The Pain Management Mega Thread v2.0

[Doomed2pain]

The age problem sucks I had it for the first 18 months of my condition. Are you getting your pain meds from a gp or a pm dr tricomb?

 

[tricomb]

Pain management. Ironically, the most opiates I ever got was from GPs though, they had me on Morphine ER, then the last pain clinic I went to was like WOAH WE NEED TO PUT YOU BACK ON COMPOUNDED OPIATES, so they put me on fucking norcos. Purely IR regimen, I had to drop out of school and move 500 miles home, where my new clinic put me on percocet, at an extremely insulting dosage. Like, I don't even feel comfortable writing it. Anyways, they finally are budging, I think it helps that I completed the 10 weeks required program, pain classes lead by a pain psychologist.

But I am scheduled to go to school again, in about a month, and I'm very worried about having adequate pain control to sit through a whole class, in those horrible desks. I know I will probably have to talk to the schools disability center to discuss better accommodations.

 

[Doomed2pain]

Definitely speak to your schools disability department, the one at my uni was great they provided me with thousands of pounds worth of equipment for at home as well as in class, unfortunately I had to quit when the crps spread tomy right arm and I could no longer produce enough artwork to keep up.

I cannot believe they will not give you extended release medication, it is better for your pain and for the dependency/addiction factor (ir means you get a quick release and therefore are more likely to crave the feeling it gives you). What is your condition if you don't mind me asking?

 

[HaZeX]

I Do feel for you Tri, I know what your going through as I had the same exact problems, as I'm "young" also and according to them I shouldn't be in pain, even though I mounds of documentation to prove it. I must have went through 20 PM places until I found one who would continue what my GP was prescribing me.

 

[tricomb]

Thanks guys, like I've said, I get alot of pain relief just from the support network of chronic pain patients. The one at my pain clinic, and the online communities, especially this one here at bluelight.

@doomed2pain, that's fucked up. But yep, they'd rather me on a pure IR regimen "because I'm young", and they HAVE to give me the APAP because of the fucking DEA.

I've honestly had multiple doctors say they feared losing their DEA# to give me Morphine ER. OxyContin I can't tolerate anyways, since they changed the formulation, it worsens my GI pain. I'm willing to bet the new Opana ER would not go down well with my body either, I don't know, I've only ever snorted the old octagonal ERs and IR oxymorphone, and taken my prescribed meds orally as directed.

I used to be on 64mg dilaudid per day, 8 x 8mg IR, another completely IR pattern that actually worked amazingly well, since we don't have HydromorphContin.

 

[Doomed2pain]

Have you ever kept a pain diary? I have kept one for nearly 3 years now and it helped my drs understand more and they then started to actually listen, understand my pain properly and then treat me more adequately.

I make a note of what my pain is on the scale every 3 hours and describe how the pain feels in detail, I also make a note of what I have been doing in that amount of time so that they understand what activities i am limited to (pretty much everything now lol)

I also add pictures, my condition makes my limbs swell, go weird colours, freezing cold and clammy or black but hot like they are on fire. you can get an app for both iphones and android phones. very very helpful for chronic pain patients and their drs. I would give it a try they are more likely to change your meds then to longer acting ones. worth a try?

 

[gromit12]

At my new PM doctors office right now. Waiting to get called in. Wish me luck.

 

[tricomb]

Honestly, I have thought about it, and I always regret not having started one, especially throughout the major traumas of my life, car accidents.

What app can I get for iPhone? I would be ecstatic if they'd just give me my damn morphine ER haha, or even back on hydromorphone, anything other than this oxycodone APAP bullshit.

 

[Doomed2pain]

For my ipad i use an app called anote, it has lots of dividers for different subjects, which I find helpful as I use one for my pain diary, one for my anxiety/panic, one for my daily routine so I can figure out which parts of my routine cause me the most anxiety and panic attacks, and one section for my meds as I am on a lot of different ones for my conditions that need to be taken at different times, with/without food etc.

If I hadn't kept the pain diary I doubt Id have been able to get my drs to listen as I was only 23 when I had my road traffic accident. also on a random tangent have you ever tried meditation for your pain? I meditate at least 3 times a day and it helps me immensely, it takes a bit of practise to get it right and find the right technique for you, but it really does help.

I'm mad now that your dr is discriminating you and making your pain seem illegitimate due to your age, it infuriates me, what just because we are young means that we cannot possibly be in as much pain as someone older? It is bs!

 

[tricomb]

Yes I practice meditation and guided imagery, etc.

BS indeed. I'll look into that app, I just dont know what I would write.

 

[Doomed2pain]

Start with what number your pain has been at in that time period. Then describe the pain be as descriptive as possible, dull ache, burning, sharp piercing, shooting bolts etc like right now my bones feel like they are on fire, there is a shooting pain like electric shocks going from my toes all the way up my legs into my mid back, the pain is like fire but like a chemical ice burn all at once and i am getting spasms in all the muscles in my legs and arms that feel like they are being stretched and crushed. the more you can describe it the better. also note what kind of activities you have done and how that is affecting your pain levels.

It is hard at first but once you get used to it and into the habit of keeping the diary, it will most likely benefit yo and help your drs treat you. Do you do any physio or exercise to help? Tai chi and yoga are good for a lit of types of pain, i cannot do it anymore but I still try and do my physio exercises to my best ability or i would lose all movement in my legs back and right arm.

 

[gromit12]

At my new PM doctors office right now. Waiting to get called in. Wish me luck.

Pain management doctor appointment went pretty awful all things considered.

Seemed very sympathetic to my pain, as my MRI reflects the issues I have, but seemed puzzled as to why I was having nerve pain in my hand. Started talking to me about how I needed to get nerve testing done to check for Carpal Tunnel. I explained that I had already had this testing done at a nearby facility (which he is familiar with because it's literally within walking distance) and I explained my concerns in doing further testing as my insurance is pretty skimpy and actually hired a company to investigate why I was getting so many tests. I also explained that the tests showed that I was negative for carpal tunnel.

Long story short, he, in a very uncomfortable tone, explained that some doctors don't catch things that others do and that this friend of his was the best in this type of field....

Oh please....8)

I'm getting really tired of this. Tests, tests, tests, tests, tests that don't need to be conducted as I have a sufficient amount of information pertaining to my condition (a very clear MRI of my nerve impingement, dislodged disc, etc.) and really additional testing at this point is ludicrous (also considering I paid $700 out of pocket for the last MRI)

He gave me 30 5/500 vicodin and said "if you need to refill it, do nothing. These are only for rainy days"

I haven't even gone and picked them up. I'm pretty depressed and feel kinda hopeless. Sorry for the rant.

 

[tricomb]

Oh man, I'm so sorry. 5/500 hydrocodone is like the most insulting thing you can get scripted, short of tramadol of course. I've actually gone into urgent care with a pain flare, and they wanted to put me on an SSRI. Another time, they put me on Elavil. -______-.

Even more insulting when I bring up that I've tried most anti-depressants for anxiety/depression and I know they did jack shit for pain.

 

[Survival0200]

Have you guys tried any adjuvant medications for pain; like levomepromazine? I heard some of them may decrease the amount of opiates needed for pain management.

Btw, what's wrong with the oxycodone/APAP compound? It still has oxycodone in it - and oxycodone is oxycodone no matter what it's compounded with.

(Sorry for my ignorance.)

 

[macd610]

Have you guys tried any adjuvant medications for pain; like levomepromazine? I heard some of them may decrease the amount of opiates needed for pain management.

Btw, what's wrong with the oxycodone/APAP compound? It still has oxycodone in it - and oxycodone is oxycodone no matter what it's compounded with.

(Sorry for my ignorance.)

Hi there!
I'm just going to address the oxycodon/APAP (which is percocet) question. The highest dose it comes in, that I know of is 10mg of oxycodone.
Oxycodone immediate release has no Tylenol in it, and is available in doses up to 30mg.
If someone takes narcotic pain meds over a long period of time, a tolerance develops.
For example, I take 60-75mg of oxycodone ir every 4 hours as needed for breakthrough pain along with 100mcg Fentanyl patch. If I were prescibed 10mg percocet, it would take between 6-7.5 pills to equal my prescription.
It all comes down to tolerance, and one's level of pain

 

[doppelganga196]

Hey everybody, i noticed a mention of elavil (amitriptyline). I've had it pushed on me before for insomnia & recently had all my pain medicines cut off when my GP saw the trackmarks on the back of my hand (march was the first time in my life i'd ever i.v'd a drug before, things went out of control) so because he was so worried about me overdosing what with me being on a diazepam reduction too.

Basically he gave me 56 25 mg elavil & said i should use otc analgesics until i see the addiction speacialists.

Well i'm now on 55 mg of methadone per day & while aside from morphine it's the best painkiller i've ever had, i still feel twinges of pain so adding 25/50mg of elavil to the methadone really, really does seem to be the best analgesic combo i've ever had, & it no longer gets me "messy" (at first on the methadone i was quite sedated) now i just seem more like my old self.

Also i'm a tad worried lately that i may be putting myself at risk since before going on methadone (17th of april) i'd taken diazepam everyday for months. But when i started the methadone, not only did i not crave painkillers like dhc & codeine, i didnt feel the need for the diazepam so i gave what i had left away to a friend who's a fairly old chap & has been depessed & can only ever squeeze 7 2mg diazepam out of his doc so i gave him a box of 28 & just said 'buy me a drink sometime', as he was very very grateful.

Now i'm out of diazpeam until about the 8th & i wonder if suddennly stopping them may be contributing to my severe muscle spasms when sitting/lying still.

Also, when i began the methadone & was topping up painwise with elavil, i was very concerned about respiratory depression taking those meds along with diazepam so i left them alone.

I'm quite scared of being on methadone & am thinking of having my dose reduced by a mg a day until i hit 30 so i can switch to subutex, but now from what i've read it doesnt sound like the best med for me, only + to it would be getting take home scripts as today i almost missed my mthadone dose - stayed up until 5 am drinking,smoking & chatting with friends & woke up after 5pm so almost missed the chemist! That would have made for a very unpleasant night.

Okay that's my babbling for today, i got somethings off my chest but i'm not sure i worded the whole post correctly... Ho hum It'll do : )

 

[tricomb]

I've tried amitryptamine (Elavil) for GI pain, at 25 and 50mg nightly due to how sedating it is. I never noticed any improvement in my pain symptoms though

Pretty much the only things that help are opioids, carisoprodol, sometimes pregabalin for certain pain. Topamax was a total fail for me, it destroyed my appetite and did nothing for pain.

What's wrong with APAP? The problem with Compounded opiates is that most doctors feel safer writing these prescriptions than "pure" opiates like roxicodone, or Oxycodone IR (5,10,15,20,30mg) and would rather give it to you with large amounts of tylenol, which has been linked to liver problems. APAP is extremely hepatoxic, especially over time.

Think of it like this. I've been on pain meds for many years, and most of the time, they've been compounded with APAP. Why? To help kill my pain better? No. To protect my doctors. Why are they poisoning me, to protect their DEA# License to prescribe? They are poisoning my liver, to protect their careers. Compounded opiates are fine for acute pain, you know, but think about it like this, do you think they really intended me to be taking tylenol every single day for YEARS on end? This pain is chronic, it's not going away. Why can't they spare me the bullshit? Will I need cirrhosis or liver failure before I finally get put on the right medication?

 

[macd610]

I've tried amitryptamine (Elavil) for GI pain, at 25 and 50mg nightly due to how sedating it is. I never noticed any improvement in my pain symptoms though

Pretty much the only things that help are opioids, carisoprodol, sometimes pregabalin for certain pain. Topamax was a total fail for me, it destroyed my appetite and did nothing for pain.

What's wrong with APAP? The problem with Compounded opiates is that most doctors feel safer writing these prescriptions than "pure" opiates like roxicodone, or Oxycodone IR (5,10,15,20,30mg) and would rather give it to you with large amounts of tylenol, which has been linked to liver problems. APAP is extremely hepatoxic, especially over time.

Think of it like this. I've been on pain meds for many years, and most of the time, they've been compounded with APAP. Why? To help kill my pain better? No. To protect my doctors. Why are they poisoning me, to protect their DEA# License to prescribe? They are poisoning my liver, to protect their careers. Compounded opiates are fine for acute pain, you know, but think about it like this, do you think they really intended me to be taking tylenol every single day for YEARS on end? This pain is chronic, it's not going away. Why can't they spare me the bullshit? Will I need cirrhosis or liver failure before I finally get put on the right medication?

TC, probably a dumb question, but I am wondering how many Md's/pain clinics you have tried? Someone somewhere on here said it took them MANY different tries before finding a dr who would address their needs properly?
I know I had to sign a" pain management contract", and one of the rules stated was that I could not visit another dr without letting my current md know. If you have something like that, it makes it tougher.

 

[tricomb]

Dozens and dozens.

I had to sign that contract too, so it sucks, my pain clinic wont keep prescribing me carisoprodol because "its a controlled substance" even though only since january 11th, of THIS YEAR 2012, yet when I complained of more pain/spasms, they just doubled my oxycodone dose.

So I was originally thinking, "no problem, I have a million doctors who would/have prescribed me carisoprodol" Then I remembered that contract... They're trying to discourage doctor shopping, but this can hurt legitimate patients.

 

[GABAking]

Tricomb: it is unfortunate that you're a chronic pain sufferer and they give you compounded opioid/APAP meds to save their asses, but that's the sad reality we live in. I don't really think it's the doctor's fault at all. Most people go into the medical field to help and serve their patients to the best of the ability, but when you have some government bullshit program like the DEA breathing down your neck, they have to be careful. To go through 4 years of undergrad, 4 years of medical school, 3 years of general residency, and another 3 or 4 years of pain management fellowship only to have your license taken away because you prescribed narcotics outside of what the DEA deems "OK" is an absolutely horrendous thought. A physician's life would be over.

I'm 21 years and talked to my PM doctor about his view on treating young patients (I'm the youngest patient he treats). He says that pain is pain, and some people are unfortunate enough to experience it earlier on in life than others. He has no problem treating me as there are countless MRIs and X-rays to show that I do have a legitimate problem. However, whenever he documents his notes, he says that he has to be extremely thorough every time I come in for an office visit, leave a message, etc, just b/c the DEA is watching how he treats young patients like a hawk (I guess people my age are more likely to divert drugs to the street, which isn't really true in my opinion; anyone at any age can). I also asked him if I could get rid of the APAP in my percocet 5/325 and just get oxy 5 mg IR so that I could take tylenol PRN if I don't want to take narcotics for one dose (b/c after a few doses of the percocet, you really can't take any tylenol for risk of liver damage). He said he understands where I'm coming from but simply couldn't do it. Major bummer.
/rant