Streetcar
11-02-2004, 02:53 PM
I'm going to try and make this short (yeah right) but still give enough info so you can see where I'm coming from.
:( Two years ago I had major surgery and the incisions became infected causing three nueromas which are acting like pain generators. Without any pain meds at all I have 15" of scar tissue that constantly feel the same as they did 5 days post-op :blob_fire . Before getting into PM, drs tried me on Nuerontin w/ vicodin. The neurontin worked great for the pain but the side effects were completely intolerable. When my vicodin useage started getting to close to the max daily amount my PCP sent me to PM. Started on MScontin 15Mg q8h and MSIR 15Mg x2 PRN for BT med. Pm dr also tried me on Zonagen (sp?) which falls into the same category as Neurontin and had the same side effects, so that was a no-go. Tried a couple of nerve blocks without much benefit. At about the same time my diverticulitis returned and PM dr was going to up my MScontin to 30Mg q8h with Msir 30Mg x2 BT meds but because of my diverticular problems and the fact that the MScontin REALLY kept me constipated he switcthed over to Oxycontin 20Mg q8h with Oxycodone 10Mg (really 2 5Mgs) x2 PRN for BT meds. The Oxy is providing adequate relief but It is driving me nutso. I always feel super tense and uptight and it seems like I can never relax so I'd like to switch to something different, if possible. I just don't know what might be a logical next step and at what doseage. Let me add, that once the diverticular problems calm down I would like to resume trying some of the other non-narcotic meds that are being used for PM and backing off of the opiates/opiods.
Does anybody have any experience with what works/doesn't work for their neuropathic pain and also what might be the next logical opiate in this case? I'm going to be seeing my PM dr tomorrow afternoon and i'd kinda like to know which direction the appt might go once I bring up the dislike of the Oxy.
Tahnks for the help and be comfortable!
:( Two years ago I had major surgery and the incisions became infected causing three nueromas which are acting like pain generators. Without any pain meds at all I have 15" of scar tissue that constantly feel the same as they did 5 days post-op :blob_fire . Before getting into PM, drs tried me on Nuerontin w/ vicodin. The neurontin worked great for the pain but the side effects were completely intolerable. When my vicodin useage started getting to close to the max daily amount my PCP sent me to PM. Started on MScontin 15Mg q8h and MSIR 15Mg x2 PRN for BT med. Pm dr also tried me on Zonagen (sp?) which falls into the same category as Neurontin and had the same side effects, so that was a no-go. Tried a couple of nerve blocks without much benefit. At about the same time my diverticulitis returned and PM dr was going to up my MScontin to 30Mg q8h with Msir 30Mg x2 BT meds but because of my diverticular problems and the fact that the MScontin REALLY kept me constipated he switcthed over to Oxycontin 20Mg q8h with Oxycodone 10Mg (really 2 5Mgs) x2 PRN for BT meds. The Oxy is providing adequate relief but It is driving me nutso. I always feel super tense and uptight and it seems like I can never relax so I'd like to switch to something different, if possible. I just don't know what might be a logical next step and at what doseage. Let me add, that once the diverticular problems calm down I would like to resume trying some of the other non-narcotic meds that are being used for PM and backing off of the opiates/opiods.
Does anybody have any experience with what works/doesn't work for their neuropathic pain and also what might be the next logical opiate in this case? I'm going to be seeing my PM dr tomorrow afternoon and i'd kinda like to know which direction the appt might go once I bring up the dislike of the Oxy.
Tahnks for the help and be comfortable!
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twisten
11-02-2004, 03:22 PM
I don't know anything about drugs used for nerve pain. As for opiates though I would suggest talking with your doctor about the duragesic patch. It doesn't enter our GI sytems at all so the issue of constipation and your diverticulitis should be helped with this med. Hopefully someone else will come along to give you more info on it.
Phlox
11-02-2004, 03:40 PM
Ive noticed that since being changed to Oxycontin, Ive been more irritable lately...but Im still wondering if its because of the problem with it not lasting to provide relief the full 12 hours, or the Oxy itself. Ive had other days where the different meds I was on wasnt stopping the pain, but that didnt make me feel as 'irritable' as Ive been lately.
When you say "its driving me nutso", what symptoms are you experiencing, and how does it make you feel? Just wondering if its similar to the same agitation Ive been feeling, if thats normal even for the first month or two with Oxycontin, or if its really just the fact that Ive been putting some home projects off because I dont want the pain to get any worse than it already is, since this doesnt seem as effective for me as the "weaker" SA meds were. Strange, how these meds work so differently from one person to the next!
When you say "its driving me nutso", what symptoms are you experiencing, and how does it make you feel? Just wondering if its similar to the same agitation Ive been feeling, if thats normal even for the first month or two with Oxycontin, or if its really just the fact that Ive been putting some home projects off because I dont want the pain to get any worse than it already is, since this doesnt seem as effective for me as the "weaker" SA meds were. Strange, how these meds work so differently from one person to the next!
Streetcar
11-02-2004, 04:06 PM
Hey Phlox!
"Nutso"...It's kind of hard to describe but I always feel "driven", like I HAVE to do one more thing, whatever that may be at the time before I can sit down for few moments and rest my body. I think that it's what is referred to as "wired" but I'm not really sure what that is either but I've talked to some ex-methamphetamine user at the clinic and that's what they called it. I've also noticed that in the eveningwhile preparing dinner that I'm extreemly tense which is something new for me. The tension I mean, not fixing dinner. I notice that all the muscles in my upper back are just tied into knots. My PM dr Rx'd me some muscle relaxers for that reason and they do seem to help somewhat. I don't know any other way to describe it other than I absolutely can't seem to relax for a few minutes and by the end of the day I'm exhausted from being so darn tense all day. Since I taking the Oxy 3x daily the coverage is good so I'm not irrateable from the pain.
"Nutso"...It's kind of hard to describe but I always feel "driven", like I HAVE to do one more thing, whatever that may be at the time before I can sit down for few moments and rest my body. I think that it's what is referred to as "wired" but I'm not really sure what that is either but I've talked to some ex-methamphetamine user at the clinic and that's what they called it. I've also noticed that in the eveningwhile preparing dinner that I'm extreemly tense which is something new for me. The tension I mean, not fixing dinner. I notice that all the muscles in my upper back are just tied into knots. My PM dr Rx'd me some muscle relaxers for that reason and they do seem to help somewhat. I don't know any other way to describe it other than I absolutely can't seem to relax for a few minutes and by the end of the day I'm exhausted from being so darn tense all day. Since I taking the Oxy 3x daily the coverage is good so I'm not irrateable from the pain.
Streetcar
11-02-2004, 04:20 PM
Hey Twisten!
thanks for the reply, I'll mention the patches and see what the doc thinks in light of trying to get the opiates down to as small an amount as possible. I will say though, that starting PM and viewing this board, that my preception of opiates has changed and is longer the big bugaboo that it once was to me.
thanks for the reply, I'll mention the patches and see what the doc thinks in light of trying to get the opiates down to as small an amount as possible. I will say though, that starting PM and viewing this board, that my preception of opiates has changed and is longer the big bugaboo that it once was to me.
Shoreline
11-04-2004, 12:35 PM
Hey Street car, Duragesic woul eveviate some of the constipation and isn't one of the keto pro opiates that tend to be energizing or cause anxiety. Methdone is the preferred opiate for neuro pain because it's an NMDA receptor blocker. Howewver you could use Nemanda, a new alzheimers med that is a potent NMDA receptor blocker that is being used for off label purposes to treat neuro pain. My wife is doing quite well with it and has minimal side effects. It might be worth discusing with your PM doc.
Added side effects are improved memory and weight loss with nemanda.
Good luck, Dave
Added side effects are improved memory and weight loss with nemanda.
Good luck, Dave
Idiopathic
11-08-2004, 09:48 PM
Try another method, I have done the oxycontin,the lidocaine patches over the scars and they work for the day. I am trying BUPIVACAINE, it gets injected on the scar and to the left and to the right. I have found that you can do more around the house without the side effect of the drugs. Ask your Neuroligist what he or she thinks. It s working for me.The idea is that it stops the signals to the next nerve. Scar tissue is the toughest so check the color of the scar tissue too. Thats the visable clue-BUPIVICAINE
Shoreline
11-10-2004, 01:19 PM
Hey Idio, Are you describing something different from a standard trigger point injection? Docs use a combinationof an antiinflamatory and some type of local anesthetic, either Lido, Bupivicaine or marcaine all the time for TP's, They aren't anything new, I've ben getting them for almost 12 years.
Some docs also use the needle itself to break up scar tissue, if your numb they can do some real work on you.
Scar management with a PT is another way to deal with scar tissue and myofacial release techniques. For whatever reason nobody even addressed my scar from the last surgery untill 2 years later during that round of PT. The scaring was so bad, purple and puckered, My skin and myofacial layer was just bound to constantly rigid muscle. If you put your hand on my lower back and tried to move skin, it just didn't move more than a couple mm. I know I scar heavily anyway from previous surgeons trying to clean some of it out. The PT was shocked nobody had adressed that yet. Once it was released it was so much more comfortable getting up and down and twisting, Just moving in general.Pror to treatment, I could feel scar tissue tear if I moved to quick or in the wrong "right" direction.
Some PT's are the real healers and a huge part of recovery. You just have to find a good one much like finding a doc that has the touch giving TP's. Anyone can learn to do TP's just like they can learn the merrdians to do acupuncture. But I've experienced a huge difference from one practioneer and another. With needle work, docs either have the touch and can find that right spot or they are just peppering the whole area hoping to get lucky.
JMO
Good luck, Dave
Some docs also use the needle itself to break up scar tissue, if your numb they can do some real work on you.
Scar management with a PT is another way to deal with scar tissue and myofacial release techniques. For whatever reason nobody even addressed my scar from the last surgery untill 2 years later during that round of PT. The scaring was so bad, purple and puckered, My skin and myofacial layer was just bound to constantly rigid muscle. If you put your hand on my lower back and tried to move skin, it just didn't move more than a couple mm. I know I scar heavily anyway from previous surgeons trying to clean some of it out. The PT was shocked nobody had adressed that yet. Once it was released it was so much more comfortable getting up and down and twisting, Just moving in general.Pror to treatment, I could feel scar tissue tear if I moved to quick or in the wrong "right" direction.
Some PT's are the real healers and a huge part of recovery. You just have to find a good one much like finding a doc that has the touch giving TP's. Anyone can learn to do TP's just like they can learn the merrdians to do acupuncture. But I've experienced a huge difference from one practioneer and another. With needle work, docs either have the touch and can find that right spot or they are just peppering the whole area hoping to get lucky.
JMO
Good luck, Dave
Streetcar
11-10-2004, 07:40 PM
Hey Idio
Thanks for the relpy and welcome to THE board. My PM dr is an anisthesiologist and we have tried the trigger point injections with only limited success. Due to the cost of the injections vs. the pain relief obtained from them, they aren't an economically feasible treatment modality in my case. He put me on Duragesic 50mcf/hr patches last week and they seem to be working great except that the pain coverage is a little spotty the last 10-12 hrs. although a heck of of alot better than no coverage at all.
Be comfortable...for most of us pain free just isn't a reality any more.
Thanks for the relpy and welcome to THE board. My PM dr is an anisthesiologist and we have tried the trigger point injections with only limited success. Due to the cost of the injections vs. the pain relief obtained from them, they aren't an economically feasible treatment modality in my case. He put me on Duragesic 50mcf/hr patches last week and they seem to be working great except that the pain coverage is a little spotty the last 10-12 hrs. although a heck of of alot better than no coverage at all.
Be comfortable...for most of us pain free just isn't a reality any more.
madhatter
11-13-2004, 04:52 PM
Hi! I know for me,i was taking ms cotin and i was always tired,now i'm taking oxycotin,and it seems to give me energy[more so than morphine]also,i find myself building a tolerance up more-so with oxycotin than anything else.
twisten
11-15-2004, 12:22 AM
Hey Ken, glad to hear you didn't have any problems getting him to prescribe the duragesic patch for you. You could ask him if it is possible to change the patch around the 60 hr mark instead of 72. Are you on bt meds also? If not maybe he would even prescribe some for you for the last 10-12 hours instead of changing the patch?? I hope they work out good for you.
Streetcar
11-15-2004, 02:50 PM
Hey Twisten, Thanks for the follow up. It's kinda weird, I apply the patch around 6-7PM and when I wake up on morning three the pain level is starting to elavate but by early afternoon it's back down and stays down to manageable levels. You would think that if tpain levels were rising at hour 60 and I was staying with that patch until changing at hour 72, that the following morning I would have used up all meds that had been in the skin and that I would effectively be starting from scratch with every patch change but I'm not. It's as though pain coverage is deminished only for hours 60 thru 66. Does what I'm trying to explain make any sense?
I do have BT meds which since switching over to Duragesic I've seldom used except for that 6 hour period eveery three days. I'll diefinately mention that to the DR next month. Other than that one small thing, I really love the Duragesic, they make life so much more enjoyable again.
Be comfortable!
I do have BT meds which since switching over to Duragesic I've seldom used except for that 6 hour period eveery three days. I'll diefinately mention that to the DR next month. Other than that one small thing, I really love the Duragesic, they make life so much more enjoyable again.
Be comfortable!
twisten
11-15-2004, 03:16 PM
Yes, I understand what you're saying. I'm glad you have bt meds to help you through the 6 hr period. It will be interesting to see what the doc says. Let us know after you see him.