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Old 08-17-2008, 05:42 PM   #1
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Some of the Psychological Effects of CP...

It was two years ago this month that this chapter in my chronic pain journey began. I have had serious pain, since my external fixator was placed to fuse my ankle and a case of osteomyelitis ensued.

Finally, I believe I am done with my surgeries as everything looks good according to my ortho surgeon. However, I still have pain that to date nobody has been able to explain. I have learned this is often the case for chronic pain sufferers.

I have started seeing a pain psychologist, and while she has provided me with some excellent tools, I am really not ready to be med-free. My pain management dr talked me into trying to go off the meds last week, but my pain has persisted and dramatically limited my activity. I am now faced with the questions:
Do I go back on breakthrough meds?
Do I settle for very limited amounts of activity?
I'm just not sure what my next move is going to be. I see pain management Tuesday, so I would like to be prepared before I go in for my appointment.

Also, I am having all of these thoughts and feelings, almost residual in nature, from all of the pain I was in and the helplessness I felt.

Does anyone else ever have these feelings? Can you share some insight?

Thanks!
Step

 
Old 08-17-2008, 06:49 PM   #2
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Re: Some of the Psychological Effects of CP...

Hi Step,

Your questions are good ones, but tricky ones too. I think it all boils down to what each person is experiencing, what your long-term pain prognosis is and where you are in your life in terms of responsibilities (ie, age, children, work).

For me, it was an easier decision to go ahead with a med regimine, because I no longer work, I have a grown daughter who no longer lives with us, and I can make my own schedule. I don't have the responsibilities of a young parent or a single person who needs to provide my own income.

If it were me, I would ask myself some questions....... Do the meds help substantially with my pain? Would I be able to function at the level that I need to without them? Do they impair me in any way that would make it difficult to perform the tasks that I need to every day? If you really think about these types of things, then I think you'll have your answer.

I'm not sure if this was the type of answer you are looking for, but I just thought I'd throw my opinion in the ring, so to speak. I'm sure that others will chimme in with some great advice/suggestions. Whatever you decide, I wish you the best of luck at your appointment. If there is anything that I can clarify or add to, please don't hesitate to ask. Take care and please keep us posted. CMP/MM

 
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Old 08-17-2008, 07:25 PM   #3
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Re: Some of the Psychological Effects of CP...

cmpgirl,

Thank you so much for the reply. These are great questions to consider.

Step

 
Old 08-17-2008, 07:34 PM   #4
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Re: Some of the Psychological Effects of CP...

Cmpgirl has laid this issue out very, very well. To be honest, I'm not sure any of us can help you much. We really don't know the full extent of your pain & etc. I think you have to trust your Doc and obviously, if you can function without meds, it is the much preferred route. I would LOVE TO be able to stop taking meds....I HATE being tied to them. However, I HATE PAIN even more. One must weight the "pros" and "cons" of taking meds. For me, the "pros" far outweigh the "cons."

If you can get by without meds, I would highly encourage you to do so. Any reliance upon them will only make stopping that much more difficult later. I only say this because of what your Doc has said to you. On the other hand, if meds provide some sense of normalcy, then that's a different story.

You have a lot to think about and decide upon. I hope you make the right decision, and I think you will. Take care, and God bless.

Regards,

Ex

Last edited by Executor; 08-17-2008 at 07:35 PM.

 
Old 08-17-2008, 08:55 PM   #5
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Re: Some of the Psychological Effects of CP...

I think cmpgrl and Ex gave you great advice. When I first took meds, I had no idea how difficult it would be to take them long-term and I "didn't get it" when a doctor told me that many CP patients used alternative techniques either in addition to or instead of medication because they wanted to feel more control. I thought to myself - the meds are working great - why would anyone want to get off of them? What does the doctor mean by feeling more control? That seems like a very long time ago now - Just as pain is very limiting, so is taking the medications. I too hate taking these medications. I reread your post and see that you've been on LA meds - possibly for as long as two years, so I imagine you know many of the cons and stresses associated w/ taking medication so it's probable that I'm not saying anything you don't already know. I've said it anyway...:-)

I find traveling and picking my scrips up stressful - I tend to be spacey and I am always concerned about losing the scrip or some of my meds. So, if there is a way to control your pain w/o staying on the medication, I would certainly try to do that. Only you know how effective other treatments are for you and how much pain limits your life. I wish I had used every alternative treatment I could find right after my surgery and tried as hard as I possibly could to get off of medication. At this point, it would take a lot of time to go off the meds and for my receptors to return to normal. I don't have time or money - I feel like I did not get a chance to try everything possible to avoid medication and still hope to have the chance to do this someday.

I was also in so much pain, and so grateful for the relief, that I didn't do the kind of thinking or research I think I should have done before I took the plunge into long-term LA meds. I honestly wish a PM doctor had discussed this with me - I didn't have a very good PM my first time around - I might have felt upset if someone had suggested I go off the meds - not sure - when I started taking them, I never thought I would be taking them several years later. Perhaps reading some of the posts here will help you with your decision.

One factor I don't think others mentioned is whether or not you think your PM is just against meds [there are PMs out there who do not believe in treating patients with opioids long-term.] If you feel that your dr. is biased against opioid treatment, it's a bit different, though it still comes down to what Ex and Cmpgrl talked about --

As they said, if it is too hard to deal with your pain, and if your pain prevents you from functioning well, then medication may be the answer. I think Ex summed it up really well. I'm a fan of cost-benefit analyses...or analyzing the pros and cons..

Last edited by Confused089; 08-17-2008 at 09:08 PM.

 
Old 08-18-2008, 06:09 PM   #6
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Re: Some of the Psychological Effects of CP...

Thank you all so much for the advice. I truly appreciate it. I have written a list of questions/points to ponder before my appointment tomorrow morning. My husband is going with me for support, since I have a tendency to let drs talk me into or out of things.

 
Old 08-18-2008, 08:55 PM   #7
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Re: Some of the Psychological Effects of CP...

Quote:
Originally Posted by stepbystep89 View Post

I have written a list of questions/points to ponder before my appointment tomorrow morning. My husband is going with me for support, since I have a tendency to let drs talk me into or out of things.
Best of luck to you! Please let us know how it goes.

Excellent idea to take your husband (or anyone for that matter). I think it's harder for Docs to tell two people "no" than just one.....JMO.

Regards,

Ex

Last edited by Executor; 08-18-2008 at 08:56 PM.

 
Old 08-20-2008, 11:02 AM   #8
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Re: Some of the Psychological Effects of CP...

Well, I went to my appt. yesterday and was able to be assertive about my needs. I spoke articulately and with confidence. I am not always able to do this, but with the help of these boards and some meditation, I did it.

I am now on Lyrica for the nerve pain. I hope there are no nasty side effects to it. I am in management and need all of my faculties working in order to be effective.

One interesting note: I thought Tramadol was a non-narcotic. I am confused because pain management told me if I need it I can have it prescribed by my pcp. However, the dr also considered it to be a "step backwards" in my recovery. I'm not sure how to sort all of that out.

So, my plan right now is to give the Lyrica a shot and try to stay away from any b/t meds stronger than Extra Strength Tylenol for now. I'm not sure how long it will last, but your advice and the list of things to consider will certainly help in the choices or decisions I am faced with as I continue on this journey.

Thanks again! You are all wonderful!

Step

 
Old 08-20-2008, 08:48 PM   #9
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Re: Some of the Psychological Effects of CP...

Quote:
Originally Posted by stepbystep89 View Post

Quote:
I am now on Lyrica for the nerve pain. I hope there are no nasty side effects to it. I am in management and need all of my faculties working in order to be effective.
Glad to hear your doc gave you something for the nerve pain. Lyrica can have some sedative side effects, but not everyone experiences that.

Quote:
One interesting note: I thought Tramadol was a non-narcotic. I am confused because pain management told me if I need it I can have it prescribed by my pcp. However, the dr also considered it to be a "step backwards" in my recovery. I'm not sure how to sort all of that out.
Tramadol is not an opiate/opioid, but what some docs fail to tell their patients (because they don't realize this themselves) is that with long-term use, you would need to titrate down to prevent withdrawl. I've read some posts here in the past where people who didn't know, and stopped cold turkey, had a rough time of it. Is this what you've been taking along with your BT meds?

Quote:
So, my plan right now is to give the Lyrica a shot and try to stay away from any b/t meds stronger than Extra Strength Tylenol for now. I'm not sure how long it will last, but your advice and the list of things to consider will certainly help in the choices or decisions I am faced with as I continue on this journey.
I'm not sure what you've been taking for BT, but if it is an opiate/opioid med and you have taken it regularly for a long period of time, you should also titrate this med down. If you were only taking it a couple of times a week or something, then it shouldn't be an issue.

Best of luck with everything. Keep us posted as to how you are doing. CMP/MM

 
Old 08-21-2008, 09:03 AM   #10
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Re: Some of the Psychological Effects of CP...

Actually, Tramadol is an opioid with antidepressant elements as well (both as a serotonin reuptake inhibitor and a norepinephrine inhibitor).

This is why going cold turkey is so hard and not recommended. With prolonged use, the body becomes dependent on tramadol, to both the opioid and anti-d elements, and the WDs are awful.

steve

 
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