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The Pain Management Mega Thread v2.0

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phenethylo J said:
I do completely understand that this is the DEAs and pollitions fault not the doctors. I know how much stress and pressure they put on the doctors and the threat of loosing there practice. I didn't mind and agreed when the doctor told me she would not keep me on clonazepam and just gave me one last script of it when I was put on morphine. I had already tapered off the clonazepam shortly before I started going to her so I didn't care.
The doctor there is very friendy and caring. She told while this dose can be dangerous I would be way worse off without them. The nurse however is pretty cold. I just hate how she was treating me like I'm a junkie when all I am trying to do is make it so I have enough relief to get out of bed.

Like I said before my anger lies with the way the nurse treated me overall and her knowledge of medicine not just that she condridicted what the doc told me as far as dosage. The nurse seems to think any medication that is not abusable is 100% safe; anti depressants being one example. What pissed me off most of all is that she said I was making excuses when I told her about my sleep issues. That really upset me because she does not have any idea how much it effects me. It along with my pain is why I had to drop out of college and wont be going to grad school. On counless ocations it was so bad I would hallucinate from sleep deprivation and there were times when I was ready to down every pill bottle in my droor because I could not take being so sleep deprived yet still not being able to sleep anymore. The sleep issue also makes my pain several times worse which makes me have to go up on my medication. Thankfully last week I started taking a combination of 5htp and another capsule with a bunch of differnt herbal meds in it; L theanine, melatonin, omega 3, ect. It is working amazingly for me and is helping me sleep just as good as weed does.
Click to expand...

Another thing to try is valarian root. I've found it to be incredibly effective.

Also, for me personally, opiates disrupt my sleep big time. Worse than caffeine. If I take any kind of opiate I can't go to sleep for at least 4 hours. This might be something you want to take a look at.

I know how sometimes you just get people that are cold. Is there another nurse practitioner in that office?
 
I understand the sleep deprivation i once went 17 days without any due to being in so much pain, i often cant sleep because i am sensitive to pressure and touch so every position was hell. i was in such a state by the end oc those 17 days in a full psychotic episode.

I have tried valerian root and it didnt help. I have always wanted to try melatonin but we cannot get it in this country. Now I meditate at least 5 times a day to help with relaxation, pain management and sleep, oh and a special anti pressure mattress. It helps but my sleep is still pretty interuptted.
 
As my friend Tricomb has noted here many times and as have I as a fellow young chronic pain patient, we are at the mercy of a system that does not have an appropriate approach towards treating young people with degenerative pain conditions.

After 3 lumbar fusion surgeries and 5 different pain management doctors...and a little sister with 2 lumbar fusion sugerise and 3 pain management doctors, I have seen just how pathetic things can get with getting adequate relief. My sister and I had to resort to bringing our mother or father with us to all of our appointments to maintain an image of an above board reproach and a squeaky clean image, With my sisters and I having our fair share of drug abuse in the past, we were both subjected to the patronizing and discriminating attitude of many physicians when it comes to writing triplicate prescriptions to people in their 20's or even younger.

As patients, we have to take control of the situation and view ourselves as consumers of a service who can fire the provider of the service if we decide we are not satisfied with his or her services. Even though this becomes tiresome and there is difficulty in finding or predicting how a doctor will handle patients of a certain age, nonetheless we have to take the bull by the horns. We need to tell physicians what has worked for us and what hasn't and we need to stand up for ourselves if we feel we are being pandered or patronized.

And finally, we also need to set a good example. We can't walk in to an exam room with bloodshot or glass eyes, slurring our words or dressed sleazily and expect that a doctor is going to feel comfortable prescribing drugs to us that can cause him to lose his license, livelihood or potentially his freedom (the DEA, is another subject in itself). All in all, we can do a lot to demonstrate a certain amount of above board behaviors and appearances that can satisfy the opinion of a doctor who has maybe 10 minutes in a one-on-one exam to gauge if their patient is trying to goad them into prescribing pain meds to a drug seeker or whether you are truly suffering and your youth is just a matter of fact or if your youth is a contributing point to their negative opinion of us.

I wish all you other pain sufferers a pleasant and pain free weekend.
 
I keep a very detailed and accurate pain diary. I update it every 2 hours. It really helps get the medication needed. I am young too so for the first 18 months I was only on codeine, I tried everything else they suggested, nerve blocks physical therapy all meds including tricyclic anti depressants, gabapentin, pregabalun, lidocaine patches, tens machine etc.

I was put on various middle strength opioids and then I went onto fentanyl. I was on it for 4 months but the allergic reaction to the patches was too much to cope with anymore so I stopped cold turkey. I stopped opoid therapy for 4 months then decided to go back on them before my annual winter pain relapse, first it was morphine then oxycontin with liquid morphine for bt and now oxy er and ir. And other medications too, diazepam for themuscle seizures, drugs for my stomach problems and drugs for my mental health conditions.

I cannot go on like this though so I need to change the oxy to something else, I constantly wake up due to the pain and I cannot sit up right for longer than 15 minutes before the pain is that intense and crippling that I need to lie back down it is beyond a joke now.

I wish you all a pain free or low pain weekend too. It is 4.10am here and the pain is yet again disturbing my sleep
 
Let's keep the discussion from turning into "things you can say and do to get a doctor to trust you."

Have any of you people who are very bad off tried acupuncture? Yoga? Meditation?

My pain is bad, but it is "just" nerve pain and not usually skeletal or muscular which means it does not affect my mobility or activity levels, just that I can be doing any number of random things and it hurts like hell. More often than not, it feels great while I am skateboarding or cycling or running, and hurts so bad at night and while just hanging out... anyone else experience this?
 
REPLY TO DOOMED TO PAIN=
I was on methadone for CP for a few years and just got switched to fentanyl patched. I was on 80mg of methadone a day for Crohns' disease and degenerative disc disease. It worked pretty well I thought and felt absotluly no high....but I must admit I am not a great one for that subject as I have never gotten a real "high" from anything yet, still waiting :)....anyway. It worked well I though at least for me much better than long term morpine with breakthrough meds. MY regime was soma q 6 hr., dilaudid 8mg q 4-6hrs. and then the methadone 2 10mg tabs q 6 hrs.
I liked methadone and still do for pain managment...but that is my opinion...now because of the Crohns flare all my tab's are literally running right through me and not absorbing so they put me on fentanyl patch 75mg.
Oh, also I take nerontin 800mg 3x a day. Plus, all my other meds' for crohns.
Waiting to see how I like the patch still? Might need up the dosage....I'm sure of it. Waiting to try som MJ to see if it works for stomach pain and nausea....cause I'm tossing most of my med's if they don't flow through me. My added woes...sorry!
 
BTW-I'd also like to know the best place to place a sandoz fentanyl patch? Why do they say to put it on fatty tissue? I understand it's taken to the blood stream that way ect. but it that is the case then me as a woman the best place on on my breast....right? I mean it's ALL fatty tissue. I have lost alot of weight from not eating and pain and that is getting close to the last resort area for placement? I mean how much fat do they want? The more the "Merrier."?
 
It's highly lipophillic and extremely effective via the transdermal route. Be careful with the sandoz fent patches, unless they've changed them they contain a gel reservoir of fentanyl, instead of the matrix formulation which have pretty much replaced the gels due to how dangerous the gels are.
 
So, where do you recommend is the best place? I've done groin, heart, arm, upper back and seem's of those for me...upper back is best but looking to try another spot?
Thx
'
 
i used to put my patches on my chest or tricep area, anywhere above the heart, also avoid hair shave the area if need be.
 
im sorry I didnt mean for my post about keeping a pain diary to sound like 'here is how to get meds' I just meant that it is helpful for my drs to understand my condition and pain better.

as for the pain being worse at night, I find when I have a day where I am able to get in my wheelchair for a while during the day my pain is a lot worse the following night and days after.

I do meditate, I used to do tai chi too until my condition deterorated. I am going to see domeone about accupuncture soon, did you find it helpful? I am willing to give anything a try if it means a little more relief from the pain. I am just worried about the needles causing the condition to spread futher as this has been known to happen.



muvolution said:
Let's keep the discussion from turning into "things you can say and do to get a doctor to trust you."

Have any of you people who are very bad off tried acupuncture? Yoga? Meditation?

My pain is bad, but it is "just" nerve pain and not usually skeletal or muscular which means it does not affect my mobility or activity levels, just that I can be doing any number of random things and it hurts like hell. More often than not, it feels great while I am skateboarding or cycling or running, and hurts so bad at night and while just hanging out... anyone else experience this?
Click to expand...
 
muvolution said:
Let's keep the discussion from turning into "things you can say and do to get a doctor to trust you."

Have any of you people who are very bad off tried acupuncture? Yoga? Meditation?

My pain is bad, but it is "just" nerve pain and not usually skeletal or muscular which means it does not affect my mobility or activity levels, just that I can be doing any number of random things and it hurts like hell. More often than not, it feels great while I am skateboarding or cycling or running, and hurts so bad at night and while just hanging out... anyone else experience this?
Click to expand...

Hey mate, I hope that wasn't directed at me, more so trying to take it in the direction of why a professional would see one's behavior as drug seeking.

Anyway, this is exactly how my problem is. I wake up in little to no pain, and am very active (I surf almost every day, lift, run, etc.) and my job involves heavy lifting. I rarely experience pain while doing these activities, buy my god about 4-5pm hits and a lot of days I feel like death.

My situation is skeletal, but I feel the nerve pain more. I have a bone spur on c4 that pinches my radial nerve, so if I get any inflammation in my neck...ouchie.:\
 
muvolution said:
Let's keep the discussion from turning into "things you can say and do to get a doctor to trust you."
Click to expand...

I certainly wasn't trying to advocate any strategies to manipulate a physician, so I hope that comment wasn't directed towards me. But, as someone who has had several spine surgeries, I have encountered the same stereotyping I've heard from other young chronic pain patients here on Bluelight and I simply wanted to stamp out what I believe to be the details of how such encounters with physicians should be approached and dealt with....for people with legitimate pain problems.

I am a believer that the people who approach physicians trying to scam or looking to be drug seekers end up ruining the situation for the rest of us legitimate sufferers. No scam, no bullshit no manipulation...just what approach has worked for me, and a philosophy of standing your ground and being your own best advocate.

If I wasn't the person you were addressing...LOL...please dismiss this whole rant....
 
Hi there!

I realize this is a pretty old post that I am responding to, but I thought that my experience may help you figure this thing out (if you have not already done so).
I have been taking oxycodone immediate release along with the patch for quite a while. I don't notice that the oxycodone take any longer to kick in than it did before I began using the patch. I have never taken methadone before... but I have heard that its effects build up over time, and it takes awhile for it to get out of your system. hopefully this is just a something related to the switch, and once you get into the swing of using the patch it will get better.
I am having a hard time putting things into words today, so I apologize if that did not make much sense. I hope by now things are going better for you... I think changing medicines is probably one of the scariest things I've gone through in my life.... not knowing what's going to happen, being afraid that I have made a mistake in switching and so on.

BiggDirty01 said:
Question BL:

I am noticing, with my ER medication change from methadone to fentanyl, that the onset of analgesia and euphoria of my oxycodone is a lot longer. The duration of these feelings to me appears the same; It is just the time it is taking for the onset to occur.

Has anyone else experienced something like this? I am not sure which combo is better on my back right now (only been on the fentanyl for a week or so), but the long wait for the oxycodone onset (as my breakthrough med) is somewhat disturbing being so fresh from surgery and not really wanting to wait so long to feel its effects.
Click to expand...
 
I just have to vent and figure this is the place to do it. I am a pain patient, and recovering addict (over 4 years). Because of the abuse and and being exposed to opiates most of my life (and every day for the last 15 years), my tolerance is UNGODLY. I have been on the same dose of Opana ER for 3 years now, after I found a great pain doc who also treats addiction. Last year my doc moved far away and after a long search was able to find another DR willing to script me the same high dose. Well, because of certain medical problems, I am unable to take the new formula of Opana, so my DR was willing to script me to the 15mg generic old formula, but since and equaivalent dose to what I was taking would be thousands of pills, she had to lower the daily dose (and I have to see her every 2 weeks instead of every month). I didn't mind since it would only be til Sept, when generic 40mg comes out. Well, the lower dose (I am on 30% less than I was), has been tough on my pain level. Then last week I go in to her office for my appointment and she tells me she is no longer comfortable prescribing at such high doses, and I have 2 weeks to either find a new Dr who will script me at what I've been on for over 3 years, or I have to start taking MORE cuts.....25% next appointment, 25% MORE the appointment after that and then and undetermined more after that. So pretty much, I am in a ton of extra pain right now, barely able to function, and now she wants to cut me down dramatically. My original Dr. is horrified (his words) but there is not much he can do, and obviously i am not going to be able to find a new Dr to script me at incredibly high doses (Especially with my history). So thanks to the Gov't and my doctor being scared of the gov't, I am going to lose most of my quality of life. The last time I was at such low levels of pain meds, I was in a wheelchair for a year, while we titrated up on the opana when I first started. I hate American medicine.
 
Roxicodone King said:
I just have to vent and figure this is the place to do it. I am a pain patient, and recovering addict (over 4 years). Because of the abuse and and being exposed to opiates most of my life (and every day for the last 15 years), my tolerance is UNGODLY. I have been on the same dose of Opana ER for 3 years now, after I found a great pain doc who also treats addiction. Last year my doc moved far away and after a long search was able to find another DR willing to script me the same high dose. Well, because of certain medical problems, I am unable to take the new formula of Opana, so my DR was willing to script me to the 15mg generic old formula, but since and equaivalent dose to what I was taking would be thousands of pills, she had to lower the daily dose (and I have to see her every 2 weeks instead of every month). I didn't mind since it would only be til Sept, when generic 40mg comes out. Well, the lower dose (I am on 30% less than I was), has been tough on my pain level. Then last week I go in to her office for my appointment and she tells me she is no longer comfortable prescribing at such high doses, and I have 2 weeks to either find a new Dr who will script me at what I've been on for over 3 years, or I have to start taking MORE cuts.....25% next appointment, 25% MORE the appointment after that and then and undetermined more after that. So pretty much, I am in a ton of extra pain right now, barely able to function, and now she wants to cut me down dramatically. My original Dr. is horrified (his words) but there is not much he can do, and obviously i am not going to be able to find a new Dr to script me at incredibly high doses (Especially with my history). So thanks to the Gov't and my doctor being scared of the gov't, I am going to lose most of my quality of life. The last time I was at such low levels of pain meds, I was in a wheelchair for a year, while we titrated up on the opana when I first started. I hate American medicine.
Click to expand...

Your hardship almost brought me to tears. As a fellow pain patient (and recovering addict) I have been through 5 different pain management doctors for one reason or another and just now have found the most compassionate and thoughtful PM doc out of the 6 I've seen throughout my life. It is truly staggering how hard it is to find a PM doc who actually CARES and is INVESTED in the health, recovery and state of mind of his/her patients.

I am afraid you are going to need to find a new PM doc. Perhaps your old doctor can help find you a referral to someone he or she knows, and perhaps can speak on the phone with the new doctor to advocate on your behalf. I am so sorry to hear that you are being forced into more pain when doctors, even for legit patients, become uncomfortable sustaining chronic pain patients on narcotics. I am not sure what your issue is, but perhaps there are better medications more suited to your pain issues (Lyrica for nerve pain, perhaps Methadone or Levorphanol as an atypical opioid that also helps with other kinds of pain).

Again, best wishes and PM me if you wish or need to discuss further.
 
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