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Needing Pain Meds Infomation

Dear Pain Management Group:

You have helped me before, so I am now asking for your help once again.  My doctor raised my MS Contin up to 30 mg. twice per day, as the 15 mg. 2 per day wasn't working even with the 10/325 percocet for breakthrough pain.  Well, now that I am on the 30 mg. twice per day I still need to take four (4) percocet for breakthough pain!  And, this is on days when I do almost nothing at all.  I'm beginning to lose hope!

At first I thought my body just needed to adjust to the larger dosage of MS Contin, but I have been taking this dosage for a month now and still need the four (4) percocet for breakthrough pain.

I am supposed to go to a back pain doctor who will give me shots in my back.  To be honest I am terrified of anyone putting needles anywhere near my spine.  I've heard various things about these shots.  Some say they have worked well for them and others say they did nothing.

I will make the appt. with the back pain doctor, but my question to all of you out there is:  am I a total freak?  I really thought that with the increased dosage of MS Contin I wouldn't need to take 4 percocet as well, but it seems that I do.

Please, anyone, have any of you had this situation happen to them?  Does my body just eat up pain meds and spit them out?  What's up with this?

Hopefully someone of all the group here has had a similar situation.

I'm desparate for some educated (people living with constant pain) information about why my body doesn't seem to go along with these meds as I'd hoped for.

Sorry about the long diatribe, but I really, really need some answers from others who live with this.

Thank you in advance,

Suda
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Avatar universal
Dear Geminigirl1963,

First off, thank you for responding.  Every response to my queries gives me more and more hope that I am not the big freak that I have begun to believe I am, what with these strong pain meds really not doing the trick.

I finally called the back pain shot doctor (I'm sure that's not his title, but for now it will be) and was asked if I had the MRI of my back!!!!

Nooooo, I certainly do not have that MRI, I'd would have thought that they would have received it by now since they'd called me in Feb. to set up an appt. but I didn't have the $$$$ to pay for said appt. at that time, so therefore I put it off.  Well, the $$$ and the fear what with all my lousy, deadly reactions to all these other previously taken, supposedly safest medicines, and the fear of somebody injecting something anywhere near my spinal cord.

So, at least I called and I gave them my phone number and asked that they give me a call back whenever the do receive the MRI of my back.  Then I'm to make an appt. for a "consultation".  What?  I'd been told earlier by this same office that the doctor would meet with me and we would have a consultation to see exactly what would be needed, and then he would decide, then numb my back, wait 30 mins., numb it once more, and then inject whatever it is they are going to inject that is supposed to help with this excruciating pain.

But, now I find out that they don't even have the back MRI.  Sooo, I await their phone call when the do get it, and then I get to go in once for the consultation, then go home and they told me that maybe a week later I would have another appt. made where then they would inject me.

So, I'm proud of myself for calling to make the appointment today, which I have delayed forever, but now I find they don't even have the proper information (back MRI) to look at to even have a consultation.

I'm off the hook, so to speak, at least for the time being.  And to be honest with you guys, I'm not sad, or very upset about it at all.

I will let you guys know when and/or/if I ever get a return phone call from the back pain people.

I will also let you know what my regular doctor says about the vitamin D thing, as well as why my body ***** up these very, very strong pain meds as if they are simply water.

As it stands now, I wasn't expecting to have to call in my 10/325 percocet at 4 times per day, at the end of the 30 days period from whence it was refilled, but as it is at this moment I do believe I will be calling in for a refill at 30 days.  

Talk about being embarrassed!  I can hear myself now; "Oh, yeah, I take really strong long acting pain meds, as you well know, yes I do, and by the way, I am also calling in for a refill of the break through medicines because I am also taking four of them each and every day!!!"

Pray for me, and those of you who don't pray, keep your fingers crossed, that is if it's not too painful for you.

Thank you, geminigirl1963, and all the rest of you wonderful people who make me feel like I'm semi-normal and not totally alone in this world of pain!!

Big Hug,

Susan
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Avatar universal
Dear Namnam46,

I will certainly discuss this vitamin D situation with my physician.  I thank you for your kind response, along with everyone elses.

It is such a relief, if not from the actual physical pain one is living with, but the psychic pain one has to abide because of the way that the outside world views people who must take strong pain medicines simply to have a "do nothing at all" day.  

That's what most of my days consist of anyway.  Oh, I do clean up the kitchen after my dear sister and her neanderthal boyfriend (who seems to think that since I have a vagina I should be highly blessed to clean up his messes, NOT!).  

So, my days consist of straightening up our kitchen and the main bathroom, and if I'm feeling like Wonder Woman, Ha! then I may trying waxing and dusting.  But those days are very few and far between.

I just wish that I had any little bit of energy at all.  I thought that taking such strong pain meds would help with the pain, which they do somewhat, though not at all as much as I'd hoped.  But I did think that I would have more energy because I would be in less pain, but this has not been the case.

Again, thank you for your concern and your advise.  It helps so very much for me to come on this site and discuss my problems with this group of people.  Not to be judged is somewhat of a miracle, especially in America where we are all supposed to just "suck it up" and live with whatever pain we find outselves in.

Best Wishes,

Suda
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Avatar universal
First off, I'm sorry you've been experiencing so much pain lately and your pain meds don't seem to be making much difference.

You've definitely gotten some great advice here in regards to tolerance and the need for breakthrough meds.

While I've never had a steroid injection in my back, I have had them in both of my knees and my right shoulder.  I also was terrified before them (although I'm sure I'd be even more terrified about getting on in my back) - however, the actual injection was not as bad as I had imagined it would be.  They do add some numbing medication to the injection, which definitely helps.  A friend of mine gets shots in her back quite often and her doctor pretty much always sedates her at least a little before giving them.

I, also, suffer from SLE, fibromyalgia, severe osteoarthritis and they are now doing some testing to see if I may also have RA.  You mentioned that you thought your pain tolerance was very low - I also felt that way until one of my doctors explained to me that in actuality it may not be my "tolerance" to pain, but rather how the fibro affects the way my body reacts to it.  With fibro they say the pain receptors are overly sensitive, so what feels like a simple pin ***** to someone else, feels more like a knife cutting us for those of us with fibro.

Never feel like you are a freak for having chronic pain or for needing your pain medication.  Most people with any type of chronic pain need daily pain meds just in order to be able to lead a somewhat normal life, although our level of "normal" can be quite a bit different from someone who doesn't have chronic pain issues.

Definitely talk to your doctor and tell him that your medication is still not working the way that it should and you're finding that you're still having to rely on teh breakthrough meds on a daily basis.  He may need to do some additional "tweaking" of your long acting meds, or even try you on a different one.

I wish you the best of luck - keep us all posted on how you're doing.

Gentle hugs,
Robyn
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Avatar universal
Hi Suda,

Definitely check your Vit. D. When I moved here to AZ last July, 2009, the first thing that my new Dr. did when he found out how tired I was, and my heart condition had checked out alright with my cardiologist, was to do a complete blood workup on me and discovered that my Vit. D was extremely deficient. It was less than 10 and should have been between 35 and 80. So I am on 1000 iud of Vti. D 2 times a day.

It took it a little while but my energy has increased quite a bit now. I'm still on the Vit. D but that is fine with me.

I hope you will get this checked out. This was something that I never would have considered. I always was concerned that I was having more heart problems. (I have 2 stents so I worry about that  whenever I'm tired or not feeling well.)

Please let us know what the Dr. says.

There isn't much I can add to any of the posts that you have already received.  Everyone has given you EXCELLENT advice.

Take Care...Sherry
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Avatar universal
Dear Nemmon59,

I have been reading up on, and hear about vitamin D deficiency and how it can really mess with you body by exacerbating one's pain.

Next time I go see my doctor I will certainly ask for a test for the level of vitamin D in my system.

I'll do and ask for anything that will help me live a functional life.  

Today, I really need to wash my bedding, but guess what?  It's not gonna happen.  I simply don't have one iota of energy to even begin the process.

Thank you for responding to my queries.

I hope that everyone out there has one of their less difficult days.  And, some days that is a total miracle.

Best Wishes,

Suda
Helpful - 0
Avatar universal
Dear SageRave,

I had an MRI done on my back 2 1/2 months ago and that's when they found that I had degenerative disc disease.

That's also when my doctor wanted me to go get these shots in my back.  So, it is all my fault, because I have'nt even made an appt. to get these shots.

I've had a history of having very severe side effects to the simplest medicines, i.e. NSAID's, I am deadly allergic to any of them.  Then, I have tried all of the anti-depressants on the market at one time or another.  Not for depression, but for help with anxiety and pain.  But either I'd have bad side effects, or I'd take them the correct amount of time and nothing changed, nothing.

So, besides the fear of anyone injecting things anywhere near my spine, I also have a fear of whatever it is they will be injecting making my body go into some type of total rejection of said meds.

Thank you for saying I'm not a freak, but the fact is I was raised to believe that I wasn't ever really sick, I either just wanted attention, or I did'nt want to do something, etc.  It was just the way my family dysfunctioned is all.

Now, I must be brave, believe in myself, that I am really not some freak and tell the doctor I need more help.  Oh, so much easier said than done, as I'm sure we all know.

Thanks again for all your support.  Without this site I would most likely give up the ghost and become one.

Big Hug,

Suda
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Avatar universal
Dear Tuckamore,

Yes, your are so right!  It is the chronic part that wears all of us down to a nub.  And you are also correct in the fact that if only some of the "so-called concerned friends" had to live in our bodies for even a day, (I'd wish for more like a week or two really, Ha!) then they wouldn't have any smirks, nor raised eyebrows when asking about your pain.

I suppose it is only human nature to negate another person's pain.  Or, at least that is what I have noticed.

Once, while living in Fort Worth, TX I was helping to form a medical clinic, working literally 18 - 20 hours everyday, then bam!  Surprise, surprise after going to the ER the week before because I was having trouble breathing, I was told by our Medical Director of the clinic that I had pneumonia (sp?) and just go home a rest.  I did so and then went back to work after 3 days of resting.  All the doctors said how much better I looked and each time I heard that I told them I really didn't feel that much better.  Suffice to say that that very weekend I was back in the ER, then the ICU and was being told that I needed to have a pericardial window, and I needed it done "yesterday."  

That's when I was diagnosed with lupus (LSE).  I still kept working after that, but about six (6) months after having the operation I was told by the Med Director, that the CEO that I had been working for had decided that I really wasn't Admin. Assistant material.  Oh really!!!???  This was an easy way for them to hire a healthy person to take my place after I had done such a huge amount of work for & with them helping to finally form that company.  It's sad when I think about it because, well these were all physician's except for the CEO, she was just a sociopath who couldn't be bothered to help me after I had helped form their company.

After that my work record, being able to work at all, got worse and worse.

I was great friends with about five of the physicians in this group and one of them had this horrible back pain.  Well, he had an operation and was sent home to recoop.  Well, his pain was so horrible that he was crawling on the flooring screaming and crying and when the ambulance came, he screamed over the EMT's disccusion with the hospital ER doctor whom he knew and told the EMT to tell the ER doc his name and that he wanted morphine!  He wanted morphine now!  Well, he got his morphine.

After the second operation on his back, just before they closed him up someone saw a small bone chip!  They found that bone chip, took it out and then sewed him back up.  

Very long story, and not short at all, but this doc friend of mine was fine after that second operation because it had been that bone chip they'd missed seeing on the first operation.

And, I bet you all can guess that this doctor was way, way more amenable to prescribing strong pain meds to his patients who were it pain after that.

Like you said Tuck, if only they had to live in our bodies for a bit of time.  Well, this guy had to, and it actually ended up helping his patients who were trying to function while living in horrible pain, because he didn't immediately negate their complaints anymore after that.  He certainly didn't think they should just "suck it up" as he'd thought before.

Ah, if only most of the rest of the world could experience just a modicum of what we must survive each and everyday.

Thanks for all your support, always.  For there is nobody out here in the non-internet world who I can discuss all this with.

Sincerely,

Suda
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Avatar universal
I have lived with pain for many years.  Pain pills, anti-inflammatories, neuralanalgesics, you name it they kept adding it and it didn't seem to make any difference.  Walking became harder and harder.  Well, to make a long story short, i was reading on a discussion board about having  your vitamin D level tested.  So on a fluke last time I was at the doctor I asked to have mine tested.  Mine was 4.32.  The most recent research says you should have your level at around 50 with 35 being the bare minimum.  Vitamin D deficiency causes terrible bone and joint pain.  I wish I could say that I have no more pain, but I can't because it is going to take time to raise my vitamin d level but my doctor was a. horrified that it was so low and b. encouraging that my pain would get much better over the course of the next few months as they raise my vitamin d level.  It is hard to believe that I may been struggling with this pain of unknown origin for so many years that may have been from a simple vitamin deficiency.  So I hope anyone who reads this who has pain that seems untouchable even by pain meds will ask their docs to run a vitamin d test.

LS
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1152183 tn?1273011695
You are not a freak, and you can refuse any treatment you are not comfortable with, just be sure re you refuse. You may need to look for another doctor if your current doctor is stubborn.

"Tolerance" refers to your ability to take medication and still function, as opposed to taking the same medication and being knocked out until time for your next dose. You have to develop tolerance to lead a normal life.

When did you last have an MRI?

Since the shots may be riskier than you feel reasonable, try getting new imagery, which might reveal changes in your condition!

Just a though...hope it helps!

SR
Helpful - 0
547368 tn?1440541785
You are always welcome. I think most of us feel the same way, this is the only place we can discuss our pain without being looked at with raised eyebrows and hear the whispers. I never wish bad on anyone but I would love those with the raised eyebrows to walk in my shoes for one week.

Whenever I complain of my pain to my physician, which isn't often I usually end with, "I'm sorry. I hate whiners." You assures me that I am not a whiner. Like you I have multiple reasons for pain. She tells me I have a high pain tolerance. I am guessing the same is true with you. So please don't beat your self up.

I remember when I had my fist child. He was a nine pound, fifteen and a half ounce boy. I weighted just 113 when I got pregnant and was only 15 when I delivered him. I was given nothing, I mean nothing for pain. I never moaned, groaned, called out or made a one peep through the entirely labor and delivery process. Judging by that experience I'd say I have a pretty high pain tolerance. Last summer I passed a 7 mm kidney stone with nothing more than a vicodin on board. I bet you can say recall similar situations. Yet this chronic pain can reduce me to tears.

We have nothing to apologize for. We are not weak nor do we have low pain threshold. You have multiple medical conditions that can cause severe pain.

You should not feel like a failure. You may require just another slight increase in your long acting pain medication. Don't be fearful of discussing this with you physician. Choose your words carefully and explain that though it helped you are still in significant pain. Ask what he/she suggests.

When someone asks me how I am feeling I smile and say. "Oh about the same. Thanks for asking."  I figure the "thanks for asking " will shut those up that really don't want to know. The friends I have that care or try to understand will usually ask another question (which I keep short) or say that they are sorry I am doing better.  So I understand where you are coming from.

Please remember that you are worthy. Don't let anyone make you feel like you are being a baby or a complainer. Give them our pain for a week and things would change...you know that and I know that. So hold you head up high and be proud of the fact that you are able to cope with difficult days that most other ppl never even have to experience.

You are one of us and we'll look forward to hearing from you soon, and often.
~Tuck
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Avatar universal
Dear Toolmaker & Tuckamore,

Thank you both for responding to my questions and my venting.  It's not like I can talk to any of my friends about my pain med problems because if I even mentioned the type of pain meds I am being prescribed now, well, you can just imagine the looks I would get, oh yes, and all the comments too.

I'm sure you're both correct in that things have gotten worse with me physically, and I've also gotten a tolerance.

I did ask my doctor if she felt I may be one of the people whose body just allows strong pain meds to go right through it without any affect on the pain censors.  She said no.  But her comment when she upped my MS Contin to 30 mg 2 per day, which was "I'll fix that", did and still does make me feel like I am a failure.  Because of they way she said "Oh, I'll fix that" made me think oh, well whatever she ups it to will totally "fix my problem" and it didn't and it doesn't.  And, still I'm having to take almost always four (4) percocet per day for the breakthrough, and that doesn't always cover the majority of pain of alot of days.

I do have lupus, fibromyalgia, osteoporosis, and degenerative disc disease, and therefore I have a myriad (sp?) of options to blame all this pain on.  I do know that my pain has gotten way worse as the years have gone by too.

Besides a built up tolerance, I have wondered whether or not I am actually one of those people who has a naturally, extremely low tolerance for pain, and an extremely high tolerance for pain meds.

I will discuss this with her in my next appt. with her, but still, maybe it's the way we are in America, or the way I was raised, but I feel as if I am just some big baby and a whiney big baby at that!

Again, thank you both so very, very much for responding to my question.  As I said earlier, this is the only place a person (or at least this person) can feel comfortable discussing these types of problems.

For I'm sure all of us at one time or another have made the big mistake of telling a friend what types of pain meds we are on, only to have them look totally disgusted by us, and/or immediately after the disgusted look ask;  "Oh, I have a really bad pain in my "whatever, fill in the blank", could you give me a couple of those pills until I can make an appointment with my doctor?"

Yes, nobody seems to believe anyone else is in pain but themselves.  I've seen it way too many times.  So, now I simply lie through my teeth when asked by a friend how I am feeling.  The answer is "Oh, fine, thanks for asking", and the answer is almost alway a big lie.

Best Wishes,

Suda
Helpful - 0
547368 tn?1440541785
Hi Suda,

Welcome back. I am sorry to hear about your increased pain. Many of us have been there and we know how challenging that can be.

When we have chronic pain our body does "eat up" opiates. They are busy working on the pain. Some physicians beleive, as I do that rather than a tolerance issue your condition can deteriorate, or become worse as toolmaker suggested. That could account for the ineffectiveness of the narcotics and your need for higher doses.

You are not a freak, far from it. These problems occur with many of us. You condition may have just gotten that much worse and you require these opiates to control the pain that it is causing. Please discuss this with your physician. I also think it is a good idea that you are looking into the option of a steroidal injection. Some ppl have great success with these procedures.

Every now and again I develop severe trochanter (hip) bursitis. When it happens all it takes is one steroid injection into that hip and I am good to go. That one injection usually last years. I know that is not the same as your spine but it is similar.

I wish you the very best and do hope that you will keep in contact with us. I'll look forward to hearing from you again, and often.

Take Care,
~Tuck




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Avatar universal
Is it possible that you may be in more pain now than before?Spinal injections are not that bad but make sure you will be sedated beforehand.
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Avatar universal
Dear Mollyrae,

Thank you so very much for your response.  I just feel totally lost because I know these meds I'm on are very strong, and when I informed her that the 15 mg. MS Contin wasn't lasting as it should and still with the 4 percocet per day she said "Oh, I can fix that", and up my MS Contin to 30 mg. twice per day.

But as I said earlier, I am still having to take the 4 percocet for breakthrough pain and they way she said "Oh, I can fix that", makes me feels as if I'm hopeless.

I am going to breakdown and make an appt. with the back pain shot doctor no matter how terrified I am about getting those, but you telling me that it may be a tolerance thing makes me feel a whole lot better.

Still, the idea of those shots scares the #$%$ out of me!!!

Anymore of you out there who may have gotten these shots, or been in a similar situation?  I'd really appreciate the input.

Thank you for your help.

Sincerely,

Suda

Helpful - 0
535089 tn?1400673519
The problem with these pain meds is the tolerance issues. While the Doctor may have increased the dose, it is still not enough.

Have you ever thought about going to the Fentanyl Patch? It works around the clock and is 80x more potent than Morphine. Many Chronic Pain Patients are using the Fentanyl and are now comfortable.

Please ask your DOctor upon the next visit if this might be an option for you.

PLease take care,
Mollyrae
Helpful - 0
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