I am writing this reply to Peskypain's post but this reply really applies to both Pesky and Annette.
I think both of you are taking my words to the extreme, twisting them around, and adding additional words that I did not write.
First of all, from reading Lita's posts it is obvious to me that she is looking for support and advice on how to get her physician to listen to her concerns about severe pain. Let us not forget that pain is widely undertreated in America and we are the minority. There are so many people out there struggling with severe pain each and every day because physicians are not willing to prescribe medications (both opiate and non-opiate) that can help. There are so many people struggling each and every day to survive while enduring severe debilitating pain that have NOT abused prescription medications, have no history of suicide, or any other mental problems...just PAIN.
It is so easy to sit behind a computer after taking effective medications and then make determinations on why certain people aren't getting EFFECTIVE medication (I say effective, because better was considered a myth). To me, a medication that is more effective is better! Pesky, in your post you talk about how this support group is there to provide others empathy. Smacking someone's hand for getting street medication to get relief from severe pain is not helpful. Nor is it helpful to assume that person is an addict because they did that. I am not saying that is an OK thing to do. I am exhibiting empathy (putting myself in someone else's shoes), how would I feel being under such severe pain with no relief for days/weeks/months/years?!?
Cweinbl always posts that it is best to treat chronic pain with a short acting and long acting opioid versus short acting opioids alone. Why am I getting this type of response when I relay the exact same thing?!? I did not say short acting opioids lead to addiction, I said used by themselves can lead to abuse (taking more than prescribed) especially if they are ineffective. This type of behavior is called "pseudoaddiction", exhibiting addict like behaviors until the pain is at a manageable level.
I, myself will admit that before being switched to morphine from vicodin/tramadol, I was switched to percocet 5/325 - 1 every 6 hours. I was in SO MUCH PAIN!!! I bought heating pads, creams, took OTC medication and after 3 days of intense pain, I called for a pharmacy consult and asked if I could add 2 5/500 vicodin to take inbetween percocets doses? The pharmacist said yes that it was safe and I proceeded to take it and the pain receded. I went in for a doctor visit the next day, and told the physician all of this and he knew I needed stronger pain medication. He did not dismiss me or label me an addict.
I was never suggesting that she should NOT consult her physician about all of the options I posted. They were only suggestions as I am far from a physician. I stated that purely from an opioid conversion/strength comparison, she is opioid tolerant enough for an extended release medicine like morphine. I am not the one doing the prescribing so if there are other underlying health conditions such as COPD or asthma, etc., then that would be another thing to consider before the physician prescribes a stronger medicine. I was just trying to relay these facts to her so that she is more knowledgeable when she goes to her appointment about what is potentially available to her. I know many doctors will say they only have x medicine and it is NOT true and if you aren't aware that there are other medicines, you may walk out the door without achieving your goals. I had to tell my physician that I heard it is best to treat chronic pain with a long acting opioid and then use the short acting opioid for break through pain. After I said those words, my doctor gave me the option of morphine or methadone.
I am and have not in no way offered medical advice. You have twisted my words and made it appear that way.
I agree with TDXSP08. Miralax has been a miracle for me. Nothing worked for my constipation until I tried Miralax. I tried stool softeners and stimulant laxatives and they did nothing.
I mix the powder in cranberry-apple or cranberry-blueberry juice and the juice tastes the same as if you drink it without the Miralax mixed in. You can mix it in any non-alcoholic beverage 4oz or 8 oz. Make sure you stir it well until it dissolves. I find it works best if I take it before bedtime. I am able to go in the morning when I wake up.
There have been times I have had to repeat it the following evening and another following evening before I was able to go but never more than 3 doses (1 dose per day).
Usually opiate induced constipation is very difficult to prevent. You will more than likely have to take a medicine like Miralax on a consistent basis as long as you are on opiate medication. It is more a matter of managing constipation than preventing it.
Thank you for sharing this great story that provided you a lot of relief from pain. It sounds like it is something that I should consider for the future. Going down to a C from a DD I can see would alleviate a lot of added weight as 800 grams from each side adds up to a lot!
I also get tight bands across my back and I have to punch them out with the theracane every 3 to 4 weeks because they start to cause radiating pain usually up and down the sides of my back.
I am also interested in the perkyness you talk about lol! Mines are slowly being overcome by gravity and me smashing them while I sleep at night...lol! I didn't know the breast reduction also restores the breasts to the natural shape they were in when we were young. That also is an added incentive!
I am glad to hear everything went well at your post op check up. It sounds like a win win situation to me!
I think you may have gotten the wrong idea about my post. Lita posted earlier that the 3 vicodin she was taking wasn't helping with her pain at all. She said it would bring the pain level down from a 9 to a 8. Additionally, given all that she has going on with her back and comparing her conditions to my own back condition, I couldn't imagine vicodin would help very much at all for her type of pain.
I wasn't suggesting that fentanyl was the solution. I was simply trying to elaborate on the range of extended release medications out there based on the length of time that they provide pain relief. The only pain reliever that I suggested was tramadol and I think we both agree that tramadol is a starter opioid.
I was on vicodin before I transitioned to morphine ER and percocet. So I don't think an extended release medication is out of the question for her. I agree Fentanyl is something for down the road but I wanted Lita to know that there is a wide range of opioid strengths to choose from to manage her pain for a lifetime should she need it.
I am pretty knowledgeable about opioid conversions and comparative strengths so I am certain that she can transition safely to an extended release medicine like morphine on the lowest dose without severe respiratory depression. Once she finds a good PM or psysiatrist doctor, they will make sure to transition her safely should both her and physician agree that a stronger opioid is the right solution to better manage her pain.
Cweibl, helped me get to where I am today in terms of pain relief because he responded with how opioids are supposed to be properly used for chronic pain. If it weren't for his post, I wouldn't have brought up the option of adding an extended release medicine and would have still been suffering. Short acting opioids for chronic pain are not the optimal solution. You are welcome to disagree with me on this. But being prescribed only short acting opioids causes one to "chase pain all day and never win". I would only get 1 to 2 hours of pain relief when it is supposed to last 4 hours and I would crawl up in a ball and suffer until my next dose. It was no way to live. Now I have so much more freedom, flexibility, and capability now that my pain is well controlled on a consistent basis. Short acting opioids can also lead to abuse because the pain relief is so short that people so desperately want to bring it back and keep the pain relief going that they take more and more. For me, I just suffered and complained.
Lastly, it wasn't so much about dosaging even though I did refer back to the 3 vicodin, I was more thinking about the short span of minimal relief she was getting from 3 vicodin. You are right that some people are super sensitive and fall to floor after taking one vicodin. But based on her post, the 3 vicodin aren't doing much at all for her pain and I wanted to pass on the "good news" that Cweinbl passed along to me that there are better options out there that could help bring her pain level down to a tolerable level. I think once she starts steroid injections, she will feel a lot better from those too.
Anyways, yes I am trying to help and I am a rather blunt and frank person. I am always going to tell all especially if I have been helped from someone that did the same for me.
I have a kind of personal question for you. What was your cup size before you had the breast reduction surgery and what is it now after surgery? If you don't feel comfortable answering, I understand. I am just very amazed by your story about how much your back pain decreased after having the reduction. I am a DD and they are really heavy when I pick them up such that I know the weight must be adding pressure to my spine.
I know the reason behind your suicide attempt doesn't make it right but I have been there and I empathize with what you were going through and how you must have felt. I know during those times it is hard to do what is right as what is right at that time is really wrong. I also think folks that haven't had such immense emotional pain in there lives to drive them to consider suicide, don't understand and can't comprehend why a person would go to that extent. But, I (like you) understand.
About MMJ, I don't think you will have any trouble at all getting a prescription for MMJ. Trust me, it is not very restrictive at all. They treat the qualifying conditions and that's it. They don't play games like some physicians do when narcotics get involved as part of the treatment plan for chronic pain. You can also mix MMJ with opioid medications. There are two different strains, indica and sativa. Indicas are downers, and they are really good for sleep and chronic pain in general. Sativas are great for reducing anxiety, depression, and increasing energy and motivation. So you could take the strain that works best at the time, given which bipolar state you are in. The MMJ wave is spreading so hopefully it won't be long before it is available in MD.
3 vicodin a day isn't sufficient in strength to significantly reduce your pain. There is a wide range of stronger meds that are available to bring your pain level down more so you aren't so fixated on it 24/7. They rarely take away all of the pain but they can make the pain manageable. The optimal solution is to have an extended release opiate medicine that slowly releases medicine over 8 to 12 hours (or in the case of fentanyl, 48 to 72 hours) so you have a more stable state of pain relief. Usually, a short-acting opioid like vicodin or percocet is prescribed to take only as needed when the pain breaks through the extended release medicine.
I also take flexeril (cyclobenzaprine) and it helps a lot for me too. I used to take vicodin but I took 4 a day coupled with 4 Tramadol. My pain worsened and my PCP put me on morphine ER and percocet. Could you ask for a prescription for tramadol to augment the vicodin until you can find a PM doctor? Have you tried Tramadol before? Physicians provide prescriptions for Tramadol a lot more easily as it is a weak opioid and not scheduled. It may provide you with some additional relief. The only catch is it increases serotonin levels in the brain like an antidepressant which may aggravate the bipolar condition you have.
I have also been researching pain management doctors in my area as well as I will lose my long time PCP of 5 years when I am forced to switch insurances at the end of the year because my employer is no longer going to offer the carrier I am with now. During my search, I have discovered that I need to look for a Physiatrist not a PM doctor. Once I started looking for Physiatrist, I found many that offer pain medicine as well as injections/surgery/etc. When I searched for a pain management doctor, all I found were interventionalists (injections, surgery but no pain meds). So you may have better luck searching for a Psysiatrist versus a PM doctor.
It is hard to tell which of the medicines that you received at the ER are helping extensively with your pain.
The prenidisone is a oral steroid and in the past I have taken a regime of this medication and it has helped my pain extensively. Prenidisone is not a medication you can take long term as it will do more harm than good. It is okay to begin a regime every now and then (perhaps once or twice a year? at the most).
I am also on percocet and valium and also morphine. I am also 30 years old as well. I was on Tramadol for 5 years for chronic pain before switching to stronger meds. I have been on valium for 5 years or so as well. I find that this combination helps considerably with my pain. I also take gabapentin and it helps a lot too. It is usually effective at relieving pain due to nerve damage. Gabapentin is a non-narcotic medicine so your PCP should have no concerns prescribing it.
I would be open, honest, and up front with your physician. Let him/her know that the medicines you received in the ER were extremely helpful for your pain but also tell them that you are still interested in the additional tests to hopefully find the cause of your pain. Keep in mind, finding the cause doesn't necessary mean a cure. So it is important that the physicians know that the percocet and valium help your pain so that may possibly become a part of the plan to manage your chronic pain should a cure not present itself.
Our house isn't equiped with any medicine cabinets. So all my medicines are in a tray in our bedroom which is assessible by keyed entry. It rarely gets humid in Colorado; however, right now we are having one of those rare moments. Any humidity from a shower in our bathroom in our bedroom is quickly zapped away by the dry nose cracking air lol!
We have OTC meds like Aleve (helps decrease pain in my low back when inflammation gets out of control), Advil and Excedrin because hubby gets frequent headaches and getting him to the doctor is like pulling teeth lol.
I have all my prescription meds in there and they travel with me to work, shopping, etc. (only the ones that are scheduled to take while I am out).
I have a lot of meds that I don't take anymore that I really should get rid of but with the insurance switch coming up at the end of year, I just may need them if I run into issues finding a physician. They aren't 2 years old either, those have been properly disposed already. I only keep fresh medications in my tray lol.
Perhaps if I clarify that the steroid injection bathes the nerve root (not the nerve) with medication, that would clear up any confusion. I posted a link to a rather educational video that explains the procedure in detail and how fluroscopy (live X-ray) is used to ensure proper positioning of the needle.
Still, I would love to hear a professional's point of view on this procedure.