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Harm Reduction The Pain Management Megathread (Chronic and Acute Pain Discussion) Version 5.0 ~ V

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For some people lyrica can make it harder to function than opiates (me included). For many the extreme dizziness and brain fog clear up after a week or so of continued use but some just can't handle the side effects and have to discontinue it. I know everyone is different but it always amazes me that some people take lyrica recreationally as I find its effects extremely unpleasant.

Hopefully you will find some relief somewhere though as being in chronic pain and still needing to remain functional for work is something I understand all to well......good luck.
 
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Hello all.
I've had an interesting month, my old pain doctor was retiring, and then had a stroke, so retired very suddenly, before I could have another appointment. Fortunately I had enough meds to last me the extra 2 weeks until I saw a new doctor.

I saw the new guy and he seems good. Younger and more concerned about managing my pain long term. He acknowledges the chronic nature of crohns and just want to make sure I don't raise my dose now so I'm SOL in 10 years or if I ever need surgery. I also talked about getting an ER med instead of just IR.

So we cut my oxy ir dose and added morphine ER. I'm not sure it'll be great because I've heard morphine can have more of an effect on motility than oxy, as well as being more sedating. But it's technically a lower dose in equivalency so I'll see... Haven't gotten it yet though as it wasn't in stock.

As for me, I'm fucking starving at the moment because I'm fasting for my enteroscopy on Friday, should be a whole bunch of fucking fun, I hope I don't die. I mean, I want to die sometimes, but not like that.
 
This is something that bothers me a bit. I mean the doctor acknowledges the seriousness of your condition and you're clearly a genuine pain patient and not a scammer so why not give you the adequate amount to control your pain? Why do some docs think its a great achievement to send you out of their office with a lower dose than you need to effectively control your pain? I get that he doesn't want your dse to scyrocket but a sufferer of a chronic condition like crohns should be receiving adequete pain relief not simply the minimal possible.

Just my opinion anyway (as someone who works in the medical field and also a chronic pain sufferer). I hope your new morphine/oxy combo works for you and helps ease the pain a bit. Also good luck with the endoscopy... not a pleasant procedure. Are you being sedated (midazolam)?
 
Thanks englandgz, but I really invited it, as I wanted an ER medication, and I want to stay on as low a dose as possible. Straight IR oxy wasn't serving me that we'll either, and I'm not sure what my best option really is. If the morphine is no good I may try the new hydrocodone ER (Zohydro), but I think this is just what he's used before. I mentioned opium tincture to him as well but he was against a liquid medication because of spillage and dosing issues. I figure I can try what he's giving me, I can always tell him it doesn't work and go back to what I had.

And the procedure is an enteroscopy, not an endoscopy. If you want the full name it's a 'retrograde double balloon enteroscopy'. Less fun than a endo/colon combo... Basically just a colonoscopy with an extra long camera so they can get all the way to my small intestine.
 
Hi everybody, I finally got my etizolam so now I'm comfortable and doing a CWE of 20-24 pills and gulping it down first thing in the morning works well for pain. I still take a little kratom and weak PST but that's about it. I'm going to order 60 mg codeine off the internet so hopefully I'll get it before my next epidural shot. The soreness after one of those shots is excruciating. I have to call and make an appointment for it but I'm going to wait til the pills are in my hands so I can take a few days and relax. Still separated from the hubby but I'm hopeful. All the best, everyone!!!
 
This pain sounds terrible,i had a head injury once that was pretty bad,i had staples too put some of my scalp back,not a large place but not small the best meds for me at the time was methadone,since i was already taking it.When i didnt take it for like a couple of days and just had tramadol i could tell the difference ,but im sure my head injury was not as severe as yours,but maybe they can switch you to methadone,i dont know,i was taking around 40mg a day,4 x a day.Hope you heal good and stay strong-
 
Whosajiggawaaa said:
Yeah man, Lyrica should sort you out. ^

Doing a lot of home physio exercises has helped my shoulder quite a bit since surger 2/3 months ago.
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Yup, lyrica fo sho. ^... I'm prescribed that as one of the meds I get for a similar problem, as in, not so much "degenerative disc/pinched nerve". My lower discs were turned into a goopy substance by an infection which went untreated for far too long and for no good reason. But, I'm guessing that it resulted in at least similar nerve pain, and lyrica(and gabapentin) has worked great at helping the "nerve" part of my overall pain. Unfortunately it doesn't do much for the just plain "pain" pain... if you get what I mean. That's what the fent and oxymorphone are for. Allthough they barely help anymore. BUT... the lyrica is still going strong as far as its effectiveness, even after yrs of use.
 
Really pleased that the lyrica is working so well for you mate, that's excellent. Just going off anecdotal evidence lyrics seems to either extremely effective and well tolerated or not tolerated at all depending on the individual.

Take care everyone.
 
jamesBrown said:
Yup, lyrica fo sho. ^... I'm prescribed that as one of the meds I get for a similar problem, as in, not so much "degenerative disc/pinched nerve". My lower discs were turned into a goopy substance by an infection which went untreated for far too long and for no good reason. But, I'm guessing that it resulted in at least similar nerve pain, and lyrica(and gabapentin) has worked great at helping the "nerve" part of my overall pain. Unfortunately it doesn't do much for the just plain "pain" pain... if you get what I mean. That's what the fent and oxymorphone are for. Allthough they barely help anymore. BUT... the lyrica is still going strong as far as its effectiveness, even after yrs of use.
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James, what's the next step for pain management if opana & fentanyl stop working?
 
I actually made a typo, which you just made me realize... its hydromorphone I take, not oxymorphone. sry bout that.

Anyway, I'm not exactly sure what you mean by "stop working". But I assume you mean, if my tolerance becomes to high to the point where the fent and Dilaudid aren't effective enough.

But, my doctors have NEVER talked to me about what they would do if the meds I'm on stopped working for me. I'm guessing they would try other meds. I don't really know for sure. I do know that there isn't any surgery or procedure that would benefit me. I've already tried(earlier on in my pain management) different types of injections into my spine... which didn't help at all.
So I guess that kinda leaves me with a big question mark when it comes to the issue of..."if my pain meds stop working". Kinda scary.
 
^^^^^^^


My spine specialist actually advised me against the shots because she's seen so many of her patients have them w/o any positive outcomes.

I'm scared if surgery because if something goes wrong, last thing I want is to wind up worse or a wheel chair.

As for pain meds, you could move on to oxymorphone if the others stop working.......just pace yourself on the meds, easier said than done when we're suffering from chronic pain......
 
Ugh, feel like shit today. Been feeling like shit since the procedure so today is no different really. Pain inside like some little elves crawled into my stomach and kicked all the way out..

Also my first day of trying some Kadian (Morphine ER as beads in a capsule) with OxyIR on top instead of just the oxy. Seems to be working ok since I was just able to take a nap, but the depression and malaise say otherwise (but hell, it could still be working and I'm just in a shitty mood anyway, I guess anything's possible).
 
Felonious Monk - are the morphine ER capsules12 hour or 24 hour release duration? We ddon't have kadian brand in the UK but we do have MST which are 12 hour film coated pills and MXL which are (supposedly) 24 hour capsules with the small wax beads inside. We also have zomorph which are also capsules but I forget what duration these are. Having been prescribed all of these I personally found that the peaks and troughs of pain relief were very pronounced necessitating a lot of breakthrough IR meds. Usually in the UK doctors tend to stick to the same drug in both ER and IR form I.e. morphine ER along with morphine IR and likewise with oxycontin (ER) and oxycodone (IR). The practice of using morphine as the ER med and oxy for breakthrough isn't one I've heard of being used much so I would be interested to know how you get on with it.

JackiePeyton - Felonious Monk mentioned in an earlier post that he had an enteroscopy.
Take care.
 
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It was a retrograde double balloon enteroscopy. Now because they didn't see what they wanted to they want to do the non-retrograde version...

Kadian is a 12-hour ER capsule. It's filled with white beads that are either plastic or wax. I was concerned yesterday because I felt like I hadn't taken anything other than the IR oxy (because I often have trouble digesting things, etc...).

Today seems to be a bit better so I'm hoping that it just too a very long time to kick in (which is kinda what the Dr indicated). I'm hoping that just taking it every 12 hours it'll just start working. I medicated heavily with cannabis last night as well so I slept through the night great and have felt pretty ok this morning as well (motility a little off but it's been off since the procedure prep, lol).

The combination of morphine ER and OxyIR seems alright so far, it's definitely something I'll monitor though. I didn't get overly tired or anything yesterday when I took both, but it took the oxy to get me out my malaise.
 
Have they tried Aminosalicylates, corticosteroids or immunomodulatory agents yet Monk? I don't understand sole opiate therapy when you are wasting away.
 
No, they've yet to find evidence of active inflammation so every GI doc doesn't want to treat me with anything Crohn's-specific (like everything you mentioned) that could have bad side effects (a plan I generally agree with, since I'm not sure I want any of that stuff anyway).

It kinda does leave me stuck between a rock and a hard place though. I need to just put more effort into my own recovery and maybe just give up any faith I'll get real improvement from biomedicine.. I've been doing pretty well with my diet lately (seeing improvement overall), and with an increasing amount of exercise I'm feeling more confident in my own ability to heal. I'm also about to move into my own place (away from my now-gf), so my stress level with decrease and I hope that will improve things as well.
 
That is really unexpected tbh. R they sure you have Crohn's at all? Could it not just be severe IBS? Are you a very high strung guy?
I have IBS-C and I know it isn't anything like what you have, but it really is a downer. The meds make me sick but without them I am not good either.
I thought when I got off the opiates everything would sort out, but it hasn't changed at all, 5 months after quitting bupe. So anyway. I guess this is good news. You get to keep your colon then?
What about medications for your stress level? Or do opiates just seem to work best? If so what about something like paragoric? Opium tincture
 
Yeah, it was for me too. That's why the Cedars small intestine specialist just turned around after the last procedure and said she wanted to do it again, but from the other way, so they could see the ENTIRE WAY through my GI tract. They got pretty far up my small intestine this last time but didn't quite get to where the ulcers and strictures seen by the pill cam are, so they made a tattoo to mark their progress (what if the inflammation has already been cleared by cannabis oil though?).

It is possible I don't have Crohn's. It is possible I just have IBS. I am high strung and have always had issues with anxiety, including various diagnoses from different psychs. They'd gotten better, but have since gotten worse since I got sick 3 years ago and then got together with my gf 2 years ago (who is exponentially more high strung than me and makes less effort to do anything about it).

So yeah, definitely a bummer to be stuck in so much pain when I don't even know what's wrong. Good news is I get to keep my colon though, haha, and no one mentions surgery or anything since they can never find anything...

No medications for my stress level besides cannabis. Occasional etizolam as well but I was once overprescribed benzos so I'd rather steer clear.

Opiates work the easiest but aren't a cure-all. Paregoric might work better but my new PMDr was against liquid medicine. I'm not a huge fan of this Kadian though so we'll see.. I kinda liked the control of just OxyIR better (but part of me thinks I'd be better with nothing, but at least I'm more regular and my days are more predictable now--fewer 10+ movement days...).
 
Have u looked at gluten ?
What about diet changes- I saw u mentioned that- how has that come along? Total elimination diet then slowly add one thing at a time. There has to be an answer. How did you feel when taking the benzos?
 
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