Harm Reduction The Pain Management Mega Thread Version 4

[tricomb]

Doctors like to do things like that so their supervisors don't think they just hand out narcotics, even if injections don't help your chronic pain. Not to mention that (particularly steroidal) spinal injections hurt like a bitch and they have yet to manage my pain as they jab you with a four to six inch long needle, leaving me in even more pain than I was to begin with for days and days after.

Oh and without a doubt, go with the morphine ER. I totally disagree with every post in here saying that it is an ineffective narcotic that lasts 5-10 minutes. When I administer a MS ER 100mg via the rectal ROA, I get analgesia on par with fentanyl patches lasting 24-48 hours. Plus I don't have to worry about dying in my sleep because I take other CNS depressants multiple times a day, ones that do NOT play nice with fentanyl.

Save fentanyl for your absolute last line of treatment. If you start down that road now, how will you manage your pain in 5 years? or even 1 year?? Fentanyl is the end of the road when it comes to pain management and I strongly advise that anyone reading this considering going on it to have some restraint, and save it for when you need it. I went down that road as a teenager and found all other opioids with the exception of oxymorphone being able to even touch my pain after taking patches for a while.

 

[kenai_kings]

Tricomb,

thanks for your reply!

I HAVE to be able to work my part time job. And it's on those days I work that I have planned ahead so I could take a higher dose of the generic Percocet. Always being aware of and respectful of, the amount of acetaminophen I will get in addition to the increased oxycodone. I think I know how to do a CWE but have never tried it. I can't tlell if your reply above was to me or someone else. But I am pretty certain I will have more surgeries in the coming years and it would be really poor to have "wasted" the effect of fentanyl when it would be the last resort for pain management. I was completely honest with the nurses I had a month or so ago about my never having experienced morphine. And they seemed nonplussed when I told them that I received absolutely NO relief from the three injections into my IV. Anyway, I am allowed 20 MG of Oxycodone every 6 hours.And on the days I work I sometimes take twice that amount so I can handle the pain and work for 5 hours or so. Can you give me some idea what kind of dosage I'd need to have using morphine ER pills to have the same effect I now get with the perc's? I'm used to the releif not lasting until it's time to take my next dose. And I get the idea behind these "ER" pills is to fix that problem. Are they manufactured the same way the infamous oxycontin pills are so it's impossible to defeat the time release function? Does body weight have anything to do with the efficacy of pain meds? I confess to being a fat guy.I'm about 5'10"and weigh about 265 pounds. Whatever I decided on, and whatever my Dr approves, it will be two weeks till I could ask for any change. And I HAVE to be able to work these next couple of weeks.

 

[bennyZA]

Benny--glad to hear the new meds seems to be working AND that you have a pain doc that is on his game. That is good news. Methadone scares the shit out of me. I have never taken it, but have read a lot about it. My pain doctor suggested it for and I said, no way. I guess what scares me is the "what happens if I have to go off of it".

Sucks about the incision opening up. I remember right after I got home after my lung surgery, my incision opened up and you could actually hear AIR coming out of the space when I breathed. It was gross and weird and scary.

It's crazy, in the hospital when they were trying all these different methods out for the pain, nothing worked and the doc suggested methadone. Last time I was on methadone for pain I was abusing the shit out of my meds and I od'd on methadone and died for a minute or two. So i said absolutey not and then I tried it and ity worked really well. So part of the reason for my compliance is cause I know what can happen if you play games with methadone.

I still haven't explained what happened at the hospital, and I will do a write up and some point, but suffice to say it was one of the worst experiences in my life. I was essentially abandoned for stretches at a time. So I actually got a call from an obudsman today saying they want to talk because they found out from some of the nurse directors at how fucked up my care was. I'm going ot have a long convo with them tomorrow.

 

[Corazon]

Doctors like to do things like that so their supervisors don't think they just hand out narcotics, even if injections don't help your chronic pain. Not to mention that (particularly steroidal) spinal injections hurt like a bitch and they have yet to manage my pain as they jab you with a four to six inch long needle, leaving me in even more pain than I was to begin with for days and days after.

Thanks.
Hoping that all the PM doctors in my area aren't 'centered around' the injections.
If it can't be negotiated for some reason, I would be willing to do 1 shot on a 'trial basis' to see if it helps. I definitely don't want to be expected to get regularly monthly or bi-monthly injections.
I had to have my spinal artery detached and then re-attached during one of my open heart surgeries and the whole procedure from pre-op scope threaded up my spine, to post surgery massive spinal headache was no fun.
I've also literally had about 20+ CT scans with contrast dye + various other procedures, and the x-ray guided shots use a contrast dye as well. I'm kind of pushing the recommended limits of that dye .

Seeing a new primary care doctor for the first time today. I shouldn't have any problems with a referral to PM , but it's hard to trust that things will have a logical outcome.

 

[balcony]

I am currently on pain management with the use of methadone. I take 40mgs a day, 20mg every 12 hours, luckily here in EU the pharmacy gives me the whole months supply in one go. Before the methadone I was on oxy for pain but I changed because the doses of oxy needed to relieve the pain were immense. I must say that methadone is a great pain management drug. I just can't stand the amount of sugar they add to the lemon flavored syrup it comes in (100ml) bottles 1ml/1mg. Without methadone, I wouldn't be able to function due to pain.

 

[Corazon]

I am currently on pain management with the use of methadone. I take 40mgs a day, 20mg every 12 hours, luckily here in EU the pharmacy gives me the whole months supply in one go. Before the methadone I was on oxy for pain but I changed because the doses of oxy needed to relieve the pain were immense. I must say that methadone is a great pain management drug. I just can't stand the amount of sugar they add to the lemon flavored syrup it comes in (100ml) bottles 1ml/1mg. Without methadone, I wouldn't be able to function due to pain.

glad it's working for you.

I went to see the primary care doc today. She was intelligent and very reasonable. She wrote me a script for some weak pain meds(which i was lucky because for some reason they have a non-narcotic policy...), kinda stinks that she wrote it for 2 months (1 refill) - (with emphasis that she would not write more) - but the pharmacy basically trashed that extra refill because apparently a state law says O refills. Should hold me over until I get the Pain mgmt referral apt. - hopefully that doesn't take forever to be seen. I have zero tolerance so I'll make it. Was also empathetic about me not needing injections and that they wouldn't help me.
Referred me to some other specialists for additional issues.
Can't complain.

 

[Dr Pepper]

Taking a break from pain meds. Exercise always seems to help. What do ya'll do for exercise? I had a fractured pelvis, so limited to swimming, walking, and pull-ups,dips and other upper body things. Kayaking is good too.
Anybody try some yoga? Other recommendations? Might start rock climbing again soon if it doesn't cause too much discomfort. Used to be pro status.

 

[Chembow]

Reaction to Talwin NX has labeled me an opiate abuser

Hello everyone, I'm new here. My recent experience with the problems of prescription medications has introduced me to this forum. I was researching Talwin and discovered this place. So hello to you all firstly.

Ok, now I'll just get into the good stuff. This is going to be a partial vent so please just hang in there with me, as I'm still feeling real gross after my hospital visit, and I've been up almost 24 hours.

I'll start with the basics, I'm a normal 28 year old mom. I dabbled in things when I was younger, but never for long periods of time and it all stopped after I turned 17 and had my first child. After his birth, I was diagnosed with a cardiomyopathy. It took a year to get a diagnosis because the doctors didn't believe the symptoms were real. They knew I had mild anxiety and assumed I was a hypochondriac so I got sent to talk to a counselor instead. So for a while, I went knowing something was wrong with my heart, but not getting treatment. After 3 back to back trips to an ER my grandfather drove me to a different city, where I was given real tests and they discovered I had something wrong with my heart.

Fast forward 4 years later, that part resolved and I was pregnant with my second child. My pregnancy went smoothly, but with the complications to my heart from my previous pregnancy they did a c-section and I went home feeling great. I still had mild anxiety, but was never treated, since I never thought it was bad enough to need medications. 6 months after my second child was born, I started having pain in my right side. The doctor I saw insisted it was due to ulcers. I was in severe pain for weeks until I demanded an ultrasound or something to confirm it. It turned out that I had Pancreatitis. A week after my hida-scan we discovered I was pregnant with my third, so I didn't have any other tests or procedures and the pain eventually stopped. During my third pregnancy I was diagnosed with a Mitral Valve Prolapse, and Supraventricular Tachycardia. My heart will jump up to around 150-170 sometimes.

Now, after my third child was born, it felt like my uterus would fall out. I was in agony for about 3 years and after 3 years of going from doctor to doctor(all of which did nothing), I accepted the fact that maybe I was crazy. After all those doctors know more about the human body than I do..WRONG. Around my youngest daughters 4th birthday, I was in so much pain I thought I was dying. I go to a new doctor, with no hope or expectations. He does one exam, and says something isn't right with my uterus. To make a longer story short..I had a hysterectomy. My uterus was smooshy and full of adipose tissue. The doctor said all my pains have been from adenomyosis and polycystic ovarian syndrome. During these years, the doctors would give me usually hydrocodone, maybe percocets for the pain. I was only taking them as needed, never more and my tolerance was incredibly low so I was cutting the lortab 5's in half. One bottle of 30 would last me two months. One year later, pains returned and after several months of testing on end, it was discovered that I had endometriosis on my appendix. My appendix was removed, and boom.. the pain was gone.

As if that wasn't enough, I started having nerve pain/issues in my arms and face. I was diagnosed with carpal tunnel and trigeminal neuralgia. I pass out from my migraines. The medications for this given to me by my neurologist was amitriptyline.
Back in June, I was at the ER for one of my headaches. I waited 12 hours in agony for help, and they gave me a shot of Dilaudid which was too strong for me, and I started puking violently. They sent me home with tramadol for the pain. I ended up taking the tramadol and finished the bottle of 20 finally last week. I had no withdrawal symptoms afterwards and I felt fine..until the back pain started.


Now, fast forward to today. I've been having horrible back pains by my kidney, so I went to the urgent care here, since I don't have a primary doctor yet(we just moved here). They did a urine analysis and it turned out fine, so they just gave me these pills to take until i can see a real doctor. I went home, took the first one..and then in about an hour, I felt sick. Like nausea, but my heart rate got into the 160-170s. My husband said I didn't look well and since my heart rate was so high, he rushed me to the ER. While I was there, I noticed they were full, so I went on ahead and took an extra 50 mg of my toprol. It slowed my heart rate down, but since I was there I just wanted to get checked out to make sure my heart was ok. I waited hours, and by the time the doctor gets in the room he says, "You're going through opiate withdrawal."

So to the point of this post, if I were to take tramadol weeks earlier, and not have any withdrawal from them....what am I withdrawing from?

I'm very concerned now because this diagnosis is not a reaction to a medication, but a label as an opiate abuser. As soon as the medication wore off, my heart rate returned to normal.

Which in no way, was I ever taking more than prescribed, it was always significantly less.

I have been trying to find doctors to speak with about my health issues, but I'm terrified now. Especially after the first one I met here in this town, and he started grilling me on the amount of procedures I've had at my age(Only two, hysterectomy and appendectomy), and then when I mention pain they actually roll their eyes at me. I'm so terrified of my pains, my head feels like it's going to explode, my pelvis is cracking in two, and my back is a constant ache. I get turned away before ever getting tests done because I'm a young healthy adult, and 9 times out of 10 when I go to the hospital for heart problems, they make me wait because young people don't have bad hearts.

I'm finding more and more of my friends with health problems are unable to get pain medications. I have no issues with people that use them to get high, that's their life, but I'm about this much closer to looking for a way around the doctors.

Sorry for the long post. Please feel free to move this if it's not in the right section.

I've updated the time stamp on this for you and am going to merge it into our pain management mega thread. You should find a lot more advice there. All the best in feeling better. -bronson

 

[VanWeyden]

Hello everyone, I'm new here. My recent experience with the problems of prescription medications has introduced me to this forum. I was researching Talwin and discovered this place. So hello to you all firstly.

Ok, now I'll just get into the good stuff. This is going to be a partial vent so please just hang in there with me, as I'm still feeling real gross after my hospital visit, and I've been up almost 24 hours.

I'll start with the basics, I'm a normal 28 year old mom. I dabbled in things when I was younger, but never for long periods of time and it all stopped after I turned 17 and had my first child. After his birth, I was diagnosed with a cardiomyopathy. It took a year to get a diagnosis because the doctors didn't believe the symptoms were real. They knew I had mild anxiety and assumed I was a hypochondriac so I got sent to talk to a counselor instead. So for a while, I went knowing something was wrong with my heart, but not getting treatment. After 3 back to back trips to an ER my grandfather drove me to a different city, where I was given real tests and they discovered I had something wrong with my heart.

Fast forward 4 years later, that part resolved and I was pregnant with my second child. My pregnancy went smoothly, but with the complications to my heart from my previous pregnancy they did a c-section and I went home feeling great. I still had mild anxiety, but was never treated, since I never thought it was bad enough to need medications. 6 months after my second child was born, I started having pain in my right side. The doctor I saw insisted it was due to ulcers. I was in severe pain for weeks until I demanded an ultrasound or something to confirm it. It turned out that I had Pancreatitis. A week after my hida-scan we discovered I was pregnant with my third, so I didn't have any other tests or procedures and the pain eventually stopped. During my third pregnancy I was diagnosed with a Mitral Valve Prolapse, and Supraventricular Tachycardia. My heart will jump up to around 150-170 sometimes.

Now, after my third child was born, it felt like my uterus would fall out. I was in agony for about 3 years and after 3 years of going from doctor to doctor(all of which did nothing), I accepted the fact that maybe I was crazy. After all those doctors know more about the human body than I do..WRONG. Around my youngest daughters 4th birthday, I was in so much pain I thought I was dying. I go to a new doctor, with no hope or expectations. He does one exam, and says something isn't right with my uterus. To make a longer story short..I had a hysterectomy. My uterus was smooshy and full of adipose tissue. The doctor said all my pains have been from adenomyosis and polycystic ovarian syndrome. During these years, the doctors would give me usually hydrocodone, maybe percocets for the pain. I was only taking them as needed, never more and my tolerance was incredibly low so I was cutting the lortab 5's in half. One bottle of 30 would last me two months. One year later, pains returned and after several months of testing on end, it was discovered that I had endometriosis on my appendix. My appendix was removed, and boom.. the pain was gone.

As if that wasn't enough, I started having nerve pain/issues in my arms and face. I was diagnosed with carpal tunnel and trigeminal neuralgia. I pass out from my migraines. The medications for this given to me by my neurologist was amitriptyline.
Back in June, I was at the ER for one of my headaches. I waited 12 hours in agony for help, and they gave me a shot of Dilaudid which was too strong for me, and I started puking violently. They sent me home with tramadol for the pain. I ended up taking the tramadol and finished the bottle of 20 finally last week. I had no withdrawal symptoms afterwards and I felt fine..until the back pain started.


Now, fast forward to today. I've been having horrible back pains by my kidney, so I went to the urgent care here, since I don't have a primary doctor yet(we just moved here). They did a urine analysis and it turned out fine, so they just gave me these pills to take until i can see a real doctor. I went home, took the first one..and then in about an hour, I felt sick. Like nausea, but my heart rate got into the 160-170s. My husband said I didn't look well and since my heart rate was so high, he rushed me to the ER. While I was there, I noticed they were full, so I went on ahead and took an extra 50 mg of my toprol. It slowed my heart rate down, but since I was there I just wanted to get checked out to make sure my heart was ok. I waited hours, and by the time the doctor gets in the room he says, "You're going through opiate withdrawal."

So to the point of this post, if I were to take tramadol weeks earlier, and not have any withdrawal from them....what am I withdrawing from?

I'm very concerned now because this diagnosis is not a reaction to a medication, but a label as an opiate abuser. As soon as the medication wore off, my heart rate returned to normal.

Which in no way, was I ever taking more than prescribed, it was always significantly less.

I have been trying to find doctors to speak with about my health issues, but I'm terrified now. Especially after the first one I met here in this town, and he started grilling me on the amount of procedures I've had at my age(Only two, hysterectomy and appendectomy), and then when I mention pain they actually roll their eyes at me. I'm so terrified of my pains, my head feels like it's going to explode, my pelvis is cracking in two, and my back is a constant ache. I get turned away before ever getting tests done because I'm a young healthy adult, and 9 times out of 10 when I go to the hospital for heart problems, they make me wait because young people don't have bad hearts.

I'm finding more and more of my friends with health problems are unable to get pain medications. I have no issues with people that use them to get high, that's their life, but I'm about this much closer to looking for a way around the doctors.

Sorry for the long post. Please feel free to move this if it's not in the right section.

I've updated the time stamp on this for you and am going to merge it into our pain management mega thread. You should find a lot more advice there. All the best in feeling better. -bronson

Dear chembow, seems like you had a lot of bad luck those last 11 years. I hope your children are well nonetheless!

As I'm a soon-to-be doctor I may be able to give some explanation I might be able to give some insight about the other doctors behaviour - it's just an explanation, no justification.

The case is that you share a lot of traits with patients who seek help from a pain specialist although their primary "problem" is merely a psychological, not a physical one.

You have a psychiatric diagnosis (some kind of an axiety disorder), you are very youngand whenever one of your medical conditions is treated, another one pops up. Some of those might or might not cause pain - many patients with endometriosis, pco or fibroadenoma experience pain, but a lot of patients don't.

In your case doctors HAVE to be very vigilant and critical, simply because prescribing narcotics too lightly might cause more harm than good. Opiates mend physical pain, but they also mend mental pain, anxiety and depression. In the first case, it would be good practice to give you strong pain medication, in the latter cases it would be misuse. The meds would loose their effect pretty fast, the dose would increase more and more, that could be the beginning of a vicious circle finally leading to addiction.

This doesn't justify your doctors behaviour, but explains why you should be more patient with them in some insances.

About the "withdrawal" - it is highly unlikey that you feel withdrawal weeks after you discontinued the tramadol. Withdrawals would kick in not later than 24-48 hours after your last dose.

Wishing you the very best!

 

[neversickanymore]

I came across a great resource for non opioid therapies for pain it covers all these topics and provides a mass of information and quality links that explore these therapies.

>here<


General Pain Relief - Nondrug, Complementary, Alternative
Acupuncture
Adjuvant Drugs
Biofeedback
Botulinum Toxin (BOTOX) Injections
Cold or Heat Therapy
Electroanalgesia (incl. CES, PENS, SCS, TENS, & Others)
Exercise Therapy
Headache - Drug & Non-Drug Therapies
Herbal Medicines & Dietary Supplements
Interventional Pain Management
NSAIDs & OTC Analgesics
Nuclear Medicine
Physical Therapies (plus Massage & Shockwave Therapy)
Psychological Interventions (plus Hypnosis & Music)
Topical Analgesia
See more... Also see the following sections for additional documents of interest:

Non-Opioid/Alternative Therapies Clinical Guidelines:
Non-Opioid/Alternative Therapies Systematic Reviews:
Non-Opioid Therapies Position/Policy Statements:

 

[kenai_kings]

I've been treated by a Pain Clinic for a little over three years. Where I live there are only 2 other pain clinics and neither one would take me as a patient, not even to give me an epidural steroid injection. I have gone through drug treatment etc. but the last time was about 12 years abo, and basically since May 5th 1989 I've been clean with a few bumps in the road.

Anyway back in my early twenties I dumped a motorcycle and began a new and permanent phase of my life that included a lot of pain. At first I had long periods between surgeries where I was pain free and back then I used drugs almost exclusively for fun.

But I'm in my 60's now (my SIXTIES!!! Who'd a thunk it??) and in the past three years or so I developed chronic back pain. It's been the worst pain I've ever had and by far the most debilitating.

Long story etc...

I have been prescribed 2 10/325 generic Perc's 4 time a day for quite sometime. But now my Dr wants me to get off them and choose wither morphine sulfate ER 32MG bid or 25 mcg entangle patchs for three days.

Spending on just how bad my pain has been and whether I had to work my part time job or not I have followed the RX for the percs or sometimes save a couple of doses up to do orally all at once for fun. On the mornings I've had to work I have carefully planned it so I could take my normal dose just before leaving for my 15 minute drive to work. I work about 4 hours a day so it's REALLY helped.

Now in all my years of doping for fun and all my surgeries I had not had morphine until a couple of weeks ago when I was hospitalized. They kept injecting it into my IV but nor only didn't I get the slightest bit high it did NOTHING to help with my pain. The nurses were coy about the dosage never telling me the exact amount. But I was completely honest with them and my Dr and I spent a miserable couple of days in the hospital. When I got home and could take my perc's I felt better. I've never used Fentanyl before.

Originally my Pain Doc wanted me on oxycontins but the medicare Insurance company I had listed them as tier 3 or 4, I forget which but Perc's were a LOT cheaper. And I live very frugally these days.

But my new carrier would charge me the same for my Perc's the Morhine ER or the Fentanyl patch.

I think I'd rather keep things as they are. As my Dr won't write plain oxy script's limiting me to perc, I've hit the aceto wall.

From what I've been able to glean from a day or so of Googling the subject, my percs give a better high than either the Morphine ER or the Fentanyl patch. But I confess to being confused about how to best prepare either the morphine er or the fentanyl patch to get high as well as use for pain.

And I've read the fentanyl NEVER last three days only two. As it is now my pecr's don't last 6 hours, I get about and hour and a half of a high if I take 4 of the perc's and about 3.5 hours of pain relief.

Could you better informed folks tell me if either the morphine ER of the fentanyl would be a better choice for 1. pain relief and 2. a little fun now and then.


I know how to do a cold water extraction etc. but that isn't something I think wise to share with my Dr.

I've lost someone very close to me recently and I've had several other traumatic events in this past month so I'm really not happy about maybe losing the system I've had for pain relief as well.

I looked for the chronic pain forum but damned if I could find it so if this doesn't belong here could one of the mods please move it for me?

Thanks!

 

[Intenselife]

Hmmm if in chronic pain for that long i'd give up on the getting high from them aspect. Fetanyl patches can probably actually help you a lot more possibly, since many chronic pain patients are on that.

 

[kenai_kings]

I'm in some pretty bad chronic pain. But I'm not dead.

I'd like to be able to get high sometimes as well as not be hurting so badly I can't get dressed etc. Recently I got something that's really helped me. I got a "shower bench" that fits in my tub shower and one of these shower head gizmos. HEAVEN!

For a long time I dreaded shower time because I hurt too much to be able to stand for more than a couple of minutes. But this bench and shower head!! I'm able to sit there playing with all the settings until the water starts to get cool!

They make one with led lights but I just don't quite get that...
Heaven!

 

[laCster]

wow, thats very odd you didnt find relief from IV morphine. morphine is the gold standard for pain relief; morphine/morphine-salts are the most effective pain killers known to man despite modern science's attempts at finding more effect pain-killers. although oral-morphine has poor BA, it provides more analgesia than most pain-meds; not to mention you got INJECTED with morphine.

somethings you dont have control over in life, i say you are lucky to get ANYTHING at all, be grateful for having some type of opiate for pain relief as many people do not have the opportunity nor the finances to get on pain management meds.

 

[T. Calderone]

Originally my Pain Doc wanted me on oxycontins but the medicare Insurance company I had listed them as tier 3 or 4, I forget which but Perc's were a LOT cheaper. And I live very frugally these days.

But my new carrier would charge me the same for my Perc's the Morhine ER or the Fentanyl patch.

I think I'd rather keep things as they are. As my Dr won't write plain oxy script's limiting me to perc, I've hit the aceto wall.

From what I've been able to glean from a day or so of Googling the subject, my percs give a better high than either the Morphine ER or the Fentanyl patch. But I confess to being confused about how to best prepare either the morphine er or the fentanyl patch to get high as well as use for pain.

If getting morphine in the hospital didn't help you and fentanyl is his next suggestion, I'd give them a try. I don't know of ways to safely prepare them for recreational use though. I've heard of people doing it, but it's a dangerous practice so I wouldn't go down that road. One thing I am hoping for you since you mentioned people say their patches wear off sooner than 36 hours, (I have no experience with fentanyl patches) is your doctor can also give you something for breakthrough pain. Maybe oxycodone IR low dose without the acetaminophen or continue with percocets at a lower dose.

 

[Intenselife]

Right, i feel morphine is more potent in the pain relieving department and euphoria (the euphoria part many will disagree) compared to oxys. I hear though IV morphine beats oxys though, i've had it through the hospital and i definitely felt it but not after the 3rd or 4th injection.

Also it could just be me but even a 30mgir morphine provides more analgesic pain relief to me than a oxy30 which is technically much stronger according to most people. But that's just me. As i wrote don't hesitate to try the fetanyl's they are considered to be quiet potent especially the higher dose ones. Their are ways to get more of a "high" from them but i won't get into details with that since it's dangerous.

 

[missmeyet?]

I agree with Calderone about definitely consider the patches and then ask him to provide maybe oxys for breakthrough pain. This is considered standard practice in pain management (a long acting med coupled with short acting for breakthrough pain) though not all doctors go that route, it would definitely be a reasonable course of treatment. I have been a chronic pain patient for many years and also a nurse for 20 years. As the others said fentanyl is very good pain reliever especially when you have been taking narcotics long term. By the way, it doesn't always wear off before the 72 hours is up so don't go into it with negative thoughts about it. The biggest issue I ever had with the patches was getting them to stay on for 3 days but that is easily solved by getting Tegaderm dressing/bandages and applying them as soon as you apply the fent patch. Don't wait til the begin to come off.

There are ways to abuse these patches but it sounds like you are going to make sure you have continuous pain coverage and if you mess with the integrity of the patch in order to abuse it it will not last you long enough and you will run into some trouble.
The other problem is, as others said, it is very dangerous to play around with them. Even here on Bluelight alone there have been a few members who have died from overdoses from the patch. One of which was very experienced with drugs in gneral and fentanyl specifically.

I too get very little pain relief from morphine when I take it orally. But if it is given IV it works great. I would bet that in your case recently that the nurses were being asses and not giving you a large enough dose if you did not get relief. Especially since you already have a long time tolerance built up to opiates/opioids.

I would just ask the doc if you could try the patches on a trial basis and if he can script you oxycodone IRs for breakthrough pain in case you have any trouble with the patches. That is reasonable to ask for. And yes, feel lucky he is offering that option...these days so many people with chronic pain are suffering with nothing or very little pain relief! My point is, be xcareful screwing around with your patches, as you know if anything happens you will be out a pain doctor..and will probably have a lot of trouble getting another one to prescibe you anything more than tramadol!

 

[bronson]

BDD --> The Pain Management Mega Thread at OP request.

 

[wny]

Another new member here... I am currently fighting Spondylolisthesis - L4/L5 vertebrae pushed forward a few millimeters and irritating the nerve at that point causing the usual lower extremity issues -- pain, weakness, tingling, etc. Pain arrives about 10 minutes after walking although zapping can happen anytime. It has destroyed a weight management exercise program because I can't walk my way through the pain. Been and done chiropractor which offered some minor help, 600mg ibuprofen 3x daily which offers 10-20% relief, and was on one 7.5mg Vicodin tablet about an hour before each afternoon's walk, which probably contributed some additional minor relief, but not sufficient to keep me going.

Vicodin has been with me at that strength for several years because of a recurrent knee pain issue, and I have strenuously avoided increasing dosage to avoid drug-seeking behavior and constant dosage increases. Vicodin does supply a nice 20-30 minute confidence/minor euphoria boost that can and does encourage me to get out the door and *try* to do the right thing exercise-wise, but we're at the point where additional pain relief is needed.

In addition to physical therapy and other conservative treatment, doctor actually switched me away from Vicodin last week to try 50mg up to 4x daily of tramadol. The theory behind that is to introduce the SSRI nerve pain reduction element into the mix and not have me taking an opiate at the same time as the tramadol. He also introduced a 50mg starting dose of Nortriptyline as of Friday night as a adjunct to the tramadol.

The results have been very discouraging:

1) The tramadol, as best as I can tell, has provided absolutely zero pain relief at all. I have found myself occasionally somnolent, especially by the time I take the third tablet of the day. It is also creating sexual side effects, no euphoria/motivational boost, and has increased my fatigue (exactly the wrong direction I need to go). I think I was better off on the single Vicodin tablet.

2) I took my first 50mg capsule of the Nortriptyline on Friday night and it absolutely zombified me. I am *still* is a fogged state as of Sunday evening. No motivation, no emotion, no energy, extreme fatigue, cloudiness, memory loss, etc. A big mess. No more of that. I can't function on it.

So I am left with more or less the same pain I started with and even more medication side effects and drama I don't need. I need to figure out which medications are going to work best for me -and- have limited brain zombie side effects. I am leaning on going back to the Vicodin, perhaps at a higher dose, but it was not really effective at pain management at that level, but did help with my motivation.

I might be willing to try the Nortriptyline again, but at a 10mg starting dose and only if I can keep my head clear. Advice from others dealing with this kind of pain is welcome.

 

[Corazon]

Today went to see a pain management doctor.
He was ill-informed about my genetic disorder, had already made up my mind, and then proceeded to call me a liar.
Very frustrating.

glad it's working for you.

I went to see the primary care doc today. She was intelligent and very reasonable. She wrote me a script for some weak pain meds(which i was lucky because for some reason they have a non-narcotic policy...), kinda stinks that she wrote it for 2 months (1 refill) - (with emphasis that she would not write more) - but the pharmacy basically trashed that extra refill because apparently a state law says O refills. Should hold me over until I get the Pain mgmt referral apt. - hopefully that doesn't take forever to be seen. I have zero tolerance so I'll make it. Was also empathetic about me not needing injections and that they wouldn't help me.
Referred me to some other specialists for additional issues.
Can't complain.