It's my turn now--need a little long-term support

[snakejones]

Hi, everyone---
After being here since August and enjoying the people and fellowship, I am needing some help now. I went to the orthopedic surgeon yesterday, and unfortunately, it is finally time to do what basically amounts to a rebuild on the whole front of my right foot. He will have to break and pin two toes like a shish-kebab (for six weeks), and break, cut, and shorten three bones (metatarsals) in the body of the foot and put screws in. He told me it will take four months to heal from this. I'm terrified, but I know I need it done. I'm a nurse and I've got to be able to walk, stand, and lift. The foot has been troubling me for many years. I had surgery on it in 1989, but changes in the bones over time have caused an even bigger problem, the one I need fixed now.
But the reason I am writing to my friends here is this: I've been on Lorcet 10's and Ultram for the past 16 years for pain control for bad osteoarthritis in my knees, right shoulder, and of course, the foot. I abused the Ultram over time, saw what was happening, and four years ago, tapered down to my normal prescribed dose. I was on 18 a day of those suckers, and I took four months to taper, as I was working almost every day and caring for my elderly mother, and couldn't just stop cold or reduce too rapidly. (That is why I always like to see if tapering is an option for my friends here at the forum.) It worked beautifully, and I haven't had a problem with them since. The problem is the Lorcet 10's. My bottle says 1, 4x daily as needed for pain. When I get my bottle, I take them like candy, run out early, and go through withdrawal every month---for the past 16 years! My poor body has adapted to this pretty well; my withdrawal each month is not too awful because of the Ultram. I do get some of the symptoms---runny eyes and nose, sleep disturbance, restlessness, and I'm out of sorts for several days, but I can hide that pretty easily. And then I basically suck it up and put up with the pain the rest of the month until my next refill. Why do I do it that way? Because during the days I can take all the Lortabs I want, I am truly pain-free. I've been on them for so long that a normal dose does nothing. And I'd rather have 10 days of blessed pain relief than 30 days of pretty much nothing.
Okay, here's the situation: the orthopedic surgeons where I live are very strict--if you are on pain meds already, they won't give you more for your surgery. I was honest filling out the paperwork and saying what I take and the dosage. (I was proud of myself about that--that's pitiful.) I truly do not want additional narcotics--who needs an even bigger problem? So I will have to make it through this upcoming surgery and healing time on what I'm given for everyday use. Things need to change right now so I can re-establish enough sensitivity to the Lortab to have it help my postop pain.
I scheduled the surgery for January 18th, 70 days from now so I'll have enough time. I ran out of Lortab yesterday, so this is day 1 for me, and there'll be no more until I wake up from surgery. After I feel better a few days from now, I'm going to start a slow taper of the Ultram again until I get to 50% or less of the prescribed dose by surgery time. That's my plan. I'll check in regularly and try to not be too much of a baby while I'm going through this. Thanks in advance to all who can wish me well, pray for me, and/or give me advice!

[selfinduced]

You sound like you have a very solid doable plan. Don't be so quick to rush the ultram weaning. You will get there. Meanwhile, put pills on the back burner and do something that is not pill related to divert your mind. You will be amazed how much this works. Read a book, play tennis. run/walk. Help a less fortunate friend. Send a package to our soilders. send a long forgotton apprecition card to a friend. You got this!!! Don't falter with your plan. xx

[snakejones]

I continue to be diligent with my Ultram taper (I am taking one less pill a day until next week, when another comes off if possible), and have had no Lortab since November 8th. Today I'm not grumpy, but my joint pain is pretty bad. So I guess I'm feeling better today from stopping the Lortab, but perhaps my joints are missing the regular Ultram dose. Amazing how my body even feels it from one less pill, and boy does it let me know about it! During my Ultram taper, I'll leave the night dose intact until I have none left to cut.
Your idea about my husband holding the pills is great. He put them in his safe, and I don't have the key. I told him to not let me have a single one until I get home from the surgery on January 18th. So now I've got 60 for my surgery, and hopefully that will be all I need. As far as using other pain meds while I taper, I bought a few Aleve. I may have to take some today!
Thank you for all your help, selfinduced.....

[selfinduced]

That makes perfect sense. Hopefully you will be diligent with the taper, it just makes things so much easier post surgery. Can your husband dole out the meds? And can you alternate with another medication while you taper? How are you dealing with the absence of the loratabs? Just know you have a whole lot of people here ready to help when it gets rough. Remember all the reasons you need to lower your dose in your strict timeframe. It's a pay now or pay later kinda deal (sux's) . You will do it!

[snakejones]

Hi, and thank you so much for writing to me! As far as I know, Ultram for immediate release (IR) only comes in 50mg strength. They also have extended release in several strengths. The nice thing about the way I'm doing this is that I can even half the 50mg pills if I need to---you can't cut or break the ER strength Ultram because it's dangerous, so once you take one, you get a whole dose with no choice in the matter about cutting down gently. And the psychological effects from tapering more than one at a time for me are really horrible. How interesting that you had a harder time quitting the Lorcet than the Ultram! It never ceases to amaze me that each person's reaction is a little different with these drugs. Thank you again for your idea, and please write anytime with more bright ideas! See you again soon---Margaret

[selfinduced]

Great news on losing the loratab. For me THAT was harder than Ultram, which btw never seemed to do much for me. Anyway, one thought for you. Instead of losing a pill every week or whatever of the ultram, can your Doc maybe decrease the mg's? Phycologically this has worked for me somehow. Before I was willing to go CT , I just got a lower dose. Just a thought especially with the antidepressant effect. Ask your Doc if that keeps things more level? Your on your way!

[snakejones]

Thank you for the very sweet and much-needed posts/messages while I work on stopping my Lortab/cutting down on my Ultram before my surgery. I've had no Lortab since November 8th and have cut one Ultram out of my daily dose starting yesterday. Giving up just one Ultram doesn't sound like much, but for me, cutting Ultram is far worse than Lortab because it makes me both restless and depressed. I have learned an incredible amount since coming here--from my experience, I knew stopping Ultram was like taking your hand out of a crocodile's mouth, but didn't really know why. You at this forum taught me that it has an antidepressant effect, and that's why folks feel really bad if they totally run out. That happened to me once when my flight was unexpectedly snowed in, and even though it was only for a day, my psychological state was already frightening the crap out of me. I remember calling my husband on the flight and telling him to meet me at the gate with my pills and a cup of water, I was so desperate! So now I know why I felt like that and can slide that hand s-l-o-w-l-y out of the crocodile's mouth. Today I'm kind of grumpy and a little restless and have body aches, but nothing that can't be handled with this forum's dose of sunshine! I am proud to call each one of you my friend and am always honored to return the favor in any way if any of you need something. Bye for now, and I'll check in again soon.

[laurel453]

just wanted to add my support and well wishes :)

[gnarly_1]

I know your doing the lortab withdrawal now when are you going to stat the ultram???

[selfinduced]

Just checking on you. How are you feeling? Sending you calming energy and prayers.

[selfinduced]

I first want to tell you how I always enjoy and draw so much from your post. You are clearly a very wise person. The addict in me wants to tell you to start stock piling meds (ha), but of course that doesn't help anything long term. I was very much like you taking meds for legit pain and had an unexpected surgery "pop" up while I was still on a stream of narc. I DIDN'T tell my Doc before the surgery, but guess what?? It showed itself anyway immediatly. When I woke in recovery the nurse said "uhhhh", Have you been self medicating prior to surgery? They know by the way your body reacts to the first shot of morophine (I guess). Instead of it sedating me , it made me more alert. My long winded point is, your plan sounds great. I would however be firm with your Doc about immediate pain control post surgery. Explain your tolerance level now and that you are on a strict taper. Your going to be fine. Remember, the more diligent you can be now with reducing, the better outcome and less uncomforatable you will be post surgery. Saying my prayers for you!

[selfinduced]

I have lots to say to you, but running out the door. Stay level and cool. You will get this one worked out. Be back.....

[gnarly_1]

OK  I have lived in cronic pain also thats what made me an addict I know exactly what you saying the perscribed amount wasent enough so I took more in my hey day they dident have all the computers conented and you could have 3 doctors and 3 pharmacy I had the kind of MRIs that would get you just about anything for pain and abused for years trying to live pain free at least they still work for you it got to the point they had to go to methadone to kill my pain so drying out is good and give those pain pills to someone to gtive them to you as directed then get off them as soon as you can I lived on narcotics 16 1/2yrs and missed out on a great deal of life because of it its just not woth the price you pay those pills are evil and will take hold of you we will support your effort I might ask alot of questions but it will be out of love not to entaragate you we want you to sucseed on your goal so you have some pain relife when you need it I will help you all I can and will keep you in my prayers life can threow you some cruves I have had my share and still cary my cross God left a thorn in Pauls side he has left one in mine also but I have learned to cope the best I can I give you a lot of credit for working on a bad foot I worked 3 yrs past when the doctors wanted to retire me because of my back but I had 5 kids to support just mor and stronger dope I thank God the nightmare is over good luck with all this and God bless......Gnarly  

[vicki595]

Hey Hi-   So not taking the Lortabs any more is your choice for now? That's a good plan and you still have the Ultram for pain management.

My orthopod does the same thing. If he's handing out pain meds then you better not get anything else from another doctor. He makes everyone sign a contract. It's a good policy and keeps everyone safe.

This is a smart move for you...to not take the Lortab until after the surgery.
Why do you take them like candy? Because you like them I suppose...are you going to work on that when this is over?  Do you take them at work?

[Ann2497]

Ok so the plan is to stop the Lortab so that after the surgery you can take it for pain and it will work for the pain because you haven't built up a recent tolerance for it?  I think that is a good plan.  Sounds like a major surgery.  Good luck with your plan.  I hope it works.  You know we are here for you!