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

[tngolfer]

i've been to 2 different clinics and both used this method to determine my medication. the dr i go to now said he would get in trouble if he gave me oxycodone 30's. thx for the reply

 

[RooBear]

What area are you from? My regular appt. is Monday and I get oxycodone as a part of my regular meds, so I have no idea what I'll face. I've never heard of such a thing where I'm at, only on the internet and the like. Thanks for any info!

I can tell u I'm on the west coast. I don't wanna just say where I am from on an open thread. But from what I gathered, it depends on dr, clinic rules, and what sort of 'issues' u have.. I say issues with love, can't think of a Better word to use

 

[Rybee]

Hey guys - need some advice!

Last week I was put on 25mg Amitriptyline for my chronic daily migraines, and miraculously, today is the first day in 8 weeks that I have not had a migraine or felt nauseous!

I know that Tricyclics can take ~3-6 weeks to alleviate symptoms of depression, with greatest efficacy peaking at 4-6 months, but I can't actually find out how long they usually take to work for neuropathic pain? I'm just incredibly sceptical that after 8 weeks of severe pain and constant nausea day after day after day - that just 9 days use of a low dose Tricylcic can be so effective?

As I had envisaged, the side effects have been awful. I've been asleep for ~14 hours of the day every day, and do feel very zoned out and have very little motivation to get on with anything in life. I've never tolerated Tricylics very well but I hope I can shake this off and acclimatise to them better. If I can get them to settle to a point in which I can actually function properly, then I'd seriously consider slowly titrating up my dose to try and help with my current bout of depression as that's been really troubling me lately. Though its use for alleviating depression seems to be dosed at 75mg-125mg, significantly higher than my current 25mg dose - so it concerns me whether I could tolerate that kind of dose?

I don't know what to say really... I'm shocked, to the point of being sceptical, that enduring severe pain and nausea for 8 weeks can be completely alleviated by just 9 days use of 25mg Amitriptyline?

Also, what's the best time of day to take it? Most generic leaflet/online advice just says 'before bed' but I did read somewhere that if you take it around 6PM, or even split your dose and spread it across the day, the side effects can be less harsh? It doesn't make me drowsy after taking it, just the next day I feel awful. To try it out, I took my dose at 6PM today, instead of ~11PM that I usually would.


Thoughts, anyone?

 

[RockinRon]

Rybee,
I am on 125mg at night for Shingles PHN Nerve Pain.
It seemed to take a little bit to adjust to the dose I am at now.

Was so much better than Neurontin for me.

It does zonk you pretty fast, and hella long sleep, 10-11.

The bitch is the Shingles was on my Azz Cheek, bad place to have chronic pain.

Am on 40mg/day Vicodin spread thru day. Have learned to be pretty chill while taking them now.
This combo has been the best for Neuralgia I have been on.

 

[Harrisment]

Rybee,
I am on 125mg at night for Shingles PHN Nerve Pain.
It seemed to take a little bit to adjust to the dose I am at now.

Was so much better than Neurontin for me.

It does zonk you pretty fast, and hella long sleep, 10-11.

The bitch is the Shingles was on my Azz Cheek, bad place to have chronic pain.

Am on 40mg/day Vicodin spread thru day. Have learned to be pretty chill while taking them now.
This combo has been the best for Neuralgia I have been on.

My dad had shingles and the symptoms seemed to last forever. Well over a year later I think he still has to take Gabapentin ever once in a while when it flares up. Just from seeing how miserable he was, I can tell it's something I don't ever want to get.

 

[Runtoparadise]

Rubee, I take amitryptyline four times a day for neuropathic pain. 20 mg quarterly.

When I began and my dose was titrated, I lost a good percrentage of my sight. my dr dropped me down slightly, & things have improved greatly

Just my experience

Rtp

 

[StealYourFace]

In addition to starting a new thread, I figured I would start here.

For the past two years Ive been rx'ed 120 7.5/325 lortabs a month for rheumatoid arthritis, and bad tmj (disk slipped off the joint.)

I usually run out of my rx in two weeks and either get some 30 mg oxies (I take a half at a time) or percocets. If I can't find those, I maintain on subs which is great to keep the wd away, but don't do a thing for the pain on a low dose (An 8mg sub lasts me a week).

My question is, is oxy known to greatly reduce inflation? It takes the swelling in my hands down similar to Celebrex AND gets rid of the pain while it's working. I have searched around on the web to find any studies that shows oxycodone reduced inflammation, but came up with nothing other than a few odds and ends that say that inflamed tissue has opiate receptors- which may be why I get the result I do.

I'm a runner (used to run 20-30 miles a week before this RA shit, now I am lucky to do 12 a week) when I am on the oxy, I can knock out a 5 mile run in 40 min like I used to. It's awesome.

Any ideas?

I also feel like a combo of two opiods (like hydro and oxycodone) are better at relieving pain than just one, and can do so with less overall medication. I have brought that up to my gp, but he seems more interested in getting me off of the 120 lortabs that I get than relieving my issues. nI don't want to push the issue in fear that I will get cut off completely.

 

[Runtoparadise]

Oxy has no anti inflammatory action. Awesome painkiller tho.

For myself oxycontin & oxycodone are a winning combo, but I also did try oxy with hydromorphome ir. No joy for me, but we're all different. At one time I was taking oxy with MS Contin,& endone & dilauded for bt pain.

Hope that helps,

Rtp

 

[bunge]

Hey guys - need some advice!

Last week I was put on 25mg Amitriptyline for my chronic daily migraines, and miraculously, today is the first day in 8 weeks that I have not had a migraine or felt nauseous!

I know that Tricyclics can take ~3-6 weeks to alleviate symptoms of depression, with greatest efficacy peaking at 4-6 months, but I can't actually find out how long they usually take to work for neuropathic pain? I'm just incredibly sceptical that after 8 weeks of severe pain and constant nausea day after day after day - that just 9 days use of a low dose Tricylcic can be so effective?

As I had envisaged, the side effects have been awful. I've been asleep for ~14 hours of the day every day, and do feel very zoned out and have very little motivation to get on with anything in life. I've never tolerated Tricylics very well but I hope I can shake this off and acclimatise to them better. If I can get them to settle to a point in which I can actually function properly, then I'd seriously consider slowly titrating up my dose to try and help with my current bout of depression as that's been really troubling me lately. Though its use for alleviating depression seems to be dosed at 75mg-125mg, significantly higher than my current 25mg dose - so it concerns me whether I could tolerate that kind of dose?

I don't know what to say really... I'm shocked, to the point of being sceptical, that enduring severe pain and nausea for 8 weeks can be completely alleviated by just 9 days use of 25mg Amitriptyline?

Also, what's the best time of day to take it? Most generic leaflet/online advice just says 'before bed' but I did read somewhere that if you take it around 6PM, or even split your dose and spread it across the day, the side effects can be less harsh? It doesn't make me drowsy after taking it, just the next day I feel awful. To try it out, I took my dose at 6PM today, instead of ~11PM that I usually would.


Thoughts, anyone?

I'm glad the amitrip is so effective for you Rybee, my mum suffer with crippling migraines with severe nausea.
She is prescribed amitriptyline and co-codamol (apap and codeine) plus cyclzine for nausea.
Amitriptyline should have some anti-emetic properties as it has a strong anti-histamine effect (hence why you feel like a zombie!lol), I guess that it reached a stable blood level in nine days which led to the alleviation from nausea and amitriptyline increases blood flow to the small vessels which is why it effectively treats migraines, as it increases blood flow by constricting the small vessels and decreasing pressure in the brain. iirc amitrip is being tested on people who have received severe brain injuries as a protective drug during the critical first 24-48hrs post injury.

I wouldn't worry about your dosage having a anti-depressant effect. Your not even close to an effective dose for that indication (150mg+) and amitriptyline has always been a shit anti-depressant, it was more effective as an adjunct medication to add sedation and control mania.

In addition to starting a new thread, I figured I would start here.

For the past two years Ive been rx'ed 120 7.5/325 lortabs a month for rheumatoid arthritis, and bad tmj (disk slipped off the joint.)

I usually run out of my rx in two weeks and either get some 30 mg oxies (I take a half at a time) or percocets. If I can't find those, I maintain on subs which is great to keep the wd away, but don't do a thing for the pain on a low dose (An 8mg sub lasts me a week).

My question is, is oxy known to greatly reduce inflation? It takes the swelling in my hands down similar to Celebrex AND gets rid of the pain while it's working. I have searched around on the web to find any studies that shows oxycodone reduced inflammation, but came up with nothing other than a few odds and ends that say that inflamed tissue has opiate receptors- which may be why I get the result I do.

I'm a runner (used to run 20-30 miles a week before this RA shit, now I am lucky to do 12 a week) when I am on the oxy, I can knock out a 5 mile run in 40 min like I used to. It's awesome.

Any ideas?

I also feel like a combo of two opiods (like hydro and oxycodone) are better at relieving pain than just one, and can do so with less overall medication. I have brought that up to my gp, but he seems more interested in getting me off of the 120 lortabs that I get than relieving my issues. nI don't want to push the issue in fear that I will get cut off completely.

ive never personally read any lit that show anti-inflammatory action from oxycodone (or opioids in general), infact they are more likely to cause swelling through histamine release.
However, I did have the thought that it could be a psychosomatic reaction.
When we are in pain our body releases various stress chemicals designed to alert us to an injury. Some of these chemicals cause irritation of the nerves (pain) and some cause swelling and yet others to increase our awareness of our body's and possible dangers in our surroundings. Anyway, my thought is simply that when the oxy relieves your pain it also lowers your stress level which lowers the levels of these chemicals causing the swelling...hence leading to a reduction of visible swelling.
I don't know if that's the right answer but its the best educated guess I can make.

 

[pizznyc]

I see my new pm dr this friday. Im wondering if he can adjust the meds im on currently. Right now im on 100mcg fentanly patch. And 5mg roxicodone. Im on lyrica 150mg x 2 daily as well.

The patch doesnt help anymore for some reason. The pain in my legs and feet are some what better. Lyrica has helped a ton. Taking gabapentin was horrible.

Im wondering uf this new doc will think im nuts if I asked to be switched to a new therapy. Was gonna ask about fentanly lollipops or methadone. But wondering if im jumping the gun too quick lol

Great thread

 

[RooBear]

I see my new pm dr this friday. Im wondering if he can adjust the meds im on currently. Right now im on 100mcg fentanly patch. And 5mg roxicodone. Im on lyrica 150mg x 2 daily as well.

The patch doesnt help anymore for some reason. The pain in my legs and feet are some what better. Lyrica has helped a ton. Taking gabapentin was horrible.

Im wondering uf this new doc will think im nuts if I asked to be switched to a new therapy. Was gonna ask about fentanly lollipops or methadone. But wondering if im jumping the gun too quick lol

Great thread

I would tread lightly.. Were u requires to switch (ins ect) or did I request/find a new dr?
I would tell him that the fet isn't helping or lasting as long and as well as before, and ask if there is something he would recommend to better suit ur pain..
And make sure u let him know that gabapentin didn't do well with u too. I have noticed that most dr go right to that drug..
Hope that helps a lil

Good luck and will be crossing my fingers for u!! Let us all know how it goes!!!

 

[Rybee]

Just like to thank everyone for their useful replies re: my Amitriptyline Q's.

Flicking through my migraine diary and there's a clear correlation in a reduction of frequency and severity of migraines since starting it - though I think 25mg is still a little under-dosed so will be going back to the doc to up it a little bit more.

Kinda good to be able to live a more normal life now... I doubted it at first but I guess good old Amitriptyline is still a quality drug for pain management.

 

[Bliss26]

I think amytryptyline (sp) is an unconventional antidepressant , but I wanted to let you know that when I started cipralex the first time ( lexapro) for the first 3 weeks I felt off, like I had no emotions, but after that, I became me again, so just give it time. Also, I have been on and off several times, and only noticed the zombie effect the first time.
Stick with it- migraines are brutal!

 

[lifterpuller]

I've just come off opiods for the first time in 6+ months, almost through detox, the worst part is no dealing with the un-numbed pain. I've tried gabapentin and it helps a bit but not a lot. My pain is undiagnosed, started primarily in upper back/neck but now I have quite a bit of lower pain that feels more mechanical and less inflamatory. I've tried all NSAIDS and even humira and have gotten no relief, the only thing that helps the pain significantly is exercise and opiods but it's really hard to exercise when your in a lot of pain.

I'm looking for any suggestions on meds or other stuff to try. I've had this pain for 16 months+ now and it sucks! but not worth getting back on fucking oxy, I wasn't even on that high of a dose (40mg/day) and it was consuming my life, making me feel like a zombie. It wasn't until I came off did I realize how much of a fog it was putting over my life and I never want to go back there unless I absolutely have to.

 

[777prp]

Dear K, just read your note of a year ago & we're in the same boat (hah!). I have 12-20 migraines a month. Rebound has been ruled out. Just found out Hydro is now classified by Uncle Sam as a class 2 drug, which means no script refills & an office visit $200 for each script. I'm soooooo frustrated. I had the choice of treating the migraine with a $40 shot of Immitrex or a 40 cent pill. And now that's been taken away. I hope & pray your headaches are more under control. Just needed to vent to someone who'd understand.

 

[phenethylo J]

My pain doc wants me to see a psychiatrist in relation to my insomnia, anxiety and a very bad break down I had the other month made worse by a reaction to buspar. My rhuematologist gave me it a while back for my insomnia but I never bothered taking it. To be honest it might do me some good but not sure there is much of a point if I can't be honest about my drug history. Drug use wasn't directly related to the break down but would still like to mention it. Even with doctor patient confidentiality they have loop holes around it like if they can prove you're a danger to your self and am worried about my drug use getting back to my pain doctor. I also know they will probably try and put me on anti depressants for sleep which I rather not take. Lately my insomnia has been really bad due to my increased anxiety Cannabis has always helped with my anxiety and insomnia but now even it wont help me sleep.

On a brighter note I'm not getting those stabbing pains going from my shoulder blade though to my chest as much or as bad lately.My doctor still has me on the morphine 30mg er 2x, hydrocodone 10mg 3x sometimes an extra 5mgs, gabbapentin 400mg 6x, baclofen 30mgs(10mg+20mg), prednisone 5mgs, and sulfasalazine 1000mgs 2x.
The baclofen seems to be allot better at controlling my spasms than the tizanidine did which my doctor switched me from 4 months ago. I was on baclofen in the past and it worked which is why I asked for the switch.

 

[Felonious Monk]

Holy shit, it's been a bad couple days in the pain/nausea/discomfort area.. and still no fucking answers from the medical establishment.

I had my double balloon enteroscopy on Friday, which was supposed to complete the full visual which hadn't been achieved with the retrograde enteroscopy (basically longer versions of an endsocopy and colonoscopy, with balloons to help them see the small intestine directly). But this intrusion was not good for me, since by the time I got home from the hospital I was violently violently ill. 24 hours of the worst kind of pain and nausea followed... went to the ER a few hours later and got 2 morphine shots, 2 Zofran shots, and 2 Liters of IV fluid, but it barely took the edge off, and only for a couple hours.. I barely slept a minute before 6am Saturday and kept waking up in a pool of sweat.

They didn't even find anything in the test that made me so sick.. ER didn't find anything in the blood work either, no pancreatitis which would have kinda made sense. It may be time to visit a naturopath, I've gotten nothing from 6 or 7 different GI docs and 2 different PM docs... Everyone is just fucking stumped as to why I'm perfectly healthy from an objective point of view (scans, blood, diagnostics all come back very good), but subjectively and realistically, my health is terrible, I'm underweight (and can't gain weight on 2000 calories/day), nauseous and in pain, and I kept having these violent flares that put me near death (or at least that's how I feel)...

I just needed to get that out, I've got some support but even the cannabis professionals in my life can't do much for me. When these flares hit my inside is just on fire for 24 hours, even Rick Simpson Oil gets thrown up immediately (which is what keeps me ok on a day-to-day basis). Some dabs when I have the energy to sit up are the only thing I can tolerate...

 

[pizznyc]

I would tread lightly.. Were u requires to switch (ins ect) or did I request/find a new dr?
I would tell him that the fet isn't helping or lasting as long and as well as before, and ask if there is something he would recommend to better suit ur pain..
And make sure u let him know that gabapentin didn't do well with u too. I have noticed that most dr go right to that drug..
Hope that helps a lil

Good luck and will be crossing my fingers for u!! Let us all know how it goes!!!

Thanks roo. Well here was my visit.

Took a drug test. wanted too see if i had any thc/cocaine/benzos and whatever else. Saud that i was on the most powerful therapy one can get. I asked if the fentantyl patch could be taken off. And put on another line of help. I was placed on norco 10/325 4x a day with lyrica 3x a day.

He also believes in shots the RXs. Epidural and whatever else in the plan. I wish i could get methadone because of its long half life and call it a day. But here in new york city. If you ask for a certain Rx and ya got research about a med or therapy. Ya branded like a fiend.

Well its not great but im just ...

 

[rave_itsrealfun!!!]

I love my instant release oxycodone. 5mg is just wonderful, or even 2.5 I try to limit myself to 5mg a day, that's my goal. It's a hard goal to meet sometimes, since oxy only gives me a good 3 hours of relief or so, maybe a little longer.

Just an update, I've posted here before about how chronic pain has pretty much ruined my life and set me off course for many years. The amount of suffering I have been through due to that one day where I fucked up doing my squat routine in the gym... it can never really be understood through words. At many points of my life I have been ready to give up and die, due to the excruciating pain in my spine. I have been to around 10 doctors to no avail. Their ignorance, negligence, complacency, and lack of compassion pisses me the fuck off... I've been treated like scum by every doctor I have ever talked to about this.

I'm finally getting some diazepam. I'm really hoping the skeletal muscle relaxant properties will be mind blowing for me. Etizolam so far takes the cake. It's such a bomb muscle relaxant. Alprazolam doesn't do shit in terms of my pain and my locked up, rigid back tied in knots. Klonopin is ok but nothing special for my back pain (just really great for the panic attacks I developed after a few years of unbearable stress from all the suffering). I'd like to take a break from the etizolam, and switch to diazepam for a little while because I've been on etiz for so long.

I'll report back on how I feel the diazepam works as a muscle relaxant compared to other benzos. I'm already a benzo addict, due to my chronic panic attacks that I developed after years of complacent doctors and begging for mercy to no avail. There's no way I can attempt to control both very serious, extreme chronic 24/7 panic attacks as well as chronic pain... I need both oxy and benzos to help me out or I wouldn't last a day.

This all could have been avoided if the docs had just given me the oxy on day 1. But the suffering led me to a psychotic break. Since I got on the drugs, I'm not suffering anymore all that much and I have my life back on track.

 

[webdevii]

I fully understand the Moderator, and I wont even mention it, however the way the polititions are coming down on legitimately good doctors that have to then totally screw their totally honest and upstanding patients is horrible. I am caught up in that at the moment. It is all due to the same ideaology take it away from the good people and the problem will end. NOT. This government needs to properly treat and take steps to assure their patients are adhering to the rules and have bonified problems first off. Which I do. and Secondly control the situation by requiring pee tests every visit. along with MRI's every 6 months to a year to prove there is a problem, for one, and secondly to weed out the bad that like to sell their medications. All the current procedure is doing is turning otherwise honest people into criminals. No worries I have not even thought of it. I will tell you this, the owner of the pain clinic I was with was upstanding, however he did not control his patients via urinalysis tests on a frequent basis and found after DEA ripped through his office jerked 2 practice and script licenses and flat out ordered no drug beginning with OXY or OPA to be prescribed period. and were put on 10 years probation and left the only PA that was honest to pick up the pieces. I do feel for him. He was railroaded. It was the upper muckky mucks that caused this. Not to mention the DEA has all of his patients under investigation as well, until they are eliminated as suspects as users and abusers. Also I do not think Obama Care did much to help the situation but just made it worse with all the Micro Management of this country.

End of topic
Thanks for listening
Dev