Misc The Pain Management Mega Thread version 3.0

[Shady Kaity]

In desperation I just called my primary dr asking what to do and explaining the situation to them and they said they can't do anything.
I need to make appts for my chest xray and echocardiogram that the rheumy ordered and make a follow up with her for now I guess...idk what to do in the mean time! I guess I really need to further express how severe my pain is to her.
For tonight the bf is giving me a larger dose of suboxone and I'm hoping that will provide some relief at least...

 

[paranoid android]

I've been on MSContin and Fentanyl before as my ER medication and while those 2 may offer better analgesia for just my back, the methadone (20mg q8hrs=60mg total) has been much more effective in treating both my back pain and the nerve damage. In fact, my hospital (Cedars Sinai, well known LA Hospital) used IV methadone during post-op in combo with IV Dilaudid, Morphine and Fentanyl and even then I found the methadone to be a superb pain killer. I've tried every opioid based medication except for Opana so I can say with some authority that methadone has been a very successful medication in my 18 month ordeal of 3 spinal fusion surgeries.

My PM doc (not affiliated with my hospital) has continued the methadone and really has only rotated my IR meds and my muscle relaxer and I've been pretty satisfied with the relief from this current regimen (in contrast to last year where I was on methadone, fent patches and MSContin at the same time with Dilaudid as my IR med).

As far as constipation goes, it can be very difficult in this area but I think its worth it considering its positives. As far as mood disorders, it doesn't seem to exacerbate my depression or anxiety, and I think part of it is the very long half life and the spaced out dosing.

My pain is all neuropathic so i may have to inquire about atleast trying methadone. Sadly it's almost never used as a painkiller here and is certainly not a first or even second line choice when it comes to opiods. You can prescribe bupe for pain in Canada without a special license but not methadone.

I currently take morphine SR and although it works good it doesn't always cover the pain and i start getting sick around the 18 hour mark after my last dose. It would be nice to have a painkiller that lasts a long time, is not worth shooting and is not that recreational. Ive done it all at this point so besides the odd shot or when I'm running low i just eat the stuff instead of slamming it for a rush.

 

[BiggDirty01]

My pain is all neuropathic so i may have to inquire about atleast trying methadone. Sadly it's almost never used as a painkiller here and is certainly not a first or even second line choice when it comes to opiods. You can prescribe bupe for pain in Canada without a special license but not methadone.

I currently take morphine SR and although it works good it doesn't always cover the pain and i start getting sick around the 18 hour mark after my last dose. It would be nice to have a painkiller that lasts a long time, is not worth shooting and is not that recreational. Ive done it all at this point so besides the odd shot or when I'm running low i just eat the stuff instead of slamming it for a rush.

That's unfortunate because methadone is really helping my neuropathic issues and its a much longer lasting medication, so my PM doc has put me on it for Extended Release pain control and Hydromorphone or Oxycodone as a breakthrough med.

Hey, I'm not sure if this is the right place to post or not, but I am in a shitton of pain. I'm not currently rxd and pain medications. I have what the drs suspect to be lupus (still undergoing diagnosis as my symptoms suddenly hit full force in januarary). I'm currently. On cymbalta 60mgs plaquenil 200mgs prednisone 20mgs and some other medications for psych reasons. Naproxen and ibuprofen and tylenol and such do NOTHING for the pain. Last night. Was my third night with no sleep because of all my joint pain. I feel like I'm helpless, like literally nothing helps me...I don't mean to get all emotional and shit but if I didn't have my son to care for, I. Would probably consider suicide or be on massive amounts of drugs because idk what to do and its so hard to live like this and no one around me understands what I'm going through.
Foor example of how nothing helps, I once took ten mgs of oxycontin 800mgs skelaxin 1000mgs tylenol and 500mgs naproxen. I still wasn't able to sleep that night. My boyfriend is generous enough to give me a tiny amount of suboxone in attemt to help and no relief. I've tried tramadol and perocet and still nothing. I've been on the prednisone for almost three weeks now and still no relief.
Does anyone have any adviceo

I don't know your insurance situation and whether you need a referral to see a pain specialist but you should absolutely find a quality PM Doctor to help you work through your pain issues. I am not sure if you are able to do any Physical Therapy for lupus related pain but you should absolutely see if there are any other options to go with pain medications and something like a arthrotec type RX anti inflammatory.

Feel free to PM me if you want to chat more about this, or just need someone to listen to you! Good luck

 

[norcophile]

hi i am new here, CPP for multiple herniated discs, currently being treated with norco 7.5 tid.
i am being undermedicated but am afraid to ask doc for anything else for fear of being labeled
as a drug seeker and being kicked out of the pain clinic. being in your early twenties with chronic
pain is a challenge, getting doctors to believe you and whatnot. i am working hard to develop a good
relationship with my pain doc so that eventually i can ask for something more, i just need something
a little stronger and long acting. being a CPP at any age is rough, i hope to get help here and help others
in any way i can, i know a lot about opioids as i have an extensive history with abuse, thanks guys.

 

[tricomb]

Welcome norcophile!

 

[Bluefrogger]

Hi everyone, it's been stressful for me lately! We had a micro-burst over our house and it took out two huge trees that we had to have removed. One of them was on the house! Fortunately though we ended up with minor damages, and nobody's hurt!
Anyhow, I over-did-it of course, and now hurting for it!
How is everyone in general lately? Welcome to anyone new!

 

[macd610]

hi i am new here, CPP for multiple herniated discs, currently being treated with norco 7.5 tid.
i am being undermedicated but am afraid to ask doc for anything else for fear of being labeled
as a drug seeker and being kicked out of the pain clinic. being in your early twenties with chronic
pain is a challenge, getting doctors to believe you and whatnot. i am working hard to develop a good
relationship with my pain doc so that eventually i can ask for something more, i just need something
a little stronger and long acting. being a CPP at any age is rough, i hope to get help here and help others
in any way i can, i know a lot about opioids as i have an extensive history with abuse, thanks guys.

Norcophile, welcome to BL!
It sounds like you're off to a good start with your pain management. It seems you realize how important it is to EARN your Md's trust by being honest and genuine with him/her about your pain. This can be a long, frustrating journey that many of us here have gone through (and are still going through).
I definitely agree that youth can be an enemy of sorts when dealing with chronic pain. Mine began soon after the birth of my wonderful child over nine years ago. After years of fairly undertreated pain, a botched surgery that made things even worse, 3 ignorant and uncaring doctors who made me feel guilty about taking narcotics-I finally found the right PM Dr. for me.
I am honest and open with him; not only because I have to be, but because I WANT to be. He could see that I was genuinely in LOTS of pain and while he has treated my pain aggressively, he's conservative when he should be. I've been seeing him for about a year and a half, and my quality of life has been much much better (although I'm quick to whine when there are bumps in the road, lol).
We have a pain management contract, and I try my very best to stick with it. I've made a mistake or two, like going through my bt meds a bit too quickly, and I told him about it. I trust and respect him, and he has told me that he trusts me. That's a good feeling
Sorry for going on and on ...and on some more I just realize how lucky I am to have found this person and I know that many of my friends here are still the place I was a year and a half ago...and it literally hurts my chest when I get on here and read what some of my special friends are going through.
Norcophile, It sounds like you may end up being 1 of the lucky ones. Please continue to be honest with your doctor and take the necessary time to build a solid foundation for your relationship.
Good luck to you.
Thanks again to anyone who took the time to read this

 

[SydneyGal]

In desperation I just called my primary dr asking what to do and explaining the situation to them and they said they can't do anything.
I need to make appts for my chest xray and echocardiogram that the rheumy ordered and make a follow up with her for now I guess...idk what to do in the mean time! I guess I really need to further express how severe my pain is to her.
For tonight the bf is giving me a larger dose of suboxone and I'm hoping that will provide some relief at least...

Unfortunately, until you have a firm diagnosis, doctors will generally prioritise working out what's wrong with you over medicating for pain. Overall it's a good strategy -- if they can determine the cause of the pain, it might be fixable -- but it does mean a lot of suffering in the meantime. I couldn't get pain meds at all until I had a diagnosis, and even then, it took a while... hang in there, is all I can say. Sorry!

 

[Shady Kaity]

I saw on a form she wrote 710.0 as my diagnosis which I just looked up yesterday and it came back as being code for SLE.
I just made a bunch of doctors appointments today's and will be seeing the rheumatologist next week. Until then I guess I just suffer

 

[brighton]

So sorry to hear that, brighton. Why would they do that? Do they think you'll heal completely so you have no remaining disease/injury, scarring or nerve damage to cause pain? Or are they just in that reflexive, 'OMG OPIATES!!!!' panic?

I know it's cold comfort now, but the clinical literature shows that managing pain effectively or even aggressively leads to far better patient outcomes (from faster healing and lower surgical recovery times, to higher likelihood of keeping your pre-illness/injury job and lower chance of illness-related depression), and that opiophobic doctors cause huge problems in the health system, because they're not practicing evidence-based medicine, but rather some kind of superstitious voodoo. (Really, the chances of a patient given opiates for pain becoming an addict -- 4 in 12,000, according to the best-known meta-analysis -- are than the chance that if you went outside right now and flapped your arms about in a funky improvised rain dance, it would actually work.)

Sounds like you need a better pain specialist; hope you have the means and opportunity to find one.

Yeah its totally bizarre, the doctor was even telling me how opiates just end up making the pain worse.....she was so anti medication and full of shit. I just wanted some help with breakthru pain. Oh well I had a good pain day today, thanks poppy seeds

 

[BiggDirty01]

hi i am new here, CPP for multiple herniated discs, currently being treated with norco 7.5 tid.
i am being undermedicated but am afraid to ask doc for anything else for fear of being labeled
as a drug seeker and being kicked out of the pain clinic. being in your early twenties with chronic
pain is a challenge, getting doctors to believe you and whatnot. i am working hard to develop a good
relationship with my pain doc so that eventually i can ask for something more, i just need something
a little stronger and long acting. being a CPP at any age is rough, i hope to get help here and help others
in any way i can, i know a lot about opioids as i have an extensive history with abuse, thanks guys.

Can I ask if you have tried any physical therapy, acupuncture/acupressure, a TENS unit or yoga? I had some excellent success last year after a spinal fusion in using Yoga classes 5 days a week, TENS unit for minimum 3 hours today (feels great when its on), some acupuncture and physical therapy with anti inflamatory medications and NO narcotics and I felt better than I did on multiple heavy duty narcotics....Just saying it is possible, not dismissing your pain or need for adequate pain relief.

And in terms of dealing with your PM Doctor, sometimes giving a chance to these other options makes a physician feel better about treating younger patients (like you and me) with opioids because they feel like giving an effort at trying these alternate therapies shows a commitment to getting better, not to obtaining narcotics.

I hope I am not coming off as a dick, I just know where you are coming from as I have had 2 more spinal fusions and I STILL get some negative feedback about my pain med regimen as if I need to prove myself after a total of 4 spine surgeries.

So, attitude and effort are great motivators for PM Docs in this day of PM Docs being prosecuted for RXing opiates, even in legitimate cases.

If there's anything else I can help you with, feel free to PM me and good luck in the future with your physician.

 

[dais]

^good, solid advice there

 

[spephspeph]

Hi everyone, it's my first post in this thread, hopefully someone can give me some advice.

Last month (Friday 13th July to be precise) I got hit by a car. I was thrown over the bonnet, into the air, hit the car again and landed in the gutter, in a puddle.
Ambulance took to hospital, CT scanned me, x rayed my knee, and nothing seemed to be broken.
They discharged me with a pair of crutches and a box of codeine 30 mg. I saw my GP a week later, she gave me a box of cocodamol 30/500 and diclpfenac 75mg sr.
Another doctor last week gave me a bottle of diazepam 2mg to stop the muscle spasming/cramping/twitching. I'm on the waiting list for an MRI scan and some physio, and I'm off the crutches - albeit with a limp.

Anyway, it still hurts. There's a constant dull pain in the hamstring and the muscle above the knee, it still spasms, I can't run and I'm getting pretty down about it.
I don't think the cocodamol is doing anything, but the diclofenac helps the severe pain when moving, especially with stairs.

What should I do? Is it worth going back to my GP, and if so, what should I ask for? I'm in the UK, I don't think we have access to such a large arsenal of medicines as in the US, but they must be able to do something more than cocodamol, diazepam and diclpfenac, right?

I also take escitalopram 10mg daily, fish oil and vitamins.

Thank you in advance

 

[brighton]

Yes, totally go back and see your GP. Maybe they can help you get the MRI/physio sooner or change up your meds. It might be worth trying a muscle relaxer rather than diazepam so you dont end up dependent on benzos.

 

[spephspeph]

Thanks, is there anything specific I should ask for?

 

[Xamkou]

Norcophile, welcome to BL!
It sounds like you're off to a good start with your pain management. It seems you realize how important it is to EARN your Md's trust by being honest and genuine with him/her about your pain. This can be a long, frustrating journey that many of us here have gone through (and are still going through).
I definitely agree that youth can be an enemy of sorts when dealing with chronic pain. Mine began soon after the birth of my wonderful child over nine years ago. After years of fairly undertreated pain, a botched surgery that made things even worse, 3 ignorant and uncaring doctors who made me feel guilty about taking narcotics-I finally found the right PM Dr. for me.
I am honest and open with him; not only because I have to be, but because I WANT to be. He could see that I was genuinely in LOTS of pain and while he has treated my pain aggressively, he's conservative when he should be. I've been seeing him for about a year and a half, and my quality of life has been much much better (although I'm quick to whine when there are bumps in the road, lol).
We have a pain management contract, and I try my very best to stick with it. I've made a mistake or two, like going through my bt meds a bit too quickly, and I told him about it. I trust and respect him, and he has told me that he trusts me. That's a good feeling
Sorry for going on and on ...and on some more I just realize how lucky I am to have found this person and I know that many of my friends here are still the place I was a year and a half ago...and it literally hurts my chest when I get on here and read what some of my special friends are going through.
Norcophile, It sounds like you may end up being 1 of the lucky ones. Please continue to be honest with your doctor and take the necessary time to build a solid foundation for your relationship.
Good luck to you.
Thanks again to anyone who took the time to read this

I really enjoyed reading this and it's nice to hear that honesty has gotten you where you are

Off Topic:...Has anyone heard from Doug "Jktm"? Ever since he combined 30mg of Clonzepam and Morphine, that was his last post. He hasn't posted since then....

Im thinking something happened that night.

Anyone?

Doug if your reading this, post up. Let us know your O.K

Quite worrying

 

[Bluefrogger]

Thanks, is there anything specific I should ask for?

OUCH, that car accident discription made me shiver! I was thrown off a motorcycle a long time ago- yeesh!!
I don't know if it helped at all to read some of the posts just in the few months earlier, but please do if you haven't already. Big dirty01 posted some good advice! Please don't rush to stronger or possibly unnecessary drugs until you really know what's going on.
Sometimes you can mask the pain enough that you hinder the problem or healing process. NOTE: I don't know you're pain or tollerence though.
I would indeed do some calling/yelling or whatever, to get some faster results because it's been about a month and something doesn't sound right. Knees can take awhile though. I've had two tears and four knee surgerys.
The GP will prob. Rx his/her relaxer of choice for the symptoms you have, just use them with caution! Hope you can get some quick answers to what's causing the trouble! Blue

 

[brighton]

Thanks, is there anything specific I should ask for?

Maybe ask about muscle relaxers vs. diazepam. Try and get the MRI & physio asap. Tell your doctor about your pain and how your medications are/or aren't working. You could even ask for a referral to a specialist, you may not need it but since there will be wait for this too it might be worth getting started.

 

[spephspeph]

Boooo, GP didn't give me anything new. He just showed me some stretches to do. Ah well, the diclofenac seems to be doing the trick, little worried about gastric bleeding as I also take escitalopram, anything I can do to help this?

Also would yoga and swimming be a bad idea? I've gone from being pretty fit to this state, and am gaining a bit of weight (this needs to stop!)

 

[lady_stardust]

Norcophile, welcome to BL!
It sounds like you're off to a good start with your pain management. It seems you realize how important it is to EARN your Md's trust by being honest and genuine with him/her about your pain. This can be a long, frustrating journey that many of us here have gone through (and are still going through).
I definitely agree that youth can be an enemy of sorts when dealing with chronic pain. Mine began soon after the birth of my wonderful child over nine years ago. After years of fairly undertreated pain, a botched surgery that made things even worse, 3 ignorant and uncaring doctors who made me feel guilty about taking narcotics-I finally found the right PM Dr. for me.
I am honest and open with him; not only because I have to be, but because I WANT to be. He could see that I was genuinely in LOTS of pain and while he has treated my pain aggressively, he's conservative when he should be. I've been seeing him for about a year and a half, and my quality of life has been much much better (although I'm quick to whine when there are bumps in the road, lol).
We have a pain management contract, and I try my very best to stick with it. I've made a mistake or two, like going through my bt meds a bit too quickly, and I told him about it. I trust and respect him, and he has told me that he trusts me. That's a good feeling
Sorry for going on and on ...and on some more I just realize how lucky I am to have found this person and I know that many of my friends here are still the place I was a year and a half ago...and it literally hurts my chest when I get on here and read what some of my special friends are going through.
Norcophile, It sounds like you may end up being 1 of the lucky ones. Please continue to be honest with your doctor and take the necessary time to build a solid foundation for your relationship.
Good luck to you.
Thanks again to anyone who took the time to read this

yea, i just moved ro a small town w/only two pms to choose from. the one i've ben with is kind of crazy, intimidating, and twice now, when he has made a mistake by misreading my chart or not reading it at all, he has put it on me, accusing me of tis or that. i don't know what do to. i rhink he wants me to go to a different dr, as he's suggested it twice. i just don't know what to do. i follow his rules as best i can, tho there r many that were not on the contract i signed....i find him very intimidating and hard to impossible to talk to, so i just clam up and try to get in and out as quckly as possible.........i'm misserable, in so
much pain, and fear, and to add to it the fov't has cancelled my dissability, so ireally need this dr on my side, and don't know how much it will hurt my case to switch to the other one in town, assuming he takes my insurance.......

thanks for listening.
g