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Alternative Treatments for Pain--Diaphramatic Area, Especially

I ought to give a monetary reward for anyone who really reads all this!
I couldn't decide which group to join, since my body is failing me, but figured this group would cover a good many problems.  I have different types of pain which has debilitated me, at least, for the last 3 years, keeping me bed-ridden a good portion of each day, except, sometimes, when taking one of 2 meds (Oxycodone and Xanax) which only help some and for a short while.  I am termed a "rapid metabolizer" which means drugs pass through my liver very quickly, requiring very high doses and often don't help, at all.  I have neuropathy of both lower legs and feet, bile gastritis, GERD, hiatal hernia, advanced avascular necrosis (femurs of both hips are severely deteriorated due to long-term heavy use of prednisone), severe deterioration of most discs of my lumbar and cervical spine with arthritis, thoracic arthritis, stenosis, herniated discs, etc., ischial bursitis of both buttox, sciatica, severe osteoporosis, mutiple additional arthritic areas, as well as pain of unknown origin in the sternal area above my hernia--possible causes are estrangulated hernia or, more likely, collapsing diaphragm pressure on my lungs due to severe emphysema--something like that with differing specialist opinions.  The last one causes me the most problems, in spite of the fact that I have fallen various times due to really painful spasms in the other areas and very sharp pains.  (In addition, I have many other not-so painful problems that nevertheless create distress:  emphysema (use oxygen), asthma, double vision, renauds, hypothroidism, daily nausea, advanced kidney disease, vascular dementia, accompanying symptoms, etc.)  My main concern is that I have tried many pain meds, none of which work very well, or at all, or have too many side effects, including OTC's  mild/moderate/severe opiods, Tramadol, Fentanyl, Methadone, antidepressants, Lyrica, Gabapentin, hydrocodone, Percoset, Codeine, maybe more, and the 2 present ones, mentioned above.  Oxycodone never has worked well for any of my pains, except to make me drowsy and sleep through the pain; Xanax helps okay, but I am worried about the dependence caused by long-term usage, and the possible link to Alzheimer's, in addition to sleeping all the time.  Since I already have moderate memory, concentration, confusion problems, Xanax scares the hell out of me, if it could be making it worse.  I don't know where to turn and would like to know if there is some other option to taking another pain med that probably won't work or have serious side effects.  Has anyone tried the Tens machine?  I've heard that it is not very effective.  As I said, the diaphragmatic concern is the worst, except for some of sporadic shooting pains and spasms in other areas.  Also, the meds don't last more than a few hours, when they do, and the rest of the day I must remain in bed, since I don't function without any more pills.  On top of everything, I am 69, have no family and live alone, with little money and no assistance.  I am so sorry for this too-long post, but, as you can see, I have a lot going on--Oh, I am also mighty depressed!  I really appreciate any persons who take the time and patience to read this unintended lengthy explanation and make any suggestions or recommendations.
Thanks to all, Tamaka
1 Responses
7721494 tn?1431631564
Hello Tamaka.

In reading through your history, I see many symptoms that seem to be secondary -- ie, related to treatment or bed rest. This makes your case very difficult to manage. You are worried about your diaphragm, but it seems to me the emphysema is your most serious problem (It's hard to tell -- so much going on with you.) Unfortunately, dealing with pulmonary disease is way out of my range of knowledge, so I will deal only with the pain side of your condition.

Who is managing your pain? I suspect that it is your primary or pulmonary doc, and I feel that you need an expert in both medical management, with interventional pain skills. I'm taking about a board certified pain doctor, trained in interventional pain management techniques. This is an advanced practice of anesthesiology. I suspect there may be nerve blocks available to treat the pain in your extremities and perhaps make you more comfortable.

I also suspect that you're undermedicated because of the respiratory diagnoses. A skilled pain manager knows of adjunct medications, perhaps anti-convulsives or SNRI antidepressants, that can help treat your neuropathic pain (pain of damaged nerves), that will not suppress the respiration management centers of the brain as opioids do.

I understand your concerns about medication dependence, but that seems to be the least of your problems right now. There are alternative medications for Xanax, for instance, clonazepam. Still a benzo, but used for 50 years w/o evidence of brain damage.

I also am concerned about your lack of support. Depression is common in everyone with chronic disease. In concert with your pain management physician, patients benefit from a relationship with a pain psychologist. This kind of phychologist is not interested in your childhood, but is trained in case management relating to chronic illness,  and is a partner in finding other non-medical strategies in dealing with chronic pain. Also, knowing there's someone on your team that is pulling for you is also a mood booster. I know from personal experience. A good pain specialist is wise to the need for a multi-modal approach to treating pain and can make a referral to a good psychologist.

That's all I have for now. I am empathetic to your suffering and will try to help if you have other concerns regarding pain.

Best wishes.
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