What should they ask for at the pain management?

Discussion in 'Opiates & Opioids' started by thegoodfight, Jan 1, 2007.

  1. thegoodfight

    thegoodfight Newbie

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    Please help Swim! Swim needs help deciding what pain meds talk to the doc about, for severe pain. appt was just moved and is in 28 hrs!!

    Here is the situation: I have been on opiates for 3+ years. I have had some major injuries, one after another. These injuries are usually followed up with a surgery or two. I have had 8 months since his last operation and is in severe lower back pain with leg/sciatic pain. I have been getting really under-prescribed pain meds since the last operation. I have finally convinced his doctor that he is really in pain (needed help from those around him to "verify" his daily pain and disability). I went to a pain specialists that verified his MRI's and physical pain. The specialist thought my pain was legit and wanted to start swim on meds, but swim'd PCP was already perscribing to swim.

    This brings swim to the question. What meds should I ask for pain relief?
    Current Meds:
    10mg OC 2x ED
    5/500 Vicodin PRN 6 hrss (swim taske 1 every 6 hours, actually 24 hours after each pill)

    This is no where near close enough to ease the pain. Swim can take a 40 OC every 4-6 hrs and feel good (pain wise, not abusing at all). I have an ungodly tolerance for ANY substance. This is a dose that will allow swim to function normally and act his age instead of someone 50 years oldat than swim:(. Luckily It does not affect swim that much (as in being "high") because I has severe pain.

    Swim doctor told him to try the current dose out to see how it does. I got the pain management doc to switch the hydro to oxycodone IR.

    The doc has mentioned: Morphine, Hydromorphone and fentanyl patches.

    Idealy, I would like to be able to get 30% more meds than needed so they can be taken at times of severe pain that always happen (and the doc never believe, one doc labeled swim a drug seeker b/c my flair-ups:(). Swim's pain is as real the death and taxes..I could continue on OC's but Swim can only ge the genetic ones as Swim don't know how to get others.. It would be nioce to be able to get something "abuseable" for those times once every month or so when I would really like to feel like I was alive and above near-death..

    So, how does Swim approach my doc and tell him Swim's MAJORLy under prescribed w/o looking like a drug seeker? I could honestly break down and cry & cry in front of him as b/c this is so stressing and I feel like I have been a prisoner in swim's body for 3+ years.. Doctor knows my mental state and it is "firm"lol.. Swim just wants to be able to do a full days work so swim cand find a job, and be able to move the next day. Now swim can oly work 2-3 hours a day and then there is hell to pay afterwards.:(

    Any suggestions here are GREATLY appreciated! I am about to lose it and has thought about calling the game of life quits more times than swim can count b/c the pain is so unbearable. Also, I was on 200mg OC / day and stopped in 3 days. I have done this 3-4 times to go through withdrawl. Let swim say that withdrawl is a PUSSY compared to the pain that I live with every day. 200mg ED and only unse 5, 5mg percs to wein off in 3 days.
     
  2. blinkKDX

    blinkKDX Newbie

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    Re: What should Swim ask for at the pain management??

    I say being honest is your best bet.

    you have to understand there are thousands of people who are "honest" but are really drug seekers. if the doctor understands you well and there's trust then there should be no problem..

    but more so than anything, you dont want to give up on the game of life. we all have to play it. there are many dumb shits out there who think they know a thing or two, and you have to let them believe it sometimes so they can fill their ego, but You is always better than those people.

    best bet. get a new doc if it falls through.
     
  3. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Well it sounds like the pain could be caused from many different things. SWIdr would think Soma, a muscle relaxer, would help You out alot. Also, You has got the right idea with fentanyl, it is very powerful and effective. Also if any pain is from nerve damage, one might want to try Gabapentin, which can allieviate this kind of pain (bbut there could be better meds for this). Also a skelator muscle relaxer like Skelaxin might be able to help for tension and strains on you's skelatin. A mix of all these drugs though could cause many unwanted interactions, which would cause alot more side effects. Opiates (oxycodone, OC, hydrocodone, vikodin) can usually treat severe pain like You has described, but since they do not seem to be helping, it may seem that the pain is coming from some other place that opiates do not target.....so SWIdr hopes these suggestions help You out in his predicament. Good luck, and I hope you's pain gets under control!
     
  4. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    Thanks for the response. Let me not that the opiates are working WONDERFULLY, but I do not want to ask for a big jump from current script to what is actually needed to releve pain. Opiates have been the only thing that makes me feel like he is half normal. The first substance used by I was alcohol, which helped for pain. What was strange was after a month of drinking 3x a week (only at nights) I could drink 3-4x more than those who were veteran drinkers. Swim seems to have an incredibly high tolerance for just about anything consumed :( I am just concerned that telling the doc about high tolerance will make the doctor think I am just pill seekingm which I am not.

    I have tried Soma and found it effective only at high doses 1050mg (3 pills) every 4-6 hours, and that was only mild-moderate relief.

    Gabapentin seemed to help some at high doses, ~800mg but lasts 4 hrs or so.. Lyrica has also been used but doesn't seem to help as much. I was on 450mg/hr

    Skelaxin is a no-go as it effects swim very strangely. Bad stomach/bowl cramps and twitching. I have found baclofen and zanaflex to work, but over time the help diminished dramatically. My thinkgs it might be good to changes every 2 months of so with these meds.

    I have also been told that a morphine pump could be considered. This is the last thing that swim really wants (but is open for suggestions). I dont' like electrical thinkgs in Swim's body.

    Swim loved OC's as they help at high doses. What are you's suggestions on hydeomorphone (is that diludad?) vs Fentanyl?
     
  5. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    Swim will admit to drug seeking, but it is not for recreational use. I am drugseeking for pain relief.


    I would like to know if SwiNKKDX meant that the doc's are the dumbshit's who need to have their ego's pampered to or the or patients. Swim thinks You meant doctors..
     
  6. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Well if You asks for a fentanyl patch, the doctor would probably know youve done your research and are an experienced drug user, or you are in alot of pain 24/7. Just be honest and tell him You is in constant pain nd needs releif and fentanyl patches are pretty hard to abuse for the inexperienced drug user, so he might give it to you. As for hydromorphine, it is almost as powerful as herion (diamorphine), so the doc probably wont give it to you unless he trusts you and that you are in ALOT of pain. Also if he asks if You abuses drugs, just say u wouldnt be askking for harder-to-abuse drugs like (fentanyl patches) if You was a druggie, because You already has access to plenty of easily abuseable drugs. So basically just be honest and frank with you's doc, and hopefully he will get out his pen and pad.
     
  7. thaprepster82

    thaprepster82 Newbie

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    Re: What should Swim ask for at the pain management??

    Most Docs that have been in the game long enough can pretty much tell what the deal is after talking to the person. If I am seaking pain meds for real pain management the the doc will prob do xrays and tell if he has has surgery and if hes tellin the truth. I agree with the above post be honest. if not find another doc.
     
  8. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    Thanks a lot for the info SwiDrMuffy (like the name BTW). Swim really doesn't want to have these to abuse, but like I said, that one night a month or when I go to a wedding (as a date and doesn't want to be there)I would like something to help kick back!

    Swim thinks the best plan is to stick to OC's now as they are working (but the script needs to be increased!!). Swim's doc know I used to use drugs (weed and coke) and doc knows it was because I had A LOT of pain (hence weed use) and coke - for severe ADD. I have not used either in over a year (which is MAJOR change for swim). Also pain management states I am in legit need, swim's doc is being understanding.

    Since the drug types are figured out, swim really needs to figure out a way to demonstrate swim't elephant-like tolerance. This is what is holding swim back. meds work , but not when there is ehough to last!

    Suggestions on tolerance greatly appreciated!
     
  9. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    ^^^^^SWIDrMuffy says thanks for the compliment, and hes glad he could help! Tolerance to oxycodone, expecially in high doses like in the OC pills, can increase very rapidly and one can become dependant pretty easily if used often. SWIdr is not sure wether fentanyl and oxycodone will interfere, but the fentanyl patches and lozenges on a stick are hard to abuse, but can provide much greater pain releif than that of morphine. In fact it is measured in MCG instead of MG (like acid) because of its steangth.

    It might be a wise decision to just up to OC dose (if possible), but if a fentanyl/oxy mix is medically acceptable, then SWIdr suggests that You stays at the same OC dose, and adds a fentanyl patch to to equation to GREATLY increase the analgesia. Also, this is a weak opiate but worth mentioning due to its lack of tolerance build up, tramadol combined with OCs can also produce good analgesia (although not as much as fentanyl), nd docs feel better prescribing tht than most any other opiate. Hope this helps, SWIdr is sorry that You is in so much pain, please update us on the situation as time goes by!
     
  10. ardyrr

    ardyrr Newbie

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    Re: What should Swim ask for at the pain management??

    years ago swim a motor bike crash ,not long after a car crash,after getting a habit from chemist drugs I started drinking tusselix forte [a cough medicine in Australia] when they banned it [after 18 months] swim realised he had a monkey on his back [gorilla to be exact] thats when I started heroin,the pain would come and go depending on the quality of the smack,after dying 3 times plus many years in and out of jail and rehabs I finally got onto Methadone.After 20 years I had a family ,owns his own home and owns and operates his own business with 4 employees,if it wasn't for methadone I wouldn't be here today and I am also happy.Methadone isn't for everyone but maybe You should enquire about it,it could be worse,after 3 years of prescription dope You also has a monkey on his back by the sounds of it.
     
  11. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    ^^Thanks DrMuffy for that info. I have had tramadol 100mg's. I had to take 7-8 to get any type of pain relief and also got a euphoric feeling from it (which was ok for swim!). I was supposed to take 1 pill every 6hr, but that did nothing at all. It would be interesting if swim tried tramadol while on the OC.

    I always had a gigantic tolerance. I could drink 3x more than swim's friends and be in control while they were sloppy. Same for drugs.
    **Do some people just have natrurally high tolerances for drugs/substances?

    ^ardyrr- r r , lol :D Thanks for the suggestion about methadone and I am glad to hear you are doing well!! Isn't that Demerol? The reason I am skeptical about this is I don't want people to think it is because I was on Heroin... People see methadone and the thing heroin 100% of the time (at least people who don't have chronic pain). Swim also fears that if I am switched to methadone and it doesn't work well they might not switch swim back to OC's.
     
  12. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Methadone has and will usually be associated with heroin withdrawel programs, but SWIdr wouldnt worry about people thinking that You was a heroin addict because the ones close enough to You to know what meds he takes would already know he has chronic pain and needs it. But SWIdr would be careful because it can be a great pain releiver, but withdrawal and tolerance can be a bitch. Why dont You tell your doc his story, and then discuss with him the list of options you are willing/want to do, like increasing you's OC mgs, and if he wont go with any of you's gameplans, then go to another doc, preferable a pain management specialist.
     
  13. Nagognog2

    Nagognog2 Iridium Member

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    Re: What should Swim ask for at the pain management??

    Avoid methadone. It causes addiction that makes heroin look like a hangnail regards withdrawl. Hydromorphine works great! BUT it acts and stops working fast. Ditto for fentanyl. Morphine works for a long time - but only when injected. As an oral pain-reliever it lacks effect for many folks. So oxycodone is likely going to be the best bet.

    Be very careful not to get into using it as a recreational drug though. It is an addictive opiate-narcotic and no one is immune. And very few doctors (who aren't in jail) would boost the dosage for what was obviously compensation for recreational purposes/addiction. They'd be more likely to offer one an operation instead. Most doctors are actually quite intelligent - even if they live on an ivory tower and have trouble acting human with their patients.
     
  14. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Yes, exactly as SWInagognog says, methadone should be a "non no" in this situation due to its withdrawel. One qustion for SWIthegoodfight.......What is his position on rectal administration of drugs (mainly just morphine)? Because if You chooses to go the morphine route, it is much easier and safer to self-administer morphine suppositories than morphine injects. This question really only applies for the morphine because of its poor absorption rate orally.
     
  15. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    Swim thanks you for the heads up on methadone withdrawl, that is soming swim want to avoid. Do you mean hydromorphine stops working fast as in it has a short half-life (not time released), or the drug only releaves pain for a few months..

    I am happy with OC's and is more than happy to stay on them. Swim figures that it will take a few months to get the dosage correct to where I am not in a lot of pain.

    BTW what is a "normal" dosing of OC for someone with a Very bad lower back?
     
  16. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??


    I have never had anything administered rectally (except a colonoscopy, but I was unconsious). I don't know how to do that and it sounds very painful. Is it a pill or what? This sounds painful. I would like to keep that part of his body a virgin :D How much more absorbtion does one get from rectal vs oral, and do you use the same pill or do they prescribe somethig else?
     
  17. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Well You might want to look at this thread: https://drugs-forum.com/threads/22807

    There is a big differeence between oral and rectal absorption rates, and to tell You the truth, rectal administration isnt all that bad. Some people just get past sticking something in their ass, but when it comes to morphine, it is definatly worth it. Also SWIdr has a thread stickied on the opiate forum on how to administer substances rectally if You was wondering how you do it.
     
  18. thegoodfight

    thegoodfight Newbie

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    Re: What should Swim ask for at the pain management??

    ^Swim thanks SwiDrMuffy again!

    Now how does Swim get rid of the terrible opiate itching? It is driving swim crazy:crazy!
     
  19. DrMuffy

    DrMuffy Silver Member

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    Re: What should Swim ask for at the pain management??

    Haha, You might want to UTFSE (Use The Furom Search Engine) for more info on this subject, but generally an anti-histamine would help such a benadryl, phenergan, hydroxyzine, and such.
     
  20. ardyrr

    ardyrr Newbie

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    Re: What should Swim ask for at the pain management??

    methadone is without doubt the worse drug I has ever had the misfortune to withdraw from,with hanging out for more than 8 months and no reduction in severity or sleep,swim knows of many people on methadone because of pain related reasons,I'm not condoning the use of methadone but for swim it was perfect as nothing else worked,but once you are maintained on methadone unfortunately you are on it for life