jcqb13
08-19-2004, 03:31 PM
Quick background...(quick if you read fast anyway) :)
I had a nightmare surgery two years ago. The initial surgery was a disectomy to remove a 3 cm herniation that had broken off at L5-s1 and had cut feeling to my right leg.
After surgery the nurse did not set the pca pump correctly and I did not receive any pain meds post surgery. Needless to say I woke up in terrible pain that just kept getting worse. I began to go into shock as all residual anesthesia wore off. The weekend staff decided to finally call the doctor the next day and he performed a 2nd exploratory surgery.
Well he didn't find anything but then they put me back on the "broken pump"
Long-Short..A freind of mine knew a pain doc who cam in and placed me into a drug coma to get a handle on the pain, as I had gone 4 days without post surgical pain relief.
Anyway, i spent the next year on strong meds(methadone, dilaudid, neurontin, viocodin, flexeril, ativan, and ambien) and became dependent on some of the stronger opiates. I have been off all meds for about 6 months but went in for an ESI recently and went through major withdraw symptoms from the opiates they use to put you into twighlight.
I have reherniated my disk and the pain is becoming worse every day.
if I need stronger pain meds what should I do? Lortab gives me terrible headaches maybe from taking it so long and the withdrawals from opiates nearly kills me everytime(not literally) but my body became sooo dependant on the opiates going back to them causes my body to need them.
Are there any alternative drugs that aren't as addictive? I['m not sure what to do at this point. My pain doc will give me just about anything saying, don't worry I have patients that take much more. but I can't stand the addictive response or the withdrawals.
Thankyou
Jason
I had a nightmare surgery two years ago. The initial surgery was a disectomy to remove a 3 cm herniation that had broken off at L5-s1 and had cut feeling to my right leg.
After surgery the nurse did not set the pca pump correctly and I did not receive any pain meds post surgery. Needless to say I woke up in terrible pain that just kept getting worse. I began to go into shock as all residual anesthesia wore off. The weekend staff decided to finally call the doctor the next day and he performed a 2nd exploratory surgery.
Well he didn't find anything but then they put me back on the "broken pump"
Long-Short..A freind of mine knew a pain doc who cam in and placed me into a drug coma to get a handle on the pain, as I had gone 4 days without post surgical pain relief.
Anyway, i spent the next year on strong meds(methadone, dilaudid, neurontin, viocodin, flexeril, ativan, and ambien) and became dependent on some of the stronger opiates. I have been off all meds for about 6 months but went in for an ESI recently and went through major withdraw symptoms from the opiates they use to put you into twighlight.
I have reherniated my disk and the pain is becoming worse every day.
if I need stronger pain meds what should I do? Lortab gives me terrible headaches maybe from taking it so long and the withdrawals from opiates nearly kills me everytime(not literally) but my body became sooo dependant on the opiates going back to them causes my body to need them.
Are there any alternative drugs that aren't as addictive? I['m not sure what to do at this point. My pain doc will give me just about anything saying, don't worry I have patients that take much more. but I can't stand the addictive response or the withdrawals.
Thankyou
Jason
Sponsor
Longfusion
08-19-2004, 04:52 PM
Hey Jason, The only thing that makes sense is that when using twilight sedation, they found your tolerance to be higher than normal, they likely increased your dose of opiates, Opiates alone will not cause someone presently dependnent on opiates to experience withdrawal or someone that is not presently physically dependent to go into withdrawal.
What likely happened, is that because it was minor surgery, and they likely used extra opiates on an already opiate dependent CP patient, they reversed your anesthesia with an opiate antagonist which would cause any opiate dependent to experience imediete withdrawal upon wakening. Ask your doc friend about that scenario and get a copy of the op report.
Opiate antagonists "Naltrexone" are not used in anesthesia other than for reversal of anesthesia, usually to speed you out of recovery and off to a room or home. If you know your physically dependent, you have to tell them your dependnet and tell them not to reverse anesthesia. You must awake naturally. The only drug that would send an opiate dependent patient into instant withdrawal is an opiate antagonist like naltrexone, brand name Narcan used for opiate overdoses.
Many of of us have had twilight sedation while being dependent on meth, morphine, fentanyl or oxy, It's the nature of the beast. Is your pain worth the trade? If not, your options are pretty limited as far as pain relief for severe pain.
Opiates are considered opiate receptor agonists, they bind to opiate receptors and give pain relief. Opiate antagonists block and purge opiate receptors causing wthdrawal in opiate dependent patients in high enough doses. If you were slow to come around, a little narcan would wake you right up with NO pain meds on board. Not a good way to wake.
Some meds like Talwyn have a very small amount of antagonsit placed in them, now called Talwyn NX to prevent IV users from injecting this drug. Talwyn and speed were a popular combo in the 70"s. Adding the opiate antagonist Naltrexone prevents the buzz if you crush and inject it.
Talwyn NX does have pain relieving properties that aren't blocked by the naltrexone when taken properly, "orally" the amount is too small when consumed orally, But it does have enough Naltrexone to activate if crushed and injected.
Opiate dependent patients can be sent into withdrawal when given combination opiate agonist/antagonist pain meds like Stadol, Buprenex, Nubain or Talwyn NX.
Physical dependnence is less likely with The combination drugs but are not as strong and dependence or adiction is still possible. Psychological addiction or physical dependence is possible with any of these meds used to treat pain, Including Ultram.
Z_____ :cool:
What likely happened, is that because it was minor surgery, and they likely used extra opiates on an already opiate dependent CP patient, they reversed your anesthesia with an opiate antagonist which would cause any opiate dependent to experience imediete withdrawal upon wakening. Ask your doc friend about that scenario and get a copy of the op report.
Opiate antagonists "Naltrexone" are not used in anesthesia other than for reversal of anesthesia, usually to speed you out of recovery and off to a room or home. If you know your physically dependent, you have to tell them your dependnet and tell them not to reverse anesthesia. You must awake naturally. The only drug that would send an opiate dependent patient into instant withdrawal is an opiate antagonist like naltrexone, brand name Narcan used for opiate overdoses.
Many of of us have had twilight sedation while being dependent on meth, morphine, fentanyl or oxy, It's the nature of the beast. Is your pain worth the trade? If not, your options are pretty limited as far as pain relief for severe pain.
Opiates are considered opiate receptor agonists, they bind to opiate receptors and give pain relief. Opiate antagonists block and purge opiate receptors causing wthdrawal in opiate dependent patients in high enough doses. If you were slow to come around, a little narcan would wake you right up with NO pain meds on board. Not a good way to wake.
Some meds like Talwyn have a very small amount of antagonsit placed in them, now called Talwyn NX to prevent IV users from injecting this drug. Talwyn and speed were a popular combo in the 70"s. Adding the opiate antagonist Naltrexone prevents the buzz if you crush and inject it.
Talwyn NX does have pain relieving properties that aren't blocked by the naltrexone when taken properly, "orally" the amount is too small when consumed orally, But it does have enough Naltrexone to activate if crushed and injected.
Opiate dependent patients can be sent into withdrawal when given combination opiate agonist/antagonist pain meds like Stadol, Buprenex, Nubain or Talwyn NX.
Physical dependnence is less likely with The combination drugs but are not as strong and dependence or adiction is still possible. Psychological addiction or physical dependence is possible with any of these meds used to treat pain, Including Ultram.
Z_____ :cool:
jcqb13
08-24-2004, 10:11 AM
Thank your for your response, your response it more than I could of ever asked or hoped for. Thakyou for the explanation of the chemistry of the opiates as well. This clarifies the importance of these medications in the pain control process.