Harm Reduction The Pain Management Mega Thread - for all your questions on dealing with chronic pain

[Cane2theLeft]

^You can try to go to a PM doctor but good ones will focus on precise diagnosis before treating (which is how it should be, its just unfortunate how expensive these tests are).

 

[shadyMyster]

Yeah. I dont have a problem with that, but apparently I was already diagnosed with a herniated disk, and mild scoliosis. The scoliosis backed by 2 different x-rays, but the herniated i guess you cant see it on the xray. I guess what i'm saying is, is it feasible to get a script for 10mg oc ER w/ the previous script of perc 5s? I guess I will see in a few weeks

 

[Nikolai]

Never saw this thread here, its interesting. I was unfortunate enough about 4 years ago to be involved in a serious incident that causes me horrible pain. I have been through a lot since then and have been on nearly every pharm painkiller for periods of time. OC and roxi's, morphine, fentanyl, methadone, dilaudid. For a little over a year now I have been on a very high dose of Opana which has helped me greatly. After trying many different ways to use it I have settled on being able to use it very frequently through the day still at a high dose. With help from some other medications I have been able to stay out of severe pain the majority of days.

Reading the thread has been interesting. I admit that I do get upset when I hear people that go to doctors with the intention of getting narcotics, especially if they are lying. I'm not sure if it would have bothered me that much before I got hurt.

I will try to follow the thread and help people any way I can.

 

[shadyMyster]

Nikolai, I too am in pain, but I also know that when I stop the meds I am in a lot of pain, which could be due to the meds themselves. After taking meds for so long, your body experiences MORE pain, I forget what it's called but it's real. Also, I am in pain but I can usually bear it, even though apparently I have scoliosis and a herniated disk, I feel like the doctor is wrong I do not have a herniated disk. It sucks because the gov is all over the meds now, doctors are scared to do their job. They will have nothing left to prescribe, except for antibiotics and blood pressure meds. Oh wait, now we're told no antibiotics for all the super bugs! And... the blood pressure/allergy meds are typically OTC now.

 

[Cane2theLeft]

^its called opioid-induced hyperalgesia and its pretty rare.

How can you OR your doctor know if you have disk herniation if you haven't had proper imaging studies to see?

Also, what antihypertensives are OTC? You got beta blockers, alpha blockers, mixed blockers, adrenergic antagonists, ace inhibitors, angiotensin II antagonists, vasodilaters and AFAIK all of those are Rx only.

 

[Nikolai]

Nikolai, I too am in pain, but I also know that when I stop the meds I am in a lot of pain, which could be due to the meds themselves. After taking meds for so long, your body experiences MORE pain, I forget what it's called but it's real. Also, I am in pain but I can usually bear it, even though apparently I have scoliosis and a herniated disk, I feel like the doctor is wrong I do not have a herniated disk. It sucks because the gov is all over the meds now, doctors are scared to do their job. They will have nothing left to prescribe, except for antibiotics and blood pressure meds. Oh wait, now we're told no antibiotics for all the super bugs! And... the blood pressure/allergy meds are typically OTC now.

I wasnt saying I didnt believe you or anyone else on here wasnt in pain. I have had friends that went to the doctor pretending to be in pain, and it is an obvious problem. Opioid-hyperalgesia is a controversial subject some think its real, others think its B.S.

I really think you are going to need an MRI if you want to get real help. Also, having scoliosis or even a herniated disc doesnt always mean that person will be in pain. Some people have terrible spines on an MRI and are pain free.

I think you need to see a doctor of some kind if you're in pain, I didnt go through the process of finding help after pain. I was severely hurt and almost immediately started on medication and Ive been on medication ever since. But I have also gone through many many other things in attempts to improve my quality of life.

Even an ER might not be a bad option for you if the pain gets severe. They may want to order an MRI though. Or just see a GP to set you in the right direction and hopefully write you a script in the meantime. All doctors are likely hesitant to prescribe narcotics, but they will for someone they believe is in pain, they look for things when they see you to help them decide on believing you or not.

IDK, someone else will probably know better what your first step should be.

 

[PLUR2000]

How do I approach a M.D. with a PM question, I've done the therapy,etc... and as I'm 25 my PCP says "I'd Rx opiates for you, but... you're too young" which I understand his worries. I need relief, my sculiosis is getting unbearable and I need help. I live in Texas (North) Any suggestions?

 

[Cane2theLeft]

^PCP's are not well-trained or comfortable treating chronic pain patients. The best suggestion anyone can give is to see a pain management specialist and work with them to find the best way to manage your pain. If you have chronic pain it should be no problem getting a referral to one from your PCP (if your insurance requires that as mine does).

 

[shadyMyster]

Yeah I have scoliosis and that is going to be a hard one to pull, doctors have a consensus that scoliosis will only hurt if you have other problems like DDD or something like that, and will maximize both pain. Otherwise they say scoliosis is relatively pain free unless your spine is over a 40 degree curve I believe they said, which I dont even see how one could walk with that much of a curve ha.


And nikolai, yeah I think its best to go to PM this summer when I can get all of that done. Problem is its so many hoops you have to jump through.. Do this get that test get this scan do that drive here appointment there etc. Adds up quick time and money

 

[scoliosis11]

Yeah I have scoliosis and that is going to be a hard one to pull, doctors have a consensus that scoliosis will only hurt if you have other problems like DDD or something like that, and will maximize both pain. Otherwise they say scoliosis is relatively pain free unless your spine is over a 40 degree curve I believe they said, which I dont even see how one could walk with that much of a curve ha.


And nikolai, yeah I think its best to go to PM this summer when I can get all of that done. Problem is its so many hoops you have to jump through.. Do this get that test get this scan do that drive here appointment there etc. Adds up quick time and money

When I found out I had scoliosis and DDD, my curve was 45 degrees, and has since progressed. It is incredibly painful, but people walk with even higher curves. Even with x-rays AND MRI's showing this plus spinal canal impingement and narrowing there are plenty of docs who tell you to take tylenol.

You just have to search until you find someone that will help you. It took me quite some time, unfortunately. There is such a huge bias against opiates along with strict federal regulations (in US) that finding good doctors is hard.

In the past, in between trying to find a doctor, I went to plenty of "pain management" clinics, where $150 got you multiple prescriptions for anything,without so much as an x-ray. In my case, I needed treatment and a solution so I kept looking for a legit. doc

 

[nobodyknows]

Moved from Intro. Question and intro

Posted yesterday in intro. Someone said to ask here.

Hello everyone! I am a 40 year old who suffers from Fibromyalgia and Bipolar. I do not do any kind of illegal drug. I am considering it though. I am here to learn as much as I can about a few drugs so that I can make an informed decision about taking something to help with my chronic pain. I have been on Hydrocodone for the past four years for the chronic pain until today. I have never experienced the high that many get from hydrocodone but wish I could. I know that sounds weird but I just have a very high tolerance to medication and my pain is so bad that I am considering smoking pot to ease it. It is not legal in Texas and I am very scared of getting busted because it would devastate my husband’s reputation at his job.

My doctor is so strict that it took four years to get her to increase my hydrocodone just twice. I was only at four 10's a day after four years. If I were to ever get a script for anything with codeine in or anything like that she would fire me as a patient. You have to sign a contract allowing her to drug test you at random. She is the only pain management doctor in my town. I am too afraid to go to another doctor for fear she will find out and I'd lose the only medication I get.

Today she changed my medication from Hydrocodone to Opana ER. I have been reading as much as I can find on the medication but it is all really just about the same from one site to the next. She put me on two 7.5 twice a day. So far... it has not helped with the pain. I am out of hydrocodone and I'm hurting so bad. How much longer will it take for it to take affect?

I can get my hands on pot because a lot of my cousins smoke it but I am just not sure what to do to ease the pain the safest way and I remember when I smoked pot a few times in high school that crap knocked me right out. I can imagine how it would affect me now. ugh!

Any ideas? Remember... I am a grandma and I keep them a lot and they are only 8 weeks and 2 years so, I can't get lost in drugs.

Thanks and God bless
Nobody knows.....

 

[dlongj]

So, when I was ten I had cancer in my right arm. Was on chemo and radiation for alittle over a year. I have been riding Dirtbikes all my life currently I still ride I even own a '74 Hd Shovel shes a beaut. When I was about 13-14 I was in a major dirtbike accident when I was racing my YZ250 In Port Angeles, Wa. For alittle over a year now I have been having Massive off and on back pain on a 8-9 scale outta 10 and a constant 4-5. (thats just the back) My right arm is in constant 4-5 pain and even Cramps up really bad from time to time and the pain goes right to a 10. It literally drops me to the ground in tears. How would I approach a Doctor about Pain meds to get threw my day? I am currently a half owner of a Steel fabrication shop it will most likely be my career for the rest of my life seeing as my dad owns the biz. Any help would be nice THANK YOU

 

[Nikolai]

Posted yesterday in intro. Someone said to ask here.

Hello everyone! I am a 40 year old who suffers from Fibromyalgia and Bipolar. I do not do any kind of illegal drug. I am considering it though. I am here to learn as much as I can about a few drugs so that I can make an informed decision about taking something to help with my chronic pain. I have been on Hydrocodone for the past four years for the chronic pain until today. I have never experienced the high that many get from hydrocodone but wish I could. I know that sounds weird but I just have a very high tolerance to medication and my pain is so bad that I am considering smoking pot to ease it. It is not legal in Texas and I am very scared of getting busted because it would devastate my husband’s reputation at his job.

My doctor is so strict that it took four years to get her to increase my hydrocodone just twice. I was only at four 10's a day after four years. If I were to ever get a script for anything with codeine in or anything like that she would fire me as a patient. You have to sign a contract allowing her to drug test you at random. She is the only pain management doctor in my town. I am too afraid to go to another doctor for fear she will find out and I'd lose the only medication I get.

Today she changed my medication from Hydrocodone to Opana ER. I have been reading as much as I can find on the medication but it is all really just about the same from one site to the next. She put me on two 7.5 twice a day. So far... it has not helped with the pain. I am out of hydrocodone and I'm hurting so bad. How much longer will it take for it to take affect?

I can get my hands on pot because a lot of my cousins smoke it but I am just not sure what to do to ease the pain the safest way and I remember when I smoked pot a few times in high school that crap knocked me right out. I can imagine how it would affect me now. ugh!

Any ideas? Remember... I am a grandma and I keep them a lot and they are only 8 weeks and 2 years so, I can't get lost in drugs.

Thanks and God bless
Nobody knows.....

Has your doctor tried lyrica yet? Thats usually the first thing they go to for Fibro, I believe its the only FDA approved med for Fibro. In combo with the opana or whatever it may help you alot.

Marijuana may not be a bad idea for what you suffer from either, but of course its illegal. And if you get tested for it you could get in trouble. I dont know if thats worth it. If you want to try it though I would get a bowl or pipe, you can get small ones at a smoke shop, and just take one or two hits/puffs at first to see how you react.

As far as Opana goes, it's what I use, I think its the best pharmaceutical there is against pain. But my pain and problem is pretty different from yours, I was put on a gigantic dose compared with yours, and I dont take it like you are.

And the extended release version of Opana can take a couple weeks to really kick in. Im surprised your doctor didnt give you something else to take in the meantime.

I would ask about lyrica if you havent tried it and also something thats like the hydrocodone you took before to take until the Opana kicks in. You should also ask your doctor about something instant release for breakthrough pain.

Keep us updated.

 

[Jabberwocky]

So, when I was ten I had cancer in my right arm. Was on chemo and radiation for alittle over a year. I have been riding Dirtbikes all my life currently I still ride I even own a '74 Hd Shovel shes a beaut. When I was about 13-14 I was in a major dirtbike accident when I was racing my YZ250 In Port Angeles, Wa. For alittle over a year now I have been having Massive off and on back pain on a 8-9 scale outta 10 and a constant 4-5. (thats just the back) My right arm is in constant 4-5 pain and even Cramps up really bad from time to time and the pain goes right to a 10. It literally drops me to the ground in tears. How would I approach a Doctor about Pain meds to get threw my day? I am currently a half owner of a Steel fabrication shop it will most likely be my career for the rest of my life seeing as my dad owns the biz. Any help would be nice THANK YOU

you're going to have to have an appointment with your GP to update any x-rays and most likely mri's and they'll refer you to a Pain Management doctor if opioid treatment is what you're after. those are your first steps.

 

[Nikolai]

So, when I was ten I had cancer in my right arm. Was on chemo and radiation for alittle over a year. I have been riding Dirtbikes all my life currently I still ride I even own a '74 Hd Shovel shes a beaut. When I was about 13-14 I was in a major dirtbike accident when I was racing my YZ250 In Port Angeles, Wa. For alittle over a year now I have been having Massive off and on back pain on a 8-9 scale outta 10 and a constant 4-5. (thats just the back) My right arm is in constant 4-5 pain and even Cramps up really bad from time to time and the pain goes right to a 10. It literally drops me to the ground in tears. How would I approach a Doctor about Pain meds to get threw my day? I am currently a half owner of a Steel fabrication shop it will most likely be my career for the rest of my life seeing as my dad owns the biz. Any help would be nice THANK YOU

I dont think there is really any secret, I would go to your PCP/GP and tell him whats wrong, and what kind of pain you're in. I dont think mentioning that you want pain meds is a good idea. A muscle relaxer may help some or he may give you an opioid or send you to a pain management clinic, or both.

 

[Cane2theLeft]

^good advice... Go see a GP/PCP, explain your situation, they'll probably do a few tests, try a few meds, see how you progress and go from there.

If you can manage well, you may stay with the GP depending on his/her view on having CP patients or you may be transferred to other docs like orthopedic surgeons, neurosurgeons, physiatrists, neurologists, etc for diagnosis and treatment or just to a pain management specialist.

 

[Nikolai]

^Yea that seems like the best first step to me, you may get lucky and find a pcp with knowledge of your injury or pain. If he cant help much he may give you a script to last until you can get in a pain clinic he refers you to.

When I first was hurt I was immediately taken to the hospital. When I was ready to go home instead of being sent to the Pain Clinic associated with the hospital I was sent to a specific PCP to continue my recovery and helping my pain issue. This PCP has a strong knowledge of my pain and injuries I think mostly because of his work as a doctor in the military. At one point he sent me to the pain clinic so they could try any procedures they thought may help, but he took care of everything else. This is a very specific example, but there are PCP's with deep knowledge of certain injuries and pain out there if you can find them.

 

[ThePharmicist]

Alright, here's my situation:

For the past 6 months, I've had neck and lower back pain, in the past 3 months it has increased exponentially. There have been times where I've been in tears over the pain. I've never had this kind of pain before. I've seen two doctors so far and had all sorts of blood-tests and xrays, but no diagnosis as of yet.

I'm going to a rheumatologist this coming Wednesday (the 5th) and I'd like to get a diagnosis, and something to help with the pain. There's a problem though. Before I ever had a problem with chronic pain, I had a problem with pain killers. Now I'm on Suboxone maintenance. What should I do? Should I tell the Doc I'm on Suboxone so if he does prescribe me anything he'll know my tolerance is high? Or should I just forget about being prescribed anything for the pain because I'm on Suboxone?

I could also take the other route, just not telling the doc at all that I'm on Suboxone. It's a catch-22, I need relief but I'm also a drug addict. I would have no problem being on pain management if I was adequately supplied with medication, but if I wasn't forthcoming and decided to hop off Subs for some shitty 5/500 Vicodin it probably wouldn't be worth it. I would need around 40mgs of Oxycodone a day just to stay (barely) well.

What should I do?

 

[Cane2theLeft]

^I would say its best to be straightforward with your doctor so YOU can receive the best treatment... as a CP patient let me tell you, if you re-trigger your pain killer problem, you'll fuck yourself over even worse as far as pain management.

There are a lot of non-opiate options out there... NSAIDs, steroids, muscle relaxers, local anesthetics, benzos, tramadol, SNRI/Tricyclics and many others that may help potentiate the analgesia from your buprenorphine and increasing your dose may also help.

I would say you should ask this in one of the suboxone threads because I imagine you'll get more experiential replies from people on maintenance who have had to manage pain.

good luck! Also, please let us know how it goes and how you're doing!

 

[Nikolai]

Its really a very tough situation. Any doctor if they were somehow to prescribe you medication would worry about potential abuse and may drug test you often. I dont even know how the switch from suboxone to something else would take place, and what kind of dose would be needed. Ive never seen an opioid equivalency chart with suboxone on it. Seems the best thing would be an increase in suboxone if its possible. Most doctors wouldnt be comfortable with a patient just happy with continous pain meds to treat their problem, so I doubt that would be their only answer.

Doing nothing will get you nowhere, so maybe just see a doctor and be honest and see what he says.