rhodyvik]

Hello all,

I'm a N00b to this site so please forgive me if these questions have been answered. I am thinking not as in depth as I would like because of my situation. Here goes...and I'm sorry it's a long dialogue but in order for a correct conversation, the back story needs to be told:

I'm a 29 year old male who had thyroid cancer in 2009. It was found during a normal physical (my PCP is awesome) and so goes the story of ultrasound, biopsy, surgery (complete thyroid removal, 1/2 on October 9th 2009 and the other half March 17th 2010). I beat cancer and I'm damn proud of it after surgery and taking a very toxic I-131 radiation pill to remove any remaining. The doctors have all said that if someone were to get cancer, this is the best kind. I would not wish cancer on anybody. It's hell. So basically after all that...my body changed completely. I'm talking hormones and metabolism. Getting the dosage of Synthroid is basically a trial and error method, and even to this day my endocrinologist and I are either at 175mcg or 200mcg. Then I started having more anxiety than normal and saw a psychiatrist who prescribed a very low dose of Ativan at the time (I think) for 1mg at night. I am now taking 8mg of Klonopin a day. That's right...2mg 4x a day. If I'm ever in the hospital or with a different doctor they are always in shock at how much I'm taking. They say that dose is enough to tranquilize an elephant (obviously an exaggeration but you get my point). Also in 2009/2010 I severely tore my left shoulder labrum, bicep going into the shoulder and rotator cuff injury due to sports. I'm a tennis player but my dominant arm is my right arm but I injured my left! It was partly due to tennis...but also getting thrown down, UFC style, on my left shoulder while in a drunken stupor fighting match with all my friends. We had rounds and all that. Who knows who the hell kept score. Anyway, I went to my doctor and then an Ortho and he prescribed Vicodin 5/500 (100 count). Then I went back to the Ortho to get more but he said he wouldn't until I got surgery. To this day, I still haven't gotten surgery because I can't afford to be out of work and couped up for 6-8 weeks to recover (more like 4 weeks since I'm young and relatively healthy). SO...I went to my PCP and he started prescribing Vicodin to me like it was candy. First we started at 100ct of 5/325 to take every 4 hours with 5 refills. I told him after a while that I was doubling up and I didn't want to hurt my liver. He then gave me 10/325 (100ct) to take every 4-6 hours with 5 refills. If you can see my CVS history of how often I was getting this medication, it's a joke. At one point the pharmacy just started giving it to me every 10 days and then a few times every 7 days. I had a real problem but SWIM was also selling it to make money. I had to change PCP's because I moved. Worst decision ever. My new PCP started off giving me 240 tablets every 2 weeks of the 10/325 strength of Vicodin. The Yellow Norco's. I then had to switch doctors because my new insurance didn't have him in my network. I go to this new doc and he says he will only give me 120/month! So I went from 480 tablets a month to 120. I went through them like crazy and had severe withdrawals. My doc said that he wouldn't let me kill myself with all these medications and the high strength. I basically told him that I have a really high tolerance to pain medication. When I've had Dialudid through an IV at the hospital (1mg) through the side of the IV that mixes with the stuff going into my body, it definitely relieves my pain significantly...but I can tolerate way too high a dose and it SUCKS. I wish I could go back in time and never had this problem with my shoulder. Anyway, to relieve the withdrawal...my old doctor who prescribed it in the beginning of this story gave me Tramadol. He said since he's not my PCP anymore that he can't give me pain meds and that was the condition to go back and seeing him. Plus I don't want different doctors prescribing pain meds when it's legitimate pain or else I won't get any, anywhere. So finally, I am taking Tramadol here and there and Vicodin here and there and it seems to be working but within a day I grew a tolerance to Tramadol. I was prescribed 50mg 1 every 4 hours. I know they come in 100mg and probably higher...and it's stupid that I have to get the 50mg. The doctor is trying his best to keep me going on in life without sweating and coming down off of opiates (I did it once when I ran out and it SUCKS). I will list all the medications I'm taking below, and then I will ask the questions. I appreciate anyone reading this. It's wicked long but therapeutic for me as well. And I want to finish before the 'Cuse-Louisville game. Medications and dosages:

1. Vicodin 10/325 (1 Tab 4x daily)
2. Tramadol 50mg (1 Tab every 4 hours)
3. Klonopin 2mg (1 Tab 4x daily)
4. Soma 350mg (1 Tab 3x daily)
5. Synthroid 200mcg (1 Tab daily)
6. Remeron 30mg (1 tab at bedtime)
7. Gabapentin 300mg (1 tab at bedtime -- I tried to increase dosage as the doctor recommended but I felt like crap in the morning after taking it one day in the morning, so I stopped)
8. Motrin 800mg as needed
9. Bentyl 10mg (1-2 tab before meals as needed)
10. Donnatal (no mg...taken as needed)

I am taking Bentyl and Donnatal due to IBD. I had food poisoning Oct 29th, 2012. Then I had to go back to ER because I was in even more pain about a month later. They found what seemed to be colitis...but it's nothing after I had a Small Bowl Series done which showed nothing. Also had a colonoscopy on Jan 4th, 2013. Basically every test except an endoscopy which I'm getting done next week and then, if necessary, the camera pill you swallow. My GI thinks is neurological and that a nerve somewhere in my stomach/intestines/colon/etc is sending the wrong signal of pain when there really shouldn't be.

SO my questions are:

1. Is there a way, without sounding like an opiate pill popper, to get the medication I need to control my excruciating pain I have daily in my stomach and shoulder?

2. Surgery is an option now since I'm out of a job and have mandatory health care in Mass. I know they'll give me stronger pain killers after the surgery but I've been taking Vicodin for so long (and oxycodone sometimes, if I need it...such as after an ER visit). How much of a physical dependence do I have now? It was hell the 2 weeks I didn't have it...and thought I didn't need anymore but I was prescribed it yet again because my doc could tell I needed it.

3. Why does Tramadol seem to be working better than Vicodin? I'm taking 200mg of Tramadol compared to 1-2 pills of the 10/325 strength Vicodin. It's weird how it seems to work better and after just half a month taking it, I can feel a dependence when I ran out. Yet another damn Rx that I will have heavy withdrawals from.

4. I have started to go to a Pain Management center and they won't even prescribe the medications I'm on! So I still have to see all these different doctors which doesn't look good on paper to CVS/Pharmacy because it looks like I'm doctor shopping which I'm not. How do I get rid of all these dependencies without going to rehab? I'm not addicted, per se. I still take the medications as prescribed nowadays but once every 3-4 days I like to pop a few extra close to 7pm so watching all my TV shows at night are even better -- and with a cigarette.

Thank you for your time...anybody. This is a much longer post than I expected to write, but it needed to happen. Please help!

-rhodyvik

 

[MTLATINO]

Well i say youve got a pretty decent addiction going, and you need to accept that. the fact that you are running out of your medications before your next script is obviously because you're taking them to get an effect and so taking youre meds ahead of schedule. The point in using narcotics in pain management is that you dont get too much of a buzz going, but enough to heighten the your tolerance to pain, except maybe at night and that is why your medications are controlled by your doctor.
although, i am a recreational user and this website is not here to judge. if your pain is severe enough then you can always source your extras on the streets, you are able to get a hold of pharmaceutical opiates as well as heroin.
however, what you could do is go the other way and slowly decrease your use of opiates, by small amounts stretched over a long period of time to lower your tolerance and to reduce dependence. this is obviously the wiser choice, because this means when your pain is really bad, when you actually need to take a higher dose, it doesnt matter as much because you will have more meds left over from cutting back, and eventually there may even be a slightly reduced tolerance so it will be more efficient.

btw youre post was excruciatingly long and clumped together, and most people wont want to read it because of that. next time use more space and simplify the text
hope i helped at all

 

[Swimmingdancer]

1. Is there a way, without sounding like an opiate pill popper, to get the medication I need to control my excruciating pain I have daily in my stomach and shoulder?

We can't help you with what to say to your doctor, just be honest and tell them if your pain is not being reduced enough and see what they say.

2. How much of a physical dependence do I have now?

Depends on how long you have been taking all of these.

3. Why does Tramadol seem to be working better than Vicodin?

Tramadol is an antidepressant as well as being an opioid, so it has a different mechanism of action to Vicodin (which is hydrocodone, an opioid + acetaminophen). However one study found that for pain, 75mg of tramadol was as effective as 1 Vicodin (containing 10mg hydrocodone), so your dosing sounds right. Everyone is also different. It's not weird that you would find 200mg tramadol more effective than 1-2 Vicodin.

4. How do I get rid of all these dependencies without going to rehab? I'm not addicted, per se. I still take the medications as prescribed nowadays but once every 3-4 days I like to pop a few extra close to 7pm so watching all my TV shows at night are even better -- and with a cigarette.

Taking your medication mostly as prescribed doesn't necessarily mean you aren't mentally addicted. Regardless, in my experience, if you want to be free from physical dependency to drugs you have to try change how you think about pain and emotions and withdrawal symptoms - for example feeling some pain or anxiety doesn't mean you HAVE to automatically take something to make it stop. And you have to be honest with yourself about all the reasons why you are taking them and look for alternatives to drugs to cope with those reasons. In order to get off them you would want to gradually lower your dose down (taper). You could tell your doctors you would like to see if you can function without drugs (or with less drugs at least) and come up with a taper plan and see what advice they have for non-drug options (although a lot of doctors are not well-versed on non-drug options in my experience - you can also get advice on ways to cope with anxiety, pain, depression, cravings, etc on The Dark Side forum). A good first step would be to try to reduce the number of different meds you are taking. I would also recommend some diet and lifestyle changes. I know it's hard, hang in there

 

[lifeisflyingaway]

Congrats for beating cancer. You are on a hefty dose of medications, and the soma which you didn't mention probably helps quiet a bit too. These days many doctors are hesitant to prescribe those medications, i have terrible anxiety (non drug related) and i was not even able to get a tiny dose of any benzos, but am seeing a new psychiatrist soon. However, you have legitimate pain and mild addiction which i advise you to be cautious of as it will only harm you in several ways. To be honest i don't know why your doctor wouldn't prescribe you a low dose of percocet (oxycodone) like 10mg 3x times a day, it should kill the pain way more than tramadol or vicodin but than again it comes with a heavier addiction as well. You are legally on a very high dose of benzos, and i hope that the doctor never cuts you off because those would be hellish withdrawals far worse than what you experienced before. If worst comes too worst, get a new pain management doctor, but becareful my friend many pain patients unknowingly become addicted to pain medications. XD