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Harm Reduction The Pain Management Mega Thread Version 4

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Hello all. I've lurked a bit here over the last few months and decided that I should finally get an account and start posting. I'll try to be brief with my story and current dilemna. I am sure that many people come here, to this particular megathread out of desperation. I'm not desperate, yet. Just looking for a little guidance from people who understand:

In 2006, I had a thoracotomy to remove an abcess in my lung.
In 2008, I developed pancreatisis due to a cyst on my pancreas (I am not, nor ever have been a heavy drinker). Surgery to remove the cyst, followed by a second surgery a couple of months later as an abcess had formed near the sight of the pancreatic surgery.

Up until the surgery in 2008, I had only off and on pain from the thoracotomy. After the pancreatic surgery (well after the recovery period), I was in constant pain--all my lovely scars are on the left side of my body and there is always something going on---whether it be a massive abdominal cramp from sneezing vigorously, or the constant ache in my back and side from the thoracotomy. I found out from one of my doctors that 50% of thoracotomy patients have pain after thoracotomy and for 30% of those patients, the pain is chronic. I can only assume that all the damage that's been done to rest of my left side exacerbates the pain from the thoracomoty.

I have, over the last few years, been on some sort of pain medication almost non-stop. The only time in the last three years that I haven't been on narcoctic pain medication was when my pain doctor suggested I try Cymbalta for the pain and had me slowly taper off everything else. I felt like the Cymbalta worked for a little while, but after about a month, I was in pain again and dealing with the side effects from the Cymbalta--sweating, weight gain. Oh, and when I stopped taking it, the withdrawals were an absolute nightmare. Anybody here ever experience WD from Cymbalta? It's like being drunk, hungover, and experiencing PMS all at the same time! But, I digress.

My current regimen is as follows:

600 mg Neurontin (I tried more, but it started messing with my vision and made my legs swell)
30 mg Percocet (Hydrocodone--5/325 mg)

I was doing just fine on that until a few months ago, when I noticed that the percocet was really not doing much for me. I stupidly took extra and of course ran out. So every month for the last three months or so, I experience few days of withdrawals. And my regular doctor won't prescribe additional pills because he's obviously worried that I'll need more and more and there's no ceiling for tolerance. He referred me to a pain specialist, who I am going to see on March 7th. In the meantime, I've really messed things up good-- I am out of percocet until the 22nd (!) and suffering again from withdrawals. When I realized I would run out before I could get my next prescription, I did try tapering for several days so that the withdrawals wouldn't be so bad. It seems to have helped a little, but I'm not in great shape today. At least I know what to expect for the next several days. *sigh* I've read a lot on here about ways to ease withdrawal symptoms and I'm trying some different things.

My main question, I guess is what should I be asking for when I go see the new pain doctor? I was thinking about asking for something long acting like MS Contin (which I used to take and it worked very well) and someting mild for breakthrough pain. I'm a little leery of tryng Methadone, though I have read that it works well for chronic pain. Suggestions? Advice? Anything would be much appreciated.

Thanks for reading.
 
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Hello all. I've lurked a bit here over the last few months and decided that I should finally get an account and start posting. I'll try to be brief with my story and current dilemna. I am sure that many people come here, to this particular megathread out of desperation. I'm not desperate, yet. Just looking for a little guidance from people who understand:

In 2006, I had a thoracotomy to remove an abcess in my lung.
In 2008, I developed pancreatisis due to a cyst on my pancreas (I am not, nor ever have been a heavy drinker). Surgery to remove the cyst, followed by a second surgery a couple of months later as an abcess had formed near the sight of the pancreatic surgery.

Up until the surgery in 2008, I had only off and on pain from the thoracotomy. After the pancreatic surgery (well after the recovery period), I was in constant pain--all my lovely scars are on the left side of my body and there is always something going on---whether it be a massive abdominal cramp from sneezing vigorously, or the o ache in my back and side from the thoracotomy. I found out from one of my doctors that 50% of thoracotomy patients have pain after thoracotomy and for 30% of those patients, the pain is chronic. I can only assume that all the damage that's been done to rest of my left side exacerbates the pain from the thoracomoty.

I have, over the last few years, been on some sort of pain medication almost non-stop. The only time in the last three years that I haven't been on narcoctic pain medication was when my pain doctor suggested I try Cymbalta for the pain and had me slowly taper off everything else. I felt like the Cymbalta worked for a little while, but after about a month, I was in pain again and dealing with the side effects from the Cymbalta--sweating, weight gain. Oh, and when I stopped taking it, the withdrawals were an absolute nightmare. Anybody here ever experience WD from Cymbalta? It's like being drunk, hungover, and experiencing PMS all at the same time! But, I digress.

My current regimen is as follows:

600 mg Neurontin (I tried more, but it started messing with my vision and made my legs swell)
30 mg Percocet (Hydrocodone--5/325 mg)

I was doing just fine on that until a few months ago, when I noticed that the percocet was really not doing much for me. I stupidly took extra and of course ran out. So every month for the last three months or so, I experience few days of withdrawals. And my regular doctor won't prescribe additional pills because he's obviously worried that I'll need more and more and there's no ceiling for tolerance. He referred me to a pain specialist, who I am going to see on March 7th. In the meantime, I've really messed things up good-- I am out of percocet until the 22nd (!) and suffering again from withdrawals. When I realized I would run out before I could get my next prescription, I did try tapering for several days so that the withdrawals wouldn't be so bad. It seems to have helped a little, but I'm not in great shape today. At least I know what to expect for the next several days. *sigh* I've read a lot on here about ways to ease withdrawal symptoms and I'm trying some different things.

My main question, I guess is what should I be asking for when I go see the new pain doctor? I was thinking about asking for something long acting like MS Contin (which I used to take and it worked very well) and someting mild for breakthrough pain. I'm a little leery of tryng Methadone, though I have read that it works well for chronic pain. Suggestions? Advice? Anything would be much appreciated.

Pain therapy by the way of narcotics is a slippery slope, as you already know. Being on only one narcotic(perc30's) is probably not helping you still have medication at the end of the month due to a lack of a breakthrough med. You'll probably want to stick to something that doesnt exacerbate your current chronic abdominal condition.... I'd talk to him about dropping your percs for Roxicodone30mg and using that as your breakthrough medication. From then on only a trained MD can truly most accurately prescribe a long acting opiate for the rest of the day.
If it's my suggestion you seek? Op40s (new formulation of oc 40s) should be more than enough to stave you away from using your IR 30s, but you may require a higher dose such as OP80s to get some degree of pain relief. MS-CONTIN 100s will keep varying degrees of pain away for varying ppl but they've always worked for me. Probiotics and vitamins will help your stomach not murder you in your sleep after a week or two on many of the "newly formulated " ER meds, including the new opanas. Talk to your doctor first and come crosscheck us after for our results and experiences :)

Thanks for reading.[/QUOTE]
Chase,
I hope today finds you feeling as well as possible.
I feel I should apologize again for my rant yesterday. I was pretty angry for your situation and I don't feel indignant rambling could've been much help to you ;)
Regardless of your drug use, I feel that you still deserve guilt free pain relief. While this does help me to understand your pm doctors concerns a little better, it does not change the fact that it was your primary care doctor who decided to up your meds.
I hope that you are getting the relief that you need, or at least coming close to it.
Oh, by the way, you were not rambling at all in your last post.
hope everyone else is doing well also.:)
Cat

Thanks for your loving concern, Cat. I had much fewer sacral issues in regard straight to pain today so your prayers worked!!!
 
Hello all. I've lurked a bit here over the last few months and decided that I should finally get an account and start posting. I'll try to be brief with my story and current dilemna. I am sure that many people come here, to this particular megathread out of desperation. I'm not desperate, yet. Just looking for a little guidance from people who understand:

In 2006, I had a thoracotomy to remove an abcess in my lung.
In 2008, I developed pancreatisis due to a cyst on my pancreas (I am not, nor ever have been a heavy drinker). Surgery to remove the cyst, followed by a second surgery a couple of months later as an abcess had formed near the sight of the pancreatic surgery.

Up until the surgery in 2008, I had only off and on pain from the thoracotomy. After the pancreatic surgery (well after the recovery period), I was in constant pain--all my lovely scars are on the left side of my body and there is always something going on---whether it be a massive abdominal cramp from sneezing vigorously, or the constant ache in my back and side from the thoracotomy. I found out from one of my doctors that 50% of thoracotomy patients have pain after thoracotomy and for 30% of those patients, the pain is chronic. I can only assume that all the damage that's been done to rest of my left side exacerbates the pain from the thoracomoty.

I have, over the last few years, been on some sort of pain medication almost non-stop. The only time in the last three years that I haven't been on narcoctic pain medication was when my pain doctor suggested I try Cymbalta for the pain and had me slowly taper off everything else. I felt like the Cymbalta worked for a little while, but after about a month, I was in pain again and dealing with the side effects from the Cymbalta--sweating, weight gain. Oh, and when I stopped taking it, the withdrawals were an absolute nightmare. Anybody here ever experience WD from Cymbalta? It's like being drunk, hungover, and experiencing PMS all at the same time! But, I digress.

My current regimen is as follows:

600 mg Neurontin (I tried more, but it started messing with my vision and made my legs swell)
30 mg Percocet (Hydrocodone--5/325 mg)

I was doing just fine on that until a few months ago, when I noticed that the percocet was really not doing much for me. I stupidly took extra and of course ran out. So every month for the last three months or so, I experience few days of withdrawals. And my regular doctor won't prescribe additional pills because he's obviously worried that I'll need more and more and there's no ceiling for tolerance. He referred me to a pain specialist, who I am going to see on March 7th. In the meantime, I've really messed things up good-- I am out of percocet until the 22nd (!) and suffering again from withdrawals. When I realized I would run out before I could get my next prescription, I did try tapering for several days so that the withdrawals wouldn't be so bad. It seems to have helped a little, but I'm not in great shape today. At least I know what to expect for the next several days. *sigh* I've read a lot on here about ways to ease withdrawal symptoms and I'm trying some different things.

My main question, I guess is what should I be asking for when I go see the new pain doctor? I was thinking about asking for something long acting like MS Contin (which I used to take and it worked very well) and someting mild for breakthrough pain. I'm a little leery of tryng Methadone, though I have read that it works well for chronic pain. Suggestions? Advice? Anything would be much appreciated.

Thanks for reading.
QueenBee,
I ABSOLUTELY can relate to the vicious cycle you shared regarding your percocet. I suffered with being undermedicated for a long while, and I went through the exact same thing until I found my current MD.
When I first saw him, I was at the point where oxycodone w/APAP 10mg (percocet) every 4 hours wasn't helping me at all.
Looking back, I wish my MD (although he is great) had moved my meds up "strength-wise" a bit slower.
I was started on fentanyl transdermal system along with various trials of BT meds. In the end, what worked best for me was (weirdly enough) oxycodone IR...but in what I consider to be very high doses (I started at 30mg q4h, and am now averaging about 60-75mg q4h-my patch is up to 100mcg).
I just find myself wondering if maybe something a little less strong then the patch would have worked to start off. I feel like the reason I need so much breakthrough pain medication is due to the high doses of fentanyl... I guess that's tolerance at work :(
Anyway, everybody has different experiences with different medications. What works great for 1 person may do absolutely nothing for another. In my opinion, it may be a good idea for you to research chronic pain medications before your appointment so you will be somewhat familiar with different medications that the PM Dr may bring up.
I don't feel comfortable advising you to go and ask for "X along with Y". All I can do is share my experience with you, as well as my OPINION that the fentanyl patch may not be the best thing to start off on.... remember, this is only based on MY experience.
Regardless of what he suggests for you, be sure to ask questions and address all of your concerns :)
Please keep us up to date and welcome to BL :) Hope you are withdrawals are as painless as possible.
Cat
 
Thank you for the suggestions and sharing your experiences Cat & Chase. I have several weeks before my appointment, so I will be doing lots of research.

Cat--today is better. Had to take some deep breaths before coming in to work (being at work is the hardest). I have some precious (because they are expensive and I can't get them anymore with my insurance) lidoderm patches on my most painful areas....so that helps some. I'm usually OK in the evenings at home--I have many ways of distracting myself and my husband is very supportive.

Hope you all are feeling as good as you can today!
 
I had my appointment on Monday and got discharged because there is nothing they can do for me, this is the 3rd specialist I've seen since sept and the same thing has happened each time. I'd got my hopes up and now they have been crushed yet again. I hope everyone is doing better than me
 
I had my appointment on Monday and got discharged because there is nothing they can do for me, this is the 3rd specialist I've seen since sept and the same thing has happened each time. I'd got my hopes up and now they have been crushed yet again. I hope everyone is doing better than me

What condition(s) are you seeking pain relief from?
What abnormalities does your MRI indicate you are suffering from?
Do you have any history whatsoever og being prescribed narcotics for pain?
How old are you?

Without these answered, I can't help you.
 
I have crps I already get medication but unfortunately my condition has no cure and means constant excruciating pain. Oh and my legs and feet are starting to change shape joys.
 
Chase, it was just an update for the regulars as they knew I'd been waiting on this appointment for months
 
You know I really want to get my back looked at. I'm pretty damn young to be having back pain like I do sometimes. Like if I worked on a busy saturday at work my back starts to have that burn/pain feeling and just gets worse and worse throughout the night. When I go to bed that night, it's like my back is in knots and laying down flat I feel the pain pretty intense again for a little bit, though its like relief eventually since my entire body is sore as beat up from cuts and bruises. Then the NEXT day of work is terrible, bad back pain all day that slows me down a lot, along with still being sore of course. Sometimes I feel like I have the body of a middle aged man lol. I shouldn't get as sore as I do.

Took ibuprofen for it once at work, didn't do shit as expected. I'm not really looking to get a narcotic prescription, I just worry what my back pain will be like when I'm actually old. Might be something actually fucked with it and I will eventually need narcotic painkillers. I'm much to young to be having this kind of back pain. I mean I do left heavy things at work and move around a lot.... I know what I do is bad for my back. It's hard to lift with my legs when what I'm lifting is at eye level or already at my waist level and I'm just carrying it somewhere to set it down. I just don't think I should have the level of back pain I get sometimes that can make me cringe in pain. I don't like to complain so I never really say anything but when I do, older people I work with always wonder why I would be having any bad back pain because of my age.

I definitely have poor posture from sitting in front of a computer most of my life. I know this and I'm certain it plays a role. Trying to sit up perfectly straight or walk standing perfectly straight up with my shoulders back brings about the same pain. I've tried to get better posture but it just makes my back hurt. I don't really have daily back pain if I'm not working and just going to classes... Bad posture must really be contributing to my back pain.

I also think my anxiety plays into other pain sensations I get elsewhere. I get random nerve or joint pain in the most random places, I swear. Like I'll just have this strong dull pain in my thumb or something for like 30 minutes and to help I usually bite my thumb or pinch near the area I have pain. It helps make it hurt less for a little before it comes back. I can get stabbing pains in my chest too, in the middle, right or left. Seems to be completely random and USED to worry me before I just said fuck it, must be anxiety.

The most annoying pain lately though is my wisdom teeth, again. Damn I need to get the surgery done and get them out. I'm getting random pain in other teeth too, making me worry. Constantly feels like there is something in the back of my mouth. I had an infection like 8 months ago and it was very similar, but I don't see one now looking in my mouth. Who knows. I know BL isn't the place for dentistry lol.
 
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hatrix--how old are you?
My next question is....other than the physical work that you do at your job, are you able to do any other exercise?

My chronic pain comes from various surgeries I've had and while I am on medication regimen, I also try to do other things to reduce my pain--heat on the painful areas, I do yoga three times a week and also walk my dog every day. I believe my pain would be worse if I didn't do these things to make myself stronger.

If you have insurance, you may want to start by talking to your doctor about having x-rays or and MRI done to see if there IS something going on there.

And it's true that sometimes stress and anxiety can make existing pain worse. I certainly have experienced that.

Good luck to you and I hope that you can get some relief.
 
Does anyone have any experience with UK pain clinics? After my last overdose which had me in intensive care for a few days I think they are going to be taking me more seriously but I am not sure.
 
I've found uk pain management clinics pretty useless merc, you are worth asking your gp to refer you though, you might have better luck than me.
 
Good day to everyone. So, I think the acute part of my withdrawals are over (I think tapering helped a lot). Now, I am just in pain. I am thinking of e-mailing my doctor and asking him if he will give me an additional, one-time prescription for enough percocet to get me through next week. He knows I've been having issues, and he knows that I have an appointment with a pain specialist (he referred me after all). I just feel so....weird doing this. But, I also don't know if I can manage another week of this pain.
 
Good morning. How is everyone today? I'm feeling pretty good. Of course, it's only 7:30 am here, and I always feel best (pain-wise) when I first wake up.

My doctor actually called in additional medication to get me through the week, so I will go pick that up later today. He gave me a lecture, but I expected that. Actually, I was kind of surprised that he agreed to give me additional meds.

I hope everyone has a decent weekend.
 
Thx for the wishes, Tri. Queenbee: 7/10 when I first woke up and Im also at my best in the mornings:eek: I've been on Ativan 2mg/iv for 10 days now 3x a day and am really afraid of developing a benzo dependence, but unfortunately I'm pretty much there. The thing is it does WONDERS for my spasms, sleep issues, and anxiety in that order. The spasms being under control is really a miracle as all other muscle relaxers failed and this is the first time on Ativan. Maybe 1.5mg/iv instead of 2mg could still do the therapeutic trick as well as start a little mini taper?

On another note, I am looking at 6-12weeks in the hospital for my osteomyilitis. No more reckless Iv solutions for me. My antibiotic, IV rosephen has been changed since it very slightly elevated my liver enzymes. Next MRI to check for signs of progress in 3days, wish me luck!
 
Doomed2pain, It is so good to see you again! I am really sorry that you are still having such a hard time getting the medication issues in order.
Tricomb, I hope you are doing well too!
Queen, I'm very glad that you got the medication that you need to make it through next week. I know the feeling of being out of medication and it sucks.
Chase, Do you have many friends and or family members to come visit you in the hospital? I certainly hope you do, having company can make a big difference in your recovery. You are in my thoughts.
Hope everyone is having as close to a pain free day as possible :)
Cat
 
Help! I have been in pain management for about 18 months now, after 3 lumbar spine surgeries. My entire lumbar spine has been fused, and I have chronic leg pain. Iv been prescribed 15mg oxycodone 4 times a day and was still sore. My last visit to pain management I was also prescribed Nucynta er 200 mg. Nucynta is a schedule 2 drug, and I cant figure out why. Not only do I have to take pain meds, but I also enjoy the effect, oxycodone makes me feel great and I get up and get things done. As for the Nucynta, It make me want to sit in front of the tv all day in a sort of daze. What would I have to do to get somewhat of a buzz from nucynta. I know its an opiate but so far it doesn't seem like one. Can anyone explain this to me? I take a 200 mg every two hours and im afraid to take more and possibly OD. The pill is tamper proof but there has to be a way around that, and im gonna ask my doctor for something other than nucynta. Any suggestions on what to ask for that stops my pain and gives me an oxycodone type buzz. Thanks friends

modnote: This is against forum guidelines and site policy, please review the BLUA and OD Guidelines prior to posting again. The links can be found in my signature. We do not allow discussion about how to get you high/buzzed, nor do we allow "what should I ask my doctor for?" questions.

-tricomb
 
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Hatrix - how old are you? What kind of shape are you in? Also, when did you back pain start and how long have you been at this job that requires heavy lifting?

Im only 21 and deal with chronic pain from benign joint hypermobility syndrome and some type of auto immune disease thats still undergoing testing to get the diagnosis. So the auto immune causes flare ups ontop of my everyday pain.
Anyhow, i started physical therapy two months ago and the therapist said that my back hurts, esp lower back because i had gotten very out of shape over the last year cuz i was in too much pain to exercise and scared id hurt myself further. He told me that i have extremely terrible posture and that my core is very weak. Since my core is weak, the back has to make up for the things the core should be taking care of.
So, perhaps try doing some light cardio and core work. And as for the posture, i know how hard it is to get correct posture when youve been slouching for sooo long. But he told me that all i have to do is every
 
Hour on the hour, sit in the correct posture, and holding abs tight, for thirty seconds.
My posture is slowly getting better and now it feels awkward and sometimes painful to slouch.
The exercises from phys therapy have definitely seemed to help some, and esp my back.
I apologize for the two part message, my phone only allowed me to type so much at once!
 
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