maxed out on pain meds,

[twincerely]

hello.....new here 1st post.....wow i see me here in most of the posts seems we all share most of the same things trying 2 get a handle on the pain we are going through...breif history of me 56y/o male post back surgerys x3@L-4 L-5 S-1 ........long story short right now i am takeing 100mg morphine 3xday 15mg roxicodone 4xday on the break through pain management up till yesterday also takeing 300mg gabapentin 3xday..at drs appt yesterday dr says we are all maxed out have tryed everthing trying 2 get my pain under controal.. so now last plan goning 2 try acupuncture  an also doubled the gabapentin..yes 600mg gabapentin 3xday 100mg morphine 3xday an the roxiecodone 15mg 4xday.....an no just like y"all i have no quality of life i cant function takeing my meds just 2 try an keep my pain under controal... i quit driveing 3 years ago when i started takeing the morphine.been reading all the posts here over the last few days its unreal how much we all have in common.with the pain ,meds,an the  side effects we all suffer.......lil more history on me other than the back opps ...i have stenosis, ddd, excessive scare tissue build up  an arthricis i think thats all.. realy dont care any more  i just wont my life back.with no quility of life haveing 2 take all the meds just 2 be able 2 walk around stoned all the time an still be in pain..that sux.. but i am glad i found this fourm an found out that i am not alone in my quest 2 get my pain managed..one more thing i am a service connected disabled veteran.my dr an pain management an meds is through the V A hospital......

[happyhbmom]

Truthfully, you are not alone.  Finding good pain management is very difficult if you are not free to choose your own doctor, because there are so many PM doctors with antiquated ideas about the use of opiates for chronic non-cancer pain.

I do hope you find some relief soon.  Personally- and I know this is hard- sometimes it is good to taper down on the meds for a while and then back up.  It's kind of a "refresh" button for your opioid receptors.  

[twincerely]

guys i realy wont 2 thank y'all for your info an feed back.but the V A has there own way about doing things, you realy  are at there mercy, i am going 2 call an try 2 get an appt 2 see my pm dr may be i can get him 2 hear what i am saying, that i have no quality of life  always in pain an the meds are just not working, i am tired of the pain, i am tired of the nausea, i am tired of the weight loss,i am tired of getten sick when i eat ,or getten sick if i dont eat,it may be 6 or 8 weeks be for i can get an appt 2 see him.his office canceled the epidural that i was supose 2 of gotten oct 7th an next avalable one is not till jan 27th.the 1st time i talked with my pm dr we both deceided that i am not a canadate for any more operations as long as i can walk, till then treet the pain with meds..the bigest reason im not a canadate. [other than i refuse 2 have another] for any more surgerys is the excesive scare tissue build up .when i got back 2 my room after the 2nd opp i was screaming out in pain, i kelp telling them my stomach is burning  i am on fire, i am in pain they give me a shot of morphine ,i am still screaming out  that i am on fire my stomach is burning up,,, ooooooooooook the rest of the day an all night same thing  scream out another shot of morphine which was not haveing no effect on any of my pain. finely next morn i demanded the get another dr in 2 see me that something was wrong here. sure nuff lil while later i get a dr in 2 see me he ask me cpl questions an then ask the nurse how long had i been complaning bout my stomach pain , nurse told him sence he got back from surgery yesterday, an what did you tell him, nurse= that it was just side effect from the operation,from being put 2 sleep.===nope dr had tore a hole in my bowels........ paratenitis was already setten up i was with in a few hrs of dieing...the excess scare tissue had adheased itsself around my bowels..so now i get a bowel resection.......dont ask me how a dr can  do that but he did ... i was there i no....but i will keep y'all informed on what the V A drs deside what aproach the will try next on my meds..an yes i will ask about the fentanyl.....i just wont a funcional life back.

[JadedSweetheart]

I'm sorry I was late getting to this thread as well.  I just want to thank you for your service to our country.  I have heard of these issues with the VA pain management.  I have heard of some people feeling over-medicated and others who are undermedicated.  I feel strongly that service disabled veterans deserve the best our medical system can give.
I agree with the others that perhaps a change in medication or an opiate vacation may help you.  The opiate vacation is, understandably, extremely hard to do for anyone in constant, debilitating pain, but I've heard it really works.  
Opiate medications just don't work as well after taking the same thing for a long time.  Sometimes being on opiates can make other pains feel stronger because it can lower pain tolerance.  I have read that being in chronic pain can also reduce our pain tolerance.
I am wondering if your PMP would maybe reconsider fentanyl or oxycontin if the acupuncture doesn't work?  It's definetly worth asking.  You could also just try to explain to them the way the pain affects your life and how the meds affect your life and the pain and then ask him what else can be done.  I've found that good doctors will appreciate that approach.  
I wish you all the best and I hope you will be able to get a better level of control of the pain.  I hope you'll continue to post on this forum as well.

[happyhbmom]

So just so you know, you're not "maxed out," your doctor is just not using all of the tools available to help you with your pain.  I'm also on Fentanyl, and find it much more effective than Morphine.  I also do not have cancer.  

But just so you don't blame VA, it's an issue a lot of doctors have with severe pain patients, from what I read.  I am sorry they are not doing everything they can to help you :(

[designgyrl0112]

Wow, I can't believe they refuse to give you fentanyl. As a fentanyl user, I am so sorry they stated that.  I use fentanyl and I do not have cancer but disc problems in my neck and back that have been going on for years.  I've also done injections, accupuncture, physical therapy and and surgery.  Hopefully they will reconsider.

[twincerely]

i wont 2 thank y'all for your replys.under the V A your hands are tied,you get what they say you get an no more , they refuse 2 give me the fentanyl,says its for cancer pts only,its like my nausea meds 18 tabs is the max they will give you per mth i waited 4 mths 2 get  an epidural a week befor it was time they called an canceled me my next appt for another epidural is jan 27th, i dont get alot of releif from them but i welcome the short time releif i do get from them.even though my dr put in that she wonts me 2 get the acupuncture dont mean i will get approved 2 get them , an if i am approved it may be 2 mths befor i get appt .the V A is a hurry up an wait we will get 2 you . my closest V A hospital is 90 miles away .lucky for me my g/f understands what i am  goen through she is my taxi for my appts an where ever else i need 2 go ..again thanks for your inputs.........twincerely ron  

[happyhbmom]

p.s.  Yes, the people who were on more than you were people living with daily 8-10 pain for years and years.  My heart just goes out to you and anyone else in that state.

[happyhbmom]

I think when you are not getting relief from one med, it's time to switch.  This is just my opinion.

So recently when ms-contin wasn't working well for me, I switched to another med rather than increase the dosage.  And I think maybe you can do a roundabout like this on all of the meds and slow your increase.

Also, why is that "maxed out?"  I have known of people taking more medication than that for pain.  Who decided that was the most you could take?  If you did, then that's fine.  I wonder if you've tried Fentanyl.  Or maybe a switch to Oxycontin.  You know, lots of things that could jump start your opiate recepters.

[Tuckamore]

Hello Twincerely,

Welcome to our Pain Management Forum. I am glad that you posted but sorry to hear about you pain issues. If you've been reading, you know we can relate. Please excuse my tardy response.

We are all different and respond differently to opiate and other medications. I am sorry you are maxed out. I hope you will be able to find other alternatives to pain management.

We have members that (under their physician's guidance and monitoring) have gone off most all opiates for a time and started up again with a different opiate at smaller doses. It has been effective for some ppl. You might want to discuss this approach with your physician. It's not an easy choice but it can "reset" your tolerance.

Most good, knowledgeable physicians today believe in the "less is best" theory that was discussed above. I doubt most of us long term chronic pain patients expect to achieve no pain level. That is an unreached and unrealistic goal. My level averages a 6 on low doses of long acting and moderate doses of a low potency, short acting opiates. I don't even know what a pain level 3 feels like any more.....and I haven't had the three spinal surgeries that you have undergone. You've listed multiple reasons for chronic pain. My heart goes out to you.

You sound like you have a very good attitude. It can make a such a huge difference in pain management. I think we all share the dream of getting our lives back. What I have found is that I have a new life. It's no worse or better than before chronic pain changed it........it's just different. And with life comes change, for everyone. It's finding the good in it that really counts. Making the best of what we do have and learning how to mange the unwanted differences that chronic pain has brought into our lives is the key to finding contentment.

I hope you will discover some alternative treatments that will help better manage your pain. I see an Internal Medicine D.O. (Doctor of Osteopathy) that practice OMT (Osteopathic Manipulation therapy). Her manipulations keep me functioning and reduce my pain levels. She has been a God send. I am certain without her I would be in a huge world of hurt. If you have not consulted a DO that practices OMT I encourage you to do so.

I'll look forward to your active participation in our community. I too thank you for your heavy contribution to our safety and freedom. I'll look forward to hearing from you often.

Best of Luck and Take Care,
~Tuck

[paingotago]

Hi there, First I would like to thank you for your service for our Country. I don't know if this will make you feel any better, but let me share a little story with you some things I have learned from being a Chronic Pain Patient for several years. "A long time  time ago I thought more was better ,and years back some Dr.s had that same theory. As time went by I found out for myself that I was getting into deep doodoo with the (no ceiling theory), I was losing weight, not eating properly, and the sedation feeling, also my Seritonin Norenephreneprine, and dopamine pain receptors were all out of wack, and strangely sometimes in more pain.                                                                                                                                    First I do need to be respectfull, and say for chronic pain patients that live in a daily 8-10 level pain their are, (exceptions), for them if a patient is terminal, or in daily fainting or crying pain these patiants obveously need care givers and require alot of pain meds.                                                                                                                                           People though that can live on a pain scale of 6 or less now in the last 5-8 years the Dr.s are more edjucated in treating chronic pain. They are trying to change to a method of "Less is Best", They try very hard to keep are three main brain receptors in ALINEMENT so we can think clearly enough to both take our meds.,and funtion in a proper way so that are motor skills are still atleast average enough to do what we need to do on a daily basis.                                                                                                                              They do this by just giving us no more meds. then they have to. Some times we have to go 1 to 2 years before we get an increase. They have found through years of treating us that if they keep us to a say: Hypathetically on a conversion table scale that is equivilant to 200-300 mgs of the medication oxycodone. So whether a person takes a (75mcg patch,and 4 IRs a day), is the same as (2 80's, and 4 IR's) a day, or take you for example; you take 300mg of morphine and 4 IR,s. So do you see what I mean by all of my comparassions?. I could be wrong, but I think at least 60 to 70% percent of us are all in the same boat.                                                                                                                                    The main reason for this is to  control are pain to 50% and hope that we try aletnative methods to add to the 50% of medication control. Another Very important Reason is so when we go to the Hospital to get our surgeries we are what is concidered "TREATABLE" so when we go under anethesia we will wake up. The last reason is what I already stated above, and that keeping are three main receptors equally balanced the best of their ability so we can funtion without the risk of resperatory, or motion skill crash, and possibly serous dependance.                                                                                                                       Well  I know this won't make your pain feel any better BUT, I just wanted to let you ponder the thought?  Has anyone ever wondered why pain Dr.s now do what they do, and treat the way they do. I think this is close to an answer. I hope this knolege helps you atleast a little bit, and also  helps  with those tough questions we all think about ,but we know the Dr. doesn't have time to answer in 10 miniutes. Nice meeting you, and I wish you the very best of health always. Sincerely Paingotago

[TrayCee]

Welcome to the PM Forum.  Lots of good ppl here!