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Question for Duchess Golden (or others that may know)
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Question for Duchess Golden (or others that may know)

Hi everyone,

Thank you to those who have posted responses to my previous posts.  I really appreciate the support.  I was hoping to get a response from Duchess Golden as well because she seems SO full of information. :)  Only if you have time though, I don't want to be any extra trouble for you.

I know we want to stay as anonymous as possible and I don't want you to give away anything that could possibly identify you but can you tell me how you have become so knowledgeable in this area?  I can tell you know what you are talking about and not just spouting of false stuff like some people who "think" they know what they are talking about say.  Are you currently or have you had to withdraw from pain meds?  Do you have a pain problem?  I read the posts regularly (I did miss some time in there, I think when you probably first started posting) but I don't remember reading anything about you personally.  You are always so giving to others in regards to support and information.  You are truly a blessing to this message board!

This question is to you and the rest of the board as well.  This is a silly question but when saying you are 24 hrs, 48 hrs, etc. when do you start counting?  Is it from the last time of your last dose of your medication.  I am wondering because of the peak of the withdrawals being at 48 to 72 hours.  The last dose I took was at 1:00 p.m. on Wednesday afternoon.  I did fine on Thursday, it was a busy day and had no wd's.  I slept fine.  Friday was a different story.  I was at home alone all day and had a touch of diarrhea (not that bad though) mainly lack of motivation.  I am taking tons of supplements to help me through and I started taking them prior to help build up. continued below...
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I did have to sleep with heat wraps on my legs last night to be able to sleep.  Not fun.  I didn't do much yesterday, I just didn't have it in me.  Today I did do quite a bit, my children had prior commitments and that kept me driving for a couple of hours and did a couple of hours shopping that had to be done.  I kept wanting to go home so bad I was really hurting (from real pain that I have taken pain meds for).  I got home about 5:00 p.m. (left around 11:00 a.m. so we were out for quite a while) and I put away the things we bought (with the help of my wonderful children!) and then I went to lay down with a heating pad on my legs.  I woke up with a headache though.  I feel better now as far as the original pain (still have the headache).  I am waiting to eat to take aleve or motrin (I did take Tylenol though).

"addictedtolortab" mentioned in a post a long while back that she had went to an herbal addictionologist and he recommended for her to take l-phenylaline to help with addiction.  I have read up on it and it is very helpful with increasing endrophins and help with apin.  I have been taking it (not sure if it helps with pain or not) for quite a while.  Do you know anything about this product?  It is sold at all of the typical health food stores and GNC type of places.  If you do know anything about it, what do you think?  I have read up on it but would like to see if anyone else has an opinion, addictedtolortab said they were always out of it when she went to get it so she didn't stick with it.

Right now I am not having any kind of cravings....my reason for taking pain meds was strictly for pain....severe pain.  I don't know if you read anything about me so I will try to quickly recap (I get long winded...sorry).  I had horrible debilitating pain for well over two years until I was finally diagnosed with the correct thing.  I had surgery and am slowly getting better (hence the screen name).  The surgery wasn't an overnight miracle but I went so long without being diagnosed it caused other problems.  I have been working with my physician and slowly weaning off the meds since my acute post op pain was over because I continued to have pain even after that.  Today I did have a spike in pain but over all my pain levels are getting more tolerable depending on what my day is like and what I have to do.  I am overall a healthy person....just had a serious injury that was very illusive and took a highly specialized doctor to find it.  I had weaned down to 1/2 percocet 5mg twice day. I did have one day in there about 4 days prior to my last dose that I had to take about 3 because of some severe pain.  But I had been taking 2 and then 1 pretty consistently prior to that.  

So there's a big chunk of questions all in one.  Do you think that my pain will get worse or my wd's?  I know that pain meds increase the pain cycle.  The more pain meds the higher amount of pain receptors are produced hence the reason people have to increase their dosages to get the needed affect on the pain.

Thanks so much in advance to those who read and/or answer my post!  You all are great!

SB
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Thank you for your post, I have been wanting to poast to you for a while just been so hectic this week and last night. To tell you where I get my info. from: I am a licensed psychologist with a specialty in neurology and pharmacology(in a nutshell) My husband is a doctor at a methadone clinic and also in privaye practice. We both got CAADAC certified during undergrad. I went through a PA (physician's assistand program) during my first masters so I can prescribe medication under an MD. I have my own private practice.

Yes I have been in w/d several times and I have tapered off of several opiates and benzos. I have mentioned personal things in posts to people who had asked me about it and my line of work to people who ask me about that. There are those who already think I appear to come off as being "high and mighty" do I do not post my line of work and credentials unless asked.

I do not remember what you initial diagnosis was but you were taking 10mg percocet correct? And how many times per day? Were you using any other medications in conjunction with the percocet to control the pain? If you don't mind me asking what was your diagnosis again? And btw, you are never a bother! This is what we are all here for, and there are no dumb questions especially when it comes to w/d. The 48-72 hours when w/d symptoms tend to peak is from the time the drug has left your system. You might find information that says "since your last dose" but this is incorrect. And this is just a average, with opiate especially w/d can be very unpredictable. You can go 10 days and stert feeling better and on day 11 feel like day 3 or or worse again. However, you mentioned that you tapered right? Tapering is much better on your body and will significantly reduce w/d symptoms. It is possible to avoid w/d all together for some, it is just important to taper as slowly as possible especially toward the end. You can cut the pills into halves, fourths, eighths, etc. You can shave the pills down as much as you need to in order to get the smallest doses possible for your taper. You mentioned that you have been taking some tylenol and noproxen (aleve), and motrin to manage pain correct? How has this been helping? Have you tried any alternatives like flexeril? (muscle relaxant) for pain relief. Let me know if there is anything I forgot, as you can see I am terribly long-winded myself, I ramble on and on all the time lol.

Oh yea! L phenylalanine. It is one of the 20 essential amino acids. It is turned into L-tyrosine (this is in the thomas recipe to help with withdrawal), L-tyrosine gets converted to L-dope which the body turns into dopamine.

What can help produce endorphins is black cohosh. Often women during menopause or after hysterectomy take this to help with hot flashes. Recent research has suggested that black cohosh helps with hot flushes due to its binding to the mu opiate receptors (these are the same type of receptors that hydrocodone, oxycodone and most other opiates bind to). This is because your endorphins play a key role in temperature regulation, hence the sweats and hot flashes in withdrawal.

xoxo- D.
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Thanks so much for the response.  I know you are very busy answering everyone's posts so I do understand.  I don't know how you do it running your own practice and then helping people on the forum.  I can tell you really have a heart for helping people.  It seems a lot of practitioners are oblivious to the internet forums (or at least it seems they are) and I just figured they were too busy with their own lives after work to look at such things.  So it is refreshing to see someone so passionate about helping others.  I don't know why anyone would think you come across as "high and mighty."  You have a lot of education and even personal experience.  I appreciate your willingness to help.

Please don't take this the wrong way but for the sake of anonymity I prefer to not go into my actual diagnosis.  It is not terribly rare but it isn't all that common either.  I will tell you it took me going to probably over 10 doctors to finally get it figured out.  I had a rather major surgery to fix the acute problem.  Their is another problem which may be why I still have pain but I am in physical therapy trying to do strengthening and such to hopefully fix it enough to where I won't need another surgery which would be a much more involved surgery.  As far as the pain meds, once I was properly diagnosed I had to go through some rather painful diagnostic procedures which flared the pain.  I went to pain management and took a long acting form of morphine and Percocet 7.5 for break through pain.  I weaned off the morphine shortly after surgery with no problem.  I didn't take it all that long though, maybe four months total.  It seemed to work well and it didn't have all the ups and downs that the percocet has.  I have been off of that for at least three months now.

I haven't had a problem with sweating, do you think the black cohosh would still be good to take?  Can you take it with the l-phenylalinine?  Do you recommend the l-phenylalinine or do you think the l-tyrosine is better?  I have tried the l-tyrosine and I didn't really like it so much.  Do you have any experience with it personally or with patients on it?  Did it help?

It makes sense that the time of your medicine wearing off would be the time frame.  I started feeling a LOT better around 8:00 p.m. this evening.  I even got housework done, imagine that!  So that would have been 79 hours since my last dose or a little more that 72 hours since the medicine wore off.

I did taper very slowly according to my doctor's instructions.  So my body has had plenty of time to adjust.  I didn't go all the way down to 1/4 tablet though.  Maybe if I had I wouldn't have had the lack of ambition I have had.

Have you noticed that people's pain decreases once they are off pain meds for a while?  The aleve and tylenol do help some.  I also use ice packs, heating pads, muscle rubs, and all that kind of stuff.

Have you had an injury yourself in the past that required pain medication?

Thanks again for all of your help!

SB
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Yes I do have quite a heart for helping people, I always have. I knew I wanted to be a psychologist since I was 12 lol. I have just always enjoyed being there when someone had a question or just needed to talk. Even when I was in jr. high school, all of my friends came to me for help and advice. When I was about 16 I found out that my name means advisor. And my mom's name means counselor, and she is an attorney;) I also knew early on that I wanted to have not only my own practice but my own building, my own company so that once I got married and decided to have kids I could stay home to raise my babies and still have money coming in and work as much or as little as I wanted, so that's what I did. I usually post between seeing patients and when I'm on myspace goofing off and typing up patient notes and stuff. And I am so naturally nocturnal so I am online when hubby and baby are asleep and I'm wide awake. I was also an addict so this forum is great for me too. And there are forums and websites where you can chat with doctors and professionals at certain times or post your questions to them but here I can be so much more open with everyone and talk as friends and still be able to help. I have always had a lot of friends and family who are doctors and I know a lot of them don't have time for much else after work. Doctors in private practice sometimes have more time than those in the ER working 12 hour shifts. A friend from grade school is a surgeon at both hospitals at NYU in Manhattan where he went to med school and he always finds plenty of time to come out here every couple months to visit and he always has plenty of time to party, he's a big fan of tequila and the nose candy(cocaine).

Anyhow (see, rambling again) It sounds like your doctor gave you a very good taper plan. If you are still feeling bad it shouldn't llast long at all. The l-tyrosine is basically just skipping a step in taking the L-phenylalanine but the biosynthesis gets pretty complicated so I would just take the l-tyrosine. It will increase your dopamine,norepinephrine and epinephrine (adrenaline). I have taken the black cohosh when in withdrawal but didn't notice too much of a difference, it helped a little especially with the changes in body temperature. It has worked well for some of my patients. With herbs and natural supplements just keep in mind that they are not chemicaly manufatured to do the same thing in everyone's body. If you take prozac it will increase serotonin, if you take morphine it will increase endorphins, and although meds can effect people differently it is even more so with herbal and natural supplements. They are not FDA approved (there are a lot of political reasons for this) but they won't always have a good effect on everyone. With phenylalanine just keep in mind that this amino acid uses the same pathway as tryptophan, which turns into serotonin. So too much phenylalanine can interfere with serotonin levels  making them lower and you do not want that.

I feel like I am forgetting something here, if I am please let me know, I went to eat after I started typing this so I may have left some things out
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