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922573 tn?1304099329

Question about pain med and anxiety

Hello everyone,
I suffer from chronic pain due to a disease that has required me to have bone drilled from my skull multiple times. I will spare you the lengthy details, but the pain I feel now is as followed (it is the best way I know how to describe it). After the surgeries I felt like someone was stabbing me in the head with an ax. It was excruciating, but has now subsided to this: I constantly feel as if I was beat in the head where the bone was drilled and as if someone is pressing on the bruise. It may sound weird, but that's what it feels like. Right after the surgery I was on oxycontin twice a day with percocet for breakthrough pain. After a few weeks, I asked to be taken off the oxycontin because I didn't want to be on anything long term. I have remained on percocet for breakthrough, and now only take it twice a day. I thought that after I healed from the last surgery that the pain would go away. I have since been told my my surgeon that the constant pressure I feel is permanent nerve damage from the multiple surgeries and bone pain. Since percocet only lasts for a few hours, taking it twice a day really doesn't help all day, but I don't want to have to take it all day either. I have also suffered  from anxiety for years and have difficulty sleeping. For that I take xanax, usually just at night to help me sleep. If I don't take it, I will lay there and worry all night so it really helps me and has helped me for years. I am prescribed to take it up to 3 times per day, but I don't like to take it during the day since it can make me sleepy. Lately, however, I have been experiencing anxiety every time I take the percocet. It says on the bottle "may cause dizziness", and I am wondering if the sense of dizziness triggers a panic attack for me. My disease is in my ear, so I also have problems with vertigo. I don't know what to do. If I don't take anything for pain, I am extremely uncomfortable. When I do, it tends to make me anxious. I am wondering if I am on  the wrong medication. Percocet did not make me anxious at all (for months) until lately. Has anyone else experienced this side effect? I am wondering if there is a medication out there that does not have this side effect. I have tried ultram and it does nothing for pain. Over the counter medications do not work either. I have no clue why I am experiencing more anxiety now. I have had to take a half on a xanax during the day to help with that. I do not want to be on more medication than I need to take. I feel stuck between a rock and a hard place. Since I now know that my pain will be chronic, I hope to find the right treatment for me. Obviously, that would be something that doesn't make me anxious. I am seeking biofeedback treatment to help with the anxiety and processing of long term pain. However, self talk alone will not relieve the pain. I don't know why something that worked well in the past now has undesirable effects, unless my ear disease is progressing to add to the vertigo (balance systems are in the ear). If anyone has any suggestions, I am all ears. Thanks for taking the time to read this :)
7 Responses
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596605 tn?1369946627
Good luck with your PM doc. I just saw mine today and we are tweakinga few things.
Helpful - 0
922573 tn?1304099329
Thanks Jan, I appreciate your advice. That is the same amount of xanax I am prescribed, and it works like a charm. I never take more than prescribed. I have been on the same amount for years. Like you, I spread it out a little in the evening. I take one about 2 hours before bed and the one before bedtime. I sleep fine. It helps to relax my anxious mind. I don't like to take it earlier in the day, it can make me sleepy if so. I only will do that if I am really anxious, but I will only take half. I also have a disease that causes chronic dizziness and it is progressing. My surgeon said that it triggers anxiety for me. The xanax is not the issue right now. It's definately the chronic pain not being properly.
I saw my surgeon yesterday (not the pain management doctor, but the neurotologist). He told me again that I have permanent nerve damage that will never go away. There is a hole in my skull and to drill it out they had to cut many nerves. I have only known for a few months that this is chronic, before that I thought I was just healing- as I have many times before after many surgeries.
Yes, it makes much more sense to have a longer acting medication to last all day and then something short acting only if needed. It does not make sense to take a short acting medication only twice a day. I have not been very outspoken to my PM dr, but I need to be. Now that the short acting medication is not working as well, the pain is interfering with my daily life. I am glad I found this site for support. I see my PM dr next week and am hoping to get this under control so that I can move on!
Thanks for your time,
Keri :)
Helpful - 0
710547 tn?1295446030
Hi Keri,
I wanted to chime in here because I read something in your first post that I could relate to.  When you were taking the longer aching pain med with the percocet, you were covered with a steady long acting drug which evened out your dose.  That is always the best approach for chronic pain treatment.  As you mentioned, you did what you knew at the time, and now will seek to try the long acting meds again.  I think Avinza is great - it's basically a long-acting slow release morphine - but you'll need to discuss the exact drug with your doctor.

The anxiety is what I wanted to address more particularly.  I too started using xanax for sleep.  I was prescribed 3/day prn, but my doctor knew I was using it primarily for sleep and let me regulate my dose.  The longer I took it for sleep only, the more I began to feel anxiety during the day.  I believe it is nothing more than our bodies becoming tolerant of the drug at night and then craving it during the day.  

I liked it for sleep rather than many of the sleep meds, because of its short half life.  In the morning, there was no drowsiness.  However, like so many meds, tolerance becomes an issue.  As you continue (if you do) to take the xanax - be careful not to up your dose - but rather, spread it out a bit.  Please accept this advise as its intended - with good will, based on my own personal experience - of course check with your doctor first.  Anyway - I decided to take one of the xanax and divide it in half and take it twice during the day, the second in the evening as bedtime was getting close, and then the final one as I went to bed.  This has allowed for a more steady dosing, yet still delivers the most at bedtime when I want to sleep.  If I'm having a really difficult night, I'll add a Benadryl (diphenhydramine) with my doctor's blessing.

I know it's hard to face a condition as being chronic - we want something to be able to be cured!!  It will be easier though as you get your medications titrated correctly and you settle into a comfortable routine.  Support here and of course from family and friends will help.

Blessings, Jan
Helpful - 0
922573 tn?1304099329
Thanks for all of your input. I do think that a long acting medication would help. When I was on oxycontin after my surgeries, it helped a lot. I took the percocet for breakthrough. Not knowing at the time that the pain would be chronic (nerve damage), I asked to be taken off of oxycontin and just took percocet as needed. Now that I know the pain is not going away, perhaps a low dose of something long acting would make more sense. At any rate, a discussion with my doctor is obviously necessary. It is ridiculous for me not to have adequate pain relief when there is surely something out there to help. As far as the anxiety goes, that is an issue that I have dealt with for a long time now, prior to the pain. I have learned how to control that for the most part. It just  seems aggravated by the medication that could very well have something to do with the dizziness and my disease. As far as finding the nerve, not possible. They are all in my skull near my brain and have already been permanently cut. I just need to find the right medication to make it tolerable. Thanks again for taking the time to respond. I appreciate all of your thoughts on  this.      :)
Helpful - 0
596605 tn?1369946627
Hi-
I suffer from head pain due to nerve damage from a pituitary surgery. Hydromorphone is what works best for me short term, but then I take Oxycontin for more long term. Also my docs have identified the nerve and I am going to have a nerve ablation (kill the pesky nerve). So...you might work with your pain docs on a short term pain solution that works better for you. But there may be a procedure that might help you more long term. I feel for you regardless.
Helpful - 0
535089 tn?1400673519
Hi kerri. Sorry for all your troubles. There is a solution to your anxiety with taking the Percocet. I have found that Morphine 15mg tabs might be a better choice for you. You will not get the jittery, anxiety feeling like that of Oxycodone (Percocet). Percocet can tend to make a person euphoric as well and in taking the Morphine, you will not get that effect.

You might want to have a chat with your Doctor about this possibility. Morphine in 15mg tabs is about equivalent to 5/325 Percocet.

Also, there is an anti-depressant by the name of Zoloft that has been known to lessen the pain and anxiety at the same time. I take it and it really does work for my anxiety.

Take care and good luck.
Mollyrae
Helpful - 0
356518 tn?1322263642
I would talk to your doctor about other options. Medications effect each person differently and even though this side effect has just started it may be that you can not take oxycodone. There are other medications you can try though.
Percocet is oxycodone.
I would recommend talking to your doctor about an extended release formula medication. You have a chronic pain problem which will need to be addressed for you to have a quality of life and be able to function. As you know no pain med will take all the pain away but only make the pain bearable.
Also you may have other issues that needs adressing as far as the panic attacks. The symptoms could have gotten worse and the percocet may have nothing to do with the anxiety your feeling.
Talk to your doctor and explain everything that's going on.
Please keep us updated on how your doing:)
Helpful - 0
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