The Pain Management Mega Thread v2.0

[muvolution]

I am in moderate to severe pain, and my 2 month trial on Suboxone has been OK. However my anxiety has gone up and depression worsened as a result of my more severe day-to-day pain, so I'm looking to get back on full agonists.

I went to a new Orthopedist which deals with professional athletes, and i finally got a concrete diagnosis, I have a non-treatable "crush" injury to my L. ankle which may improve with time. In the meantime, I got referrals to 4 different PM clinics. the first two only do injections at the site of injury, one only does injections followed by short-term medication management, and the fourth is, of course, the old PM clinic which I left because I was getting less than satisfactory treatment.
Now I have no choice but to go back to this same PM clinic, and to top it off, they will only put me with the same doctor.

To summarize, we have never gotten along since my old doctor left the practice and I was switched to this new woman. When I started, I was completely honest and divulged that I was using Marijuana for pain as I am a legitimate and legal MMJ patient. I was never given a contract, etc... and then when I was due for my first test, they didn't even bother sending it in since on the little questionaire, it asked what medication I was using and i listed Cannabis, my doctor called me and for the first time told me that it was not allowed. Between then and my next appt, she left the practice and I got transferred to this new doctor who only sees this "red flag" and treats me as a drug seeker. Now after 2 months off PM (on suboxone + tramadol) I am forced to go back to this same doctor.

My psych. has no problem with me using Marijuana and I have been in the meantime, but when I go in for my appointment in a couple days, she will have lots of questions for me. I simply plan on telling her the truth, that I was unhappy with her treatment of me and sought alternatives which were not feasible for adequate PM, and that I have been using Marijuana as I was no longer going to PM. Now that I am starting again, I have no problem quitting, but does anyone have any idea what I should say in the meantime?

I mean, I don't like to lie to doctors but this is a pretty exceptional case, so I'm just wondering what the fuck?
I mean I'm exasperated by this whole process, the games, the circular network of orthopedists and PM clinics, and the insurance shitstorms.

What do I do? I am really exasperated.

 

[lowrider6967]

if you have to lie to get releif from your pain so be it!!no one chould have to live in pain when there is help to be had..You have it right! ITS A FUCKING GAME!! so play to win!

 

[lowrider6967]

Tell them what you think THEY WANT TO HEAR!

 

[muvolution]

I am in this for the long haul, i'm in my mid twenties, and the very renowned (new) orthopedist I just saw said that with my high levels of exercise and low-impact activity (a good thing) I may be able to start feeling better within 5-10 years, so hopefully by the time I'm 30-40 I will be completely off PM.
It's untenable to lie to her about my marijuana use and I refuse to do it, not only do I (and the state I live in) think it is a legitimate mediaction, but i have shown nothing but willingness to follow guidelines by cutting it out when I am in PM.

What do I do about the fact that she doesn't like me and I don't like her?

How do i explain that not just the medical treatment but the way she was treating me led me to seek alternative options?

How do I ensure that she doesn't take my experiment with Suboxone as a try to kick an addiction? (I truly have very minimal withdrawal symptoms when I stop a pretty heavy regiment of opiates - a sign that I do indeed need them).

Should I have my new psychiatrist talk to this woman? What can I do?

I get treated like shit, but I went to just as much fucking school at twice the university, got a degree of the same caliber that she has, am gainfully employed, a well adjusted member of society, etc...
It's just exhausting.

 

[Nibblez]

Renowned means marketable. Doesn't have shit to do with how good a doctor they are most of the time, just means that they can suck a mean dick and play office politics well.

 

[muvolution]

Renowned means marketable. Doesn't have shit to do with how good a doctor they are most of the time, just means that they can suck a mean dick and play office politics well.

Or, ya know, that they are the exclusive orthopedist of the U.S. Olympic Cycling Team.
anyways, thanks for that incredibly insightful post.

 

[Tommyboy]

i get frequent migraine headaches (1-2x a week, each lasting an avg of 2-3 days). i know the issues that arise with opiates and migraines (cranial pressure), but my Dr prescribed opiates anyway. his credentials from a podunk med school tell me he isn't that great of a specialist, but opiates worked to manage the pain so i kept going to him. he prescribed 7.5mg vicodin per month and injectable dilaudid for severe breakthrough pain.

my employer cut their health insurance so i can't see any doctors or buy scripts. i'm forced to turn to legal alternatives, namely kratom and tea from poppy seeds. has anyone had positive experiences treating pain (of any type) with poppy seed tea? what dependency can i expect from daily usage of 6-8 oz of poppy seeds per day?

Poppy seed tea works quite well for pain. It has a long duration as well. You will become dependent on it with daily use. Some people become dependent sooner than others, but I would think that most people would feel some withdrawal symptoms upon discontinuation after 1 month of use.

I think that you would become dependent rather quickly since you are swithing from vicodin, if you are not already dependent on the vicodin.

I would explore other options for treating migraines if you have not already done so.

 

[lowrider6967]

OK,i understand your frustration,you seem to be well educated and you said yourself its a game,so if you want to be the one to change the rules,by all means,do so.you would,in the long run be helping all legit people who are suffering life debilitating pain,but in the meantime your going to be the one to suffer.good luck ! Chose your battles wisely!

 

[aPIMPnamdSLICKBACK]

Doctors often treat patients as if they are drug seeking right off-the-bat, and the patient will have to convince them otherwise in order to get adequate treatment/medication. While this sucks, it's pretty much standard where I live (in KY--is terrible to be a CPP here), so I've had to go through hell just to get ninety 10mg hydrocodone a month. It has, however, taught me a few things that may help some of you.

Description of pain is a very qualitative thing, and doctors might not take your word for it. So, try to quantify it. Keep a calendar of your daily pain levels and symptoms. Before you go to the doctor, draw conclusions from the data (i.e. my pain is a 6 most days, but jumps to 8 or higher twice a week, etc). This can help you understand your pain better, as well as the doctor. They're more likely to take you seriously with well-presented information.

Also, be prepared for a urine analysis. While some doctors may not care about THC in your system, others will throw the book at you, and it's not worth getting red-flagged for life. If you don't have a prescription for something, even if you have a legit need, it's best to not piss dirty for it, or say that you take it. If the doc sees you're self-medicating & getting stuff "off the street", he's probably going to label you a drug seeker (that is flawed thinking, I know, but trust me it happens).

If you're wanting to get pills, you can't just overtly say so--doctor doesn't like it when you try to make his decisions for him. So, make a list of the therapies/medications you've tried that haven't worked (ones obtained legally, of course), and the things you have tried that did work. I, for example, told my doc that I had gotten some 10mg hydrocodone for a root canal, and had a few left over. When my neck pain would get unbearable, and nothing else seemed to help, I tried taking one of those, and it actually helped. I didn't come out and say I wanted pills, but hydrocodone was on my short list of things that had helped me in the past.

Be prepared to handle the doctor's objections. When one told me that he wanted me to try injections, I told him I was uncomfortable with that approach, and had information to back up my concerns. If a doctor wants to force you into a treatment that you're uncomfortable with, you need to go somewhere else.

Hopefully this can help some of you. If you live in a state with less strict regulations, this may not be necessary, but it certainly couldn't hurt.

Good luck!

 

[muvolution]

Thanks for the helpful advice.

For those of you interested in this, or who live in "Green" states, what do you when you have a legal prescription for marijuana AND are a CPP? Does FDA/ DEA regulations overrule that? Doesn't the DEA have an executive order to not prosecute MMJ patients in states that have legalized it? Does exclusion from PM not count as prosecution or unfair treatment?

 

[hydrochron]

^most pain managments allow you to smoke medical marijuana if you have a card. They dont prosecute people that are just buying ounces. It's pretty random, none of my friends have ever been in trouble. But I know the clinics get shut down all the time, depending on where there operating. Like I said it's usually the clubs that are bending the rules a little to much.

Now i've been having some back pain lately, but I dont think anythings wrong with my back YET. What are the best steps to take to prevent it from getting worse?

 

[muvolution]

^most pain managments allow you to smoke medical marijuana if you have a card. They dont prosecute people that are just buying ounces. It's pretty random, none of my friends have ever been in trouble. But I know the clinics get shut down all the time, depending on where there operating. Like I said it's usually the clubs that are bending the rules a little to much.

Now i've been having some back pain lately, but I dont think anythings wrong with my back YET. What are the best steps to take to prevent it from getting worse?

Can I ask what state are you in? PM me if you want to keep it private.
I started PM, no problem, then found out 3 months later at my first UA I couldn't smoke (even with my card) it was weird.

For your back: Get new shoe beds, like some of the Dr. Scholl one's are OK but you can get hard foam one's that you heat up and put in your shoes then stand in and mold for like 30 minutes. They are nice.
You can also get really expensive custom orthodics but they don't work much better than the above mentioned.
New shoes might be in order, too. Something slip on with an arch that matches your foot. Also, strengthen it with a multivitamin and some exercise.

 

[lowrider6967]

prevention

^most pain managments allow you to smoke medical marijuana if you have a card. They dont prosecute people that are just buying ounces. It's pretty random, none of my friends have ever been in trouble. But I know the clinics get shut down all the time, depending on where there operating. Like I said it's usually the clubs that are bending the rules a little to much.

Now i've been having some back pain lately, but I dont think anythings wrong with my back YET. What are the best steps to take to prevent it from getting worse?

I wish i had been smart enough to recognize the symptoms and take appropriate measures to prevent the damage before it ruins your life!! I would contact a doctor tell him what you are trying to accomplish,i would guess hes going to recommend light to moderate exercise to strengthen the back area. its important to do this BEFORE the pain prevents you from helping yourself,probably not going to be easy but like i said i wish i could have gotten my head out my ass before it was to late,It kills me how some people,after hearing of all the meds your on to say,"YOUR SO LUCKY I WISH I COULD GET SOME MEDS LIKE THAT!" What they don't realise is the pain ain't worth it,after a week the buzz don't happen any more and your lucky if you can just get back to being able to function.anyways good luck

 

[Nexus298]

My Doctor has never had an issue with me using weed. I've seeen him like 8 months. Last month I was abstaining from all drugs for a sleep study and only showed for weed not benzos like I was prescribed. (Also Opana but It hasn't shown up on any tests yet even though there is an oxy one)
So this last visit he UA's me again and I didn't think I had anything to worry about but I tested positive for meth and MDMA. Needless to say I had Ingested neither. But Just so happens I took Mephedrone the night before. It is my understanding that the metabolites cross.
I am prescribed dexedrine and my argument was that Amphetamine was so close to Meth and MDMA that they must be false positives. Does this argument hold anyground.
He said he was going to send the results away, for further evaluation. I think when the more conclusive tests come in it will clear my name. But what if it doesn't? Can he legally still prescribe me my meds?
Another big deal for me is will it show positive for oxycodone from opana?

 

[Cane2theLeft]

^Simple office piss tests can more easily confuse drugs that are similar (and many will only show use of a CLASS of drugs rather than a specific) but the gc/ms testing that labs do will not make these mistakes. They will determine the exact metabolites you excrete and so not only will your doctor know that you used, but he'll know that you lied to him.

Legally I don't see a reason why he couldn't keep prescribing but why would he administer a test if he didn't care what you consumed? He might not want the personality liability of prescribing controlled substances to someone you uses other controlled substances... and why would he? If you dropped 200k and a decade of your life to get a medical license, would you risk it on giving a drug user a bunch of controlled substances?

With all that said, I have to hypocritically say that drug testing discussion is not allowed so I can't let this proceed any further. I just wanted to inform you of the above. If you have any questions about forum policies, please feel free to PM me.

 

[brain trauma]

I just posted this in the intro area then found this so I'll put it here too:

Well, I've got lots of stuff wrong with me and my doctor told me to research various meds as fas as prices go from various pharmacies and i kinda stumbled onto this site.

One of my big problems is Dupuytren's contracture, a soft tissue disease in your hands which causes you to get knots in your palm and forces your hands closed/wont let you open them. It is not normally as painful as mine...nor is it supposed to start as soon as mine. Normally starts in late 50's to 60's and mine started when I was 25... My hand doc has never seen it in someone as young as me(now 29). Here's the kicker though...I'm a mechanic This makes things with my hands exponentially worse.

My other problem is that I was in a very high speed car accident(i'm not a normal mechanic, i build hotrods and racecars) and somehow survived. I did major damage to my spine and brain causing nerve problems in my left big toe, left shin, and right hand(the Dupuytren's is in my left hand). All those body parts are numb 24/7 except when I move in certain ways then they feel like they are set on fire while being ripped off my body with a pair of pliers. All together a very unpleasant experience when I say... reach forward and turn up the volume on the car stereo with my arm straight and twist my wrist. That sets my thumb on fire. Or if I have my left leg straight and point my toes. That lights off that shin and big toe...and apparently I naturally do this in my sleep. I dont like to complain about it too much because it was my fault I wrecked going so fast so this is my punishment, but it does suck ALOT.

As far as medication goes, my hand doc had me on 2 Darvocet during the work day then 2-3 Lortab at night and that helped for a while. Then the whole nerve damage thing got me and I had to go to a specialist. He first started me on 10mg Methadone 4 times a day with Lortab every 4-6 as well and 2mg of clonopin(sp?) at night to help me sleep. The Methadone kinda helped pain wise but made me so sleepy/out of it during the day that people close to me didnt like being around me because my eyes would constantly be going in multiple directions while I was trying to keep them open. I changed from that to MS Contin 30mg ER 3 times a day and the same lortab every 4-6 and clonopin at night. That stuff seemed to do nothing so he upped it to 30mg 4 times, still nothing so he put me on MS Contin 60mg ER 3 times a day and the same lortab/clonopin. Still no relief and the only thing that happened from that was that in the month between doctor visits I think that I only used the bathroom 4 or 5 times and constantly felt awful because of it. Here in the past couple weeks he just put me on 10mg Opana IR well, its generic so its Oxymorphone I think. Still the same with the lortab/clonopin. He also is having me still take 2 of the MS Contin 60mg a day for the first to weeks then 1 for the next until I'm off of them.

I feel like this Opana stuff is working somewhat, but I think its gonna take more of it. Unfortunately the dosage I'm at now, 10mg IR is the only type of it that is available in generic and my insurance kinda sucks. I just met my $500 deductible with the $340 for 120 10mg generic opana.

My question for ya'll on the site is this, what all would you have me ask my doctor about medication wise that is strong enough to work but isnt insanely expensive at the pharmacy? My doc is a great guy and very intent on helping me get though this, but I'm sick of paying all kinds of money and only getting moderate relief and having to wait a month(insurance will only pay once a month visit) to get back in to see him while just having to deal with it in the mean time.

I dunno if this is the typical intro thread and I may put it in a different place too, but its what I had to say at midnight when I cant sleep to spite taking a dozen pills thoughout the day/night. Thanks for reading about my fun life and I appreciate any input.

 

[BlueLightBeam]

I find that different opiates work better or worse. For instance I get very little pain relief from methadone or even heroin, and the best pain relief from oxy codones. Why is that? Is it just in my head?

 

[TINK]

There are sooooo many things to address here. I work in the medical industry, the reason for the drug tests and for legal reasons. Specifically if you overdose, they can not blame your pain doctor because they will know what is in your system and what they are prescribing you. So, if you OD with something else in your system or with more than the normal levels, they have their asses covered. The pain management doctors are audited every so often by the DEA (just fyi).

I have a lot of medical issues one of them being a chronic pain issue. I was addicted to opiates because of this for over 8 years. I have not been on any opiates in over 4 years and my pain is more under control than it ever has been. I am a firm believer that opiates should only be used for acute pain for short term use. Long term use of opiates end up causing lots of other issues like tolerance and Opioid-induced hyperalgesia or opioid-induced abnormal pain sensitivity.

My chronic migraines are caused by a few different things. Arthritis in c2, c3 and c4, fibromyalgia, and low magnesium blood levels. I use a daily preventative and imitrex for specifically bad ones. And, if that does not work, I end up just going to urgent care and getting a muscle relaxer injection along with promethazine. But, never an opiate.

I also recently discovered the BEST thing in the world for migraines/muscle tension....... Magnesium Supplements. Greatest thing EVER.

And, I am sort of confused at the sort of pain management you are all going to. Mine is a program that makes you see a psychologist, physical therapist and a medical doctor , in addition to meeting in a class room environment twice a week for 3 hours learning different ways to life our lives with chronic pain (not just taking medications).

 

[BlueLightBeam]

It's funny to say it, but I only need a legitimate script to fix many issues in my life. The legal and financial consequences of having to procure my own medications are not good in the slightest.

 

[muvolution]

It's funny to say it, but I only need a legitimate script to fix many issues in my life. The legal and financial consequences of having to procure my own medications are not good in the slightest.

It's your responsibility to find a doctor and work with them legitimately, because there is a huge difference between self medication and medical supervision. Opiates are addictive, it sucks, and that is why it is so difficult to be a pain patient, or pain doctor for that matter, but you gotta deal with it because a full-spectrum pain treatment option is better than self-medication.

The system sucks, but you need to find something with oversight that works for you, or you'll just up and up your dose continuously.
For me it was starting traditional acupuncture with an acupuncturist that you have to be honest with, and therefore with yourself.
But it's whatever man, you can do what you want, but as many pain patients will attest to, it can run away real fast.