Hiatal Hernia + Ulcer....... Pain

[Yoked_Dragon]

Ok, I am posting this here in hope of some advice from experienced and knowledgable people.

Background:
I suffer from various pain problems. I have moderate to severe chronic back pain, both from a bad car accident 6 years ago and work related injury. I also have a plate in my arm, which I broke severely twice in my pre-teen years, that is painful to use in certain ways. I also have arthritits in in several joints as well as tendonitis in several places. I also suffer from myofacial pain from broken jaw(from car accident) and have a plate on each side of the face. Also, about 7 months ago, ,I began to get severe headaches and almost daily mild headaches. I am 23 years old.

I have always just toughed out the pain through the years, ,but it is getting significantly worse. I have been using motrin and naproxen in fairly high doses. It helped a little. I was taking norco 10/325 prescibed once daily along with the NSAIDs. But, ,I just had endoscopy done on my upper GI and have been diagosed with an ulcer and hiatal hernia. So I can no longer take any NSAIDs. I am also taking 20mg of pa elor (nortryptylline) at night. it helps a little. Now I can only take narcotics, and I already have a high tollerance. I am now taking other narcotics that I get from some one I know. I have been taking 800mcg of fentanyl orally (actiq)a night. It has been working wonders. however, I can not afford to keep buying these illeagally, and if my wife found out she may leave me.

I am going to be reffered to a pain management doctor. I don't have a problem taking narcotics daily, , like oxycontin or something, but I don't want to get hooked on very high doses, as I already can't stop what I am taking. And my wife is %100 against it! I also have a 3 month old newborn that I love with all my heart, and I dom't want her exposed to me hooked on hih doses.

So OK, now my question. What can I expect from the pain management? Are they just going to be managing pain medicine, ie narcotics, Or are there other options? Are things like hypnosis, alternative medicnes, etc available through them? Are they effective? Is ti realistic to be on a narcotic like Oxycontin or related meds at low doses effectively for long periods of time, or will that lead to high doses inevitably(sp?)??

Thanks in advance to all who reply!!!

 

[Negro-kitty]

I have a hiatus hernia too but not a very severe one.

You should be able to get treatment for the hernia and ucler that will put you out of pain, and treat the problem itself, without requiring a need for painkillers.

I couldn't figure out whether you need painkillers for your other problems as well...or whether it is primarily the hernia and ulcer that are causing you problems?

Oh yeah, and if you are taking ANY opiate painkiller regularly, you will VERY quickly need to be taking higher and higher doses. Opiate tolerance is rapid and inevitable.

 

[Yoked_Dragon]

Sorry, I should have made that clearer. I mostly need pain management for my back, and head/face, and arm.

How is your hiatal hernia treated? I am awaiting biopsy results, and was not really explained on what is needed to be done. Or at least I don't remember, ,except that I need to take my nexium twice a day now instead of once, and stop taking all, , NSAIDs.

 

[day_for_night]

be forewarned, if you are taking those kind of doses of fentanyl daily (or nightly, in this case), you will have significant withdrawal symptoms should you quit cold turkey. i am assuming you have been taking narcotics for a while...

it would be best to taper your dosage down over a couple weeks, and/or switch to a lower strength narcotic. something like hydrocodone should help ease this process.

 

[Negro-kitty]

Have you considered seeking chiropractic care? I also suffer from chronic back pain but through a combination of chiropractic therapy and massage I make the pain tolerable so that I do not need to usually take painkillers (I try to limit myself to a few times a month on days that the pain is severe). There are definitely options to deal with pain that do not involve addictive/tolerance building opiates!

Also, I don't know your precise condition, but I find that gentle exercise (walking, swimming, yoga and stretching) helps control my pain tremendously.

I think the nortriptyline is excellent. I know that while I was taking zoloft my pain was better all around. There is some value in the nociceptive effects of tricyclics and SSRIs.

Oh, and I've been treating my hiatus hernia mostly via dietary restrictions and taking antacids etc as needed. I haven't had a severe flare-up in several years, fortunately. It used to be quite bad when I was running competitively but I'm lazy now so it's settled down a fair bit.

I would get off the fentanyl if I were you...the addiction potential is too great as d4n pointed out. And yeah, I wouldn't stops suddenly. Switching down to a weaker opiate will be a good place to start but eventually you should plan to be opiate-free, and seek other pain treatment like I described.