Chronic pain treatment and Hep C

[averagegeek]

First of all, I'm in the acute stage of Hep C as far as I know. Titer 561 that's not a misprint...fivehundredsixtyone Viral Load. Genotype is not able to be said because the lab does not have enough genetic material (virus) in my blood to be able to test it.

Second, I have Degenerative Disc Disease (DDD), a ruptured disc at L5-S1, ruptured toward the right, and disc fragments on the left impinging the S1 nerve root. My left foot is cold and completely numb, skin from toes to knee is numb, and I can barely feel pressure (let alone feel my fingernails on my skin when I have an itch). Shooting pain from back L side, into back of left leg, burning, electric shocks. Rt side of spine beginning to hurt more each day: sharp shooting pains into Rt bottock, back of thigh.

Dr has prescribed Vicodin 5/500 3xs daily for a month (5mg hydrocodone/500mg tylenol)...Have recently been having upper right ab pain. Begged Dr. for Vicoprofen (7.5Mg hydrocodone/200Mg Ibuprofen). I also take 500Mg Naproxen with Vicoprofen at bedtime, and upon awakening in the morning. During the night the pain wakes me over and over, and I cannot find a comfortable position to relieve the pain.

Without these pain meds, I have been having to crawl out to the kitchen counter, dragging my cane, then with MUCH effort and pain, I can manage to get myself somewhat upright (bent over the counter with left leg unable to straighten out, let alone be placed flat on the floor.

Based on how much pain I am in I had my second MRI in about three months, and will receive results on Tuesday, the 22nd.

My question is this: Is all this Vicodin/Vicoprofen/Naproxen OK for my liver? My last ast/alt were completely normal after retesting after 1 month without using Naproxen. The Dr.s say since my enzymes were normal (a couple months ago) it is ok for me to be taking these meds. But, like I said, I have been having sporadic upper Rt ab pain for the past week.

I know the liver can repair itself, as mine has shown me it absolutely can; however, I am on about 8 other meds besides the pain meds...for Schizoaffective disorder, anxiety, ADD, high blood pressure, depression (yes, I really am only 31),

Do any of you out there have chronic pain treated with meds PLUS hep C? What is the long term damage to the liver, and how long can it keep repairing itself before it just tires out and begins to become fibrotic? Are there effective ways to treat chronic pain from DDD, ruptured discs, fragments, etc. that don't require meds and won't harm the liver? I had an epidural spinal injection of cortico steroids but it was so extremely painful I had nightmares about it until the Neurosurgeon said I didn't need to have another one.

There have got to be non drug pain treatments out there. I just can't find them. I feel too young to be taking harsh narcotic pain relievers long term, especially with Hep C. Any and all advice will be carefully considered, and much appreciated.

Sincerely,
AverageGeek

PS: Sorry I'm so verbose, I just feel I have to tell the entire story.

[franke566]

Ask your pain dr to give you 10/325 Norco so you can break them in half and get less tylenol-also ask for a tens unit.  I had L4 L5 S1-surgery did not work-pain returned after a couple of years this time both Butt cheeks legs and feet so I know what you are going thru.  During Tx I was on a duragesic patch-no help-then Morphine, also no help.  By breaking the 10s in half you still get 50 mg of codein and less tylenol which is more toxic to liver than the tylenol.  The Tens unit really saved me alot of agony-especially at night

[averagegeek]

I just wrote a journal entry viewable to everyone about the Dr.s visit about MRI results, dated Sept. 24, 09. Tells what Dr had to say, results, etc. Also, there was a new med I forgot to list up there for high blood pressure, called Lisinopril, 10 Mg once daily, and it's already working. I have a home BP cuff, and all readings have come down from 150/100 to 129/80. I know 150/90-100 isn't terribly high, but those numbers have been consistent over the last 1 year or more, so my PCP decided to treat.

[averagegeek]

Hey, np. I'm taking the Restoril because of terrible, chronic insomnia, and when I don't sleep well the schizophrenic psych symptoms skyrocket. Klonopin has been off and on for about 10 yrs due to generalized anxiety disorder, panic attacks, and post traumatic stress syndrome. I don't believe in a pill for every problem, but I do believe in better living through modern chemistry  :) That's why I want off the pain meds, because these others are going to be necessary indefinately.  

[desrt]

I was thinking the Restoril and Klonopin. But there I go thinking again .....always gets me into trouble ;-)

[averagegeek]

I actually just started taking the Adderal last week, and it seems to help quite a lot to help me finish things around here. Last year I read thru all the report cards my Dad kept from Pre-k thru about 3rd grade, and they all mention "talks in class, disruptive, daydreaming, not turning in homework..." Dr seems to think I've had the ADD all my life since throughout the past 11 yrs and more than 30 meds have not helped with distraction, losing train of thought, lack of followthrough, lack of focus, etc. So I doubt the Adderall is causing any of the symptoms I have, but it is helping to recuce some symptoms. None of the meds I'm on are to treat med side effects...Note the lack of Cogentin in the list of meds, which is commonly prescribed to treat tremors caused by other meds.

There may be (and I hope there is) a physical treatment for the degenerative Disc Disease, ruptured disc, and disc fragments. I recently had the second of 2 MRIs in about three months. The second one was called for because the symptoms have been getting worse, not better, since the 1st MRI. I'll find out on Tuesday, when I visit my Dr about the results whether or not he recommends surgery. The thought of surgery is daunting, but to me now, seems like my best hope. I don't want to be on all these pain meds what with having a liver disease, and the sadly necessary Psych. Meds.

BTW, all of those meds were Rxed before Adderall ever entered the picture. I really do have acid reflux disease, and more psych problems than I listed above. I'm curious to know which 2 meds you think were prescribed to treat med side effects...no offense.

~Averagegeek

[desrt]

It looks like you're at the point of having to take two more meds to deal with the side effects of each of the previous meds you've been Rxd.
Not being judgemental - your doc may have good reasons for treating in this fashion - but it seems like if you could find some way to deal with the ADD without the Adderall, you could wean off about half the stuff on that list. It would probably be a long process since you're on a couple different benzo's. Again, this is just a layman's opinion, given without knowing anything about your circumstances [blah, blah, MedHelp posted warning about taking advice from non-professionals over the 'net]. Is there some 'mechanical' way (surgery) to deal with your disc problems? I'm the last one to promote unneccessary procedures, but trying to balance pain meds  and NSAIDs on top of everything else you're taking seems rather daunting.
Best of luck with it and take care.

[averagegeek]

Here is the complete list of all the meds I take: (maybe you all can shed more light on this for me if you know everything going into my body):

Omeprazole (Prilosec), 20 mg 1x daily--for Acid reflux
zantac as needed when the omeprazole doesn't work completely
Vicoprofen 7.5/200 3 Xs daily--for severe pain
Naproxen 500mg as needed to reduce pain/swelling
Pristiq 50 Mg 1x daily--antidepressant
Adderal, 10 mg 2xs daily--for adult ADD
daily mulitvitamin plus thiamin--prescribed because Potassium was recently so low I was in the ICU taking IV supplements to get stabilized
Klonopin 1Mg 2Xs daily--anxiety and panic
Seroxuel XR 300MG 2Xs daily--antipsychotic/mood stabilizer
Temazepam (Restoril) 30 Mg @ bedtime--to induce sleep
Cigarettes, 1 pack per day
Coffee, about 4 cups per morning
Aspirin, 650 Mg in place of Naproxen occasionally

No illegal, unprescribed, or street drugs...no, I was never an IVDU...I was exposed thru a cut on my hand and a dirty/bloody counter at an IVDU's house. (I know, truth is stranger than fiction.)

Acute Hep means aquired within the last 6 months, right? I'm pretty sure I was exposed around Thanksgiving last year 2008, so maybe it isn't acute anymore, cause I'm still positive for the antibodies.

[catqueenjune]

Hi,  I cannot take any NSAIDs and when I talked to my pharmacist she asked if I'd had tests to determine if they were hurting my kidneys (which is where it hits me) but without insurance it's all experience based.  At any rate what I'm trying to get to is ask your Dr for pain meds WITHOUT the analgesic.  It might make a difference.  Everyone is so quick to use the Nsaids but I can't.  I even tried Alleve since there's so much positive stuff out there about it but 12 hours after taking it I had back pain and a week later am still dealing with gut ache.  Best of luck, the warm water in the morning is an excellent idea.  Also meditation or prayer or funny movies.  You're all in my prayers.  This has to get better.

[HCA]

Is your acute status confirmed by experience?
i.e You know how and whe you became infected.
If so and you are acute you can think of your liver as a normal liver rather than a Hep C liver.
It takes years for the liver to even begin to fibrose,although inflammation may start to creep in.
Most of us lived with Hep C for twenty years and didn't know,so take the doctors advice and take the medication.
The liver is amazingly resilient,so concentrate on the DDD for now.

[bajawoman]

Wow you sure have a lot going on for only being 31  Pain on a daily basis is not good causes all the other problems I am speaking for myself  Pain brings on Panic attacks anxiety anger and depression I have had pain since your age and have had all the other symptoms never treated them with meds just alcohol and recreational drugs  lol  well that worked fine until my early 50's not really fine after falls and car wrecks leaving me in more pain etc  high anxeity and panic attacks couldn't drive etc. HCV did bring all this to a head  so started on vicodin  5 mg and take maybe two or three a day if needed  xanex very little now as I am on Lexapro I have not abused them and take very small amounts  seems to work  I have tried anti inflamitory drugs cannot take those  i was dx last year with HCV up until that point no doctor could ever find out what was wrong ???
lexapro really helps with the drepression but only 10 mg  I started these about a year ago before that I took Prozac on and off  I have not been a serious drinker for some time and I do not drink or smoke at all now and have cut way down on my coffee consumption and sugar  intake   but the question was

Good Pain Management Meds   this is not a joke but I heard  a glass of warm water every morning and flush your system through the day with water good water will help your pain  and of course small amounts of vicodin or another that is processed through the kidneys    
best wishes to you for having a less painful life    Baja

[mhudnall]

A list of drugs that cause liver damage can be found here:

http://www.hepcnet.net/drugsandliverdamage.html

Mike H