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What are my options?
I was in an accident in 2003, and I had my jaw broken in several places. I currently have several plates in jaw, and I have been taking vicodin for nearly this entire time. I am on 10-660mg. I have been taking steriod injections for the past year and I think they are working, but I cant kick the vicodin, even when I try after 1-2 days I start to get weird symptoms. And the pain is terrible! I dont know if it is legitamate pain or addiction! I have to admit this has been a scary revelation and I want to stop but I cant live with this pain! mental or physical! what are my options and ways to see if it is real pain or my mind tricking me! Help! Help! Help!
Sounds like you have it far worse than me, so I'm sorry to hear you're experiencing this, I did quite a bit of reading around the subject when I was suffering and it appears you have genuine trigeminal neuralgia. I was quite lucky in comparison but what I did experience allows me to sympathise greatly. When I had a bunch of broken bones in my face the nerve probably got crushed which prevented it functioning (in retrospect, quite forunate because it stoped me feeling the amount of pain I should have from all those broken bones!) Consequently, I couldn't feel a thing in the whole of the right hand side of my face. Really weird, like a dental anaesthetic that affected the whole side of my face - I could feel half my teeth and half my nose, the other side, you could have stuck a pin in anywhere and I wouldn't have felt it!
After my surgery,the feeling started to come back, and it hurt a lot, but luckily didn't last long - and of course I started to play with opiates so that may have helped to conceal the pain! Now it's no more than uncomfortable (certainly not the real pain that it sounds like you might have) and I still have a few small areas of little feeling. I was told it could take 18 months to 2 years for the nerve to recover all the function that it's going to, so I live in hope that I won't develop what affects you...
Obviously, I'm not an expert on this but some of what you've been told sounds a bit unlikely. I can easily believe that the operation may or may not work, at a stretch I could believe it might affect your eyesight (although I question that, the eye has it's own nerve system I believe...) but the idea of damage to the ear sounds wrong. It's been a while since I looked at the diagrams of the nerve, but as I remember, one branch goes up around the eye, another to the mouth/nose and the third to the jaw/chin (from what you say, this is the one that's causing you trouble). Nothing goes near the ear as I remember. I'm certainly not going to say that what you've been told is wrong because I don;t know enough. However, if I were you, I'd look into it a little because it never hurts to be better informed. For example, surgery is only one option - usually the last one - there are other treatments that can be tried first.
For what it's worth, I had my surgery at Kings Colege Hospital in London and they do a lot of research into trigeminal nerve pain etc there. If you go to their website, you can go to the research section and contact them and ask for some details. They gave me some good links to information when I asked them to. Their site is here:
http://www.kch.nhs.uk/services/dental-institute/oral--maxillofacial-surgery/
Some other good sources of info are here:
http://www.emedicinehealth.com/trigeminal_neuralgia_facial_nerve_pain/article_em.htm
and
http://www.tna.org.uk/
Hope any of this helps and I wish you luck.
After my surgery,the feeling started to come back, and it hurt a lot, but luckily didn't last long - and of course I started to play with opiates so that may have helped to conceal the pain! Now it's no more than uncomfortable (certainly not the real pain that it sounds like you might have) and I still have a few small areas of little feeling. I was told it could take 18 months to 2 years for the nerve to recover all the function that it's going to, so I live in hope that I won't develop what affects you...
Obviously, I'm not an expert on this but some of what you've been told sounds a bit unlikely. I can easily believe that the operation may or may not work, at a stretch I could believe it might affect your eyesight (although I question that, the eye has it's own nerve system I believe...) but the idea of damage to the ear sounds wrong. It's been a while since I looked at the diagrams of the nerve, but as I remember, one branch goes up around the eye, another to the mouth/nose and the third to the jaw/chin (from what you say, this is the one that's causing you trouble). Nothing goes near the ear as I remember. I'm certainly not going to say that what you've been told is wrong because I don;t know enough. However, if I were you, I'd look into it a little because it never hurts to be better informed. For example, surgery is only one option - usually the last one - there are other treatments that can be tried first.
For what it's worth, I had my surgery at Kings Colege Hospital in London and they do a lot of research into trigeminal nerve pain etc there. If you go to their website, you can go to the research section and contact them and ask for some details. They gave me some good links to information when I asked them to. Their site is here:
http://www.kch.nhs.uk/services/dental-institute/oral--maxillofacial-surgery/
Some other good sources of info are here:
http://www.emedicinehealth.com/trigeminal_neuralgia_facial_nerve_pain/article_em.htm
and
http://www.tna.org.uk/
Hope any of this helps and I wish you luck.
I have been having trigeminal nerve pain since 4-2004. I began having this facial pain that caused me to drive off the road during on attack. I went to the dentis, oral surgeon, a TMJ specialist..anyone how would see me. I wanted all my teeth pulled because I could not take the pain or the fact no one beleived me or wanted to even deal with me. I finally went to a nueroligest(sp) and was told what was wrong. I believe that my pain was caused from the tube they put down to knock you out for surgery. They are suspose to move that tube througout the operation, but perhaps someone was sleeping on the job. The tube went into a space where I am missing a tooth and therefore sat on the nerve for several hours. I was so releived to finally get someone to listen to me. I had another attack this week, and I felt as though I was being shot in the face. I could have an operation, but the chance it will come back is 90%. I could lose my hearing or sight if I choose to have the operation. This condition has contributed to the addiction of pills I have now.
It is nice to hear from someone else who has suffered with the trigeminal issue.
It is nice to hear from someone else who has suffered with the trigeminal issue.
Seems to be standard practice in the UK, I've had more broken bone surgery than I care to think about (gotta love those sporting injuries) and every time, afterwards I've been prescribed codeine, APAP and diclofenac for pain relief. Seems to just be the standard way of doing things here. It's considered that codeine isn't great as a painkiller on it's own but when combined with APAP is quite effective - and I can tell you, it is (remember that whenever you see comparative analgesic strengths of opiates, it's just the opiates, not a combination of drugs.) Dihydrocodeine and tramadol are used occasionally but very rarely.
For the most part, it seems that morphine and morphine like drugs eg oxycontin are strongly held back and will not be prescribed by any regular doctors/surgeons. To get those you would need to be seen by specialist pain management doctors and they seem to only give out those kinds of drugs under very controlled circumstances - so unless you're an inpatient or undergoing cancer care, you're not likely to get them.
It's the same with dental care, diclofenac, codeine and APAP, and we seem to cope!
To be honest, looking at things from the outside, it seems to me that this restrained attitude probably prevents a lot of people getting into problems with stronger drugs and the fact that people all over the UK go through surgery or dental extractions etc and seem to cope just fine without having to take oxys or hydromorphone etc suggests to me that maybe the US docs are a bit too free and easy with these things?
For sure the fact that largely our government is picking up the tab for our medicines has an effect on what is prescribed too so it probably isn't all about being responsible, it's probably also determined by lots of research into which are the cheapest meds that releive pain effectively (enough) .
For the most part, it seems that morphine and morphine like drugs eg oxycontin are strongly held back and will not be prescribed by any regular doctors/surgeons. To get those you would need to be seen by specialist pain management doctors and they seem to only give out those kinds of drugs under very controlled circumstances - so unless you're an inpatient or undergoing cancer care, you're not likely to get them.
It's the same with dental care, diclofenac, codeine and APAP, and we seem to cope!
To be honest, looking at things from the outside, it seems to me that this restrained attitude probably prevents a lot of people getting into problems with stronger drugs and the fact that people all over the UK go through surgery or dental extractions etc and seem to cope just fine without having to take oxys or hydromorphone etc suggests to me that maybe the US docs are a bit too free and easy with these things?
For sure the fact that largely our government is picking up the tab for our medicines has an effect on what is prescribed too so it probably isn't all about being responsible, it's probably also determined by lots of research into which are the cheapest meds that releive pain effectively (enough) .
okay so I have to ask...why so much codine? Why not a much lower dose of something stronger. Codine is a very weak opiate.
I had many bones broken in my face a couple of years ago and like you, have a bunch of metal plates in place to remind me of it. The injury did substantial damage to my trigeminal nerve and I was given 240mg codeine a day to take fro about 4 weeks if i remember correctly. My codeine habut eventally grew into an1800mg/day habit but realistically, I didn't need the pills from probably a few days after the surgery. After that, it was all about recreational use.
Now that I am clean, I feel the nerve damage and am more aware of the plates but they are at most uncomfortable, not really painful. So based on all of that, I'm guessing that maybe you've done something similar - although the steroid injections aren't something I experienced.
Based on my experience of having bones plated back together (I've had others, not just my face) it would be unlikely for you still to be feeling pain after all this time but obviously I cant say you aren't or that nobody does. Your doc would have to advise there.
Anyhow, alhough your dose is unlcear (as others have said) from your description it sounds like you're experiencing withdrawals when you try and stop. and that's to be expected if you've been taking a high dose for a long time...
Now that I am clean, I feel the nerve damage and am more aware of the plates but they are at most uncomfortable, not really painful. So based on all of that, I'm guessing that maybe you've done something similar - although the steroid injections aren't something I experienced.
Based on my experience of having bones plated back together (I've had others, not just my face) it would be unlikely for you still to be feeling pain after all this time but obviously I cant say you aren't or that nobody does. Your doc would have to advise there.
Anyhow, alhough your dose is unlcear (as others have said) from your description it sounds like you're experiencing withdrawals when you try and stop. and that's to be expected if you've been taking a high dose for a long time...
Hey there -- so sorry to hear of your predicament. If you've been taking vicodin for 6 years now, then no doubt you are having withdrawal. I think you should talk to your doctor and try a tapering plan. Do you take them as prescribed? Do you take more? Run out early? Even if you take them exactly as prescribed and are not an 'addict' per say your body is physically addicted/dependent on this medication. You can approach it that way with your doctor. Unfortunately when our bodies are dependent on opiates and we take those opiates away, any minor pain becomes exacerrbated and is much much worse than it would normally be. You really wont be able to gauge your true pain level until the withdrawal is over. There are things your doctor can give you to ease some of the withdrawal, but you should definitely talk to him. It should not be a surprise to your doctor that after 6 years of vicodin, you've become physically dependent on them. He/she should help with a taper plan and with some meds that can ease the pain. Best of luck and keep us posted ok!
You are probably having w/d. How many are taking a day? Can you be more specific with your symptoms?
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