chronic pain bad side effects or no relief

[mindysu3]

Hi i am a 25 year old that has had chronic neck and upper back pain also down r arm and into hand for the last 8 years.  I have tried alot of meds for my pain and would rather not take them because they make me nauseated and I feel like I constantly have to eat. Vicodin,percocet,norco and many other doses.  The pain is almost unbearable and the first pain doc i saw said he could not do anything for me because narcotics do not relieve fibro pain.  Well I take cymbalta 60 mg, wellbutrin 300mg, neurotin 600mg, Alprazalom .5mg for chest pain due to anxiety from the pain and cyclobenzaprine 5mg.  My pain has not decreased and the pain in my right arm and hand and the numbness wake me up constantly at night. Also pain from my neck down to the middle of my spine wakes me up.  It is also very hard to fall asleep at night.  A rheumotologist told me to take ibuprofen and there was nothing else he could do.  I have been through phyisical therapy many times a pain clinic chiropractor visits massage.  But with a 3 and 5 year old and a husband that thinks I just like to go to the doctor it is hard to find time to do these things now plus they only helped very short term if at all.  The tens unit only changes the pain while it on and a thera cane changes the pain while I use it and the my skin feels bruised the next day.  I finally foud a pain doc so far willing to try something different but  I am still getting very frustrated. Last week he tried me on a 25mcg fentanyl patch and those were the only two days I have been without pain in many years.  I put it on at 4:30pm last friday and saturday anything I ate or drank came back up.  I was pale looking and very faint feeling.  I called my doc and he said to keep it on so I did.  Sunday I felt a little better but the the pain came back that night.  Monday I called the doc and he changed it to 1.28mg patch so I took the other one off and put the new one on.  this dose also did not relive any of the pain like the 25mcg did. Tuesday morning I got up and in the shower to go to work and felt like I was going to pass out and also started to throw up while i was in the shower. I took the patch off and called the doc at 8am to let them know what was happening.  The doc was gone tuesday and wednesday so I had to go without anything again.  I felt faint and sick all day at work and when i got home i slept alot even on wednesday.  Now he prescribed me oxycodone hcl 5mg it does not make me sick but it does not take the pain away either.  I tried 1 and 1/2 and still no relief but at least it doesn't make me sick. I have had three normal mri's and am awaiting the results of my fourth.  Did I have a bad reaction to the patch because i wasn't taking anything prior and even though the oxycodone isn't helping the pain should i keep taking and hope that if i try the patch again i will have a little tolerance to it and maybe not such bad side effect.  I am not worried about addiction because I know I could become dependent on it to relieve my pain and that is not the same as addicted.  I am dependent on all that other medication and feel horrible if i forget to take the cymbalta for one day.  I am tired of trying to live with this pain and am getting so frustrated with the medication.  Please if any one has any suggestions or ideas that i could present to my new doc i would really appreciate it.  Also should I feel like i am being a pest to my doc calling and telling them everything that is going on.

[nick30]

you have many problems, and to be honest i don't know the answers to all your troubles. however I would like to suggest you try sleeping on your back, not sides. I do it(despite finding it hard to get to sleep this way). If I lie on my side or front it causes lots of pain. it took me weeks maybe months to get used to sleeping on my back but it has definately helped. maybe it would help your hip pains. good luck, let us know how it goes if you try it.

nick.

[mindysu3]

I saw the doctor friday and he started me on 12 mcg of fentanyl again.  He told me to continue taking the oxycontin but I felt nausea and sweaty all day saturday and sunday so I did not take the oxycontin.  Monday I changed the patch and now the pain is back?  I do work as a home health aid for hospice, last tuesday during a suppervisory vist with my manager I mentioned to her about what was going on and she asked me if I was clear to lift 50 pounds, I told her that the doctor did not mention anything.  When I saw the doctor on friday he said I should not be lifting more than 20 to 30 pounds.  I worked all weekend and on monday my manager called me in and explained that they could not let me work until I was clear to lift 50lbs.  I got a hold of my doctor and now he said no more than 20lbs and no bending or twisting of any kind.  I cannot afford to be off work and my husband and mother-in-law think that I can tell my doctor to relaese me to lift 50lbs, Is that true? They believe my manager is out to fire me but she seemed so nice and told me to see a neurosurgeon and even called the office of one to find out when I could be seen.  She also called our leave management person to get things set up for short term disability.  My manager said that and epideral injection in my neck will cover up the pain and should maybe be a last option not a first.  Would a pain doc suggest a injection even if you might be a candidate for surgery and with an injection would I be able to go back to work or should it be fixed? I am worried about what the future hold for work,My doc did not explain much about the disc and how it heals or if it will or how long I will be off work.  I also worry that maybe I should not return to work b/c a year ago my MRI was normal according to a different pain doc and lasy July I started working 3 days a week and now the MRI did show something.  There is no way I could do an office job since I tried going back to school and had a very hard time sitting through class.  In the last 8 years my "fibromyalgia"(diagnosed in 2003) has progressively gotten worse and now this.  I am also woken up about every hour by extreme pain in my hips whichever side I'm laying on and then have to change sides , and my lower back seems to have flared up again, it feels like my right leg wants to give out when I step on it and lots of sharp pain in lower back.  It is extremely tender when touched(lower back). I told my doc and he injected my r hip but never said what the problem could be.  When I just had Fibro I could not get any medication that helped the pain and now that there is a reason for the pain should I cover it up or try to get it fixed.  Was it wrong of me to talk to my manager she said I could have wrecked my career if I would have continued to work and then hurt myself when I new there was something wrong with me.  My mother-in-law said I shouldn't have told my employer about an injury b/c they blew it out of proportion,  she said most people cannot or shouldn't do what their job requires, but do it anyways b/c otherwise they will get fired. Sorry if this is confusing.  too many thoughts running through my head at once.  

[sandee1818]

If your taking the oxycontin and wearing the patch also be careful as if your not used to narcotics this is a heavy duty dosage. Also the narcotics will cause respitory difficulties with high doses. I assume the doctor told you to discontinue the Oxycontin if your going to wear the patch. I would go back to his office and see him face to face and tell him everything that's going on and what is working and whats not because he is getting the information you call in second hand and may not be getting the whole picture and that is dangerous with these kinds of medications especially taken together.( oxycontin and fentanyl)
I think you have a good doctor that's willing to help with your pain but when changing medications like this it is safer to go in and that way you know exactly what he wants you to take and when and also you can make sure he knows everything as I said he may not be getting all the information.

[neuromanager]

The bulging discs in your neck could certainly be the cuprit of your neck and arm pain.  Have you seen a neurosurgeon?  Have you also been diagnosed with fibromyalgia?  Exactly what have the physicians diagnosed you with to put you on so much heavy duty pain medication.  Please see a neurosurgeon for your neck.  We have many patients with bulging cervical discs that experience numbness in their arms, pain down the arms, neck and into the back.  When you had your MRI did it show any compression of the spinal cord?  If so, you need to get that neck taken care of.  If you fell or were in a car accident, you could be paralyzed if this is the case.  If you had to have neck surgery they will most likely wean you down before surgery off of your pain medication, otherwise you won't get any pain relief with the after-surgery pain medication.  Your body builds up a tolerance to these pain medications and our patients that come in on Oxycontin or Percocet have a heck of a time getting their surgical pain controlled.  Also, ask the neurosurgeon about a dorsal column stimulator if you don't have cord compression.   This is an implanted device that sends "signals" to the spinal cord and blocks  pain,  They work very well for our patients who have had surgery and still have pain or with our patients that do not want surgery but can't stand the pain.  If you are seeing a pain management physician, ask him/her about it.  You still have options.  Good Luck.

[nick30]

Hi there, sorry u are having troubles and pain so much. I wonder if you would be able to tolerate the patch better if you took another drug/s to control the nausea and vomiting? It could be the case that you have some degree of allergy to the patch too in which case you could try an equivalent dose of a different drug (like morphine for example or oxycontin as sandee suggested).
the oxycodone IR you took is very weak compared to the patch. but there are higher doses of longer acting variants of the drug which you may tolerate(and may help more). keep being a pain in the dr's neck, sometimes it's needed (but please don't disrespect him/her coz that won't work). I'd stick with the dr who is willing to try different things, my dr is like that, and it's been great for me to have a dr like that.

best of luck

nick

[mindysu3]

I also forget to say that my MRI did show a herniated ,bulging or slipped disc around my c4,5 or 6. The doctor was hard to understand so I'm not exactly sure

[mindysu3]

Doctor doesn't know what to do anymore.  I have been on the oxycontin for a week now and it is not giving me any pain relief.  I called the office and the nurse told me that if I was in that excrutiating of pain that I needed to come in.  She told me they do not know  what to do so I asked if I could be put back on the fentanyl patch b/c it did make the pain go away and if I have to be sick 1 day it is better than all this pain everyday.  I hope it will not make me sick this time since last time I was not taking any kind of pain medication before I started the patch. Now i have taken oxycontin for the last week and oxycodone 2 weeks before that so hopefully the patch will not be such a shock.  If an one has any ideas on what I should do it would be very helpful since the doctor doesn't know what to do and it seems as though they think I'm lieing.  I am not an addict and am not sure why they are treating me like one.  The pain is not unbearable but when it is there all the time it is hard to deal with it.

[sandee1818]

Do not worry about being a pest. You hired this doctor to manage your pain and to do that he needs to know whats going on.
I would continue with the oxycodone and let the doctor know that you are able to tolerate the drug but it is not helping with the pain. You may be able to tolerate the extended release Oxycontin since you are doing okay withe IR so that may be an option for you.
Just keep on working with the doctor and he will find the right combination that works for you. We all have to go through this trial and error to find what works for each one of us so just hang in there.