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  • BDD Moderators: Keif’ Richards | negrogesic

Is tolerance considered in pain management?

Speed King

Speed King

Bluelighter
Joined
Mar 7, 2014
Messages
6,074
Location
Orando, Florida
I'm a pain management patient. I will be switching doctors within a month. My current doctor doesn't seem to understand that I have a tolerance for pain meds.
I decided to run it out so as not to start any trouble
My concern is , would it be alright or a bad idea to tell the new PM doctor that I have a toledance to pain killers when I meet him?
 
I think it is considered, but most legitimate pain management doctors prescribe cautiously despite it for many reasons.

I probably wouldnt say you have tolerance in those exact words on a first visit. Id describe your pain levels without any medications and with them on board and how the relief you get from your current regimen is inadequate.
 
I didn't want to or plan on being blunt with the pain management doctor. I'm surprised that tolerance is such a taboo thing to admit to. I really think I have to give this a rest. It is starting to get confusing.
 
Speed King said:
I'm a pain management patient. I will be switching doctors within a month. My current doctor doesn't seem to understand that I have a tolerance for pain meds.
I decided to run it out so as not to start any trouble
My concern is , would it be alright or a bad idea to tell the new PM doctor that I have a toledance to pain killers when I meet him?
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I "spoke" to you a little on a thread of someone else's. This issue is precisely why I'm wanting to go off of Oxycodone and am trying to. I also had to switch pain management doctors and I too have a high tolerance. My problem being different from yours in one way though: I was prescribed by my old pain mngt doctor 30 mgs of Oxycodone per day. My new one will only give me 20 mgs. My tolerance grew rapidly. My sister, though, also took Oxycodone and would give me hers which made me hit an addiction to anywhere between 70 and 150 mgs per day (she also takes methadone which led to her not having to take the Oxycodone and she now has a new pain mngt doctor who took her off of oxycodone).

I also take neurontin, Baclofen (both that I told you about on the other thread), cymbalta, amytryptiline (both of those for pain, not depression) and Xanax for panic disorder.

Sometime I want to be honest about my useage because I'm so tired of going through withdrawals. Often on here suboxone has been mentioned to me but I feel like I'd just be trading one addiction for another. Do you want to get off of them or are you just wanting to feel "better" as I am?

I'm at a loss. I want to so bad but then my pain is so very intense. At 1st when I began taking them I felt just overall "ok". Now? I barely feeling anything unless I take them in excess. I feel your pain in both ways. You wrote on the other person thread to private message you if that person wished to. I want to say the same to you. Anytime, feel free to pm me. I may not have all the answers but I can promise to be here for you as a friend.
Lots of love to you<3
 
Speed King said:
I didn't want to or plan on being blunt with the pain management doctor. I'm surprised that tolerance is such a taboo thing to admit to. I really think I have to give this a rest. It is starting to get confusing.
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I agree. I feel this way each and every single day. The whole "what's your pain level today"?.....my response always? "I'd like to say a 10 but according to the "pain scale chart" I'd be laying and not talking. Well the fact is that I'd PREFER to be laying and not talking but rather keep getting the run around seeing doctor after doctor"......harsh, yes. Yet it DOES get so very frustrating!! I know so many people who go to a doctor and say they have "back pain" and get whatever they want. I have a chronic disorder plus several spinal cord issues and can barely get sh*t (sorry). The truth is this. In answer to your question....it all depends upon the doctor and that is NOT fair or right. Although it also isn't "right" that I was getting them from my sister yet yes, your tolerance does to up. I used to be at least functionable taking 15 mgs a day.....now, I'd never be and most days this is the case. I've secluded myself from fiends, rarely go out.............
Again, I feel your pain. The emotional part and the physical part so as I said, if you need an extra friend send me a message. Maybe we can "help" each other even if it's just by venting or chatting.
 
I've always had the opinion of being completely honest. I've been with the same doc for years though. When the meds aren't working so good anymore I tell him. I've moved up from T3's to t4's to percoset and now oxyneo and various muscle relaxers. I'm waiting for my MJ card now. I also get that the pain is never going to go away and have learned to live with that. I have always made a point of never asking for too big a jump, and always do research by talking to my pharmacist and others with the same history i have.

Good luck.
 
Thank you Bernc1 and Shain77 for those replies. I don't feel alone in this matter and feel understood. I was able to get what I needed from all of your posts. I agree Shain, to have a longer relationship with one doctor and not push it when increasing meds. Bernc1, I will be PM'ing you soon.
 
Speed King said:
Thank you Bernc1 and Shain77 for those replies. I don't feel alone in this matter and feel understood. I was able to get what I needed from all of your posts. I agree Shain, to have a longer relationship with one doctor and not push it when increasing meds. Bernc1, I will be PM'ing you soon.
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You're very welcome and you're not alone<3. I, too, agree with Shane77's advise. My problem though is that my doctor doesn't seem like he would increase meds (although he has changed them). I've seen so many specialists, pain management doctors, regular doctors, have undergone a neurostimulator implant, physical and aquatic therapy, surgeries....to no avail because my disorder is incurable. I can't keep switching doctors though and just have to deal with what I get. Finding the perfect doctor though is the best solution and I do have a caring one so in that aspect I can't complain. Maybe I should take my own advise for once and just be more upfront. Not demandind, as that would never go over well.
I'm kind of at a loss but as Speed King said, it feels great to not feel alone<3
 
Bernc1 said:
I agree. I feel this way each and every single day. The whole "what's your pain level today"?.....my response always? "I'd like to say a 10 but according to the "pain scale chart" I'd be laying and not talking.
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Be honest, but be as OBJECTIVE as you can. Your pain is not a 10 (and I think you get that SK). Your tolerance is also not unique, and I think you understand the concept of pain management is not to make you "pain free," but to help you manage your pain. Be honest about your priorities and what's helped in the past, but be willing to listen to the doctor (at least give and take a little).

You may have to start low, possibly even a little lower than you were depending on doctor, but keep a journal and keep track of what helps, timeframes, and what it's lacking. There are ways to enunciate how medicine is working for you if you're honestly monitoring your own progress.
 
And I'm REALLY sorry, Speed King. Your thread had nothing to do with my condition. It should never have even been brought up by myself because when I'm able to be helpful to others, there's nothing that makes me happier.
 
Felonious Monk, thanks for stepping in and replying as you did. I know where your posts were directed, but I was able to learn from them also.
 
Bernc1, please feel free to comment, or change subject, etc. We learn off each other. I welcome you to get your own questions or concerns addressed. My posts may have triggered other questions. If that is the case, then I say we have a new thread that anyone can voice similar concerns. I enjoy hearing other people's similar situations.
Bernc1, run with it. We'll start a new thread!
 
Speed King said:
Felonious Monk, thanks for stepping in and replying as you did. I know where your posts were directed, but I was able to learn from them also.
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I'm glad, I really meant that all towards you as the OP (and from another thread), sometimes I get a bit thrown off with multiple posters.

It's basically the same stuff I went through in PM (did switch docs once). I wasn't with it that long but I saw a lot of other doctors around the same condition so got a feeling for them. I got the most out of it when I put the most in. Doctors aren't a miracle but if your goals coincide with SOP for them (trying to keep your own dose of opiates low, trying other therapies, being involved in treatment, etc) than you'll feel like they're working with you more than you against them.

Don't feel obligated to try their alternatives (nerve blocks, injections, etc) as those can be a racket and/or neutral benefit---but be as proactive as you're comfortable with truly alternative therapies: acupuncture, massage, PT, cannabis, other herbs, etc.. (I can't remember where you live but that obv has great bearing on what alternatives are available).

Doctors don't like to see their patients in pain, but they also know better than to just hand out pills.
 
Felonious Monk said:
My point was simply if your pain was a "10" all the time your body would go into shock.
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One other issue I will agree with you upon but I never stated that my pain level was a "10 at all times." As a matter of fact my pain level did in fact (according to my doctors) cause a stroke because my blood pressure sky rocketed so very high.

Also, if you're referring to a multiple thread of mine? And I could be wrong. I use a phone (I do not have Internet) and recently I started a thread that didn't appear to post but then realized it did but I took it on a different level just because I was having a "7'ish pain day" and removed it.

As for alternative measures? I do agree with you there (besides the cannabis because I don't use it but I also don't condemn anyone who does as I have multiple friends who do)......massage therapy and aquatic therapy worked wonders for me up to a certain point until my condition progressed.

This is a place to meet, agree, agree to disagree but not to argue or debate (in my opinion). But anyway, all in all, if my pain was a 10 daily then I don't think I'd still be here and happily am (well, happily sometimes:)).....end of story.

Speed King, I hope all went well with your new doctor and that you were able to be honest. And it WAS wrong of me to switch topics off of your thread and bring up my own issues. Lots of love and hope to you and to Felonious.
 
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Bernc1, two things. Your posts were in the same ballpark as mine. I have no problem with you posting in this thread. Your posts flow with the thread. I just do not care for posts that drag things to a halt. Feel free to post here.

Secondly, I do not feel bad about it, but sometimes I have similar posts in other threads. I am working on not doing that.

Bernc1 I hope things are well. Looking forward to hearing from you soon.
I have not switched to another PM yet. I am getting a diffrent diagnosis from my oncologist so that I may continue to receive high quality opiate pain management. The good news is my doctor doubled my pain medicine dosage and although it's not perfect, it treats my pain much better. Coverage lasts closer to 12 hours per dose. Currently, I'm on 60mg of morphine ER / day. I'm moving up to Opana ER. That stuff lasts a long time per dose and I recieve deep pain relief from it. My goal is to stabilize on a dose and stay there
 
Speed King said:
Bernc1, two things. Your posts were in the same ballpark as mine. I have no problem with you posting in this thread. Your posts flow with the thread. I just do not care for posts that drag things to a halt. Feel free to post here.

Secondly, I do not feel bad about it, but sometimes I have similar posts in other threads. I am working on not doing that.

Bernc1 I hope things are well. Looking forward to hearing from you soon.
I have not switched to another PM yet. I am getting a diffrent diagnosis from my oncologist so that I may continue to receive high quality opiate pain management. The good news is my doctor doubled my pain medicine dosage and although it's not perfect, it treats my pain much better. Coverage lasts closer to 12 hours per dose. Currently, I'm on 60mg of morphine ER / day. I'm moving up to Opana ER. That stuff lasts a long time per dose and I recieve deep pain relief from it. My goal is to stabilize on a dose and stay there
Click to expand...
Hey, Speed King:)! I'm happy to hear back from you:)!....not so happy to hear the word "oncologist" though:(. I rambled on and on about my own disorder (and easily got angered but I think that most people who go to PM understand at least to a degree how easy it is to become that way...especially when it seems all is failing) that I never even had the courtesy to ask you why you go. Whatever cancer it is that you have, I hope and pray that the prognosis is a good one though.

Also, when the term OP is used that often confuses me as well. I understand that many use the term on here but I personally address who I'm speaking to by their username so as not to cause confusion. The thing is is that I actually did the same as you and made similar posts. I don't know, I just personally wouldn't become angered if someone else did it yet I guess it could become confusing.

Upon actually thoroughly reading Felonious's responses though they really were not rude as I'd initially taken them but I was having a bad day and pretty much flew off the handle (which is embarrassing to me).

I also welcome others to add things about themselves and write whatever they'd wish to on my threads. I actually made one a while back in which I had 8 pages of responses (all concerning different issues) but it was because I was a severely abused woman, began using/abusing pain meds to ease my emotional pain (all given to me freely and something I'm not proud of) but then really needed them and by that time they didn't help me. I removed it because I wrote too much personal information and if anyone in my small town would've stumbled upon it there's no way that they wouldn't have known it was me. I am now out of that relationship because if I weren't? I wouldn't be here anymore. I also write a lot on "words" in case you are ever interested or "bored". Writing is a form of "release" for me. I'm not the best, but I enjoy it.

See, there I go again....speaking of myself. I don't intend to do it but it just feels good to "talk".

The reason I now need pain meds is due to a rare disorder as I stated above called RSD. I also have too many to name spinal cord issues in which I will eventually need surgery (and have had 2 minor ones already). The combonation of the pain intensifies matters because when asked what my pain level is I don't know what to say. My neck and back is a 5 and my legs are a 7. Pain meds just slightly take the edge off of the RSD pain but do help my spinal cord pain.

I had so many bad experiences with PM doctors which is why I suppose I "jumped" on your post. Right now I'm actually trying to taper my dose down and if I could take anything back in this world, I would've never touched a pill without needing them. I was receiving 30 mgs of oxycodone at one point but now am also in between PM doctors and my new PCP only feels comfortable giving me 20 mgs until I am able to be seen by my new PM clinic. It's definitely a huge cut but I have no problem saying that I never bought off the streets but rather receive the "extras" from my sister who gets them but doesn't take them due to another medication she takes. It doesn't make me feel any better about the entire situation though. I have done a rapid taper down to 40 mgs per day but I'm suffering on that dose (pain wise, not withdrawal wise since I did a lot of research to find out how to avoid withdrawals when I decided to do this taper and it worked for me but I'm still in immense pain).

I was prescribed morphine for a short amount of time but it didn't seem to work as well for me. The Opana, I know little about. The almost funny thing is that I'm one of the most drug naive people in this world yet alls it took was a few good slams to my head off of a concrete wall and my sister giving me one 5 mg pill for the pain because I didn't want to go to the E.R. I should've ran then but didn't and endured many more years of abuse.

Again, I'm sorry to go "off topic" yet in some ways (if a person is comfortable enough) I think that it's hard to give advise if you don't know what a person is exactly going through. Now I'm in a bind of wondering if I should tell my new doctors that my tolerance to pain meds is much higher then is thought. Yet if I do so it may just lead me to being "labeled" forever on my medical record. I just don't know what to do.

Anyway, if you're comfortable enough to write about your health issues publically then please do but if not please also feel free to private message me. I do tend to "talk" a lot but I'm also a great "listener". I'm also (or was) in the nursing field so I know a lot about health issues. I'd love to listen and also love to be your friend. Much love to you<3
 
I'm also sorry that I repeated myself, giving some of the same information that I already gave above on other posts within this thread but it just kind of all went together. Months ago I wrote a threat: "PETRIFIED............." plus more and the outpouring of love and caring that I received was astronomical. So enough about me (for good, I promise:)).....now I would just like to give back to others that same caring that was given to me<3
 
Hello,hello, Bernc1. First off, no need to apologise. OP as far as I understand it, means original poster. OP and the posters name are used pretty interchangeably on here.
The cancer I had was Hodgkin's Lymphoma. I am happy to say that I am in remission.
Before I was diagnosed, I had a lifestyle where I did labour intensive work.
My original oncologist and I figured out that I had cancer since 2008, but didn't get diagnosed until late April 2014. I had minor pain issues before treatment. During treatment and continuing after treatment, the pain level increased substantially. At first my Pain Management doctor and I figured that I had a real bad case of fibromialgia. I'm sure that is part of it, but after doing a little research, I discovered that pain and other things like joint pain can be caused by the chemotherapy itself. I can definitely say that the level of pain I have been experiencing has gone up a lot after treatment. I also discovered that Pain Management doctors do not think that plain old fibromyalgia is treatable with opiates, yet opiate pain medication works wonders for me.
The name of the disorder is chemotherapy induced peripheral neuropathy. Long story short, it causes the majority of effects I experience including pain. That is a little better than fibromialgia. Anyway, that's it in a nutshell,
From advice given to me by a trusted Bluelighter, directly coming out and saying that you have an opiate tolerance, probably is not the best idea. I agree with the advice as it could sound like maybe opiates were over used or abused in the past. I am progressing correctly with my Pain Management so that I don't come across incorrectly. I must say that things are progressing just fine for me.
I think that things will progress for you after your doctor gets to know you better. Also, you can have your doctor put in a referral to pain management, so you can get the treatment you need.
I look forward to PM'ing you soon.

Speed King
 
Speed King said:
Hello,hello, Bernc1. First off, no need to apologise. OP as far as I understand it, means original poster. OP and the posters name are used pretty interchangeably on here.
The cancer I had was Hodgkin's Lymphoma. I am happy to say that I am in remission.
Before I was diagnosed, I had a lifestyle where I did labour intensive work.
My original oncologist and I figured out that I had cancer since 2008, but didn't get diagnosed until late April 2014. I had minor pain issues before treatment. During treatment and continuing after treatment, the pain level increased substantially. At first my Pain Management doctor and I figured that I had a real bad case of fibromialgia. I'm sure that is part of it, but after doing a little research, I discovered that pain and other things like joint pain can be caused by the chemotherapy itself. I can definitely say that the level of pain I have been experiencing has gone up a lot after treatment. I also discovered that Pain Management doctors do not think that plain old fibromyalgia is treatable with opiates, yet opiate pain medication works wonders for me.
The name of the disorder is chemotherapy induced peripheral neuropathy. Long story short, it causes the majority of effects I experience including pain. That is a little better than fibromialgia. Anyway, that's it in a nutshell,
From advice given to me by a trusted Bluelighter, directly coming out and saying that you have an opiate tolerance, probably is not the best idea. I agree with the advice as it could sound like maybe opiates were over used or abused in the past. I am progressing correctly with my Pain Management so that I don't come across incorrectly. I must say that things are progressing just fine for me.
I think that things will progress for you after your doctor gets to know you better. Also, you can have your doctor put in a referral to pain management, so you can get the treatment you need.
I look forward to PM'ing you soon.

Speed King
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I'm looking forward to addressing you more personally (via reading and returning you private message) but I must say that maybe I am a bit of a "dumb blonde" (KIDDING and no offense to ANY blondes out there:)) because I thought that OP meant "other person". So each time it's been used I've thought: "Wait, which "other person"?? A small laugh to that:).

I will say a bit publically though. For one, I'm extremely happy to hear that you're in remission. I am very familiar with Hodgkins Lymphoma as it was thought that I had it at one point in my life plus I was about 5 months away from completing R.N school (with a degree in both med/surg and psychology) ummm, about a decade (ugghhh makes me feel OLD:)) ago but stopped due to reasons beyond my control swearing I'd go back but sadly never did. I also have a nephew that I'm very close with who was diagnosed with it 6 or so months ago.

Anyway, it's also quite ironic that we "ran into" one another on here because my disorder causes peripheral neuropathy and I KNOW 1st handedly the pain it causes:(!!!!!

Chemotherapy pain is one in itself though. I've watched many people I cared for (I was still able to get a good job eventually due to my background but it was working with mentally challenged elderly people....I LOVED that job but had my 1st stroke while working alone with them during the night and knew I couldn't place them in the grave danger again that I unintentionally did so I resigned....it was hard. For me and for them). I'm sure it was quite hard for you to also give up your job:(.

As for fibromyalgia? Some people tend to underestimate it. It's a VERY painful disorder in itself yet you're right. I have 3 friends who suffer from it yet the pain of that (although intense) is caused by "flares". At least when it comes to the people I know their pain is not constant but rather just comes on without warning and then they feel absolutely debilitated. You're right though: Due to the misuse/abuse/selling of and deaths caused by opiate useage doctors have cut down DRASTICALLY when it comes to prescribing them. Yet opiates DO help some Fibro sufferers.

My issues was this: I did have a pain management doctor (one with not so wonderful "bedside manners" to say the least). I also had a PCP who I felt the same about so I decided to switch. A person's blood pressure shouldn't raise just because they are "scared" of their own doctors...people that they entrust with their lives!! So I switched. Upon doing much research I found one with wonderful reviews (a PCP) who was affiliated with a PM clinic (both in which accepted my insurance). Well, wouldn't you know....a week after my 1st appointment with my new PCP, the PM center stopped accepting my insurance. Thankfully, I'm in a position that I was able to switch insurance companies but when I called last month I was one day off on having it go into effect on October 1st. It will though on November 1st.

My new doctor (being aware of this) agreed to prescribe me medication until I am able to see them which I'm assuming will be very shortly after the 1st as he's already put in for an immediate referral but not much can be done until my insurance changes.

I've also recently had some health scares. I have a tumor growing in my stomach. I have Facebook and kind of made a "joke" (saying amongst serious issues as well that if anyone has seen me lately I'm not pregnant even though as a woman I probably do exaggerate the fact that I feel I look pregnant just because I was always an avid exerciseaholic) after posting a picture that I wish I could share with you. Anyway, long story short (as if any of my posts ever are:))...the picture says H.O.P.E. (shows a picture of a bumpy path) and says below: "Hold On, Pain Ends". I'm not crazy about Facebook but many of my friends are pain sufferers with diseases that I myself had never even heard of. Anyway, I felt the saying was true yet had to laugh a bit when I showed it to a family member of mine who has Fibro and she said, "When's it end? When we are dead? That looks like a path leading to heaven or something."....I nicely told her to ummm, "shush! That it wasn't meant that way:)!!".....

Anyway, lately I've been finding myself coming on here (and probably have a few people concerned) and secluding myself because on here I can be myself. It's not like I'm going to put on there: "Hey, all!!! Just so you know I take a narcotic and think I'm addicted but I hope you all are well!!" Here, I can be myself without judgement passed which feels amazingly wonderful<3

Anyway, I just wanted to say a few (a "few", right???) things on here but am going to read your message now and respond. I somehow set myself up to I believe living in Australia?? I must laugh at that because it's 3am my time (I did go to bed at 10 but abruptly woke at 2 due to the pain) and was happy to hear back from you again. Love and hope always<3........Bern:)
 
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