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Dilaudid_Hell
01-23-2004, 12:43 PM
I hope my story below does not offend anyone. It is reality for me and maybe it will help someone out. Having had TMJ since 1986, I have great sympathy for my fellow sufferers....

In 1991, I had surgery to remove a perforated meniscus (disc/cartalidge) in my jaw joint. The surgery helped greatly in releaving the piercing pain in my jaw and face.

In 2002, I had open joint surgery on the same side to aleviate chronic aching pain in the joint. The joint turned out to be fused to the capsule - the condyle was shaved down and smoothed during the surgery and afterwards I found relief - for a while....

About 6 months or so after the surgery, I started to get pain back in the joint and surrounding tissue. I tried to remain stoic about the pain, but was frustrated in who it affected my ability to be a good husband and father (We had a beautiful daughter in 2002).

One day, I came home after searing pain in my face and scouted in the pain cabinet for something to allevaite the pain. I took a Vicoden ES and magic, the pain went away. I think I decided at that point that maybe I could handle the meds, taking them at night on an as needed basis.

Long story short, I gradually moved up to more and more Vicoden and then, this last year or so, swtiched to Dilaudid 4 mg (hydromorphone). The Dilaudid really helped and I started out taking one in the morning and one at night. Pretty soon I needed them at a greater frequency. Soon after that I needed more of them. At the end I was taking about 15 per day.

Two weeks ago, I could not get a refill on my prescription because it was 'too soon'. I came home and threw myself and my wife. "Take my pills and help me" . That night with raging withdrawl, I ended up in the Emergency Room going into Active Detox. Embarrased, afraid and writhing with anxiety and sickness, I felt more alone then at any point in my life. How did my life come to this?

The next day, I put myself, with the help and support of my wife, in a detox center. The first few days were awful. I was here after having legitimate pain and my roomies were both Herion addicts. Slowly the realization of what I had become had taken effect. After those first few days it has been 'one day at a time' getting a litter better each day. Two weeks later, I am weak but happy that I am all in one piece and getting better each day.

I still have the pain that got me to this low point, but I am exploring all avenues of pain relief minus opiates. I just got in injection yesterday that seemed to really help. I am trying chiropractic for some relief also. I am going to start exercising and get back to where I was.

I know pain relief is legitimate, but I wanted to share in case it has become a cruch and you need someone to illuminate this.

I can say that before the pain meds I was happy and yet in pain. After the pain meds, I was numb and miserable. I'm 35 and there is so much more life left for me.

Dave

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GJA
01-23-2004, 04:01 PM
Thanks for your story. Everybody reacts differently to medication--what is helpfull
to some may be a disaster for others.

I am 38, my wife and i had our first child (girl) in 2003. My problems(started in 8/2001) have been neck tension from clenching and posture which has caused headaches, vertigo, foggyness and dis-equilibrium ( also had bouts of ear fullness-popping-minor clicking).

I have gone to an MD,ENT,chiroprator,osteopath,physical therapist,massage therapist, many dentists, tried 3 different splints..etc etc.

Unfortunately, the thing that helps the most is .5mg Klonopin taken before bedtime.

I rarely take it--usually once or twice a week. I am much better than i was 8 months ago, but not close to normal.

I think the web is an excellent source of information--forums like this one for example--there is always hope, and if one massage therapist/dentist/doctor doesnt
help you--try another.

-gja

saaraah
01-23-2004, 05:30 PM
dave - thank you for the story about your problems. i wish that you didnt have to go thru such a horrible experience.

because im young [22], doctors have been very hesitant to prescribe me narcotics and strong pain pills over the years, which i suppose is the result of good intentions and the fear of getting me dependent on drugs. however, when someone genuinely needs pills, it becomes a strange ethical dilemna... is it better to suffer in agony or take the chance of becoming dependent..

what are you doing now for pain relief? what type of treatment are you undergoing for your TMJD?

anyway, take care.

- saaraah.

PINKYPRISCILLA
01-23-2004, 05:56 PM
Burt Reynolds went thru a similar experience with tmj.
The doctors didn't know what was wrong with him. Until
he had extensive dental work on his teeth.

TiffanyAnn
01-24-2004, 12:27 AM
Hi Dave and welcome: :wave:
Thank you for sharing your story here. Pain management is a difficult one for all chronic pain sufferers and TMJ is definately chronic pain. I have personally had my struggles with pain meds but I always felt I had enough problems without getting addicted to pain meds so I was careful to monitor them myself and not take more than allowed. At times that made things harder but I felt in the long run I'd probably be glad I did.

It was a brave thing to do to check in for detox, but I imagine it was the smartest thing you could have done. You're right, we get so far down when suffering with chronic pain then we have to work our way back up. It's very hard but extremely worthwhile. It sounds like you are on the right track now and I congratulate you. The work is hard but all of us are worth it.
Tiffany

Cymy Sue
01-24-2004, 10:25 AM
Dave,
You are to be commended on your courage and intelligence in knowing when it was time to take control of the situation.

There are many instances of long term, severe chronic pain that does require treatment with narcotics/opiates. Without it, many people would have no quaility of life at all.

In making this statement, it is not an endorsement in any sense for everyone in pain to seek this type of treatment. This is a decision to be taken very seriously and one to be made by a quailified Doctor as to the degree of pain suffered and if the benefits outweigh the risks.

There is still so much misunderstood about people who are in "Pain Management" using drugs. In all fairness regarding this issue, I would like to relate my experience.

I had both disc removed in 97. I was in unbelievable pain before and could not believe it could be be worse after, even though I was told it would be. I had several prior surgeries which damaged nerves, muscle and bone. This surgery was to remove cartilage replacements that had been used when my originals were removed in 92. I was told in 97 prior to the discectomy that I would have to go into "Pain Management" after the surgery, I would have no choice. I had suffered severe and increasing pain since 1988 when I had Orthognathic Procedures. I took regular Tylenol during these years other than a few weeks around each surgery. Since 1988, I've had 8 surgeries. 6 TMJ related.
Almost 10 years after my first surgery for TMJD, I was put into Managed Pain Care. ( 10 years of almost constant and incredible pain. I was in pain for many years prior to the surgeries. It increased with each attempt to fix my TMJD)

This Center had very strict rules. You had to attend 3, 2 hour classes on Drug Education , 6 hours total. You were evaluated by the Director (Senior Anesthetist) and a psychologist. Other members of the staff also did interviews.
You were questioned about alcohol usage/problems, any illegal drug use, any prior legal drug prescriptions and your entire life.

They basically had an incredible profile of you as a person before you were accepted as a patient. (if you told the truth) I did. They told you if you were considered high or low risk for addictive behavior. I thankfully was told I was very low to no risk, but I was scared. This was new to me, I didn't know what to expect and I was told it would most likely be for a long time. I didn't have a choice, I couldn't live with the pain.

I had taken very few prescription drugs throughout my life even with all the surgeries, so I did well with Tylenol # 3 and I was on 1 mg. of klonopin due to muscles drawing my face. They also added baclofen, because I could not tolerate neurontin for nerve pain.
The pain steadily increased for a few months and I was told I could have a stronger pain med., but I declined and toughed it out with the combination I was on. I did not intend to stay on it for a long time, regardless of what they thought.
After about a year, I was still in pain, not as bad and I decided to get off of the meds. I was given a taper schedule and found that I could taper much quicker than they had prescribed. I got off all with only a few minor discomforts and that was probably from coming off faster than scheduled.

(I never took more than my prescribed daily dose. I didn't take scripts from other Doctors, I did exactly as I was told. I think this helped alot when I decided to stop.)

I did not take any presciption meds for well over a year even though I was still in a good deal of pain.
It started to increase at an alarming rate, I was back to taking regular Tylenol 4 times a day, every day. (Which is worse on your liver than opiates) and I went back to see if there was anything else the surgeon could do. There was not, he told me going back to my Pain Management regiment would be far better than the max allowed for Tylenol everyday. I was having an episode of nerve regeneration and the pain was close to as bad as before.
I did go back for a while, the pain calmed a little again and I did the taper and was off again..
About 3 years ago, the pain returned with a vengence, I had several other problems that appeared to be nerve and muscle related. Something had changed, had caused the pain to become almost unbearable and I thought I had 2 options. Pain medication again, or Metal Implants. I managed with regular Tylenol for about a year or so and went back and ask for the Implants. They turned me down for any more surgeries and told me to stay medicated was my only option.

I did go back, still staying with Tyl #3, which seems to work for me reasonably well. I was afraid to take anything stronger. I did not want to continue this, so I did start looking for other options and found a splint therapy last year that did work. I don't need pain medication for TMJ pain any more. Hopefully, never again.

I know that some people do have conditions that will never change. To be in any degree of comfort, they wll have to take medication forever and much stronger than I took. They don't have a choice. I was fortunate. On & off for almost 6 years was much better than the original prognosis and being able to stay with a milder opiate.

My point is, Managed Pain Care can be maintained. The key is being closely Managed.
I did learn that some people, due to no fault of their own, but due to chemical make up, can not handle taking opiates.
I learned that some people can.
Some people develope a tolerance and have to take stonger meds to control pain.
Addiction and dependence is not the same.
Addiction is a need & want for more.
Dependence is developed by most people due to the body getting use to the drug, but does not mean they will develope addictive behaviour.
It means they can not just stop, or they will experience physical symtoms.

Your post is very important and everyone should read it and think about the awful consequences and problems that can occur with taking narcotics

On the other hand, Managed Pain Care is many times a necessity and when handled properly by the Doctor and the Patient, can give comfort and add to quality of life that otherwise could not be attained.

Education for Patients, some Doctors, and for the Public regarding Managed Pain Care would be a wonderful endeavor. I felt the "Sting" of ignorance on the subject more than once, because I was taking an opiate everyday.

To some, I was a prescription drug addict, to the educated, I was in controlled and Managed Pain Care for severe chronic pain.

I do believe many people are left to suffer needlessly due to ignorance among the Medical Profession. On the other hand, I believe some hand out prescriptions too easily and do not follow-up with their patients.

I write this to agree with you, everyone should take a very close look at themselves and decide if they may possibly be at risk, when taking narcotic medications or considering this option.

Also, for those who have no other options, Managed Pain Care is for people who are in severe chronic pain and if we do what we're told, it affords a better life.
For me, it was short term compared to many others. For many it will be always and people should not feel stigmatized, due to a condition and situation that they did not ask for.

All whom I met at the "Center" who were truly in pain, did not enjoy taking meds and they would have changed their situation, had it been within their power to do so.

This is absolutely not an endorsement for narcotic medication. I was blessed to be able to take it or leave it. Everyone is very different and we respond differently to medication. Had I been different or on a different med, I could be telling the same story as Dave. The risk is, we don't know if we're "OK", until after we take it for a while or reach a point when we are well enough to stop.

This last statement would not apply to those who have conditions so severe, they will always have to take pain medication, to have any quality of life.
My Mother is now in this category and I'm very happy and Thankful that her pain can be managed to some degree.

Cymy Sue

sunshine123
01-24-2004, 01:48 PM
I hope my story below does not offend anyone. It is reality for me and maybe it will help someone out. Having had TMJ since 1986, I have great sympathy for my fellow sufferers....

In 1991, I had surgery to remove a perforated meniscus (disc/cartalidge) in my jaw joint. The surgery helped greatly in releaving the piercing pain in my jaw and face.

In 2002, I had open joint surgery on the same side to aleviate chronic aching pain in the joint. The joint turned out to be fused to the capsule - the condyle was shaved down and smoothed during the surgery and afterwards I found relief - for a while....

About 6 months or so after the surgery, I started to get pain back in the joint and surrounding tissue. I tried to remain stoic about the pain, but was frustrated in who it affected my ability to be a good husband and father (We had a beautiful daughter in 2002).

One day, I came home after searing pain in my face and scouted in the pain cabinet for something to allevaite the pain. I took a Vicoden ES and magic, the pain went away. I think I decided at that point that maybe I could handle the meds, taking them at night on an as needed basis.

Long story short, I gradually moved up to more and more Vicoden and then, this last year or so, swtiched to Dilaudid 4 mg (hydromorphone). The Dilaudid really helped and I started out taking one in the morning and one at night. Pretty soon I needed them at a greater frequency. Soon after that I needed more of them. At the end I was taking about 15 per day.

Two weeks ago, I could not get a refill on my prescription because it was 'too soon'. I came home and threw myself and my wife. "Take my pills and help me" . That night with raging withdrawl, I ended up in the Emergency Room going into Active Detox. Embarrased, afraid and writhing with anxiety and sickness, I felt more alone then at any point in my life. How did my life come to this?

The next day, I put myself, with the help and support of my wife, in a detox center. The first few days were awful. I was here after having legitimate pain and my roomies were both Herion addicts. Slowly the realization of what I had become had taken effect. After those first few days it has been 'one day at a time' getting a litter better each day. Two weeks later, I am weak but happy that I am all in one piece and getting better each day.

I still have the pain that got me to this low point, but I am exploring all avenues of pain relief minus opiates. I just got in injection yesterday that seemed to really help. I am trying chiropractic for some relief also. I am going to start exercising and get back to where I was.

I know pain relief is legitimate, but I wanted to share in case it has become a cruch and you need someone to illuminate this.

I can say that before the pain meds I was happy and yet in pain. After the pain meds, I was numb and miserable. I'm 35 and there is so much more life left for me.

Dave

Hi Dave:

I commend you also. You're a very strong person to overcome your addiction. I've never been prescribed many pain meds. I guess the Drs. out here are afraid of addiction, even though I've read that when people take drugs for pain and not to get high, then there isn't a problem. I had knee surgery 2 years ago and the postop pain was indescribable. I was given Vicoden which had absolutely no effect on the pain. Then, I tried a couple of other meds. which didn't work either. Thankfully, the pain subsided eventually. Now, I'm dealing with arthritis and TMJ. I just pray that all of us will get some much needed pain relief soon.

sunshine123
01-24-2004, 01:50 PM
Hi Dave and welcome: :wave:
Thank you for sharing your story here. Pain management is a difficult one for all chronic pain sufferers and TMJ is definately chronic pain. I have personally had my struggles with pain meds but I always felt I had enough problems without getting addicted to pain meds so I was careful to monitor them myself and not take more than allowed. At times that made things harder but I felt in the long run I'd probably be glad I did.

It was a brave thing to do to check in for detox, but I imagine it was the smartest thing you could have done. You're right, we get so far down when suffering with chronic pain then we have to work our way back up. It's very hard but extremely worthwhile. It sounds like you are on the right track now and I congratulate you. The work is hard but all of us are worth it.
Tiffany

Hi Tiffany:

Are you still doing well with your splint? I hope so. Have a great weekend.

Hugs,

Sue

Cymy Sue
01-24-2004, 06:08 PM
Sue,

You bring up a point that I did fail to mention. I have been told by more than one Pain Specialist, that people who are in pain and do not get high on pain medication, do not become addicted. I was told if patients followed instructions in taking their medication, they would not get into a problem.

I hope my post did not sound in any way biased against pain control for anyone who needs it. I realize I did focus mainly on long term situations and my situation.

I do believe most people are undertreated for pain, chronic and acute, such as after surgery, unless like me, they are sent to a Pain Management Center.

Most physicians do appear to be afraid to prescribe adequate medication.

I do think many Physicians see everyone as a potential problem or addict and do not want the responsiblity. They should become better educated in pain control, know how to handle these situations and take the responsibility of educating us on medication, so we can take it safely and as prescribed.

Tiffany, also makes a good point, she monitered herself. I did, too. I do believe we have the responsibilty to follow what is prescribed.

I just wanted to make it very clear, that I don't believe (just) severe, long term chronic pain and multiple surgical patients are the only people deserving of pain treatment. I believe everyone deserves to be treated for pain, regardless of the time involved and the circumstances.

As I stated, I felt the "sting" of bias against people taking Pain Medication several times. It came at first from family who didn't understand, friends and Physicians. I was told I was a prescription drug addict and a drug seeker more than once by other Doctors, even with my record of non-abuse, in the program I was in. These accusations cut deep when you are in severe pain and you have followed your Pain Specialist's instructions exactly.

After, re-reading my post, I realize, I am still reluctant to speak out on this issue, due to fear of being judged as an advocate for presciption drug use.

Pain Treatment seems to be in it's infancy with most Doctors. Hopefully, it will get better as Doctors become better educated and realize everyone in pain, who needs medication, does not become addicted.

I was undertreated for many years and I do understand the problem still exists for many people.

Cymy Sue

sunshine123
01-25-2004, 03:24 AM
Sue,

You bring up a point that I did fail to mention. I have been told by more than one Pain Specialist, that people who are in pain and do not get high on pain medication, do not become addicted. I was told if patients followed instructions in taking their medication, they would not get into a problem.

I hope my post did not sound in any way biased against pain control for anyone who needs it. I realize I did focus mainly on long term situations and my situation.

I do believe most people are undertreated for pain, chronic and acute, such as after surgery, unless like me, they are sent to a Pain Management Center.

Most physicians do appear to be afraid to prescribe adequate medication.

I do think many Physicians see everyone as a potential problem or addict and do not want the responsiblity. They should become better educated in pain control, know how to handle these situations and take the responsibility of educating us on medication, so we can take it safely and as prescribed.

Tiffany, also makes a good point, she monitered herself. I did, too. I do believe we have the responsibilty to follow what is prescribed.

I just wanted to make it very clear, that I don't believe (just) severe, long term chronic pain and multiple surgical patients are the only people deserving of pain treatment. I believe everyone deserves to be treated for pain, regardless of the time involved and the circumstances.

As I stated, I felt the "sting" of bias against people taking Pain Medication several times. It came at first from family who didn't understand, friends and Physicians. I was told I was a prescription drug addict and a drug seeker more than once by other Doctors, even with my record of non-abuse, in the program I was in. These accusations cut deep when you are in severe pain and you have followed your Pain Specialist's instructions exactly.

After, re-reading my post, I realize, I am still reluctant to speak out on this issue, due to fear of being judged as an advocate for presciption drug use.

Pain Treatment seems to be in it's infancy with most Doctors. Hopefully, it will get better as Doctors become better educated and realize everyone in pain, who needs medication, does not become addicted.

I was undertreated for many years and I do understand the problem still exists for many people.

Cymy Sue

Hi Cymy Sue:

No, your post didn't sound at all biased to me.

I can certainly understand people who take pain meds. for yrs. as I have friends with other types of chronic pain who couldn't or wouldn't want to survive without their meds. My family and friends who are lucky enough to be relatively painfree, are unable to relate to what others may deal with.

It seems that Drs. don't want to deal with insurance cos. either when it comes to prescriptions. I had to jump through hoops to get Bextra approved for my arthritis and that's only an anti-inflammatory. After many of my surgeries, I was given a RX for 2 weeks worth of painkillers. I felt like I had to "beg" to receive anymore. I took Ambien for 7 weeks at one point b/c the pain kept me from sleeping and someone who didn't have such severe postop pain acted like I was the drug addict of the year. I wasn't addicted to the Ambien and easily stopped taking it. People can be so judgemental and critical of others when they're not in pain.

I've read articles recently stating that physicians are undertreating their patients and it just isn't right when people with severe pain would rather die than "live" like this.

I appreciate yours and Tiffany's viewpoints.

Sue

Dilaudid_Hell
01-25-2004, 12:37 PM
I appreciate every response to my post. Thank you.

My take on pain meds before I became addicted to them was that they were for people who had intolerable intractable pain but for me they would be like 'giving up' - throwing my hands up and saying that there is no other solution. I was judgemental over people who took them. Even with my bad experience, I would not look down on anyone who takes pain meds.

For me, I was able to function, hold down a great job and thought (wrongly) that they made my life better. If I could have used them judicously then maybe that would have been accurate. The problem was that I wanted to feel pain free ALL THE TIME. That was an unrealistic expectation. Taking pain meds every day for a year and a half, call it what you want, but you are dependent on them. If you suddenly stop taking them, you are going to go into withdrawl.

I realize now that I can't be pain free all the time. It sux, but I have to get used to that idea, I guess. I still haven't given up on other therapies. I'm still gonna try to find some pain relief in non-opiate ways, but I am not too optimistic that I will be pain free. Like I said before thou, I was happy and in pain before this life-mess.

There is definately a euphoria with taking opiates. I deluded myself into thinking it was purely about the pain relief, but the feeling of well-being associated with taking those drugs hits every user - legitamate or not. I thought that the euphoria was due to the fact that the pain was gone; that was part of it but not all.

I guess now I now how numb I had become after 16 days w/o a pill. I now feel a little dead inside. I also still have severe insomnia, also. I think this next week I will start to feel better. My jaw hurts presently also. It's a slow road back but I'm getting there and I thank you all for your comments.

Dave





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