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The Pain Management Mega Thread v2.0

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I wasn't trying to keep this negative energy flowing, my last post was to try and promote an interesting conversation. I'm not sure why that is a problem. I'm not being negative in anyway, nor at all trying to start an argument. I never even thought we were arguing in the first place. From my perspective not a single one of my posts had that intent.

I have no problem with you giving me suggestions, I just rather have a intelligent conversation about it. Having someone tell me they think I should lower my dosage with out discussing it with me really isn't a very productive response, so that is part of the reason I want to try and have better conversation. Quickly on your statement about other treatments, assumingly you meant both non-pharmacological as well as pharmacology, I mentioned in at least one post, maybe two if I recall correct, going over this. I originally started out rally focusing on non-pharmacological pursuits after seeing a doctor for the first time. I made sure to cut back on the alcohol which was a little harder right since I moved to another state after leaving college, but at this point I don't drink but say max once a month (1 beer or wine). It wasn't like I was drinking daily or even more than 2 times a week, but that did become the first to go. I always try to walk at least a mile 2 hours before bed, whether or not I had a work out that day, then return home for a quick shower rinse to a warm bath. In the bath I try to message my legs to see if that can add some relief. I will admit I struggled a little bit with nicotine, but through out the last 3 months I've only bought 3 packs total. Still more than I should, but For the most part cigs and alcohol are not in my life anymore. I also try to take supplements, notably Mg2+ Citrate, but also the standard multi vit, coq12, b-complex, baby asprin, fishoil, and a protien shake. Living at home currently also helps increase my fruit and veggie consumption. A lot of my meals are actually wegiht watchers as my dad has been been following the program. I know a lot of families miss out on having dinner together, and eve though my relationship isn't that great with my parents, I've always enjoyed eating with each other,

Anyway, no one of those activities were doing very much. I was really hoping that running during the day and having a nice our walk at night would make a noticeable difference, but to be 100% honest it didn't. I've also had countless blood tests done, at my PCP, my hematologist, and gastroenterologist. I've seen my minor liver abnormalities on two tests (months a part), with clean follow ups. There was one interesting thing about about a blood test, that a first could have been a sign of a actually medial problem that could be linked my RKS, but with some genetic testing from my hematologist (along with a bunch of other tests I don't know). They saw an abnormal Fe storage capacity that could have indicated hemochromatosis. Luckily like I said that genetic test came back negative along with all of his other tests runs.

After trying to go the non-pharmacological route (not that I stopped anything), I went through two different dopamine agonists. This seemed like it could have been a very good option for me. I'm ADHD, have had symptoms of RLS/PMLS as a kid, but didn't think much of it. Thought it was just my ADHD. Now there are studies out there saying that there could be a legit tie between individuals with different variants and severity of ADHD or tic disorders as, and sleep disorders. Both individuals with ADHD and RLS/PLMS are theorized to have a dysfunctional dopaminergic neurons in specific locations within the brain. These locations have some influence over movement as one major properties, but of course many, many others (don't feel like writing paragraphs and paragraphs more). I will say though, these dopaminergic neurons are also seen to interactive with and are innervated with GABAergic as well as opioidergic receptors. There are a few theories that support where some of the uncomfortable sensations that can be considered a form of pain (don't remember the specific names of them on the top of my head) have neurological problems related to these dopaminergic, opioidergic, and GABAergic (thought i think this is way less important in neuro pain). I'm super tired right now and spent over an our trying to write out a well written discription of one of the possible pathologies involving hypofunctioning dopaminergic receptors, reduced amount of TH, and low and reduced amounts of endorphins all with in specific locations. The involvement of endorphins, or lack there of essentially produces a hyperanalgesic state, along with the hyper activity of the limbs through I believe small amounts of a d2 receptors within the central parts of the brain, playing a role as an inhibitory receptor with movement one of the altercation in movement as a biological response.

Anyway since I spent to long researching one real complex aspect of the pains assocaitied with RLS, I'll just quickly sum everything up.

The dopamine agonists, cause me a lot of problems, which required me to immeditelys discontinue their use. Honestly I wouldn't have minded ropinirole working because I found it to be a good anti-depressant, helped with anhedonia, vivid dreams, amazing for social anxiety, but just OK for RLS. So the side -effects sucks as well as the only mild effeiency, not to mention the augmentation that is seen with dopamine agonists.

After that I triend clonazepam, which I still have. That is really just to allow me to fall asleep and stay asleep (so the PLMS doesn't wake me). I just don't like clonazepam very much. Especially since it means another psychical addiction. I rather just have an opioid addiction personally. I then wanted to try and find something for my RLS. I tried gabapentin, but it worked for social anxiety and mood swings, but not any sort of RLS symptoms. I then went and tried Tramadol. I'm sad it didn't work. Unfortunately for me it is super stimulant, makes it pretty uncomfortable and don't do that much for the RLS symptoms once again. Now I would have been fine if my opioid tolerance still existed at a reasonable level. My next option was to go with a more potent opioid. I chose methadone because I know I'm a drug addict. I don't want oxy, and know I would have abused alot of it, especially since life has been fucking with me as of late. I could also get into the whole other pharmacological properties with methadone that make it appealing, the low abuse potential that exists on it, and the rare amount of side-effects that happen. Yes it can be dangerous, yes there are reports of some people dying because of heart trouble, but those individuals already had some heart problems in the first place. When they scripted me the done, they gave me a note to go to the hospital.


Anyway its late, and I got work tomorrow. I didn't mean to spend so much time reading for what was supposed to be a small post.
 
Lost my prescriptions for oxycodone by testing positive for marijuana.

I was being treated for chronic back pain. I received 10 mg of oxycodone 6 times a day. That's 60mg a day, every day. I had signed a narcotic pain contract and it was broken by me. I was supposed to be there within 4 hours for a pill count and urine test. I didn't make it! Then I fail on the urine test by testing positive for marijuana. I have been cut off anything thats narcotic in nature. She prescribed me Tramadol and Lyrica. Needless to say I'm not feeling too well and I'm FAR FAR from being a happy girl 8(
 
Did any body on painmanagement have to go through years of having to legitamise the pain that you feel. As in convince Doctors, Family and other naysayers that you are not manifesting the pain in your brain or that its some form of physcological bullshit. Its tiring man so draining
 
Did any body on painmanagement have to go through years of having to legitamise the pain that you feel. As in convince Doctors, Family and other naysayers that you are not manifesting the pain in your brain or that its some form of physcological bullshit. Its tiring man so draining

Yes!! Lol!! It took a long time for my loving hubbie to recognize I'm in pain. We have been married 10 years this September. He just reciently he accepted I use pain medication. My sister is has accepted my pain medication use. But she doesn't want me to turn out like her. She uses a lot. I don't even know. She is real secretive about it. My pain management dr is very compassionet. It took a lot of searching to find my pm dr. My neurologist just doesn't like narcotics but she is trying to help me.

Yes. It is difficult for someone to accept you have something wrong when you look fine. I get it. But this whole expierence taught me to be more trusting to my patients and take what they say at face value. A few may get over on me, but so many more are help so Idc.
 
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Yes i had to and still do even though I've now ended up in a wheelchair due to spread and degeneration
 
@Mercc96 Yes It felt like it took forever for some family and my lover to legitimize the pain. My lover also recently just became okay with the opioid medications.
 
It is hard on everyone when you look well. people stare at me now i am in a chair. i just try to ignore it but it bothers my partner as he thinks it upsets me. catch 22 lol
 
Did any body on painmanagement have to go through years of having to legitamise the pain that you feel. As in convince Doctors, Family and other naysayers that you are not manifesting the pain in your brain or that its some form of physcological bullshit. Its tiring man so draining

oh for sure. im sick of being treated like a drug seeker, and shocked at how much intolerable pain ive just had to put up with because doctors just dont care a lot of the time. i think this is probably because they have no idea what is causing the pain - so they have no clue how painful it actually is. plus a bit of discrimination mixed in as a i look a bit punky and am a young male.

saw my pain doc today and ended up with crazy amount of tramadol....got 240 instead of 60. so at least i dont have to go back for a long time :)
 
No but if my ir oxy shows to be inadequate by April we art trying it then. Im on 100mg oxycontin and 40mg ir oxycodone a day at the minute. took the edge off a little but still having awful days stuck in bed due to.pain. like yesterday and right now, huge amount of pain that is actually making me cry. Im doing chemistry revision to try and keep my mind off it. how are you hun longtime. pm me hugs to you too <3
 
Yo Doomed, coming up on 1000 posts there babaaay!

Reading this makes me realize that even though my pain causes me a lot of discomfort & even insomnia i havn't got it that bad compared to many on here.
Hopefully i'll be having surgery this year.
I just had a go with gabapentin & tramadol 2 weeks ago & let me tell you i'll never take them ever again. I have quite an addictive personality but i can keep my 120 30/500 codeine apap pills every 2 weeks under control but FUCK ME with tramadol i just kept popping them & popping them like mad & then because i had gabapentin which worked only the first time it took it left over i started combining them & basically went insane for about 4 days until they were all gone. They really turned me into a different person & truth be told i'm a little pissed at my doc for giving me those as i was on (now taking venlafaxine) citalopram & i've since read it has serious interactions with tramadol.
 
Yes it does as tramadol anti d's and gabapentin affect the same receptors. i was poorly when on 40mg prosaic 400mg of trams and 3200mg of gabapentin. gabapentin and pregabalin make me really ill.

how have you been other then than doppla?
 
Who else is attending pain management classes in addition to medication?
At my clinic, you attend several weeks of classes in a room with a dozen or so other CPP patients, taught by specialists, pain psychologists, pain doctors, and pharmacists that specialize in pain mgt. The goal is to learn other techniques to deal with things like breakthru pain, and all the implications one's pain has on their ability to live the lives they want to live. I've been benefiting greatly from guided imagery to help me get to bed (pain is at its worst mornings and nights). They teach you a whole bunch of skills and also ways to potentiate the opiates.

It's also helped me immensely just having the support of others who know what you're going through. You see so many people that have it much worse than you and how they still lead meaningful lives through the program is truly inspiring. This clinic is by far the best chronic pain clinic I've ever been part of, the first one where the doctors look at you as a person, not a number and a medical file, and THEY LISTEN.
 
Only one of us is being condescending and it certainly is not me. Pain management is a complicated buusiness. The most relief you can expect from opiates is about 20%. That means if your discomfort or pain is at a 9, you might get down to a 7. If you have "mild to moderate" neurological pain, like a 4, you might get down to a 3. So there is diminishing returns with opiates.

Are you talking about all chronic pain or just neurological pain? Either way, I disagree. If you are only talking about neurological pain, I agree that opiate medication can only obtain limited relief....in MOST cases. Of course, as you say, chronic pain is a very complicated disorder, which presents differently in each and every patient. If you are saying that any chronic pain patient can only hope to achieve 20%, then it is just plain wrong (again, I could not tell which one you meant, and if you were only talking about neurological pain, then disregard the next part of this post.). Without medication I am, literally, bedridden. Even on lower doses, I was confined to a wheelchair with about an average of 8.5 out of 10. Currently, while I am in pain which does affect my functionality, it is a 4-5 daily. I can walk, with some assistance. Most importantly, I am, for the most part, a happy person, and I can live a functional, productive life.
I guess that the point I am making is that all of us chronic pain patients have different situations. I can't count how many times I have mentioned my situation in an AA meeting only to be followed by someone who says "Well five years ago, I (insert one of the following A: Broke my finger B: Broke my toe C: Fell down some steps D:Dislocated a shoulder), and I didn't need any pain medicine, so neither do you!!! You need to stop taking that right now!! I won't get in to all my problems, but suffice to say I have pretty much never had any medical professional question my need for medicines to function. Obviously you are an intelligent and educated person, who understands many facets of the disease of Chronic Pain, and I just hope that you do recognize that there are plenty of us who use our medicine properly, which allows us to go from a non-functioning member of society, to someone who is now capable of having a productive, REAL life. I owe that to good, caring doctors, a great family,AA,and my medication. Thanks for your time reading this post, and I hope that all is well!
 
Oh no doubt. I take opiates and they help my pain immensely, I was just speaking more towards the fact that since this is a website about drugs and drug use, that we often forget to look beyond the medications to basic things we can do to reduce pain and better ourselves. Exercise, diet, meditation - they can have a profound effect on your health, and unlike opiates, they are nontoxic and actuallyI improve sociability, mood, and libido, all issues which confront cpp patients. I could go on and on, but I think you get the point.

The real gains come from working hard to counter your pain through healthy living. Aka nothing is free.
 
Who else is attending pain management classes in addition to medication?
At my clinic, you attend several weeks of classes in a room with a dozen or so other CPP patients, taught by specialists, pain psychologists, pain doctors, and pharmacists that specialize in pain mgt. The goal is to learn other techniques to deal with things like breakthru pain, and all the implications one's pain has on their ability to live the lives they want to live. I've been benefiting greatly from guided imagery to help me get to bed (pain is at its worst mornings and nights). They teach you a whole bunch of skills and also ways to potentiate the opiates.

It's also helped me immensely just having the support of others who know what you're going through. You see so many people that have it much worse than you and how they still lead meaningful lives through the program is truly inspiring. This clinic is by far the best chronic pain clinic I've ever been part of, the first one where the doctors look at you as a person, not a number and a medical file, and THEY LISTEN.

I wanted to bump my post because it's at the bottom of the last page, and was JUST discussing the points the poster above me made.
 
Who else is attending pain management classes in addition to medication?
At my clinic, you attend several weeks of classes in a room with a dozen or so other CPP patients, taught by specialists, pain psychologists, pain doctors, and pharmacists that specialize in pain mgt. The goal is to learn other techniques to deal with things like breakthru pain, and all the implications one's pain has on their ability to live the lives they want to live. I've been benefiting greatly from guided imagery to help me get to bed (pain is at its worst mornings and nights). They teach you a whole bunch of skills and also ways to potentiate the opiates.

It's also helped me immensely just having the support of others who know what you're going through. You see so many people that have it much worse than you and how they still lead meaningful lives through the program is truly inspiring. This clinic is by far the best chronic pain clinic I've ever been part of, the first one where the doctors look at you as a person, not a number and a medical file, and THEY LISTEN.

Im waiting to see a Pain Psychologist. Get out! - they teach you how to potentiate opiates??!! Give an example?
 
Next week Im going to try and get a strong low dose breatkthru med. But I always seem to hit a brick wall whenever I ask about anything stronger than DHC/Tramadol. I think I will just explain how it will give me better quality of life and all the other non drug ways I try and cope before I take my medication and that it would only be 2-4 days per month. Now that all seems really reasonable to me, but doctors are a strange breed, was wondering if there is anything else I could do that might help? Maybe a pain diary?
 
Next week Im going to try and get a strong low dose breatkthru med. But I always seem to hit a brick wall whenever I ask about anything stronger than DHC/Tramadol. I think I will just explain how it will give me better quality of life and all the other non drug ways I try and cope before I take my medication and that it would only be 2-4 days per month. Now that all seems really reasonable to me, but doctors are a strange breed, was wondering if there is anything else I could do that might help? Maybe a pain diary?


Pain diary is helpful towards telling your doctor when & how much you're in pain. I see a spine specialist & she prescribed me aquatic therapy. It helped when I was in the water & doing the exercise but once out of the water, the pain is back.

You gotta do everything your doctor says to do & the pain meds will come along but then again, some doctors dont want to help because they are scared of getting in trouble for prescribing strong meds. If the DEA would ever get out of the medical business, doctors all over could prescribe the right meds for everyone.
 
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