1. Fentanyl is not "a bad drug." Used as directed it can remove much of your pain for decades without harm. It added 9 years to my university career and I know many chronic pain patients who continue to rave about Fentanyl over decades. Nor is Fentanyl marketed as "an end of life, cancer analgesic." It has always been marketed as, "for the opioid-tolerant chronic pain patient."
You question the safety of using Fentanyl over a period of years. Many of us here have been using it for decades, not years. After a few weeks, the "drugged" feeling dissipates and all that's left is less pain.
If you, "pulled the trigger on Fentanyl" on your own, then you made a very bad decision. While I'm sorry that you had to endure the pangs of withdrawal, had you used a physician to help, she or he would have prescribed an opioid-antagonist (Suboxone, Naloxone, Naltrexone, etc.) which would have made withdrawal much, much easier.
2. You said, "Doctors can help, but there is no miracle pill or procedure that will make it go away. Waiting for a new pill or a new doctor is a recipe for failure." This statement is patently false. Fentanyl wiped out 80% of my chronic pain for several years. With breakthrough pain medication and biofeedback, it was reduced by 90%. Millions of patients observe significant improvement when moving to a different physician, who may prescribe a drug that the first physician did not, which works much better. Sometimes a new physician will see things differently, recommend a new treatment, a different combination of medications; or you can benefit from their unique experience in new ways. I hope that no one here took your word for these mis-statements and inaccuracies.
Your final paragraph...
"With analgesics less is more when in the chronic mode. You've got to let your brain calm down...another side effect of chronic pain is operating frequency shift of your brain waves. The base frequency increases making it all but impossible to reach REM state of sleep needed for restorative brain function. The drugs and shift stop the body's natural production of serotonin and dopamine."
... is nothing less than completely confusing. Perhaps you can share the government-university-pharmaceutical research that supports these claims. Really, "brain wave frequency shift, REM and restorative brain function?" Which pain drugs reduce the production of serotonin and dopamine? Do they also lower the reuptake rate? The vast majority of chronic pain patients are using a low-dose anti-depressant, which inhibits the reuptake of plasma serotonin.
If you live where medical marijuana is not yet legal, ask your doctor about an Rx for Marinol (Elan Pharmaceuticals). Cannabis has been used for chronic pain and anxiety for literally hundreds, if not thousands of years, by tribes and people around the world. As millions of Americans have recently discovered, it is most efficacious for chronic pain.View Thread
I've used Neurontin and Lyrica for the past 15 years or more. No side effects. I know many others who also have no side effects. Perhaps you have been misled. The range of side effects for anti-convulsants remains rare and it is typically not problematic. The normal way to deal with this situation is to TRY the drugs. If you have unbearable side effects that last more than a few weeks, then you can safely decrease the medications. Meanwhile, if you don't try Neurontin or Lyrica, you are deliberately hurting yourself. Why remain in pain when you don't need to?
Tramadol is not an opioid. It is one of the weakest pain medications available.
Meanwhile, just one opioid wiped out 80% of my pain and added 9 active years to my career. Many others here have had the same opportunity to enjoy life again with medications and pain management treatment options that help us to manage our pain.
If you want input, here it is. Get a referral to a comprehensive pain management program. Be attentive to mind-body treatments, such as Yoga and biofeedback. Take whatever powerful medications your doctor will prescribe and get back to enjoying life. You are cowering in fear of a side effect that you probably will not have, or if you do have - it will be manageable.
Life is for living and enjoying, not remaining in bed all of the time with pain. Get into a pain management program. Find a physician who will give you the anti-convulsant and a real pain drug, stronger than Tramadol and start living again. Good luck.View Thread
I've been posting here for at least ten years. I do not see any changes in how often and how much people help each other here. Yes, some people complain about not being treated or not being treated well. They complain that the DEA is making life difficult for us and our physicians. It happens to be true, but those of us who never have to worry about having a 90-day supply of powerful pain drugs may have trouble commiserating with those of us who do not.
I'm guessing, Mr./Ms./ Meaningfulc1952, that if you did not have those nice pain medications from your PM doctor, you would be complaining too. In fact, many of us would decide not to live without powerful pain medication. So, be happy that you have yours. Be sympathetic when others do not. And offer positive suggestions based upon what you know works for chronic pain. That's exactly what most of us do. And if we occasionally need to vent within a group of comrades, be understanding instead of critical. Many of us are one step away from being homeless, without a physician or insurance, destitute and in very severe chronic pain. Give them a little room to complain here. They need it.View Thread
You really don't want (need) an extended release medication for BT pain. Your Fentanyl is the long-acting med. Your best bet might be Oxycodone (Percocet), Hydrocodone (Vicoden) or something similar.
BTW, it is risky to ask a doctor for a specific opioid, unless you already have a secure, trusting relationship. It's sometimes considered a red flag for abuse. But if your doctor likes and trusts you, you can ask, or just wait for a suggestion. Your job is basically to tell him, "Fentanyl is good, but not enough. Sometimes I have breakthrough pain." Then, the doctor will either say, "No," or offer a suggestion. Since you've obviously tolerated hydrocodone in the past, that might be the way to go. If that still leaves you hurting, Oxycodone might be considered. Good luck!View Thread
There's too much misinformation here. Most chronic pain patients WILL continue to obtain appropriate amounts of opioids into the future, but they will need to see their doctor more often. Most prescribe without fear of the DEA breathing down their neck. I just discussed this with my physician yesterday. BTW, I suspect that many of us who have a trusting relationship with a family practitioner or internist will continue to obtain the necessary supply of appropriate Schedule III and Schedule II drugs there, as well as reduce the chance of drug interactions.
Yes, all doctors want their chronic pain patients to try a pain management program. While most pain management techniques won't work well or perhaps not at all, some do. I can reduce my pain by up to 20% with biofeedback. Others praise TENS, Yoga, PT, kinesiotherapy or even hypnosis. Mind-body treatments can help, at least a little. And most family doctors won't give you the meds that you need without trying it.
The spinal cord stimulator and intrathecal infusion pump should be last resort treatment options, since surgery is required to implant and remote the machines. Their success rate past a few months is poor and many of us are not a candidate for it.
Research now shows without a doubt that injections of steroids and anesthetic do not help chronic spine-related pain patients. Worse, yet, they remain a risk in terms of potential nerve root impingement.
Hyperalgesia is NOT a result of using opioid medications for a long time. It is an extremely rare condition in which a patient complains of a significant increase in pain associated with using an opioid medication. The vast majority of physicians will work a lifetime without seeing one case of Hyperalgesia and it is unrelated to how long one uses a drug.
It is NOT a shame when chronic pain patients must remain on powerful medications for a lifetime. Such individuals are very lucky to have a medication that can help. There are literally millions of such people who have an almost nil rate of addition and withdrawal is never an issue because they, sadly, must remain on those medications indefinitely.
Tolerance, like withdrawal, is a physical characteristic. It is unavoidable over a period of years. Resolving tolerance is a simple matter of rotating to a chemically different medications for a few weeks. You may then return to the original drug with enhanced efficacy.
Fentanyl is the most powerful pain medication available today. It exists in a wide variety of forms (Transdermal patches, IV, IM and Trans-buccal) and a wide variety of dosages, from 15 mcg. 100 mcg. Note it is so powerful that it is measured in micrograms instead of milligrams. It added nine years to my career. Initially, it wiped out 80% of my severe pain.View Thread
P.S. If the patch is not tightly attached to your skin, it is not working well. If this happens on a regular basis, you will be undertreated and have more pain. Fentanyl will only transfer into your bloodstream when each part of the patch is tightly pressed into your skin.View Thread
Ask you doctor to write a new Rx for a different type of patch.
The large Fentanyl patches do not seem to stick as well as smaller patches. Ask your doctor if you can try the Mylan brand patches. They have the same Fentanyl content as the larger patches, but they are much smaller and they seem to remain in place better and longer.
One other interesting factor. Almost everyone using the patch that I've chatted with agrees that it works well for up to 48 hours - but NOT FOR 72 HOURS. I've chatted with dozens of people using the patch and NONE OF THEM felt any pain relief after 48 hours. Ironically, that might be the most common time when patches tend to fall off the skin.
If you feel that the medicine in your Fentanyl patch is not effective after 48 hours, tell your doctor and ask if you can change the patches at 48 hours, rather than at 72 hours. Some patients change the patches daily.
This might kill two birds with one stone. Your patches will stay on better and longer and you will avoid those lapses in pain relief that occur after your patch has been exhausted of Fentanyl (at 48 hours).
Doctors are frightened about the DEA oversight of opioid Rx's. However, there are many physicians who will prescribe the most potent pain medications. Trust is the major issue. I wish that we could give you the names of physicians, but WebMD prohibits that - and for some good reasons. But keep trying. Eventually, you'll find a physician for your husband who has empathy and compassion - one who is more motivated by the Hippocratic Oath than by fear of the DEA. There are many such physicians available in every state; "bleseedlady" take notice... Unfortunately, it might take some time to locate one. But they do exist. Keep in mind that your family doctor, who knows and trusts you might be willing to provide the medications that you require much more easily than would a pain management physician. Best of luck to you.View Thread
CAT-scans are safe and effective. The amount of radiation you receive is hardly what you've alleged. I've had many of CAT-scans and never even worried about it at all. Your information might not exactly be accurate. And it's Hiroshima, not "Hiroshimo."
However, I feel your angst about being 15 minutes late for an appointment. If that's true, you should have been worked in as possible some time that day.View Thread
New research only serves to confirm older research that steroid injections for spine-related pain do not work. Furthermore, repeated injections become a nerve-root impingement risk. They can also contribute to fibrosis, which can also impinge a nerve root.
This no doubt comes as bad news to the plethora of "injection mills" that exist everywhere. Those unfortunate millionaire physicians will have to find another way to supplement their bloated incomes. Some of these physicians have the nerve (no pun intended) to call themselves a "Pain Management Clinic," even though they only offer injections.View Thread