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Chronic pain too much for you and meds not working anymore?.

edited 06/11/2012 - 8:52 AM in Chronic Pain
I have been on opiates for 12 years. Up to 150mgh fentanyl every two days with breakthrough oxy's as well. Had partial cervical fusion last november and 25 years ago it all started from a vehicle roll over-ejection on the freeway which partially collapsed t6 and t5. So much so that part of a rib facet was removed in 96. Now, I also had several more stable vertebral fractures as well as a broken sternum. The other injuries were knee, massive head trauma and a punctured lung.
I was lucky, I walked out of the hospital at 18 and further, the pain hadn't yet set in. I worked roofing, then as a mechanic and was even a firefighter for years until the damaged areas coupled with age finally slowed me down.
Here is the deal, I went through a rapid detox under sedation and it's now been a month totally off narcotics!!!!!!!!! Guess what else, I suspected and found I was correct that I was experiencing hyper algesa. Basically the body no longer finds relief from the opiates and one becomes less able to tolerate pain. So, the miracle is that once off meds I thought I'd never live without, my pain BASELINE was LESS off meds than on them. Yes, less pain now and no drugs on board. It was not a cheap route nor was it as easy as many providers of detox under anesthesia say it is. However, it was a live or die point for me so I rolled the dice, and thus far the pain is manageable, my mind is sharp and I'm told by those that know and love me that "I'm back" as in I'm no longer in a haze that I'd grown to believe was normal. To give an example of the pain meds loaded in me, the anethesiologist was unable to treat my first several hours of post surgical pain after the cervical spine fusion because I had so much in my system that he later explained if he'd given me anymore I risked death.... Imagine coming out of surgery with your neck being opened, your esophagus pulled aside, then the surgeon had to go to the rear area at a nerve bundle and grind out bone, replace a disc with cadaver bone and then came the titanium plate and 4 screws. Next, put me back together, bring me out of a dead sleep and my first reaction was shear terror because the pain was almost enough to make me pass out. That was when I kept saying "what have I done?" over and over......I share all this because I know many people are out there medicated and long termers more than a year on opiates are wondering what to do or might feel helpless. If anyone told me 2 months ago I'd be free of pain meds I would have thought them crazy! The route I chose was an obvious one because I could not taper and keep my business going and tapering is agonizing. Basically the chemical detox allows a person to kick the opiates, go through most of the withdrawals and all while sedated. Two to three months of agony and withdrawal is condensed into 1 1/2 Hours while you sleep. If I'd known more about the pitfalls of opiate use long term, I'd have changed course years ago. Drs are not always good at understanding the implications and while they may be doing the best they know to treat pain, it's sad more drs don't know the long term cost to the patient and his/her family and friends. Hope this gives someone out there a foothold and some hope. Bless all of you


  • I had a cervical fusion and did not need any pain medication. When they go in through you neck like that they do not cut through muscle. That is what causes you such pain, cutting muscles.
    I did not have to take any pain meds.

    I do not know what it is like for others who have cervical fusions but for me there was no pain. I am only speaking about myself.

    I am very happy that you were able to get off narcotics. That is great.

    Patsy W
  • What the heck are you talkin' about? under anesthesia to get off pain meds? What is that all about, I have never heard of such a thing - EVER... Do tell??!!
  • Look up Ultra Rapid Opioid Detox or UROD and you'll see it has been done for many years with mixed results. Follow on treatment and removal of original pain generator makes a huge difference in the success rate of patients staying off opioids once they've gone through this type of detox.

  • Very very interesting. I never heard of this before.

    Hi pez and welcome :wave:

    opps I see you are really not a newbe lol welcome back then instead ;)

    Thank you for expaining all this and sharing it with us :)

    PS: When you make long posts, please break up your paragraphs - it makes longer posts so much easier to read
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • As hagland mentioned, this method has been around since the late 1980's. It was orginally used, and still is, for people with addiction problems outside of pain management. I'm glad it worked for you, pez, but it's NOT without controversy and risks. It is also extremely expensive and NOT covered by most insurance plans due to the controversy with it. They claim it will remove physical and psychological withdrawal, but that is just not the case.

    IF it also removed the source(s) of pain, I think just about every single one of us would do whatever was possible in order to become a recipient of this - I know I would. There isn't any type of counseling or after care, so it doesn't deal with any of the mental aspects. Personally, if I was taken off all my medications and left with depression and unresolved/unending pain, then it would have been a waste and I would be running back to my CPP begging for relief!

    I have a friend who went through this about 10 years ago. I know what I saw happening with her afterwards and it wasn't easy or pretty, believe me. She did it because she had hit a wall as far as the efficacy of her pain meds and was just plain tired of the flack from her family re the medications she was taking. They had no understanding as to WHY she was taking them. After less than 2 months, she was put back on medication and began titrating up to an acceptable level. Her husband makes a lot of money, so the ~$20,000 cost of the UROD didn't affect them much. That is NOT an amount I would be able to just say, "Oh well..." to! :(

    Again, I am glad you had success with it, pez, and I hope things stay on an even keel for you.
  • I agree it's expensive, but its relative.... The place I went DOES follow up with 6 phycological appointments and gives a host of alternative methods to deal with pain.

    As I posted, my pain was no longer relieved by meds, further, the t5-t6 area is a partially collapsed pair of vertebrae with one rib facet surgically removed in 96 and the original injury was in 85. Thus, after countless MRI's CT's and follow ups with specialists, the news was that there was nothing further to be done surgically.

    I had looked at this procedure and it's actually improved over time. Still it was a long month post treatment. All I can say is for those who have hit the wall on meds and there doesn't seem to be a further medical solution the the underlying pain, it's out there and although I am not pain free, my baseline pain is right about where it was on the fentynal etc. Though now I'm awake and alert.

    I didn't lose control on scripts or shop doc's, people go into these programs for different reasons. I will say this, I've had zero cravings and other than acid reflux and lower GI issues in the first 2 weeks post treatment, I'm doing good.

    You mentioned your friend did it 10 years ago..... From what I found in researching the options, it's come a long way in those 10 years.
  • Is determined by the institution where the procedure is conducted. I had many months of follow on care, to include acupuncture, behavior management, pain management and monitoring by my neurosurgeon, neurologist and PM doc.

    When I mentioned removal of pain generator, I was referring to the surgical intervention where necessary to stabilize the area of pain generation and or remove/repair the site. I had cervical surgery in conjunction with the UROD so that once the detox was complete, my requirement for the pain meds should be theoretically eliminated.

    This procedure carries incredible risk to the patient and is not something to be taken with a casual attitude. Death is a very realistic risk as well as pulmonary edema. Depending upon the individual's pattern and length of opioid use prior to, the length of withdrawal after the procedure varies. Certain medications are used to help stabilize blood pressure and minimize flu like symptoms after. Auricular acupuncture helps reestablish sleep patterns and help kick start the the body's natural ability to generate endorphins, which is normally suppressed by the use of the opioids.

    It has been nearly 4 years since I went through this procedure and I can easily say that it saved my life.

  • Correct on many points, and one should be very clear on the risks. My real point was more about the issue of when the underlying problem doesn't have a surgical solution and the meds don't work and in fact are dulling ones life and spirit. Further, hyper algesea is becoming more prevalent, or more precisely, more recognized. So it is amazing that the baseline pain is about the same with or without meds.

    The benefit to be sure is getting ones full life experience back one the cloud of medications a lifted. Being on prescription opiates for so many years, its easy to feel like ones brain is functioning normally since the euphoria is long past. Its after the UROD that one realizes how hollow life was in many ways.

    And you made the ultimate point when you said it saved your life. I was implying the same in my first post. BTW the prime demographic for this treatment is not folks detoxing from recreational drug abuse. It is males, in their mid 40's and generally in managerial and executive positions. Of course given the cost, I feel that statistic is off. This procedure is not unfortunately available to the vast majority of people who might benefit most.

    Each place is different in the way they handle the safety aspect. I had to have a physical, several blood panels and a treadmill test etc before I was allowed to proceed.

    And last, the work starts after getting home, establishing a new way of coping, exercising and eating. Emotionally, it's a tougher transition than physically, my experience anyways.
  • pez,

    I am having a problem understanding your original post, but are you saying you had the detox after a fusion? Isn't it possible that is also why you are able to go without opiates now?

    I have heard about this before and it is interesting but then I think back to how I went about 5 years after my accident with very limited medication and I was in pain ALL THE TIME. When I could not stand the pain anymore I would take half of a Tylenol #3 and have a short vacation away from the pain.
  • I have been prescribed many different pain meds, I don't ever remember a euphoric feeling. What I am taking now only dulls the pain, doesn't take it away, but I'm not on high dosage of anything as I have to work.
    The only time I was pain free was during a nerve block I was given a mix of delaudid and phentanyl and I was awake and alert but no pain. Unfortunately it only lasted for a short while and by the time I got home (passenger) the pain was back.
    There is never any guarantee that you won't become addicted or abusive to pain meds but if you can survive without them, more power to you. I know I couldn't work without dulling the pain. Hopefully one day they will have a treatment whether surgical or other for those who don't get ny relief.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • My actual injury is t5 t6 wedge compression fractures along with several stable fractures from a roll over, eject on freeway in 85. Very clearly visible on X-rays etc. I was 18 so that probably helped a lot in terms of recovery and no initial limitations. In fact I was a firefighter- first responder for many years without undo issues. Kind of ironic how many people we pulled from roll overs etc. Over the years... Anyways, as time passed and I got older, there was a point the pain had progressed that I couldn't ignore it. Went through injections, PT, chiro etc. Then pain management doc introduced me to opiates. Pain then under control....... You know the rest of that story, after many years I was prescribed fentanyl patches at a pretty high dose. I went to see a specialist who went a step further and had lots of imaging done of my C-spine. That's when he found nerve bundle impinged at c5c6 and based on that, cervical surgery was done after a few more tests. So that surgery last November was successful and I now have the titanium plate and screws etc there. That took care of the neck pain I was having. The thoracic area is not fixable. They did remove a rib facet in 96 due to the bone on bone pressure and that's all that could be done there.
    So yes, I did have the rapid detox AFTER the c spine work however, the thoracic injury is very much still a problem and before I went to do the rapid detox, I tried med reductions but the pain in my mid back made it unbearable.

    I'm not saying I'm not in pain, that I'm feeling great, but I am trying to convey that my pain level on meds was no better than now and "now" is entirely void of opiates. To transition from 150 mgh every 24hours fentynal along with hydromorphone 4mg x4 daily and now opiate free in a weeks time is huge for anyone whose had that much " on board" for years.

    The original post I made about rapid detox was just putting out there that hyper algesia is a problem that can happen and when faced with chronic pain, it's enough to make a person feel desperate when the meds don't work.

    As you said, I also for the first 4-5 years didn't take anything more than ibuprofen and honestly didn't think much of it. Progressive arthritic pain and spinal mis alignment coupled with hard physical work eventually made things really bad. No doubt, my back is hurting and muscles are bunched as I write this... I could take a vicoden etc and my tolerance would be low again, so I'd get relief but I'd rather step in front of a train cause I'd eventually be in the same ole mess.
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