Aa
Turns out I'm not crazy after all!
I'm an almost 30 year old who has been suffering from increasing pain for some time. I've had arthritis in my right knee and for the last 7 months have had major problems with my left ankle-I'm now on temporary disability to try to avoid major surgery. Until recently, doctors would tell me the pain was from x, y and z and the best thing to do was loose weight.
When I first began to have knee problems I was prescribed percocet and it got out of control quickly-same old story we've all heard. At that point, was never really taking to get high-but when I took the amount prescribed I was still in a great deal of pain. I have been on and off the percs a few times and the withdrawls were not fun!
Since I began having problems with my ankle I was first given tramadol which I got hooked on and had to taper off and the withdraws for that really ****. I was prescribed percs again and I started to take too much again but I stopped for about 2 weeks and since then have been taking them as prescribed.
This week I saw an orthopedist for a second opionion and he ran a bunch of blood tests. Your vitamin D level should be 40+-mine is 9.7. He put me on 50,000 units twice a week and I'll be tested again in 6 weeks. In the mean time my Dad's pain management doctor told him I must be in excruciating pain and is surpirsed I can still walk. This was nice to hear if only because it means the pain is really not in my head. And all those times my Dad would tell me I have no tolerance for pain; it turns out I have a very high tolerance!
My question is this: when I get to see a pain management doctor anyone have any ideas what I should be asking for? At this point without some sort of heavy duty pains meds I can barely function. Even with them I was not able to stay on my feet for 8 hour shifts.
I don't want to be on the percs any longer than I need to be and I don't want to start the cycle over again but I can't be in this level of pain all the time either. Any suggestions would be much appriciated.
When I first began to have knee problems I was prescribed percocet and it got out of control quickly-same old story we've all heard. At that point, was never really taking to get high-but when I took the amount prescribed I was still in a great deal of pain. I have been on and off the percs a few times and the withdrawls were not fun!
Since I began having problems with my ankle I was first given tramadol which I got hooked on and had to taper off and the withdraws for that really ****. I was prescribed percs again and I started to take too much again but I stopped for about 2 weeks and since then have been taking them as prescribed.
This week I saw an orthopedist for a second opionion and he ran a bunch of blood tests. Your vitamin D level should be 40+-mine is 9.7. He put me on 50,000 units twice a week and I'll be tested again in 6 weeks. In the mean time my Dad's pain management doctor told him I must be in excruciating pain and is surpirsed I can still walk. This was nice to hear if only because it means the pain is really not in my head. And all those times my Dad would tell me I have no tolerance for pain; it turns out I have a very high tolerance!
My question is this: when I get to see a pain management doctor anyone have any ideas what I should be asking for? At this point without some sort of heavy duty pains meds I can barely function. Even with them I was not able to stay on my feet for 8 hour shifts.
I don't want to be on the percs any longer than I need to be and I don't want to start the cycle over again but I can't be in this level of pain all the time either. Any suggestions would be much appriciated.
The pain Mgt placed near me are hard to get into. Have to have your family dr send over their reports of the pain/ problem. Then need a cat scan of problem area. Review that info, do a consult to see if they will even take you.
Like gnarly I'm 6-7 years and I'm addicted
Like gnarly I'm 6-7 years and I'm addicted
COMMUNITY LEADER
Here is my suggestion to you, get that vitamin D level up and evaluate your pain then. If it is getting better then talk with your doctor and start a taper plan. Let us know how you are doing okay? sara
Thanks Gnarly. You're such a sweetheart! :-) I often wonder how many people become addicts solely from being introduced by a pain doctor to opiates for legitimate pain. The literature says only something 5% of chronic pain patients on opiate therapy become addicted. The number of posts on this topic both here and on other web sites leads me to believe that those 5% are only the patients who were honest about the question. Secrecy is such a huge part of addiction that I have a hard time believing any of the stats are very accurate.
bdh_girl - Actually, I WAS trying to help you by educating you about the general practice of pain management. The reason people were directing you to the PM forum is because it's much more likely that you will find someone on that forum who has dealt with something similar to what you're dealing with.
There are many cross-posts between this forum and the PM forum because many addictions begin with pain management so your post isn't all that unusual. I do understand why you posted here and I believe you have real pain. I also know how awful that grinding bone pain can be since both my hips are shot from years of ballet and will need replacement one of these years. I am on opiate therapy for constant small bowel obstruction, but meds do zero for my bone pain. It's a tough kind of pain to treat effectively.
There ARE alternatives to pills - narcotics or otherwise. Physical therapy, hot tub soaks, no-impact toning exercise, maintaining normal weight, TENS unit, hot/cold packs, etc. Even with meds on board, all these things can help however little. With any kind of arthritis, keeping your muscles toned and your weight down can make a huge difference because it takes stress off your bones. Steroid injections directly into the hip joints give me a few weeks of feeling pretty normal. That may be something to ask your doctor about where your joints are concerned.
With your additional information, I can see where surgery is a dicey proposition at the moment. If your bones can't generate new cells properly, then something like a knee replacement wouldn't be a good idea because it would either heal very poorly or not at all. Did your surgeon discuss that issue when he brought it up? Are the doctors looking into WHY you don't have enough vitamin D or are they assuming it's primarily a dietary issue?
If your therapist is not knowlegeable in pain management specifically, you might want to try one who is. There is a big difference because they also understand opiate therapy and addiction issues. There have been many chronic pain patients on Med Help who were doing just fine on opiate therapy, but stopped because of false information from a therapist who didn't know a thing about it other than what "everyone knows." The therapist assumes physical dependency and withdrawal symptoms after discontinuing the medication means the patient is an addict. Not true.
It's not just laypeople who don't understand addiction. Plenty of doctors don't understand pseudo-addiction either. That's when a patient exhibits addictive behavior like doctor shopping or taking more than prescribed. It's a fine line between psuedo-addiction and addiction and it all goes toward the motivation of the behavior. If the patient is doing it for pain relief only and not because he is craving and looking for the euphoric high, that's pseudo-addiction. It can be a tough call for both the patient and doctor, and most lean on the side of addiction.
Should it turn out that opiate therapy is your only option, then you need to plan now for how you will handle it. If you have a spouse or partner, have that person dole out your daily meds to make sure you don't give in to temptation. There are a couple people here in your shoes but with different conditions and that arrangement has worked out for them. It can put pressure on the relationship though, and where chronic pain and addiction are concerned, relationships are already usually strained enough.
Give people some time to see your post on both forums. Weekend evenings can be slow. Best of luck to you in your search for pain management. :-)
bdh_girl - Actually, I WAS trying to help you by educating you about the general practice of pain management. The reason people were directing you to the PM forum is because it's much more likely that you will find someone on that forum who has dealt with something similar to what you're dealing with.
There are many cross-posts between this forum and the PM forum because many addictions begin with pain management so your post isn't all that unusual. I do understand why you posted here and I believe you have real pain. I also know how awful that grinding bone pain can be since both my hips are shot from years of ballet and will need replacement one of these years. I am on opiate therapy for constant small bowel obstruction, but meds do zero for my bone pain. It's a tough kind of pain to treat effectively.
There ARE alternatives to pills - narcotics or otherwise. Physical therapy, hot tub soaks, no-impact toning exercise, maintaining normal weight, TENS unit, hot/cold packs, etc. Even with meds on board, all these things can help however little. With any kind of arthritis, keeping your muscles toned and your weight down can make a huge difference because it takes stress off your bones. Steroid injections directly into the hip joints give me a few weeks of feeling pretty normal. That may be something to ask your doctor about where your joints are concerned.
With your additional information, I can see where surgery is a dicey proposition at the moment. If your bones can't generate new cells properly, then something like a knee replacement wouldn't be a good idea because it would either heal very poorly or not at all. Did your surgeon discuss that issue when he brought it up? Are the doctors looking into WHY you don't have enough vitamin D or are they assuming it's primarily a dietary issue?
If your therapist is not knowlegeable in pain management specifically, you might want to try one who is. There is a big difference because they also understand opiate therapy and addiction issues. There have been many chronic pain patients on Med Help who were doing just fine on opiate therapy, but stopped because of false information from a therapist who didn't know a thing about it other than what "everyone knows." The therapist assumes physical dependency and withdrawal symptoms after discontinuing the medication means the patient is an addict. Not true.
It's not just laypeople who don't understand addiction. Plenty of doctors don't understand pseudo-addiction either. That's when a patient exhibits addictive behavior like doctor shopping or taking more than prescribed. It's a fine line between psuedo-addiction and addiction and it all goes toward the motivation of the behavior. If the patient is doing it for pain relief only and not because he is craving and looking for the euphoric high, that's pseudo-addiction. It can be a tough call for both the patient and doctor, and most lean on the side of addiction.
Should it turn out that opiate therapy is your only option, then you need to plan now for how you will handle it. If you have a spouse or partner, have that person dole out your daily meds to make sure you don't give in to temptation. There are a couple people here in your shoes but with different conditions and that arrangement has worked out for them. It can put pressure on the relationship though, and where chronic pain and addiction are concerned, relationships are already usually strained enough.
Give people some time to see your post on both forums. Weekend evenings can be slow. Best of luck to you in your search for pain management. :-)
Great post Jaybay....I did 16 1/2 yrs of pain management and all I wound up was addicted
...................Gnarly
...................Gnarly
Ok, first of all I am well aware what forum I posted to. I was looking for some ideas of what I might hear and some ideas of thing OTHER than pills. I have no intention of demanding anything but I like to be as informed of my options rather than having no clue. If the doctor is not going to allow me to ask questions it is not a doctor I will be returning to.
The WHOLE reason I posted here as well as the pain mamgement forum was to get ideas from other addicts about alternative therapies. I am not asking for stratagies to get narcotics!
As far as surgery and what is cazusing my pain-as I said in my original post, my vitamin D level is VERY low. Without vitamin D your body can not repair itself and you can loose bone mass and damage your joints. If I have to have the surgery it means I will not be able to bear any weight for at least 4 weeks and then be in a walking cast for 4-6 weeks followed by physical therapy. Since I am the sole caretaker for my father who has had a leg amputated, I am trying to avoid the surgery. Plus the surgery would require me to be on narcotics for the pain and I am trying to avoid that.
For the record, I am in therapy and have been for several months.
I posted here because I have been reading this forum for a year plus and have always been impressed by the feeling of community and advice offered and I was looking for some advice from people who understand the tightrope I am walking between cripling pain and addiction. I'm sure it was not anyone's intention but what I have received instead has felt like an attack and advice to go elsewhere.
It is frightening when a doctor who specializes in pain (my Dad's not mine) says that your pain must be unbearable and is impressed you are still walking. I'm trying to cope with the pain and a bunch of other issues and NOT use percocet.
I would love any advice or encouragement but if this forum is not the community I had thought it was I guess it is better for me to know.
The WHOLE reason I posted here as well as the pain mamgement forum was to get ideas from other addicts about alternative therapies. I am not asking for stratagies to get narcotics!
As far as surgery and what is cazusing my pain-as I said in my original post, my vitamin D level is VERY low. Without vitamin D your body can not repair itself and you can loose bone mass and damage your joints. If I have to have the surgery it means I will not be able to bear any weight for at least 4 weeks and then be in a walking cast for 4-6 weeks followed by physical therapy. Since I am the sole caretaker for my father who has had a leg amputated, I am trying to avoid the surgery. Plus the surgery would require me to be on narcotics for the pain and I am trying to avoid that.
For the record, I am in therapy and have been for several months.
I posted here because I have been reading this forum for a year plus and have always been impressed by the feeling of community and advice offered and I was looking for some advice from people who understand the tightrope I am walking between cripling pain and addiction. I'm sure it was not anyone's intention but what I have received instead has felt like an attack and advice to go elsewhere.
It is frightening when a doctor who specializes in pain (my Dad's not mine) says that your pain must be unbearable and is impressed you are still walking. I'm trying to cope with the pain and a bunch of other issues and NOT use percocet.
I would love any advice or encouragement but if this forum is not the community I had thought it was I guess it is better for me to know.
I am a chronic pain patient and I can tell you the worst thing you can do is march into a pain doc's office and ask for (demand) any particular medication or therapy. One, it's insulting to the doctor's intelligence; and two, it demonstrates something a closed mind to any alternative therapies the doctor may offer that you may not have heard or read about. It's also a good way to get yourself labeled as a drug seeker and thrown out of the practice.
Not all chronic pain conditions require narcotics. Some, like migraine headaches, only get worse with narcotics on board. Osteoarthritis and other conditions causing bone pain don't necessarily respond nearly as well to narcotics as to anti-inflammatories or even steroids. So much depends on what is causing your pain, which I admit I'm not really clear on.
Also, being as young as you are most doctors won't be willing to put you on long-term opiate therapy. Or at least, the good ones won't. Any doctor who jumps at the big guns right out of the starting chute isn't doing his job, nor is he doing what's in his patient's best interests without trying other therapies first.
A lot of people think of the pain management specialty as nothing more than one-stop shopping for pills. There are plenty of bad doctors out there who do just that, which can make it difficult to sift through the pushers and find a good one. That public perception also makes it difficult for patients who are on opiate therapy to explain the difference between addiction and physical dependence to their friends and family.
The mission of pain management is to help you "manage" your pain and hopefully make it better and to help you function better. It usually doesn't reach the "cure" status. Unrealistic expectations lead only to disappointment, frustration, anxiety and usually constant requests for more and more medication. Most people with chronic pain never find a cure for their pain.
That's another reason people get into trouble with opiates. They start out with a little vicodin or percocet and they can function again. You now know yourself that effect doesn't last long. Sooner or later you're only taking them to not get dope sick and you really have no idea how much real pain you're in.
I highly recommend psychotherapy with a psychologist who specializes in pain management. Usually a form of cognitive behavior therapy is used to help you learn some different ways of coping with your pain so that you don't always automatically reach for the pill bottle. Conscious relaxation, meditation, even self-hypnosis are not difficult to learn and have helped me immensely. It never hurts to at least try a few weeks of therapy and it may actually help. Therapy also helps you deal with all the other areas of life that chronic pain detroys like personal relationships and self-esteem because you can't do the things you once did with no problem. You can't expect others to understand what it's like to live with chronic pain because they honestly can't imagine it. A good therapist can help you find ways to improve your relationships as people in your life get used to the new you. Don't knock it till you've tried it!
Keep an open mind and have a very honest discussion with your doctor about your previous active addiction, and also your expectations of pain management. You want to be sure that you and your doctor are on the same page and working toward the same realistic goals. Don't expect to take a pill and return to the same level of activity you were at before you were injured. It's just not going to happen. You mentioned surgery was an option. What kind of surgery is has been discussed with you? Ultimately, that may be the best route for you - or not. If the underlying condition causing the pain can be surgically repaired, what are the pros and cons? It's a lot to think about, I know!
Not all chronic pain conditions require narcotics. Some, like migraine headaches, only get worse with narcotics on board. Osteoarthritis and other conditions causing bone pain don't necessarily respond nearly as well to narcotics as to anti-inflammatories or even steroids. So much depends on what is causing your pain, which I admit I'm not really clear on.
Also, being as young as you are most doctors won't be willing to put you on long-term opiate therapy. Or at least, the good ones won't. Any doctor who jumps at the big guns right out of the starting chute isn't doing his job, nor is he doing what's in his patient's best interests without trying other therapies first.
A lot of people think of the pain management specialty as nothing more than one-stop shopping for pills. There are plenty of bad doctors out there who do just that, which can make it difficult to sift through the pushers and find a good one. That public perception also makes it difficult for patients who are on opiate therapy to explain the difference between addiction and physical dependence to their friends and family.
The mission of pain management is to help you "manage" your pain and hopefully make it better and to help you function better. It usually doesn't reach the "cure" status. Unrealistic expectations lead only to disappointment, frustration, anxiety and usually constant requests for more and more medication. Most people with chronic pain never find a cure for their pain.
That's another reason people get into trouble with opiates. They start out with a little vicodin or percocet and they can function again. You now know yourself that effect doesn't last long. Sooner or later you're only taking them to not get dope sick and you really have no idea how much real pain you're in.
I highly recommend psychotherapy with a psychologist who specializes in pain management. Usually a form of cognitive behavior therapy is used to help you learn some different ways of coping with your pain so that you don't always automatically reach for the pill bottle. Conscious relaxation, meditation, even self-hypnosis are not difficult to learn and have helped me immensely. It never hurts to at least try a few weeks of therapy and it may actually help. Therapy also helps you deal with all the other areas of life that chronic pain detroys like personal relationships and self-esteem because you can't do the things you once did with no problem. You can't expect others to understand what it's like to live with chronic pain because they honestly can't imagine it. A good therapist can help you find ways to improve your relationships as people in your life get used to the new you. Don't knock it till you've tried it!
Keep an open mind and have a very honest discussion with your doctor about your previous active addiction, and also your expectations of pain management. You want to be sure that you and your doctor are on the same page and working toward the same realistic goals. Don't expect to take a pill and return to the same level of activity you were at before you were injured. It's just not going to happen. You mentioned surgery was an option. What kind of surgery is has been discussed with you? Ultimately, that may be the best route for you - or not. If the underlying condition causing the pain can be surgically repaired, what are the pros and cons? It's a lot to think about, I know!
I go to pai Mgt and can tell you they will give you what they feel is right. You aren't able to ask for anything. They might listen to what works best but it's up to them.
Wrong forum. This is for people trying to get off meds.
Wrong forum. This is for people trying to get off meds.
It is my experience that PM usually involves some sort of drug, unfortunately. But you are right, it doesn't have to be like that. I suffer with chronic pain and some things I have done and still do are: Cortisone injections, acupuncture and aqua therapy (all successful). I didn't have success with physical therapy, but that is just me. Certainly give it a try if it is offered.
If you can stay away from the meds, please try and do that. Good luck.
If you can stay away from the meds, please try and do that. Good luck.
I'm sorry if there was a misunderstaqnding-I am not asking for drug suggestions. I was asking if people has other ideas. Pain management doesn't have to be a drug. I am aware of how difficult it is for people on this forum; I have been reading it for a long time as I tried to stay off the percocet. I am an addict and I understand the concern but I am reaching out for ideas that could aid me in staying clean. Maybe I am in the wrong place after all.
Please be patient with your responses in the pain mngt community. It is the weekend and it is quiet. This is not the community for members to be telling you what pain meds to take. There are many members here struggling to get off of them and it is difficult to talk about this. I'm sorry and I hope you understand. Best of luck.
I have posted over there and got no response. I thought I would ask here since I've been reading the addictions forum since I began having problems with the percocet a few years ago.
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