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pain management

RefugeeRRefugee Posts: 100
edited 06/11/2012 - 8:27 AM in Chronic Pain
I had my surgery in july 2007. I have been on pain meds and lyrica , naproxyn. I go back to my dr next week for bone density results-told me not good??? stressing!!! Question is should i ask for something for pain in between the times that i take the other, because IT IS BACK before time to take them again. I take Darvocet now 6 tablets a day and it does help but what about the hour or two before i can take it again. Need suggestions of something not strong and easy on the stomach because i have never been able to take strong pain meds even after the surgery all i could take was loratab and suffer. Any suggestions appreciated!!


  • if there may be a long acting pain med that you can take? It would be much easier on all of your organs and you may only need 1-2 doses a day. 6 x a day of the meds with acetaminophen in it is not good for your stomach and other organs. I am not in the medical field but I would suggest talking to the doc about a long acting med. Good luck and keep us posted.
  • Maybe tell your Dr. your pain med only lasts for 4-5 hours and maybe he'll adjust your meds. My Dr. increased mine when I said they only last 4 hours and they're supposed to last 12hrs so she adjusted the dosage to a better schedule. Of course it would be nice to be painfree but I always have a bit of pain. Well I think most of us do. I hope you get some better meds or a different schedule. I take MS Contin 30mg 4x day. No nausea and no dizziness. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi all,
    I'm so glad I found this site! I have learned so much from browsing the posts. Here is my situation; I was going to my regular MD for my pain meds, something happened with this doc. and he left the practice with no forwarding address! I was going to a PM doctor during this time for injections in my lower spine. I had to ask the PM doc. for my pain meds. He flatly REFUSED to give me "break-through" pain meds (I was taking them when the regular MD was doing the Rx'ing) He put me on 50mg Morphine 2x per day - period! I have found another MD willing to do my pain management, this new doc. also says no break-through meds! I have had back problems for the past 5+ years and this is new. I have always taken a long acting med along with break-through meds. I have NEVER overused or abused my meds, taking them only when absolutely necessary. I was wondering if this is only a problem because I live in Northern KY or have others encountered this problem? I wish I didn't have to take anything but at this stage, I have no choice! I see on the boards that several of you take oxycotin. This is the #1 most abused drug in my state. There is no doctor that I know of that would dare prescribe this drug here in KY. I am currently on 80mg Morphine 2x per day. My husband and I have double Blue Cross/Blue Shield insurance, even with this coverage my prescription costs $150.00 a month! Does anyone know of a similar pain medication that would be less costly?
    All comments/suggestions are most welcome, Thanks, Terri
  • Terri, Most of us encounter resistance to pain meds. It's a nightmare in the system. Last week there was a greta big story on a woman who was scripted narcotic on pain meds, she abused them, then started buying "extra" from her friends in the bar and doctor shopping. This article made NO mention of those of us that do nor abuse, doctor shop etc, I was fuming at the end of the article. It reads like all of us are junkies and we don't need these meds etc, etc. But what are we to do? I don't dare respond, even the idea of a letter to the editor scares me. They won't print anonymus (sp) letters. The last thing I want is to attract attention to myself or my PCP! I have a hard enough time getting him to script me what he does. I have asked for long acting meds, no, he says, we will save those for later.
    It's all very frustration. I have all my hopes wrapped up in a SCS trial as I don't know what I will do if it does not work! My PCP is the only game in town. The PM center is an injection only place. They sent me to the ER for pain after the last ESI they did! It was ahorrible experience to be in that much pain and have your providers tell you NO! The ER doc was furious. Since then my PCP has written the scripts. But it took a phone call from the ER doc cheing him out for sending me to the ER to do it!
    I am in WV and expect this area is exactly as bad to get pain treatment in as yours. I contemplate moving quiute often, but with my medical history and my wifes I fear we can't leave our insurance or jobs until medicare will kick in!
  • Well Trishic, like everyone already mentioned maybe a long acting medication will be more effective for you and hopefully easier on the stomach. My only experience is with Fentanyl patches and I do take Norco 10/325 mg for BT pain. If I keep putting the patches on my belly and not elsewhere, I avoid having nausea, vomiting, headaches, and dizziness. My dose had been increased and I still don't have any side effects anymore.

    Dawn, I think a lot of doctors without PM expertise think that long acting narcotics are enough. Pain specialists understand all about break through pain and know that short acting medications are needed for it. Unfortunately some PM doctors are only doing injections like yours and you don't have easy access to an integrative pain clinic where they do everything. I only pay a $10.00 copay for 15 Fentanyl patches a month (generic). The brand name patches (Duragesic) are astronomically high. Maybe you can check with BC/BS to see where other pain meds fall in the tier system, and switch to one that doesn't cost so much.

    Wrambler, bad publicity about narcotics always wind up hurting patients who take them for legitimate pain. Usually the news is one sided and all it does is spread more paranoia, making it harder on the rest of us to get the treatment we need. It is frustrating.
  • Meydey 321,
    Thank you so much for you ideas. I tried the Duragesic patches earlier on in my "chronic pain career", I am allergic to them. My new PCP has referred me to a Neurosurgeon - my appointment is for this Friday, I am praying that he can provide some type of relief for me! This is the worst pain I have ever been in, those Morphine 80mg 2x day just aren't quite getting the job done. My pain is still at a 6 or higher. I can't even sit for very long now! I had a CT scan performed in December, it showed my lumber spine had gotten worse. In addition, bone spurring and pinched nerves were discovered. Lord knows I can take a lot of pain but this is driving me NUTS! Thanks for letting me vent : )
  • I know how that feels. My lower back feels like I've sat on a cynder block forever after getting kicked in the behind with a steel toed boot :O Darvocet is a very weak pain medicine and I'm not surprised it doesn't help you much. Hopefully your appt. goes well Friday and the doctor will have you try something else. Please keep us updated :)
  • i am a long term sufferer of back and leg pain too so i feel qualified to comment on this topic .i once had a pain doctor that treated me like a junkie.he said that all you back pain people are only after drugs .when i told him that i needed them because the pain is unbearable .he said yes ..you only want to get high don't you?? i was staggered!! i told him that i don't get high .he said that i was lying {there is no history of me being a drug abuser and i don't even drink alcohol!}.i walked out of his surgery and went straight to my own doctor {he has known me since i was 17 ,he was disgusted with this pain doctor .he apologised for sending me there.he has found me a kind sympathetic doctor now .{she is sending me for another MRI scan on the 12 off the month .both the new pain consultant and my own doctor manage my pain drugs now and they have no concern about my use of oxycontin/and oxynorm for breakthrough pain..they both know that i am in terrible pain and they are both doing their best to help me .i have already had 2 major operations and it looks like i will require more surgery as i am still in constant pain and getting very little sleep.life is very hard at the moment .i am finding even the most simplest of things a major chore
    I was reading your history and it sounds much like my own (with the exception of chrones). It's crazy the way these PM's treat the patients! My old one was the most arrogant, rude person I ever met! The funny part is, he had problems with his back - one would think he especially would be empathetic to his patients - NOT! I don't know where you live but be glad you live there because here, there is no prescribing of Oxycotin! My old PCP put me on them for one month, they really helped with my pain. The following month, I went to see him again and he was no longer in that practice! I'm sure it was a coincidence the way things happened but I must say, I found it odd. That goes to show how paranoid they are here! I WOULD NEVER ask for them by name! My husband sees a PM doctor for his back as well, he fell 20ft. off a scaffold into a tool bin. On a recent injection visit he found out there is a list the PM's get showing your prescription history! What happened to the HEPA Act? Not that either of us care, we don't misuse any medication or even drink alcohol for that matter. I was just kind of shocked by that information.
    Is Morphine 80mg the same as Darvoset? The world of pain meds is dizzying! My new PCP raised my dose to the current level (I was on 60mg). He asked me if I wanted him to raise it again but I had just started on the new dose 5 days before my visit and I didn't know how I would react to the new level so I told him no. I now wish I would have said yes! I have been in acute pain since October. I don't know what happened, but my pain level spiked. Here we are almost 4 months later and I'm just now seeing a Neuro. doctor. Had it not been for my new PCP, I still wouldn't be seeing a specialist. My PM doctor didn't want anything more to do with me since the injections/blocks didn't help me! God, I wish I had my life back!!! I get so tired/bored of sitting/laying all the time! I sit and look at all the things that need to be done and I can't do them. It drives me crazy!! I used to be a type A+, no more! I'm now a type z- lol! It's not funny, but I would rather laugh than cry!
    One more thing while I'm on my soapbox. Does anyone have a problem with profuse upper body sweating? I went my whole life and never sweated (so much so, my aerobics teacher pulled me aside and remarked on it). Now, I can be sitting still and all of a sudden I break out in a sweat - mostly my face, neck and arms. It's so embarrassing, I hate to even go shopping anymore! I know ladies, it's not the change, I had a hysterectomy in '02. I have been on a host of different pain meds and I still keep on sweating (I guess I'm just making up for all those years I didn't sweat)!
    Thanks to all for the good information! It helps me so much to have an outlet for my emotions.
  • dilaurodilauro ConnecticutPosts: 9,839
    Many times people look towards the narcotic pain medication to control their pain. That can range from any of the Schedule II or III medications. (Look at our Moderator's Bruce details about medication)


    Even with the higher dosages of these medications, many times the pain is not under control. I firmly believe that to control and manage your pain, you not only need a blend of medications, but you also need a set of other treatments.

    With disc problems, many times, there is nerve related pain. In that situation, you need medications to address nerve pain (ie Lyrica, Neurontin) You may also have muscle
    spasms,so you need a muscle relaxer (ie Zanaflex, Flexeril)
    And to top everything, you need to get a good REM sleep. This helps your body and gives it a chance to start healing itself. That is so very important. So sleep aid medications (ie Ambien, Lunesta) can be used.

    Now add to this medication blend, a routine that may consist of Aqua Therapy, or exercises approved by your doctor.

    Spine problems and chronic pain is very difficult to manage.
    I do not believe that there is one magic pill that will take care of it all. Therefore, we need to figure out what is the proper 'blend' that will help us
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • A cocktail of medication is needed to address specific symptoms.

    According to the psych I visited with, he said in addition to the medication regime and doctor-approved physical therapy or exercises, you should also undergo counseling so you can also get your mind around the changes you are experiencing in your life because of your physical inability to perform in the manner/capacity you are used to performing.

    Hell, I could save my insurance all the money I am sure they will be spending on this guy (my initial consult/MMPI evaluation cost a whopping $1,000!) and just come here to this site. I get all the counseling, information, suggestions a gal could ask for.

    But, of course, that is just ME, personally. This may not be adequate for everyone who comes here...

    Take care my cyber pals!

  • I appreciate you providing this link. I found it very informative! =D>
  • thanks for your post
    one thing that i can relate too is the upper body sweating.its horrible.i have suffered with it before the operations and when i was a fit man and the correct weight .some times all i have to do is bend down to put shoes on and it will start to pour out of me.when i used to walk the dog around 3 miles .i could get suitable attired for the weather {cold} withing 5 mins of walking my tee shirt would be soaking wet then with the cold clammy tee shirt against my skin and a cold wind blowing it made walking unpleasurable.even when i was a gym freak! just changing from normal cloths to gym kit would start me sweating { i looked like i had just finished a section even before i had started!} very embarrassing.i hate sweating .i sit in my recliner with a 16inch pedestal fan on me .no matter how hot of cold it is.i can only wear short because i over heat and i can't stand anything on my right leg {from the sciatica}.i only wear tee shirts and baggy shorts all the time /i look like a slob but its the only clothing l feel comfortable in.on a bad day i can get through 5 tee shirts.i have been tested for all the sweating illnesses.including pheochromocytoma and other nasties and all came back NAD .i am overweight by about 3 stone but even when i was the correct weight i have always been this way.i wont have a hot drink at someones house because that will start me off sweating and make me embarrassed even more.waiting in waiting rooms to see the doctors or going to the dentist are bad enough for {normal people} but i get that wound up that i take an extra tee shirt with me!.but even in no stress situations i can burst in to a sweating fit .the only excesses that i do When i feel fit enough tot do it} is swimming because if you sweat it does not show .but when it comes time to get out of the pool and dry off my tee shirt will be soaking wet BEFORE i get to my car then its straight home clean tee shirt and sit in front of the fan!!.i don't go out if i can help it mainly due to being in pain all the time but the sweating has a lot to do with it
    Sweating can put a huge damper on any social activities! I know from experience! I can't even go shopping, walking at a slow pace without looking like I ran a marathon. It drives me CRAZY. I wish someone would come up with a solution for this problem! We can only hope that a solution is found sooner rather than later. Meanwhile, I guess we will just sit home with our fans and cold houses and wait = LOL. Take care of yourself and "be cool". Terri
  • You are so right Ron, by stating on the combination is the hearth of control. At this time I am under Kadian 100mg twice a day, oxycondone 15mg three times a day, cyclobenzar 10mg. three time a day, Cymbalta 60mg. once a day, lorazepam 1mg three time a day plus trazodone 150 mg one or twice a day. with all these meds. I still get caudal shots and shots in c-7 because everywhere else is so narrow. I sill go thru the ciatic pain from buttocks to knee. and when the pain start in my neck I think I go crazy. I Did an experiment two day's ago. no pain meds as far as I could go. I gave in around 5pm. now I know wath degree I can tolarate, pain three and four I can tolarate. but not the seven and eight. I known the meds. work
  • Trishlc,
    Although we sometimes expect medication to cover all those fluctuations, it is never simple and the notion of periodic evaluation and how to deal with your current pain levels should be a concurrent strategy. Higher order medication comes with the associated side effects, which can be equally debilitating and support an improved quality of existence, which should always be encouraged.

    Research from Melzack and Wall in The Textbook of Pain suggest that misuse of medication is very small 1:10000 and we here, should not use that concept that we are seeking inappropriate medication coverage and challenge that opinion when appropriate. As Jeaux mentions a collective approach to pain management has to be the most effective strategy rather than using any method in isolation. Managing any change is difficult and none more so when that is imposed through chronic pain and evidence is here of the litany of changes we may all expect and some disbelief to adaptation we are mandated to endure, we should acknowledge these problematic changes and our capability in the daily rigour needed to tolerate them.

    Take care. John
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