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Finally saw the pain doc - thoughts appreciated!
Hi All,
I want to start off by thanking you all for being here and for your support. Although I am new(er) here, and haven’t posted much yet, I have been on the board daily for a couple of months now reading posts and feeling the comfort of knowing that I am not alone in my battle of daily pain and learning how to live with it and manage things.
I finally went and saw a pain management doc for the first time yesterday and it was a wonderful and terrifying experience all wrapped in one. I was so glad to finally find a caring doc that listened and spent over an hour with me. He respected my knowledge about my body (rather than thinking he was a god and rolling his eyes at everything I said). He said that while I might have Fibro in addition to something else, he didn’t think that was the main cause of my pain. This was a relief to me, because in the past docs have slapped a Fibro diagnosis on me due to my depression issues and told me to have a nice day. I have battled and battled through this and never accepted this diagnosis. Anyhow, because I have colitis and have had some other auto-immune things going on in addition to some joint swelling in my hands and constant “potato chip” cracking in my back, he is sending me to the best Rhemotologists in town – one that isn’t accepting new patients. He actually called him in person and got me in! Wow! So that was awesome and I finally feel like I might be on the right path to getting some real answers as to why I hurt so much all the time and why I don’t feel like a “normal person”.
On to the meds…I had been on Vicodin in the past and weened myself off because I didn’t want to be a slave to it until recently when I realized that my quality of life with my family and children was crap and I would rather take pain meds and function then be on the floor watching my children play and be unable to cook dinner etc…so I talked to my pcp who agreed to give me 2 7.5 Vicodins a day to take. This has been a god-send. I have been able to do so many things! My house has been in order…I have been able to function!! This doc is concerned that the Vicodin is going to effect my “moods” too much, as I did mark “mood swings” on my forms that I filled out. (I am currently also seeing a therapist and a psych doc for depression and ptsd) So he suggested that I look at taking something longer acting for pain to eliminate the ups and downs, and I agreed. Then he dropped a bomb on me and suggested that I try Suboxone?? Whoa?! He insisted that this was not because he thought I was an addict, but that the latest and greatest thing in PM is using this drug. I am terrified.
Does anyone have experience with this? I am really afraid of this for several reasons. The main one being breakthrough pain. What do you do if you are having a flare up? Right now I am able to manage my meds…sometimes I am doing ok and am able to skip a dose and save it for a time when I need more etc. Also, I suffer from migraines, which are for the most part under control, but once or twice a year I have to go to the ER for a shot when I’m on day three of a headache and I can’t stand it anymore – which from what I understand wouldn’t be an option with this medication.
He gave me a month to think about it and right now I’m just really freaked out about the whole thing. I’m so sorry this is long, but I consider you all my support group and really want to know what your thoughts are, so please share if you have any.
Thanks and I hope you are all having a great, comfortable day!
I want to start off by thanking you all for being here and for your support. Although I am new(er) here, and haven’t posted much yet, I have been on the board daily for a couple of months now reading posts and feeling the comfort of knowing that I am not alone in my battle of daily pain and learning how to live with it and manage things.
I finally went and saw a pain management doc for the first time yesterday and it was a wonderful and terrifying experience all wrapped in one. I was so glad to finally find a caring doc that listened and spent over an hour with me. He respected my knowledge about my body (rather than thinking he was a god and rolling his eyes at everything I said). He said that while I might have Fibro in addition to something else, he didn’t think that was the main cause of my pain. This was a relief to me, because in the past docs have slapped a Fibro diagnosis on me due to my depression issues and told me to have a nice day. I have battled and battled through this and never accepted this diagnosis. Anyhow, because I have colitis and have had some other auto-immune things going on in addition to some joint swelling in my hands and constant “potato chip” cracking in my back, he is sending me to the best Rhemotologists in town – one that isn’t accepting new patients. He actually called him in person and got me in! Wow! So that was awesome and I finally feel like I might be on the right path to getting some real answers as to why I hurt so much all the time and why I don’t feel like a “normal person”.
On to the meds…I had been on Vicodin in the past and weened myself off because I didn’t want to be a slave to it until recently when I realized that my quality of life with my family and children was crap and I would rather take pain meds and function then be on the floor watching my children play and be unable to cook dinner etc…so I talked to my pcp who agreed to give me 2 7.5 Vicodins a day to take. This has been a god-send. I have been able to do so many things! My house has been in order…I have been able to function!! This doc is concerned that the Vicodin is going to effect my “moods” too much, as I did mark “mood swings” on my forms that I filled out. (I am currently also seeing a therapist and a psych doc for depression and ptsd) So he suggested that I look at taking something longer acting for pain to eliminate the ups and downs, and I agreed. Then he dropped a bomb on me and suggested that I try Suboxone?? Whoa?! He insisted that this was not because he thought I was an addict, but that the latest and greatest thing in PM is using this drug. I am terrified.
Does anyone have experience with this? I am really afraid of this for several reasons. The main one being breakthrough pain. What do you do if you are having a flare up? Right now I am able to manage my meds…sometimes I am doing ok and am able to skip a dose and save it for a time when I need more etc. Also, I suffer from migraines, which are for the most part under control, but once or twice a year I have to go to the ER for a shot when I’m on day three of a headache and I can’t stand it anymore – which from what I understand wouldn’t be an option with this medication.
He gave me a month to think about it and right now I’m just really freaked out about the whole thing. I’m so sorry this is long, but I consider you all my support group and really want to know what your thoughts are, so please share if you have any.
Thanks and I hope you are all having a great, comfortable day!
UPDATE-
I emailed the pain doc my detailed medical history as he requested and decided to also attach a document stating some of the concerns that I have mentioned about Suboxone treatment. He emailed me back this morning. Here is what the email said:
"Good work. Let’s discuss at your next visit. I do understand the Suboxone concerns. And I feel this isn’t the only treatment available to you, but definitely worth strong consideration. I think all of your worries can be addressed to your satisfaction.
One comment: I have lots of folks who use cymbalta and also use Imitrex or a similar triptan with no difficulty. While the interaction concern remains, practically speaking it usually doesn’t stop anyone from giving it a try. I have yet to see a clinically significant interaction, but as the literature states, there have been reports. It is uncommon."
So, I feel pretty good about things as they stand. I definately feel like I'm being listened to...and at least like there will be other options if I decline the treatment. Interesting about the Imitrex too!
I also got my appointment scheduled with the Rheumatolagist on Friday so it sounds like we'll have some more information to work with by next month when I go back to see the pain doc!
I hope you are all feeling well today. I had a doosey of a day at work. We had a really long patient this morning and I was hunched over in the assisting chair for about 4 hours. I purposely didn't take any pain med this afternoon so I could save it for tonight, as I knew my back would be screaming - which it is. I'm off to use my back roller and some heat to try to get some relief!!
I emailed the pain doc my detailed medical history as he requested and decided to also attach a document stating some of the concerns that I have mentioned about Suboxone treatment. He emailed me back this morning. Here is what the email said:
"Good work. Let’s discuss at your next visit. I do understand the Suboxone concerns. And I feel this isn’t the only treatment available to you, but definitely worth strong consideration. I think all of your worries can be addressed to your satisfaction.
One comment: I have lots of folks who use cymbalta and also use Imitrex or a similar triptan with no difficulty. While the interaction concern remains, practically speaking it usually doesn’t stop anyone from giving it a try. I have yet to see a clinically significant interaction, but as the literature states, there have been reports. It is uncommon."
So, I feel pretty good about things as they stand. I definately feel like I'm being listened to...and at least like there will be other options if I decline the treatment. Interesting about the Imitrex too!
I also got my appointment scheduled with the Rheumatolagist on Friday so it sounds like we'll have some more information to work with by next month when I go back to see the pain doc!
I hope you are all feeling well today. I had a doosey of a day at work. We had a really long patient this morning and I was hunched over in the assisting chair for about 4 hours. I purposely didn't take any pain med this afternoon so I could save it for tonight, as I knew my back would be screaming - which it is. I'm off to use my back roller and some heat to try to get some relief!!
Oh, Imitrex! I was given it by IV in the hospital once when I was hospitalized for migraines. It made my blood pressure shoot up to 180/100 and my heart rate drop to 33bpm. There is a serious interaction between Imitrex and SSRIs. Please get that one checked out. I'm sure not everyone's reaction to it is as terrible, but I felt it instantly when they gave it to me.
My husband looked up the interaction as it was the only med I was on at the time and he found the interaction on his BlackBerry before the nurses realized it was an interaction.
Thanks for the info about the Seratonin Syndrome. I remember now. I remember I also had a lot of nausea and nervousness, irritability, it just turned me into a wreck.
I think so many doctors and nurses are just so busy with the general work load that they don't take the time to check these meds for interactions with what we are already taking. Please be careful about the imitrex. It didn't do any permanent damage to me, but I did have to get my heart checked out after that because they were very concerned.
I hope things get better for you soon!
My husband looked up the interaction as it was the only med I was on at the time and he found the interaction on his BlackBerry before the nurses realized it was an interaction.
Thanks for the info about the Seratonin Syndrome. I remember now. I remember I also had a lot of nausea and nervousness, irritability, it just turned me into a wreck.
I think so many doctors and nurses are just so busy with the general work load that they don't take the time to check these meds for interactions with what we are already taking. Please be careful about the imitrex. It didn't do any permanent damage to me, but I did have to get my heart checked out after that because they were very concerned.
I hope things get better for you soon!
JayBay - I don't have the appointment yet...they are supposed to call me to schedule, so I'm waiting for that call right now. I'm thinking that's a couple of weeks out at least, and they are supposed to be running tests, so I'm thinking that it's going to be at least two appointments before I might have any answers there. Fingers crossed! :)
Sherry - My Psych doc seemed a little "shocked" and called it a heavy hitter. She rolled her eyes when I told her that he was concerned that the Vicodin was going to contribute to my mood swings. During my appointment I was honest with him and told him that sometimes I over-did things at home because when I take my meds I try to clean the house and do chores as fast as I can while I'm feeling good before my pain comes back. To that he asked me if it "reves me up". I honestly responded yes to that...for the first 30 minutes or so that it does. I think I may have shot myself in the foot with that answer, but I was being honest. Anyhow, Marly (PDOC) said she would send him a copy of her notes from our visit yesterday. She admitted that she didn't know a whole lot about Suboxone and that she was actually considering a course on it next month and that she was now going to go take it! So while she doesn't have much imput to weigh in on my not taking the Suboxone, she doesn't seem concerned about my taking standard opiates and is going to communicate that to him.
Jaded, here is why you were feeling bad while taking the ssri and the Tramadol at the same time:
Due to its serotonergic activity, coadministration of tramadol with serotonin-enhancing drugs such as SSRIs, SNRIs, nefazodone, trazodone, and mirtazapine may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. Patients receiving tramadol with serotonin-enhancing drugs may also have an increased risk of seizures due to additive epileptogenic effects of these agents.
Read more: http://www.drugs.com/interactions-check.php?drug_list=2221-0,949-2273#ixzz0xH5a7lPh
It kills me when docs aren't more careful and don't carefully check this stuff out first! I was doing some research yesterday on my own and put my meds in and discovered that my Imitrex and Cymbalta have the very same warning. I took Imitrex the other day and did actually feel quite ****** afterward but just thought I was having a bad day (and very well may have), but my Pdoc and I are going to have a little chat about that because she knows I'm on it and didn't check that! Grrr...
Sherry - My Psych doc seemed a little "shocked" and called it a heavy hitter. She rolled her eyes when I told her that he was concerned that the Vicodin was going to contribute to my mood swings. During my appointment I was honest with him and told him that sometimes I over-did things at home because when I take my meds I try to clean the house and do chores as fast as I can while I'm feeling good before my pain comes back. To that he asked me if it "reves me up". I honestly responded yes to that...for the first 30 minutes or so that it does. I think I may have shot myself in the foot with that answer, but I was being honest. Anyhow, Marly (PDOC) said she would send him a copy of her notes from our visit yesterday. She admitted that she didn't know a whole lot about Suboxone and that she was actually considering a course on it next month and that she was now going to go take it! So while she doesn't have much imput to weigh in on my not taking the Suboxone, she doesn't seem concerned about my taking standard opiates and is going to communicate that to him.
Jaded, here is why you were feeling bad while taking the ssri and the Tramadol at the same time:
Due to its serotonergic activity, coadministration of tramadol with serotonin-enhancing drugs such as SSRIs, SNRIs, nefazodone, trazodone, and mirtazapine may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. Patients receiving tramadol with serotonin-enhancing drugs may also have an increased risk of seizures due to additive epileptogenic effects of these agents.
Read more: http://www.drugs.com/interactions-check.php?drug_list=2221-0,949-2273#ixzz0xH5a7lPh
It kills me when docs aren't more careful and don't carefully check this stuff out first! I was doing some research yesterday on my own and put my meds in and discovered that my Imitrex and Cymbalta have the very same warning. I took Imitrex the other day and did actually feel quite ****** afterward but just thought I was having a bad day (and very well may have), but my Pdoc and I are going to have a little chat about that because she knows I'm on it and didn't check that! Grrr...
You've gotten some great input and suggestions. You are so wise to be researching your alternatives and the Suboxone.
I have found information from CP patients on the internet regarding the usage of Suboxone for pain management. I just keep going back to the web-site for Suboxone that has the information regarding it's use for PM patients.
Many drugs do well off label but this is one that just makes me uncomfortable. As Jaybay pointed out, "Suboxone was only studied and approved for short-term use of 21 days to assist with opiate detox." I am wondering if some physicians might be looking at this as a safer alternative for them? I just can't understand the rational. Now that does not mean that there isn't a good bases with substantiating facts to account for RX of Suboxone in PM....it just means that I do not know it. And I would want to know it before I agree to put the drug in my body.
We'll look forward to your continued posts. In my humble opinion you are approaching this in absolutely the correct manner. Research and educate yourself before you make a decision.
My Best to You,
~Tuck
I have found information from CP patients on the internet regarding the usage of Suboxone for pain management. I just keep going back to the web-site for Suboxone that has the information regarding it's use for PM patients.
Many drugs do well off label but this is one that just makes me uncomfortable. As Jaybay pointed out, "Suboxone was only studied and approved for short-term use of 21 days to assist with opiate detox." I am wondering if some physicians might be looking at this as a safer alternative for them? I just can't understand the rational. Now that does not mean that there isn't a good bases with substantiating facts to account for RX of Suboxone in PM....it just means that I do not know it. And I would want to know it before I agree to put the drug in my body.
We'll look forward to your continued posts. In my humble opinion you are approaching this in absolutely the correct manner. Research and educate yourself before you make a decision.
My Best to You,
~Tuck
I wanted to add, also, that I'm glad you know about the Tramadol interaction. When I was put on it a few years ago when the pain first started I was taking Paxil. I didn't know there was a reaction and about a month after taking the Ultram daily I was such an emotional wreck that I did an interaction search and found it. I immediately made an appt with the PCP who was able to change it and then was referred to PM.
Apparently the doctor who put me on it had no idea about the interaction either. It wasn't life threatening, but the way it messed with my emotions made me feel that way.
I hope you are feeling comfortable today and that you are able to get the situation about the meds resolved. I know it's putting you in an uncomfortable position of not knowing whether it's a good med to take or not and what you should do about talking to the doctor. No one in CP should have to make difficult decisions like this. I will pray that you get the situation resolved quickly and easily.
Apparently the doctor who put me on it had no idea about the interaction either. It wasn't life threatening, but the way it messed with my emotions made me feel that way.
I hope you are feeling comfortable today and that you are able to get the situation about the meds resolved. I know it's putting you in an uncomfortable position of not knowing whether it's a good med to take or not and what you should do about talking to the doctor. No one in CP should have to make difficult decisions like this. I will pray that you get the situation resolved quickly and easily.
KittyKat - I doubt that anyone took what yo said taht way at all!! :) I happen agree with you that it IS a HUGE jump from what you are taking now. PLEASE remember that NONE of us are Doctors BUT I don't remember anyone on here (that I've seen anyway) going from TWO 7.5 Vicodins a day to Suboxone. I googled Suboxone and it said that it comes in 2 strengths - 2 mg and 8 mg. I DON'T know how that equates to Vicodin but I would think that it would be MUCH stronger than your Vicodin dosage.
You are VERY wise and have been paying attention on here when we've discussed how difficult it is when you are younger and have to be on pain medications. Good job for paying attention!!!
I hope that you will follow your gut feelings about this medication. What did your Psych. Doc say about whether or not she thought is was a "good" idea or not for you. IF she didn't will she call and tell the PM Doctor how she feels about this medication?
I'm looking forward to your updates on this!! GOOD LUCK!!!........Sherry
You are VERY wise and have been paying attention on here when we've discussed how difficult it is when you are younger and have to be on pain medications. Good job for paying attention!!!
I hope that you will follow your gut feelings about this medication. What did your Psych. Doc say about whether or not she thought is was a "good" idea or not for you. IF she didn't will she call and tell the PM Doctor how she feels about this medication?
I'm looking forward to your updates on this!! GOOD LUCK!!!........Sherry
Can't add anything much to what everyone else said other than I wouldn't take suboxone for pain management either. In my opinion, you are still opiate naive at such a low dose of vicodin that I think you'll have problems with the sub. I can understand your doc's rationale for putting you on a long-acting medication, but I'm afraid I also understand why he is pushing the suboxone. More and more pain docs are prescribing it because they think it's abuse-proof. Not true.
Suboxone was only studied and approved for short-term use of 21 days to assist with opiate detox. It was never intended to be used as a maintenance or pain medication, nor are there any studies published that I am aware of about the effects of long-term use.
When is your rhematologist appointment? You've got plenty of time to make a decision, and you may be better served by waiting to see if there is a different diagnosis than fibro. Your rheumy may not want you to be on suboxone anyway depending on what he discovers. Get his thoughts on the subject during your consultation. Never hurts to ask another doctor. :-)
Suboxone was only studied and approved for short-term use of 21 days to assist with opiate detox. It was never intended to be used as a maintenance or pain medication, nor are there any studies published that I am aware of about the effects of long-term use.
When is your rhematologist appointment? You've got plenty of time to make a decision, and you may be better served by waiting to see if there is a different diagnosis than fibro. Your rheumy may not want you to be on suboxone anyway depending on what he discovers. Get his thoughts on the subject during your consultation. Never hurts to ask another doctor. :-)
I agree that you really aren't on a high dose at all. I was on 6- lortab 7.5 a day when I switched to a long acting med.
We all know that you didn't mean anything by it. What works for one doesn't work for another and I was rather surprised by the seeming increase. Although if it's a lose dose of suboxone it might be okay.
I'd say if you have reservations about it, call the doc and see about maybe going in to talk to him again. I know it's difficult to do, though, after just seeing him and maybe the new med will work.
I know everything will work out for you.
We all know that you didn't mean anything by it. What works for one doesn't work for another and I was rather surprised by the seeming increase. Although if it's a lose dose of suboxone it might be okay.
I'd say if you have reservations about it, call the doc and see about maybe going in to talk to him again. I know it's difficult to do, though, after just seeing him and maybe the new med will work.
I know everything will work out for you.
I wanted to add that I in no way meant to suggest that there is anything wrong with taking higher doses of meds, being a mom...etc. :) Just to clarify. I just meant that for me, personally, I don't have much of a tollerance to pain meds built up yet and I know that the reality is that my condition is not likely to go away, so I need to manage things as much as I can as long as I can so that when I'm an old lady meds still work for me. :)
Thanks so much for the support ladies. I really appreciate it! I'm still curious to hear from anyone on how well it works for pain. I've read that it works for some, and that it doesn't for others, so I'm a little apprehensive about that as well.
I believe that people can take Tramadol for BT pain with it but unfortunately that one is out for me due to my Cymbalta and Topomax. There is a drug interaction there unfortunately. :(
The other thing that I'm curious about is that this seems to be quite a jump in medication strength? I take two 7.5 mg Vicodins a day. Some days that is enough and some days not. I usually break them in half and take them with another tylenol so that I can get all day coverage. So I really only take a little less then 4mg at a time. Every story that I've read while doing research on this medication is people going on it after being on much much higher doses of meds then I am on. I went to my psych doc yesterday after my pm appointment and even she was shocked by the "heavy hitter" he was suggesting. I'm just not sure I want to jump into that ring just yet. Yes, I do take opiods daily for pain, but I don't require much at this time and am trying to keep it minimal. I am young (32), work as a dental assistant (so I need to be alert at work), and I have children to take care of. I guess I should be writing this all down for myself too so I can bring it up with him next month. It just really doesn't feel right....
I believe that people can take Tramadol for BT pain with it but unfortunately that one is out for me due to my Cymbalta and Topomax. There is a drug interaction there unfortunately. :(
The other thing that I'm curious about is that this seems to be quite a jump in medication strength? I take two 7.5 mg Vicodins a day. Some days that is enough and some days not. I usually break them in half and take them with another tylenol so that I can get all day coverage. So I really only take a little less then 4mg at a time. Every story that I've read while doing research on this medication is people going on it after being on much much higher doses of meds then I am on. I went to my psych doc yesterday after my pm appointment and even she was shocked by the "heavy hitter" he was suggesting. I'm just not sure I want to jump into that ring just yet. Yes, I do take opiods daily for pain, but I don't require much at this time and am trying to keep it minimal. I am young (32), work as a dental assistant (so I need to be alert at work), and I have children to take care of. I guess I should be writing this all down for myself too so I can bring it up with him next month. It just really doesn't feel right....
I'm so glad to hear that you found a great doctor who cares! It's sad that it's such a hard thing to find these days. It's great that he spent so much time with you and realized you have a valid need for pain control.
I understand your fears about suboxone. I, too, have never taken it, but I've heard that it can work really well for pain. I did take methadone and at first I was really afraid of it and walked out of the doctor's office in tears. After trying it for a month I found that it actually worked really well. My only problem was that I only had one pill a day for BT and felt like I had to try to make a tough decision every day about whether the pain were the worst of the day or save them for events like weddings, etc.
I also get migraines so I definetly understand your fear of "What if I have to go to the ER and there's nothing they can give me?". On the other hand. They may be able to give you something like Staidol, which is also an opiod-antagonist and the only thing they gave me during a 16 hour labor with my son. (13 years ago today) So that may be an option. I also wonder if they have other opiod-antagonists that you could take for BT.
That's all IF the suboxone doesn't work wonderfully for you. I have heard tell that it's a very strong medication and works wonders for pain. The information on the website is a little worrying, though.
I'd say if it doesn't work and you have problems after taking it for about 2 weeks, you should call the doc and let him know. It sounds like he would hopefully be open to another visit or something after a short time.
I hope you are having a comfortable day as well. I'm glad to be a part of your "support group" as you all are a part of mine.
I understand your fears about suboxone. I, too, have never taken it, but I've heard that it can work really well for pain. I did take methadone and at first I was really afraid of it and walked out of the doctor's office in tears. After trying it for a month I found that it actually worked really well. My only problem was that I only had one pill a day for BT and felt like I had to try to make a tough decision every day about whether the pain were the worst of the day or save them for events like weddings, etc.
I also get migraines so I definetly understand your fear of "What if I have to go to the ER and there's nothing they can give me?". On the other hand. They may be able to give you something like Staidol, which is also an opiod-antagonist and the only thing they gave me during a 16 hour labor with my son. (13 years ago today) So that may be an option. I also wonder if they have other opiod-antagonists that you could take for BT.
That's all IF the suboxone doesn't work wonderfully for you. I have heard tell that it's a very strong medication and works wonders for pain. The information on the website is a little worrying, though.
I'd say if it doesn't work and you have problems after taking it for about 2 weeks, you should call the doc and let him know. It sounds like he would hopefully be open to another visit or something after a short time.
I hope you are having a comfortable day as well. I'm glad to be a part of your "support group" as you all are a part of mine.
Hi Kitty. I'm happy that you found a nice doctor that is willing to talk with you and willing to let you have say in your treatment. I'm kind of surprised that he recommends Suboxone, since there are so many different types of pain medication available and since it's not really to be used to control pain here.
I would research it, come up with questions, make a decision, and talk with him about your decision. If you don't want to take it, then tell your doctor exactly why. You could write a list to bring to your appointment.
Flower
I would research it, come up with questions, make a decision, and talk with him about your decision. If you don't want to take it, then tell your doctor exactly why. You could write a list to bring to your appointment.
Flower
Hi KittyKat,
I have to let you know that I LOVE your Med Help Name!!! Anyway that said I must let you know that I agree with Tuck on the fact that Suboxone REALLY scares me to death too. If I couldn't have a BT med I'd be VERY concerned. Even though I don't use mine as much as MOST people do, I love having the assurance that I have them IF I need them.
You have a lot of thinking to do and it might be a good idea to go to the Suboxone website, that Tuck quoted form, and print it out, read it and take it with you to your Doctor's appointment. That way you and your Doctor can discuss HIS thoughts, PLUS go over the information that you have brought and HOPEFULLY come up with a plan of treatment that is agreeable to BOTH of you!!
We will ALL be looking forward to hearing about your NEXT appointment with your PM Doctor. (By the way, VERY glad that you have a GREAT Doctor!!!) Congratulations!!
I wish you the VERY best.......Sherry
I have to let you know that I LOVE your Med Help Name!!! Anyway that said I must let you know that I agree with Tuck on the fact that Suboxone REALLY scares me to death too. If I couldn't have a BT med I'd be VERY concerned. Even though I don't use mine as much as MOST people do, I love having the assurance that I have them IF I need them.
You have a lot of thinking to do and it might be a good idea to go to the Suboxone website, that Tuck quoted form, and print it out, read it and take it with you to your Doctor's appointment. That way you and your Doctor can discuss HIS thoughts, PLUS go over the information that you have brought and HOPEFULLY come up with a plan of treatment that is agreeable to BOTH of you!!
We will ALL be looking forward to hearing about your NEXT appointment with your PM Doctor. (By the way, VERY glad that you have a GREAT Doctor!!!) Congratulations!!
I wish you the VERY best.......Sherry
Hi Kittykat,
Thank you for posting a well written thread that is easy to understand. I am glad to know that you have found our community to be helpful and comforting. Yes we are all in this together. It's so nice to know that we are not alone.
I understand your concern to being a slave to your opiates. But as you found there are often little other choices. Life is too short and precious, especially the missed moments with our children. I think it's a bigger shame to painfully sit on the sidelines and watch life happen without us.
It is wonderful that you have found a caring and supportive PMP. He sounds like he is going out of his way to get to the root of your painful symptoms. As you know such physicians are often difficult to find.
I agree with him and you. I do believe that there are many ppl that suffer horribly with Fibromyalgia. However I also think that too often a Fibro diagnosis is used when a physician tires of searching for reasons when we have chronic pain.
I too am concerned that he is suggesting Suboxone for pain management. Many drugs are successfully used off label. All the literature I have read on Suboxone state it is not to be used for Pain Mangement purposes. The Suboxone website says this: "Do not use SUBOXONE or SUBUTEX for conditions for which they were not prescribed. Patients with a clinical need for analgesia should not be transferred to a SUBOXONE regimen. SUBOXONE is not indicated for pain management."
.....AND this: "SUBOXONE is appropriate for the treatment of people who have become physically dependent or psychologically dependent on opioids AND who are not in need of opioids for pain management. SUBOXONE is not indicated for treating pain."
However even with the above exerts from the Suboxone website I am hearing more of this drug being used or at least suggested as a use for pain managment.
Suboxone contains Buprenorphine (opioid partial agonist-antagonists) and Naloxone (opioid antagonists). The combination of these two drugs replicate the effects of an opioid drug by producing similar effects. That's the reason it is generally effective in withdrawal and addiction. The Naloxone, as you suspected will stop the actions of all other opiates.
If you are not comfortable taking this medication for pan management discuss your feelings and concerns in detail with your PMP. He certainly sounds like he would spend time explaining his rationale. I am sure there must be pros and cons.
Personally I would be very hesitant to take this medication. That does not mean that it is not right for you or others. One of my concerns would be as you suggested. What would occur if I was in need of an opiate. I manufacture kidney stones often. At those times I am in need of strong, IV opiates. It's my understanding the the Naloxone would block the actions of those much needed medications.
I would gather all the information I could on Suboxone in pain management situations. Educate yourself so you may make an informed decision. I would than take my concerns to my next appointment with the PMP. Keep in mind that there are many drugs that were initially developed for one purpose but were found to be very effective for another purpose, called off label.
I am glad that you posted and hope that you will be more active in our community. But you are always welcome to "lurk." :) Feel free to respond to poster and ask more questions. I wish you the very best and will look forward to hearing about your decision. We are here to offer you our support.
Peace,
~Tuck
Thank you for posting a well written thread that is easy to understand. I am glad to know that you have found our community to be helpful and comforting. Yes we are all in this together. It's so nice to know that we are not alone.
I understand your concern to being a slave to your opiates. But as you found there are often little other choices. Life is too short and precious, especially the missed moments with our children. I think it's a bigger shame to painfully sit on the sidelines and watch life happen without us.
It is wonderful that you have found a caring and supportive PMP. He sounds like he is going out of his way to get to the root of your painful symptoms. As you know such physicians are often difficult to find.
I agree with him and you. I do believe that there are many ppl that suffer horribly with Fibromyalgia. However I also think that too often a Fibro diagnosis is used when a physician tires of searching for reasons when we have chronic pain.
I too am concerned that he is suggesting Suboxone for pain management. Many drugs are successfully used off label. All the literature I have read on Suboxone state it is not to be used for Pain Mangement purposes. The Suboxone website says this: "Do not use SUBOXONE or SUBUTEX for conditions for which they were not prescribed. Patients with a clinical need for analgesia should not be transferred to a SUBOXONE regimen. SUBOXONE is not indicated for pain management."
.....AND this: "SUBOXONE is appropriate for the treatment of people who have become physically dependent or psychologically dependent on opioids AND who are not in need of opioids for pain management. SUBOXONE is not indicated for treating pain."
However even with the above exerts from the Suboxone website I am hearing more of this drug being used or at least suggested as a use for pain managment.
Suboxone contains Buprenorphine (opioid partial agonist-antagonists) and Naloxone (opioid antagonists). The combination of these two drugs replicate the effects of an opioid drug by producing similar effects. That's the reason it is generally effective in withdrawal and addiction. The Naloxone, as you suspected will stop the actions of all other opiates.
If you are not comfortable taking this medication for pan management discuss your feelings and concerns in detail with your PMP. He certainly sounds like he would spend time explaining his rationale. I am sure there must be pros and cons.
Personally I would be very hesitant to take this medication. That does not mean that it is not right for you or others. One of my concerns would be as you suggested. What would occur if I was in need of an opiate. I manufacture kidney stones often. At those times I am in need of strong, IV opiates. It's my understanding the the Naloxone would block the actions of those much needed medications.
I would gather all the information I could on Suboxone in pain management situations. Educate yourself so you may make an informed decision. I would than take my concerns to my next appointment with the PMP. Keep in mind that there are many drugs that were initially developed for one purpose but were found to be very effective for another purpose, called off label.
I am glad that you posted and hope that you will be more active in our community. But you are always welcome to "lurk." :) Feel free to respond to poster and ask more questions. I wish you the very best and will look forward to hearing about your decision. We are here to offer you our support.
Peace,
~Tuck
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