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The Pain Management Mega Thread v2.0

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My story of pain

I am a 44 year old wife and mom of an 11 year old daughter. I have Rheumatoid Arthritis and am on permanent disability. I have had chronic pain for the past 5 years due to the RA. My GP has been treating my pain, and I have seen a Rheumatologist. I am not personally ready to go through all the side effects RA drugs have tied to them, so I have abstained, for the most part.

I did try Prednisone and Plaquenil for a few months, at the advice of a Rheumatologist. I didn't like the side effects of either, so I stopped taking them. I especially despise Prednisone, it's evil, IMO My GP agreed with my decision, and also agreed to help me with my pain. So, I have been alternating OTC Aleve and Lortab 10mg, along with Lidocaine patches, and Cannabis. I'm never totally free of pain, but it helps me be able to function more. BTW, I have been seeing the same GP for the last 9 years, and she is not aware of my Cannabis use, nor do any other specialist I have ever been to see.

I recently broke both of my feet. I broke my right foot the beginning of June, and I broke my left foot last Thursday. I also broke 2 ribs on my right side coughing. (I'm an ex-smoker with Chronic Bronchitis and I also have Asthma, so my cough is not suspect)

When I broke my right foot, I saw a Podiatrist, and he put me in an Aircast, and gave me #60 Lortab 5mg. (I had stopped taking the Lortab 10mg my GP gives me because I wanted to take a break, and my GP is aware of this. I even returned the prescription to her)

I was able to make the Lortab 5mg that the Podiatrist gave me last more than a month, despite the fact that I was in a lot of pain. Due to the injury, and it was also aggravating my RA, especially my lower spine. I went back for my re-check with the Podiatrist, and he said my foot seemed to be healing well, despite the fact that I still had pain. So, he refused to give me a refill of Lortab. I was surprised, but let it go. I imagine it's because I am a new patient, or it could be that I live in the "Pill Mill" capital of the United States. One or the other.

Fast forward two days to last Thursday. I was walking with my crutches in the house and lost my balance, twisting my left foot. I went to the Urgent Care where they confirmed I had a hairline fracture, and possibly worse. They recommended I get an MRI at my next Podiatrist appointment. They gave me a walking shoe, but said to walk on neither foot. It's a good thing I was already there in my wheelchair. I was in too much pain to walk anywhere, and he knew it. He prescribed me #20 Tylox/Oxycodone.

Fast forward again to yesterday (Wednesday). I saw my GP for bloodwork, and to review my regular medications. She knew about all my injuries too, both feet and the ribs. She gave me renewals for all my medications, and she also ordered a Dexascan (bone density test) because of all the broken bones.

She said I should go back and see the Podiatrist sooner than my July 20th appointment and I agreed. Despite this recommendation, she asked me if the Tylox was helping my pain (broken bones and RA), and I said yes, a lot. She wrote me a prescription for #120 Tylox/Oxycodone 10mg and #90 1mg Ativan. She said the Ativan would also help with the stress from the pain. My blood pressure was 149/97, and has been in that range since I broke my right foot the first part of June.

The Podiatrist kinda acted like I was drug seeking when I asked for a simple Lortab refill. Didn't outright say it, but said that I should not be feeling any pain now with my broken foot. I knew better, but he said I must have been "over doing it."

I know it seems weird that I hurt my left foot two days after I saw him, but I'm no drug seeker, and never have been. When I go back and see the Podiatrist this coming Monday, I do not plan to ask for any drugs of any kind. I just want him to do his job and make sure both of my feet are properly treated. Maybe he will change his thinking when I don't ask him for any meds. :)

I hate Florida because of this shit. Guilty until proven innocent when it comes to pills. 8)

Sorry for the long post.
 
New member/1st time poster here, so I hope that this is the right place to post: I've been on suboxone for two years after 5-7 years of abusing vicodin, and oxy. The suboxone has done wonders, and I feel confident in my sobriety. However last week I broke my hand, and I have been in a significant amount of pain. I cannot have a cast placed on my hand or wear a splint for more than 50% of the day(long story). So being a good suboxone pt. I refused pain mess from the ER Dr., and ortho. I then went to my suboxone dr telling him that I needed pain relief for about 3-6(weeks according to the ortho), and my suboxone dr said I had two choices. #1 decrease my dose of suboxone from 8mg bid to 2mg qid, or #2 get off of the suboxone for a few days, then start taking 5mg of vicodin. I explained to my dr that the suboxone is not helping the pain, and he replied with well suboxone isn't approved for pain management but a lower dose might work. I also told him that since I have been taking 16mg of bupenorphine every day x two years that it is possible that my tolerance for opiates has increased and 5mg of vicodin probably would not work. He replied with "yes it would, I'm not giving you fentanyl or oxycontin." The weird thing is, I've never even taken or mentioned fentanyl to him, nor did I ask for oxy. I was thinking he might temporarily put me on subutex for a few weeks just for the pain seeing as that is kind of what I'm taking now(w/ narcan) then switch me back to suboxone. I've never snorted or injected and he knows that, so why would he not put me on subutex for 2-4wks??? Also, do y'all think that decreasing my suboxone by 50% will help with pain? And as far as the vicodin goes, I've heard multiple people say that after heavy/longterm suboxone use all of the vicodin in the world won't help you....... What should I do, I just want pain relief because I can't afford to miss work due to being in pain. Sorry for the long post, I'm just anxious please any input from knowledgable ppl is wanted.
 
Sub_worthy said:
New member/1st time poster here, so I hope that this is the right place to post: I've been on suboxone for two years after 5-7 years of abusing vicodin, and oxy. The suboxone has done wonders, and I feel confident in my sobriety. However last week I broke my hand, and I have been in a significant amount of pain. I cannot have a cast placed on my hand or wear a splint for more than 50% of the day(long story). So being a good suboxone pt. I refused pain mess from the ER Dr., and ortho. I then went to my suboxone dr telling him that I needed pain relief for about 3-6(weeks according to the ortho), and my suboxone dr said I had two choices. #1 decrease my dose of suboxone from 8mg bid to 2mg qid, or #2 get off of the suboxone for a few days, then start taking 5mg of vicodin. I explained to my dr that the suboxone is not helping the pain, and he replied with well suboxone isn't approved for pain management but a lower dose might work. I also told him that since I have been taking 16mg of bupenorphine every day x two years that it is possible that my tolerance for opiates has increased and 5mg of vicodin probably would not work. He replied with "yes it would, I'm not giving you fentanyl or oxycontin." The weird thing is, I've never even taken or mentioned fentanyl to him, nor did I ask for oxy. I was thinking he might temporarily put me on subutex for a few weeks just for the pain seeing as that is kind of what I'm taking now(w/ narcan) then switch me back to suboxone. I've never snorted or injected and he knows that, so why would he not put me on subutex for 2-4wks??? Also, do y'all think that decreasing my suboxone by 50% will help with pain? And as far as the vicodin goes, I've heard multiple people say that after heavy/longterm suboxone use all of the vicodin in the world won't help you....... What should I do, I just want pain relief because I can't afford to miss work due to being in pain. Sorry for the long post, I'm just anxious please any input from knowledgable ppl is wanted.
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Call the Ortho doctor back and ask him.
 
Ortho originally wanted to give me vicodin as well, but when I told hm about the suboxone he gave me a strange look and said he thought that most oral meds probably wouldn't work that good but vicodin is what he would give any way. Plus at the time I felt that if I took opiates from him that my suboxone dr would take me off of suboxone for good, and not see me as a patient anymore. Kind of like "hey if youre going to still use opiates then you're not serious about being clean. Y suboxone dr made it clear in te beginning that Im not supposed to get narcs from anyone else which I would understand if he would treat my pain.
 
SubWorthy,

First post/new member convert from forum creeper here too.

I wanted to chime in as I too was on Bupe (in the form of subutex), albeit for an alternative treatment to chronic pain in response to some politics/stigma I was up against at the time for taking full agonist opiods, and earlier this spring made the switch back.

I expect you to be surprised by the efficacy of even 5mg hydrocodone once the suboxone has released it's grasp upon your receptors. It took every bit of 48-72 hours for me to detect the greater amount of analgesia from an approx 10mg dose of hydrocodone, and by the 4th day I was even experiencing Euphoria. That said, before the 72 hour mark - I even took up to 30-40mgs and didn't feel anything. At the same time, I don't feel like the larger yet premature doses of the hydrocodone manifested any tolerance as the Bupe just wouldn't let it.

So, I'd accept the Vicodin, but discuss with your doctor being prescribed enough to double dose for the first 3 days as you wait for your receptors to clear of the Bupe/Suboxone. That said, as soon as you feel any signs of euphoria or analgesia after the 3 days mark, don't get greedy and stick with the prescribed "regular" dose (assuming it truly provides greater analgesia than the Bupe currently is). I do assure you though, that you will be surprised. For me, starting back on full agonists after Subutex was almost like starting with a clean slate. I'm not too well versed in the different types of receptors, but it would seem that the absence of activation of whatever receptor that the Bupe does not particularly fulfill as well as a full agonist, leaves it with an ability to provide anagelsia/euphoria with a MUCH lesser dose than that in relation to what you were taking prior to the Subs (when you were abusing).

So, don't be discouraged during the first 1-3 days in particular, and maybe even on up to day 5.

I hope this helps.

I will add that the Subutex did provide relief for me up to a point from my chronic pain, but my condition worsened and I could not function as well as I wished without the aid of a full agonist. I quickly discovered that hydrocodone was not nearly enough to control my pain (but again, it DID provide much more analgesia/euphoria than I was expecting, and had I a lesser injury - like the acute one you have, it would have been enough) and having had a past with other meds (knowing what worked and what didnt) - was quickly bumped up to Opana.

Before I go, your doctor's thinking behind the lesser dose is based upon some things I've read online... where for whatever reason, pain seems to respond better to Bupe in lesser more consistent dosages (Ive read that patches were used). This was for chronic pain though, not for your acute condition.
 
Sub_worthy said:
Ortho originally wanted to give me vicodin as well, but when I told hm about the suboxone he gave me a strange look and said he thought that most oral meds probably wouldn't work that good but vicodin is what he would give any way. Plus at the time I felt that if I took opiates from him that my suboxone dr would take me off of suboxone for good, and not see me as a patient anymore. Kind of like "hey if youre going to still use opiates then you're not serious about being clean. Y suboxone dr made it clear in te beginning that Im not supposed to get narcs from anyone else which I would understand if he would treat my pain.
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Well, since the Suboxone doctor is leaving you hanging regarding pain meds for this situation, maybe you should consider asking the Ortho doc for some Vicodin.
 
Oh, I forgot to add that I was only taking 2-4mg of subutex/day... and again, while 10-20mg of HC wasn't enough to control my chronic pain after the 72 hour period, I could detect euphoria. I say that you go back to your sub doc and give it a shot.
 
Your gon prob need around 12mg of sub. U weren't f in around with vicodin u had the possible strongest shit on the market and u didn't have a baby tolerence. I have a lot of experience wit sub . N also wAit til your sik as fuk to start weening on the sub or you'll get sicker than sick
 
I will re-iterate what has been said many times before: You can have one doctor treating your pain. Any more than that and it doesn't look like drug-seeking behavior, it *is* drug seeking behavior.

Please, if you are on suboxone, try tramadol with it to relieve the pain, they synergize well to produce a very strong analgesia compared to the normal effects of tramadol.
 
schememo said:
Your gon prob need around 12mg of sub. U weren't f in around with vicodin u had the possible strongest shit on the market and u didn't have a baby tolerence. I have a lot of experience wit sub . N also wAit til your sik as fuk to start weening on the sub or you'll get sicker than sick
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There's no benefit to taking 12mg of sub a day for pain when doses above 4mg don't produce any further analgesia. In fact, this is really stupid because if you require more analgesia for surgery, have an injury, etc. it's going to block the effects of other opioid agonists making it more difficult to dose them.
 
aPIMPnamdSLICKBACK said:
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!
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That was really good advice. I agree with everything you said.
 
I am 23 and I suffor severly from ankylosing spondylitis and also get uvitis( a very painfull inflamatory eye condition) as a complication from it. It started getting chronic when I was 17. I feel the pain in every joint in my body and wake up every morning feeling like I fell off a roof.I feel like I have the back of an 80 year old. Some times something as simple as moving my finger will send a shooting pain down my arm. Besides my arthitic condition I am worried that my pain may also be coming from nuerological issues since I was born with neurofibromatosis and it is possible for neurofibromatosis can cause pain from tumors on nerve endings.

Even with all the medication I am on I am still in constant pain all the time. The meds I am on for pain right now daily are hydrocodone 40mgs, tramadol 300mgs, gabbapentin 2400mgs, tizanidine 8mgs, sulfasalazine 2000mg, and prednisone 5mgs. I only get an hour or 2 of relief from my opietes and the relief isn't even that good. I keep trying to convince my doctor to take me off the tramadol(since It is causing me bad side effects) and up my hydro or switch me to something stronger but she doesn't want to listen to reason and common sence. In the past I was on humira which is a tnf blocker for 9 month. I had very high hopes for it but instead of getting better both my joints and my eyes much got worse. Before I took it my pain was still very bad but pretty much just in my hips/legs and lower back; now it is everywhere. I'm not saying it made me worse but it did nothing to help.

My doctor recently suggested cimzia which is another tnf blocker but am a little warry do to the last one not working and its large list of bad side effects. Has any one had any experience with it and did it help.


I recently finished physical therapy and joined the gym I did it at and am continuing the same exercises I was doing during my therapy and have also been swiming. It has been helping me somewhat.

I will wright up more details when I'm not so tired; I just felt like giving a brief wright-up right now.
 
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^ if you want to try stronger opiates you generally have to try suggested non-opiate approaches first.

ive had chronic pain all year and yesterday my new doc actually listened and took me seriously and gave me a slightly stronger opiate.
have you tried taking your mum or dad with you to appointments? im 24 and found it to be immensely helpful. no drug seeker takes their mum with them!!!
good luck
 
yo man, you should try acupuncture. I know chronic pain is shitty, but I have mad alot of posts on it, and I went from terrible pain, where even 60+mg of Oxymprphone would not help it to only needing a random dilaudid now and again. I accomplished all of it through non-medication avenues. Search this thread and the Pain Management thread in The Dark Side for alot of my posts on this topic.
 
just wondering what peoples expericences are like with presenting to ED?
my local ED just treats me like a drug seeker, i havent been in months, and
now i have a letter and doctors notes to take if i have to go....i just dont know
if they will treat me any better now i have the proper documentation...??

i have chronic pain in my wrist that flares up every now and then, wondering if
it would even be worth bothering going to ED in the future if its gets really bad...
 
I'm on fentenyl and I'm wondering if poppy pods/seeds would help with the break thru pain?? I know I'm on a high dose fentenyl 75mcgs every 48 hours but it's not always enuf. I work full time and try to live a somewhat productive life, thank god for my dr he is the best.. I knows he understands how much pain can affect ones health and mental status.. I've tried everything accupucture, vicoden, oxy, morphine, tens implant, 6 rounds of cortisone shots.. Only thing I have not done is surgery and meditation (trying 2 learn meditation please anyone w/ ideas please help me) I'm 2 young 4 surgery .... So should I try poppy pods????
 
NO. Especially if you are young and in pain, follow your doctor's advice, don't deviate, don't abuse your meds, and you will have a chance of living a normal life.
 
Just a question, but what type of recreational drugs should one avoid if dealing with chronic pain?
 
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