Treating pain and insomnia...

[zapeddo]

Following two Traumatic accidents in 7 years I find myself disabled and in constant pain, one accident involved overturning a 38 wheeler semi trailer with great cunning I used the trucks brakes, a railway bridge and my skull to avert major disruption to the railway system the truck was totaled and my skull was fractured but hey, the trains could still run (bonus eh?) the later incident involved a house fire leaving me on life support in induced coma for 5 weeks, I died in hospital but the grim reaper didn't want me (perhaps he thinks third time lucky) but I have news for him, I don't like his outfit and will never attend his party. History complete now for my questions.....

I am prescribed Tramdol, Ibuprofen both boosted with Paracetomol for pain and also Temazepam for sleep the Temazepam @ 40mg each night as 2x 20mg but it simply does not cut the mustard at less than 200 -240mg which basically is coma country and expends my 56 day supply in around 4 or 5 days which incidentally I recover without noticeable effects. I have access to triazolam. etizolam.xanax and other benzo/benzo derivitives (tho not from legitimate sources) but again if taken alone the dosages required to overcome the underlying pain are so huge I'm afraid that one day I will wake up dead . Sure it won't hurt anymore but I have a wife and custody of four grandchildren for whom my passing by apparent (though in-deliberate) suicide will ruin their lives.

I have no experience of true opiates in fact I am afraid of them so please don't read this post assuming that I am soliciting a source for such a commodity.

To my actual request for advice then: using the medication I have detailed can anyone suggest mixing those meds which would start with the fastest onset closing with the item which would maintain sleep to around 8-9 hours.

If a better solution exists (other than a rope in the outhouse) feel free to elude to it but keep it within forum rules for not only my sake but for your membership too!

 

[dokomo]

I moved your post into its own thread, since its pretty specific.

A couple of initial thoughts -

Your benzodiazepine tolerance is large, to the point where using them alongside other pain treatments is going to be a bit impractical because of the requisite dangers.

The first thing you need to do is get your pain treated and get that under control (easier said that done, I'm know.) I know you mentioned those accidents, but what is the actual cause of your pain? What is the diagnosis? You need to explore these with your doctor and work toward getting the pain adequately treated. If you're still having insomnia at that point, then its time to explore that a bit. Right now, though, the pain is the likely cause of your insomnia and there are so many treatments available for it that warrant looking into.

 

[kokaino]

^ Totally agree with dokomo.

If you continue to have insomnia after your pain is sufficiently controlled, then look at things like Seroquel, olanzapine, or trazodone. Your benzo tolerance is high and if temazepam can't get you to sleep unless you take massive doses then none of the other benzos you mentioned will help you either, as you already know since you've already tried them.

 

[zapeddo]

The painful areas in the main

All in all I have worn facet joints in my lower spine 3rd 4th and fifth vertebrae (upwards) which pre existed before the truck crash. My legs became partly numb following the period in I.T.U on life support and a subsequent MRI scan identified nerve damage which is more pronounced in my left leg It was been suggested that because I had many lines to filter my blood and other fluids by machine outside of my body due to organ failure some nerves may have been damaged . (I can actually stick pins in my left thigh and feel nothing) but can hardly bear weight on the leg when walking and as I have severe arthritis in my right ankle I have to use crutches for short distances and a wheelchair for distances in excess of 100 yards or so. My consultant wants it to get worse before considering surgery and my GP practice are loath to prescribe proper opiate painkillers because I have only recently been able to control the epilepsy which resulted from the head injury in 2008.

I appreciate the advice regarding Seroquel, olanzapine, or trazodone but have concern that I might be considered to have a bi-polar disorder and am nervous of the stigma that might attach to me.

That said, should I approach my GP and suggest investigation into that possibility? furthermore would that imply that the injuries I have carried for so long exist only in my mind?

Many many thanks to yourself and dokomo for your interest and I sincerely hope that subsequent posters keep their posts pleasant rather than insulting me for their own brand of humour.

 

[dokomo]

Ah, the epilepsy does complicate things indeed when it comes to opioid analgesics.

Has your doctor considered/tried Lyrica (pregabalin)? It can be very helpful with nerve-related pain and is also an anti-epileptic.

As far as surgery goes, that may be the best option based on the specific details of your injuries. It might be worth it to further push the matter with your consultant, its definitely to the point where its severely limiting you in your life.

 

[laCster]

i know the perfect solution to your problem!! look into a pregabalin (lyrica) script!! lyrica will increase the effects of your tramadol and benzos by alot...
and lmfao @ tramadol....they are alright to take but i have found they never help with any pain at all...tell your doc they just arent cutting it and you cant even sleep because you are in so much pain....in addition, i always have found tramadol is rather stimulating and can cause insomnia in many people including me...the next step up from tramadol would probably be vicodin (hydrocone/apap) or percocet (oxycodone/apap)...hope this helps!! wait, i know this would help hahahaha! but hang in there man, it seems like you have been through some nasty shit..

oh yah! how the fuck could i forget? do you smoke weed? some marijuana would greatly help with pain and sleeping especially combined with opiates/benzos...and oyu can also look into potentiating your tramadol/benzos with Tagamet or WHITE grapefruit juice (must be 100% natural and not from concentrate)...also try some DPH or doxylamine succinate with your opiates, they will increase pain relief and the itches hahaha

...stay safe man

 

[TheLostBoys]

After being threw what you've described in both accidents, how in the world are you only prescribed Tramadol? You should be on oxycontin, morphine or opana.

 

[zapeddo]

After being threw what you've described in both accidents, how in the world are you only prescribed Tramadol? You should be on oxycontin, morphine or opana.

I appreciate your post but please read the previous post by Dokomo, Pain in it's self is debilitating but epilepsy can be fatal (Google Status epilepticus) for an insight

 

[J. G. Wentworth]

You need to let your docs know that you are massively dosing yourself with benzos.

Benzo withdrawal often causes seizures. You do not need to add to the problem. With proper pain control, you can get some better sleep. The pain you describe needs opiates. Strong ones.

Some epileptics find reduced seizure activity when on opiates. Go find a good pain management doctor.

 

[zapeddo]

You need to let your docs know that you are massively dosing yourself with benzos.

Benzo withdrawal often causes seizures. You do not need to add to the problem. With proper pain control, you can get some better sleep. The pain you describe needs opiates. Strong ones.

Some epileptics find reduced seizure activity when on opiates. Go find a good pain management doctor.

Thanks for that advise, in the UK we register to a GP practice more often than with a single GP, but taking your advice on board I will request an appointment with one of the other doctors n place of my regular GP and see if they might look at my situation differently otherwise I'm reluctantly considering self medicating using the online options. I dare not mention the massive benzo doses or they will for sure take me off of them and then I think I will be unable to cope at all.

 

[PoppyField]

I deal with bad pain too that can keep me awake all night. I think your pain needs addressing rather than trying to treat the insomnia alone.
Also, I must second what someone else said- tramadol, although used to treat pain, makes some people more "awake"- if I took a lot of it before bed in an attempt to dull the pain enough to sleep, I'd instead end up wired/hyper. I think you could benefit from a good pain doctor, who would work as a "team" with other doctors for you (eg dr for your epilepsy, etc)- so that they can figure out the best meds for your different conditions and how they would interact/work together. Otherways to treat the pain need exploring because I know by experience, tramadol, even if one could handle taking huge doses of it (I took as much as 600mg at one time, every 3-4 hrs on my 'bad days'), just can't control the kind of chronic pain from injuries like this. Now I take Fentynal- and just a 25 patch (not a very high dose) and I'm in so much less pain that im 100x more functional, and can sleep for a decent amount of time. I dont know if fentynal is safe for you, but just illustrating what a difference findign the "right" pain med can make. A good pain doctor cooperating with the rest of your drs can hopefully find something that will work for you- to treat the pain, and your sleep should then improve where you will either not need sleepign pills, or if you do, you wont need to take massive amounts- good luck

 

[Altered Perception]

Tramadol acts like a stimulant for me, everytime I take tramadol I end up staying awake untill sunrise, you need a sedative type of opiate , not tramadol which seems to be more of a neuroexcitory and stimulating opiate.

Try the sedating type of opiates that will make you drowsy and sleepy such as morphine, fentanyl, codene

and stay away from stimulating opiates like dilaudid (hydromorphone) tramadol and even oxycodone.

 

[shmeglyn]

I appreciate your post but please read the previous post by Dokomo, Pain in it's self is debilitating but epilepsy can be fatal (Google Status epilepticus) for an insight

I'm shocked they would give anyone with a history of seizures Tramadol as it lowers the seizure threshold and it was the sole reason I had a seizure last year. That makes no sense to me. I would inquire re: long acting painkillers like Xr's Sr's, etc as they are less "buzz" worthy yet still narcotics so they work. Tramadol will easily lose any effects as weak as they are to begin with. Hope you get the relief you need.

 

[kokaino]

I understand what you're going through. I was just diagnosed with fibromyalgia and my rheumatologist sent me to a pain clinic because Lyrica or Gabapentin didn't cut it. I hate tramadol and I told him that because he offered to give it to me.

I'm waiting for an appointment now. They are supposed to call me sometime next week to schedule an appointment with the pain specialist doctor. I have to sign "treatment agreements" and other shit like that. It's crazy how they are so afraid of scripting opiates. I'm on methadone, so he's going to have to give me high dose and strong opiates.