Many of us have been on higher dosages of Fentanyl than that over decades. I'm sorry to hear about your problem. But please do not extrapolate that to others.
As long as one very gradually increases the dosages, you can remain on very large amounts without causing any damage. Opioids are natural substances that bind with opiate receptors in the brain.
The great danger is respiratory depression. But you risked it only ONE TIME from ONE MISTAKE. That does not mean Fentanyl was not - still is not - your best medication. Are you out of pain now? Because I'll gladly trade a cloudy head for pain management - any day.
I would not wish your experience on anyone. But let's look back. Your mistake caused you to have too much Fentanyl in your system. The fact that you flushed it out and went though detox does not mean you no longer require powerful pain medication, does it? In fact, had you not made that one mistake, you might be today much better able to deal with your pain - still using Fentanyl and having better pain control.
So where are you now? You have a more clear head; but you are still in severe pain. How will you deal with that? What NEW way will you try? Will it help? I'm guessing that you'll end up with a similar amount of powerful opioid medication. And all that you went through would only be because you made that one mistake - not because you were using the wrong medication.View Thread
Yes, your spine sometimes cracks when you exercise. Does that mean you want to take a chance that the cracking sound or pain comes from a tumor that no chiropractor can diagnose? What kind of logic is that?
It's not a matter or "good" or "bad chiropractors." NO chiropractor is a medical doctor. NO chiropractor has graduated from medical school or completed a residency. NO chiropractor is qualified to make a medical diagnosis, prescribe medication, have hospital privileges, order and interpret radiological tests (beyond an X-ray, which does not reveal soft tissue, like tumors) and NO chiropractor can be trusted to diagnose any pain. Only medical doctors can do that.
Nothing is more important than your health. So, why would you want to trust it to someone who is not a medical doctor. You might as well as a welder to diagnose and treat your back pain. Or, take your chances...View Thread
A chiropractor is NOT a medical doctor. They call themselves a "doctor," but they are no more a physician than is a plumber. They are typically not bright enough to enter medical school. They never benefit from a residency or a fellowship. They are not allowed hospital privileges, cannot prescribe medication, cannot order critical radiological tests and are not trained to interpret them. Yet they have the chutzpah to crack your bones and ligaments together. They make a diagnosis based upon an X-ray, which will NOT reveal soft tissue, such as tumors, disc material or other damage. You could have a tumor and a chiropractor will not see it on the X-ray. By the time a real doctor finds the tumor, you may be on your way to the cemetery. Medical doctors diagnose with MRI, CAT-scan and myelogram. But chiropractors are not allowed to order those tests. That's because... they are not medical doctors.
If you need a will, you call a lawyer. If your sink is stopped up, you call a plumber. If your kid needs tutoring, you call a teacher. And if your body hurts - YOU CALL A PHYSICIAN - a real medical doctor - one with the letters "MD" after their name.
I've had a lifetime of back pain and I've been in doctor's waiting rooms for years. The one constant factor that I hear from patients is that "some d#&m chiropractor screwed up their spine." I've asked each doctor and surgeon and they ALL said the same thing. Many of their injured patients were made injured by chiropractors. They are DANGEROUS.
Look, nothing is more important than your health. So, why trust it to a "fake" doctor - a chiropractor? Trust your health to a real doctor - a physician. Trust your health to someone who completed medical school, a residency and maybe a fellowship. Otherwise, you're cheating yourself and your loved ones. Think twice before you may be damaged (maybe permanently) by a chiropractor. Trust your health to a real doctor.View Thread
Shalom, Channa. Thanks for writing here. I have a couple of comments.
1. "Klonopin" is an anti-convulsant. It is not appropriate for use as an opiate antagonist.
2. I want to congratulate you. It must feel wonderful to no longer have chronic pain. Why else would someone want to stop using the medications that help to manage chronic pain? So, best of luck to you. I think virtually all of us here now would kill be in your shoes.
3. Treating the temporary conditions associated with opioid withdrawal today is much easier than in years past. Your physician will recommend the use of an opiate antagonist (ex. Suboxone or Nalaxone) to make withdrawal easier than ever. You should also know that withdrawal symptoms depart after a few days, at most. Yes, it can be uncomfortable. But it is far less uncomfortable with the opiate antagonists mentioned above.
So, you're on your way. Congratulations on your diminished pain. I would kill to have little or no pain. And have no fear about withdrawal. It's much, much easier than it has ever been in the past.
Best of luck in your pain-free life. Shalom.
P.S. For the rest of us... know that a person can use opioid medications (as directed) for decades with no fear of organ damage. They bind with opiate receptors in the brain. Virtually every recent double-blind/control group research in the past couple of decades reveals an addiction rate of less than 3% (less than 1% if you remove patients who already had a history of addiction disorder).View Thread
I've had degenerative disc disease that manifested in herniated discs beginning at age 17, from a congenital disorder called central canal stenosis. For 10 years, I tried every possible treatment for chronic pain, including biofeedback, TENS, acupuncture, PT kinesiotherapy, injections, rhyzotomy, etc. I waited until I could tolerate the pain no longer and then I had surgery after surgery after surgery after surgery. My 4th included multilevel fusion.
I believed the physicians when they said that the success rate was "80% or higher." Long after all of my 4 failed spine surgeries, I conducted my own extensive research. The REAL success rate is much closer to 60%; fusion is lower than that. And with each failure, you grow more and more fibrosis (scar tissue). My last myelogram resembled a road map of New Jersey, with fibrosis everywhere, including some that impinged my spinal nerve roots. That's in addition to the extensive spinal nerve root damage that I received during my surgeries and the collapsed vertebra that resulted.
If there is a chance (likelihood?) that you'll need opioid medications WITH spine surgery, what do you hope to gain? You might be better off using the opioids (assuming they help) and bypassing the nerve root damage that virtually always goes with spine surgery.
The research shows that the long term (12-month) success rate for spinal fusion is between 40% and 60%. Do you want to bet the rest of your life on those odds?
Spinal fusion should be the last resort option, after you have tried the spinal cord stimulator and after you have tried the intrathecal infusion pump. Please, do not risk the rest of your life unless you know it's needed and you've tried EVERYTHING else. Don't end up like me: forced from my university position into retirement at age 51 - forced to be horizontal virtually all of the time for the rest of my life.View Thread
I'm not sure that you can provide empirical evince that "They're (Doctors) the biggest abusers there are in the medical community." For one thing, doctors represent a tiny percentage of, "The medical community." There are far more emergency personnel, RNs, aides, counselors, therapists, specialty-surgeons, administrative staff, clerical staff, etc.. They would all need to be abusers at the same time to constitute a noticeable percentage of that community. I've also lived and worked with doctors for virtually all of my life. If I can characterize them in general in any way, the only word that comes to mind is "integrity."
I've been in chronic severe pain for more than 40 years, due to a congenital spinal condition. I know exactly how you feel. The blame does not belong with physicians, except to the extent that some of them have decided to stop prescribing opioids because they fear raising a flag for the DEA. They have ditched the Hippocratic Oath in favor of the country club golf membership. And as much as I despise that behavior, I also recognize that the vast majority of physicians have their patient's best interest in mind at all times.
There are plenty of people to blame for this travesty when chronic pain patients must suffer indigenously because the public wants to punish drug abusers. But very few of them are "doctors." If you wish to view the abusers, just examine the health insurance industry.View Thread
The SCS and IT Pump are for patients with chronic moderate to severe pain that does not respond to any type of pain medication or combinations of medications. Similarly, it is for patients who cannot manage their pain with physical therapy, kinesiotherapy, injections, Yoga, meditation, rhyzotomy, acupuncture, biofeedback or hypnosis. If NONE of these interventions help, then you might be a candidate for the SCS or IT Pump. Two factors with the SCS: 1) It is primarily for neuropathic pain; pain that radiates. If most of your disabling pain is not neuropathic but nociceptive (like mine), you're better off with the intrathecal infusion pump. The type of pain you have will help your doctor decide if you might be a candidate for the SCS or the IT Pump. 2) Be certain to use the trial unit of the SCS or the IT Pump before making a decision. The trial unit is a small mechanism worn outside the body, with leads that go into your spinal nerve roots (with the IT Pump, it's with a catheter that drips an anesthetic solution on your spinal nerve roots). If the trial unit does not help, having a surgically implanted permanent unit makes no sense. You can also test the process to some extent by using a TENS unit. I wore one every day for six months. TENS is exactly the same principle as SCS, but without the risks of surgical implantation. Also, be advised that all surgery entails a risk of morbidity. There have been chronic patients who died as a result of contracting a post-SCS-surgery MRSA infection. Of course, this type of morbidity is rare. Still, before having any kind of surgery, including surgery to implant a mechanical device, do the research and know the risks. The most common reason for SCS failure is leads that are improperly placed or that move away from the nerve root after implantation. The most common reason for IT Pump failure is catheters that become crimped or blocked, or by reservoir pain drug that no longer works well over time. You will hear some people rave about these implanted devices and others who found it to be a horrible experience and who could not wait to have the devices removed. The average long-term success (12 months or longer) with these implanted devices is about 60% to 70%. I know that sounds nice to someone who is in chronic severe pain. But would you really want any other surgery with a success rate that low? Caveat Emptor! Here is a link to the best research I've seen related to spinal interventions, including the SCS, IT Pump and all other major interventions for spinal trauma and disease: http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf .View Thread
I've had four failed spine surgeries, including multilevel fusion. I've devoted the last 25 years to researching spine-related trauma and disability, along with viable treatment modalities.
The SCS is only for patients who have chronic leg or arm pain and are unable to benefit from normal long and short-acting pain medications. If your pain medications were helping, and you had not yet reached the maximum safe dosage of both long-acting and breakthrough medications (plus anti-depressants and anti-convulsants), then you are NOT a candidate for SCS. Sadly, many patients and physicians give up far too soon on combinations of opioids and off-label drugs (anti-depressants and anti-convulsants). Again, the goal to manage the pain, not to eliminate it.
Be careful what you wish for. Many of us have significant spinal nerve root damage, fibrosis, stenosis and osteoarthritis that require high dosages of powerful opioids. Sadly, many physicians are reluctant to prescribe the dosages of potent opioids that can significantly reduce our pain. They refuse to give us the most powerful drugs or if they prescribe them, it's in far too small a dosage to help. So, we grasp for anything that might help like the SCS or the IT Pump.
Sometimes when we demand something new and different as a treatment for chronic spinal pain, we end up with even more pain and with a mechanism surgically implanted that does not help at all. The success rate for the SCS with patients who have had prior spine surgery is about 60% (http://www.painphysicianjournal.com/2009/july/2009;12;699-802.pdf ), especially prior fusion. That, ironically, is the same deplorable success rate for spine surgery in the first place.
Bottom line... before you ask for something different for your chronic spine-related pain, do your research (see above). Otherwise, you may find that you no longer have access to the pain drugs that really were helping, although perhaps in too low a dosage. And you'll end up with a mechanical device implanted in your body that doesn't help.
Chronic severe pain can be managed, but only by using the most powerful opioids at appropriate dosages and off-label drugs in combination with mind-body treatments like biofeedback. Asking for something different in exasperation can often result in the loss of pain medications that really were helping in the first place. Be careful what you wish for.
Most of us with chronic severe pain will never again be without it. Nothing will eliminate it. Our job is to learn how to MANAGE the pain - how to reduce it with a combination of medications and other treatments - not eliminate it. This can and should include mind-body treatments like biofeedback, systematic relaxation, meditation, acupuncture, TENS, combinations of opioids and off-label drugs, PT, kinesiotherapy, hypnosis and all other non-invasive options. When all of those fail, we can consider more invasive options, such as injections, SCS, IT Pump and surgery. But the success rate for surgery is still around 60% (lower if you have had prior surgery).
The best pain patient is the informed pain patient. Make sure that you have done your research!View Thread
Sorry about your pain. My first disc herniation (L5-S1) was just days after my 17th birthday! Because of degenerative disc disease secondary to central canal stenosis, I had to live with increasingly more painful and frequent episodes of severe leg and back pain. There are definitely no age limits for spinal trauma and spine-related disorders.
At age 31, microsurgery arrived. I had pieces of the extruded L5-S1 disc removed. Less than four months later, L4-5 herniated. At age 32, I had more surgery. I never recovered. I spent the next few years trying every pain relief treatment available, to no avail. When I was 38, I had a laminectomy, this time in Cleveland, about 90 miles away. I used a world-famous surgeon who created the fellowship in spine surgery at Case Western University. For about 18 months, I was somewhat better. Then, the pain came crashing back. So, I went back for a 4th spine surgery, another laminectomy - this time including multilevel bilateral fusion. I never recovered.
I had to retire from a wonderful university career at age 51. That was ten years ago and I continue to get worse. Thankfully, everything else in my life is virtually perfect. But I am reduced to being nearly horizontal virtually all of the time.
Spine surgery today is about 60% effective. It still makes sense to try every possible option first, including the intrathecal infusion pump and the spinal cord stimulator. A comprehensive pain management center will offer literally dozens of interventions; most of them are non-invasive. I can reduce my pain by up to 20% with biofeedback alone.
Most of us all do the same thing. We wait until we cannot tolerate the pain a moment longer and then we schedule surgery. But be wise about it. If a surgeon tells you that you have an 80% chance of a complete recovery, flee. It simply isn't true. And once you have one disc removed, others are at greater risk of herniating.