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Old 01-10-2010, 05:35 AM   #1
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High tolerance to Pain meds. HELP PLEASE!!!

Hello. I'm extremely worried again. I believe I have a very high tolerance to narcotic pain meds. Everything was really fine till recently. I was on 10mg Oxycontin and then told my doctor that stopped working and then my doctor increased it to 20mg...then soon later, say a week later, told my doctor it's not working. I'm losing my mind completelly.

My doctor is nerveous on me. Since I have lot's of 20mg oxycontin left he said take them together and come back again for the 40mg Oxycontin.
When will this end??? I feel like a complete failure.

My doctor told me he has a patient who has been taking 20mg Oxycontin for years now with no need to increase. What's wrong with me??? Is it a weight issue, let's say if I put on weight will this stop this high tolerance to narcotic pain meds?. I'm 5'4, 107-108 pounds.

Should I go back to Percocet, perhaps it's less addictive?. but percocet only helps for 3 hours. I'm not sure what should I do now. Is it cause it's chronic neck pain + TMJ that makes me with such a high tolerance to narcotic pain meds?.

Is it better for me to go on a patch?. but then the patch will stop working. What's WRONG with me?.

Please anyone with answer help me. Thanks in advance.

Last edited by nochange; 01-10-2010 at 05:37 AM.

 
Old 01-10-2010, 08:53 AM   #2
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Re: High tolerance to Pain meds. HELP PLEASE!!!

Quote:
Originally Posted by nochange View Post
My doctor is nerveous on me. Since I have lot's of 20mg oxycontin left he said take them together and come back again for the 40mg Oxycontin.
When will this end??? I feel like a complete failure.
Tolerance is a normal part of PM. Good PM Docs understand this concept. You shouldn't feel like a failure. If it makes you feel any better, the dose you are on is not very high, from a PM standpoint. In fact, you are on the very low end for chronic PMers. Just as a point of reference, I know someone who takes 700mg of Oxy per day. Granted this is the highest I've come across, but there are a bunch of people in between you and her. It's not unusual at all for someone to be on 150-200mg per day, which is very typical.


Quote:
Originally Posted by nochange View Post
My doctor told me he has a patient who has been taking 20mg Oxycontin for years now with no need to increase. What's wrong with me??? Is it a weight issue, let's say if I put on weight will this stop this high tolerance to narcotic pain meds?. I'm 5'4, 107-108 pounds.
Not everyone is the same. In fact, this bit of information is really worthless, no offense to your Dr. I can shoot holes through it really quick. For example, maybe the patient is afraid to ask for an increase and thus suffers miserably. Many people won't ask for increases for fear that they will be cut off completely. Secondly, the person may take them recreationally, and thus, doesn't need more. Quite frankly, as a Dr., I'd be more worried about a person who never needs an increase and seems to be very satisfied, than vice versa. True PM doesn't respond to the same med forever. That's not how it works.

As far as your weight goes, the more you weigh, the less effective the med will be. Conversely, if one loses weight, the med may have a greater effect. Med and body weight work the same way as alcohol and body weight....Takes more for a bigger person to get legally drunk (for driving). This is why women reach the .10 (or.08 in some states) much more quickly than men.


Quote:
Originally Posted by nochange View Post
Should I go back to Percocet, perhaps it's less addictive?. but percocet only helps for 3 hours. I'm not sure what should I do now. Is it cause it's chronic neck pain + TMJ that makes me with such a high tolerance to narcotic pain meds?.
I think if you went back to Percs, you'd find things worse. Both Percs and OC have the exact same active ingredient, Oxycodone. The only difference is that Percs are immediate release while OC is sustained release, or long acting. If you take 10mg of OC, 5 mg is released when you first take it and the 5mg is released about 4-6 hours later. But, this can vary greatly in certain people due to metabolism and etc. Some people need OC 3 or 4 x day due to faster metabolisms. If you do some research on this site, you'll find that many complain that the med doesn't last 12 hours. OC taken 3 x day if very common. In fact, fast metabolizers will take it 4 x.

The problem with Percs is that the med is in and out very quickly. Thus, once it starts to wear off, you can get a case of the "ups and downs".....or mini WDs in between doses. OC keeps your blood plasma levels consistent. In fact, Purdue Pharma's (maker of OC) research has shown that taking a 10mg OC results in higher plasma levels than taking two 5mg percs 4-6 hour apart. This leads to better pain fighting.


Quote:
Originally Posted by nochange View Post
Is it better for me to go on a patch?. but then the patch will stop working. What's WRONG with me?.
The patch is a completely different med altogether, or fentanyl. There is no guarantee it will work. I guess you could try it if the OC does not work for you. I used the patch with very good success, but I had issues with the patch mechanism in general. I was always aware of it....Itched and etc. Plus, in the warmer months, I would sweat and it would move around slightly. Just wasn't a good mechanism for me.

Has your Dr talked to you about oral morphine (Kadian, Avinza or Ms Contin)? I have been on OC, the patch, and now Kadian, and it is by far the best, IMHO. It can be a little sedating, but I only have that issue at night....Which is good because it helps me sleep.

The good news is all of this is it sounds like you have a very progressive and compassionate Doc who is willing to work with you. This is huge in today's PM. Many people have just the opposite effect....Can't find a good Doc.

Hope this helps and please let me know if you have any questions.

Regards,

Ex

 
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Old 01-10-2010, 11:35 AM   #3
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Re: High tolerance to Pain meds. HELP PLEASE!!!

I with Executor here. I'm 6'5" and currently weigh 235 lbs, I'm 59, I take 80mg of oxy three times a day and am allowed another 3 percocet 10/325 for BT pain daily. Most days I take the 3 percocets. I just glad that my pain is finally under control! I had been in pain for almost 12 years before that and was in PM for 2 until the doctor (#2) finally got the pain in control. Yes it does suck that I have to take these pills, yes the constipation also sucks, but it's better than the pain. I was actually relieved to hear Executor say that most people take 150-200 mg of oxy a day, because I had thought that I was on a huge dose due to my size, and size does matter, the bigger you are the more it takes.

 
Old 01-10-2010, 06:01 PM   #4
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Re: High tolerance to Pain meds. HELP PLEASE!!!

I am taking 40mg of oxycontin twice a day and it just gets me by but quite often I need to top up with endone which is just a quicker release of the same thing Oxycodone. I also take paracetamol 3000mg a day and celebrex and I use valium as a muscle relaxant.
This is not a large dose for me and I feel that later on I will need to increase this dose. My problem is the doctor who started me on the oxycontin has left and I had to go back to my old doctor and he told me strait that he will not increase the dose at all.
So you are lucky to have a doctor who will increase the dose so you can have adequate relief. I don't know what I will do when the time comes. Now I have to be very careful what I do as any wrong movements and my pain sky-rockets. I suppose I will have to seek out a pain management doctor as I only have a GP and a muscular skeletal specialist who gives me injections regularly. One type is for the nerve roots and another for the facet joints. They do help but it takes a while for the needles to settle down as they actually stir things up for about a week first.
Don't be scared to increase the dose as it doesn't take long to get used to the extra. I hope this will give you some peace of mind.
Allan

 
Old 01-10-2010, 08:47 PM   #5
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Quote:
Originally Posted by Executor View Post
I think if you went back to Percs, you'd find things worse. Both Percs and OC have the exact same active ingredient, Oxycodone. The only difference is that Percs are immediate release while OC is sustained release, or long acting. If you take 10mg of OC, 5 mg is released when you first take it and the 5mg is released about 4-6 hours later. But, this can vary greatly in certain people due to metabolism and etc. Some people need OC 3 or 4 x day due to faster metabolisms. If you do some research on this site, you'll find that many complain that the med doesn't last 12 hours. OC taken 3 x day if very common. In fact, fast metabolizers will take it 4 x.

The patch is a completely different med altogether, or fentanyl. There is no guarantee it will work. I guess you could try it if the OC does not work for you. I used the patch with very good success, but I had issues with the patch mechanism in general. I was always aware of it....Itched and etc. Plus, in the warmer months, I would sweat and it would move around slightly. Just wasn't a good mechanism for me.

Has your Dr talked to you about oral morphine (Kadian, Avinza or Ms Contin)? I have been on OC, the patch, and now Kadian, and it is by far the best, IMHO. It can be a little sedating, but I only have that issue at night....Which is good because it helps me sleep.

The good news is all of this is it sounds like you have a very progressive and compassionate Doc who is willing to work with you. This is huge in today's PM. Many people have just the opposite effect....Can't find a good Doc.

Hope this helps and please let me know if you have any questions.

Regards,

Ex
I have to agree with Ex here... the best way to lower your tolerance is to switch to something different right now I'm on MS Contin (morphine) 30 mg TID (3 times a day) before that it was Methadone. I use 10/325 Percs for BT pain.

A good doctor will switch your regiment once your tolerance is too high to a different painkiller and probably even rotate you through pain killers as your tolerance to one builds up and the other has dropped maybe even a cycle of 3 different types to allow your tolerance to fully drop. So maybe a cycle like Oxy, Morphine, Methadone then back to Oxy for example...

I've never been on Oxycontin myself its just been a rotation between Morphine and Methadone with Percocets for BT pain. But I have had a regiment of Methadone and instant release morphine tablets when my Percocet tolerance was too high.

The trick is to keep rotating... Hope this helps.

Michael

 
Old 01-14-2010, 06:16 AM   #6
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Re: High tolerance to Pain meds. HELP PLEASE!!!

Thank you so much for taking the time replying me. That really helped me so now I don't feel like a failure. Now I know it's not my fault. Thanks again.

 
Old 01-14-2010, 06:26 AM   #7
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Re: High tolerance to Pain meds. HELP PLEASE!!!

Quote:
Originally Posted by allanbruce View Post
This is not a large dose for me and I feel that later on I will need to increase this dose. My problem is the doctor who started me on the oxycontin has left and I had to go back to my old doctor and he told me strait that he will not increase the dose at all.
I don't know what I will do when the time comes.
Allan, I will start looking for a new doctor right now who will agree to increase your dose. Or you should look for a "temporarily" pain clinic. You never know when that time comes, believe me.

Last edited by nochange; 01-14-2010 at 06:27 AM.

 
Old 01-14-2010, 06:59 PM   #8
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Re: High tolerance to Pain meds. HELP PLEASE!!!

I am new on here and I am having the same issues and more. I was diagnosed in July with interstitual cystis(painful bladder syndrome and pelvic myofasical syndrome and all my pelvic muscles are in a complete spams and SI joint disfunction and both my butt checks are in continous spasm. I started taking two lortab a day 7.5/500 until September then I was put on 10/325 mg of oxycodeine three times a day and then finally was referred to a pain specialist who in October put me on Oxycontin 15mg twice a day and still oxycodeine 10mg three times a day. Every month I still had poor pain control except for one month and then over the last 3 weeks I have been living in hell. I am now on 20mg of oxycontin four times a day and 10mg of oxycodone three times a day and there has not been one day that I haven't had to take 5 more oxycodone to get by and my pain doctor is aware so no lectures. I went to the ER the other day cause I took 30mg of Oxcontin and all doses of oxycodone in 3 hours cause every muscle in my vagina, pelvic and back where in complete spasm cause I had physical therapy the day before and my pelvic muscle tone increased from 20-30(most women are 2-3). I knew I was in trouble. I called my pain control doctor and he was out of town and was told to go to the ER. The ER of course treated me like crap cause of the oxycontin but I went to the hospital where the pain clinic is cause I wanted my pain clinic to get all the proper info from the ER and also wanted the ER to look at my records from the pain clinic. Of all the people that treated me the worst was a male ER nurse who I use to work with. I bet you a lot of money if he had a minute of my pain he would cry like a baby. The ER doctor however was very kind and did her best to help me get some pain control. She gave me small dose of morphine and what helped the most was the valium she gave me.. I am suffering and today has been awful. I made another appointment with my PC but he cannot get me in until Tuesday and I am so sick of having to call them all the time and another side not I am also having issues with high blood pressure and docs and tellling me it is because of my pain. I hate being on narcotics and I have taken care of a lot of chronic pain patients and it always bothered me but what really got under my skin was taking care of drug addicts and drug seekers cause the truly take time away from the patients who are in real need and I can't believe I am now on narcotics but the amount is also unreal to me. I also worked 12 hour shift yesterday and in the middle of my shift my bladder went into complete spasm and my back did also so my coworkers wrapped an ice pack around my back and by the end of the day my feet were swollen three times their size and I could hardly walk. I am only 35 and I am a very small person. This has never happened to me. Please understand I only want relief and walk a block in my shoes before you make any quick judgements cause I have already run across some judgemental people on here and wondering if I chose the right web site. I have never been nodding out from these medications or short of breathe. I am also completely with it which is even more concerning. I am afraid there is no hope for me. I use to work out all the time and was a very cheerful happy nurse. People would ask why are you so happy all the time. Now they ask me if I am going to make it. I cannot beleive this has happened to me and I am trying to find acceptance. I have also tried a variety of alternative methods before getting on pain meds and I still use a lot of relaxtion techniques but have to admit my feet swelling that big has really scared me and increased my lack of acceptance. Deep down inside I have this feeling that their is something else going on that the just haven't found it yet. Thanks for reading my post

Last edited by crissyc; 01-14-2010 at 08:33 PM.

 
Old 01-14-2010, 07:06 PM   #9
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Re: High tolerance to Pain meds. HELP PLEASE!!!

My spelling also sucks cause I was typing too fast and kinda emotional and felt funny sharing all that info with complete strangers. I do need some experience though from other members. Thank you.

 
Old 01-17-2010, 03:06 AM   #10
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Re: High tolerance to Pain meds. HELP PLEASE!!!

Quote:
Originally Posted by crissyc View Post
I was diagnosed in July with interstitual cystis(painful bladder syndrome and pelvic myofasical syndrome and all my pelvic muscles are in a complete spams and SI joint disfunction and both my butt checks are in continous spasm. I am now on 20mg of oxycontin four times a day and 10mg of oxycodone three times a day and there has not been one day that I haven't had to take 5 more oxycodone to get by and my pain doctor is aware so no lectures.I knew I was in trouble. I bet you a lot of money if he had a minute of my pain he would cry like a baby. what helped the most was the valium she gave me. I hate being on narcotics and I have taken care of a lot of chronic pain patients and it always bothered me but what really got under my skin was taking care of drug addicts and drug seekers cause the truly take time away from the patients who are in real need and I can't believe I am now on narcotics but the amount is also unreal to me. This has never happened to me. Please understand I only want relief and walk a block in my shoes before you make any quick judgements cause I have already run across some judgemental people on here and wondering if I chose the right web site. I am afraid there is no hope for me. I cannot beleive this has happened to me and I am trying to find acceptance. Deep down inside I have this feeling that their is something else going on that the just haven't found it yet. Thanks for reading my post
Hello Crissyc. Sory it took me a while to get back to you.
I'm really sory to hear you suffer from pain. Did the doctors say it's chronic?.
I've been living with chronic neck pain for 4 years already. It took me about 4 years to accept it. I always asked why me. what have I done to deserve this, you know. After all, I've always been the one who helped people and been good to people and it happened to me.

Being in this forum here really helped me accept it cause I know I'm not the only one who is going through this. I believe you are in the RIGHT forum. I don't think you can find a better forum than this one(never tried another one)that's the first one I tried but there is no need to try another forum. Here there are lot's of educated people who can help you.

So I will help the best I can though I've been taking narcotic pain meds not for a long time. I agree with you, noone knows what it is to live with chronic pain unless they actually experience it. I had to dump my last pm doctor cause he told me he doesn's know how I feel with this pain. can you believe it?. Also when I wanted to "demonstrate" him how this horrible horrible pain in the neck feels he was smiling. A pain doctor who smile when he sees you are in agony?. He needs to find another profession.

I understand you hate taking narcotics. But you need to know there is no other way. I've been trying all type of pain meds and nothing helped(advil, tyneol etc). If you won't take it you won't be able to keep your job and or function at all. you will be miserable.

My only "comfort" for you is that you live in a good country. There are lot's of countries that don't allow the use of narcotic pain meds like Russia, South america, Asian countries, lot's of european countries(they limit it over there)and of course third world countries. Over there you will cry and cry but doctors will say not allowed. So people with pain turn to alcohol and/or recreational drugs or what allow here in the u.s with the name marijuana which I'm really against it. There is no need to it while doctors are allowed to prescribe narcotic pain meds.

Did you try taking nerve pain meds like Lyrica or Neurontin?. it doesn't help 100% but it helps together with the narcotic pain meds. It kind of make it work better I think.

Valium helped you. You should go ahead and tell that to your doctor. So then you need to take muscle relaxant meds. I don't know why but valium(diazepam)caused me stomach pain. Do you have any idea why?.

Perhaps you need to increase the dose you are in. you are taking 20mg oxycontin?. perhaps you need 80mg?. Sounds like you are suffering big time.

Also physical therapy didn't help me also. If it's causing you problems, stop going there.

Did they do all the blood work needed to be done. Did they do the thyroid check?, Iron check?. White and Red blood cells?. Please let me know.

Please don't be in panic and don't be so sad. Chronic pain or diseases can happen to anyone even to nurses or doctors. Nobody is immuned, so I've learnt. It's not your fault.

hoops, I forgot to ask you. Do you sleep ok?. High blood pressure had been associated with lack of sleep. (also the pain issue too).

So we really hope to hear from you again. and let us know how you're doing. All the best, god bless you and talk soon

Last edited by nochange; 01-17-2010 at 03:16 AM.

 
Old 01-17-2010, 03:17 AM   #11
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Re: High tolerance to Pain meds. HELP PLEASE!!!

I apologize, this is like repeating itself.

Last edited by nochange; 01-17-2010 at 03:28 AM. Reason: it's repeating itself by mistake.

 
Old 01-20-2010, 06:17 AM   #12
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Wink Re: High tolerance to Pain meds. HELP PLEASE!!!

Hi,

After taking these strong meds fr a while, it's not unusual that your body gets used to the meds. Have you tried to locate and go to a pain management center? They may be able to help a bit more with helping your pain.


 
Old 01-20-2010, 07:42 AM   #13
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Re: High tolerance to Pain meds. HELP PLEASE!!!

No change, Im going through much the same. Started out with percocet for yrs. & just went on oxycontin not long ago. At first the 20mg worked ok & then after a couple weeks it stopped working. My PM increased the 20mg in the morning to 40mg & I made the choice to stay on the 20mg at night. Im allowed 3 10s of percocet for breakthru per day. Once again I felt relief from the increase & as time goes by Im not getting the same kind of relief.

Im glad Im on an LA vs. just staying on the percocet, I was feeling what I would consider mini WDs & after a couple hrs after taking the percocet I was back in pain.
Im on the small side to, for yrs I know I had a fast metabolism but I think as I get older its slowing down.
The 40mg is better but I was thinking due to being on percocet for so many years the oxycontin may not cut it like it would for someone who had not been on the percocet for yrs. Im sure there is a tolerance issue.

I was just thinking about the rotation of meds, it makes sense to me. Id rather attempt that then keep increasing. Not sure how my PM would react but if I have the same with the 40mg I may bring it up.

Crissy there are all types on every board I think. There are some good people here & for the most part understanding. I feel really bad that you had to experiance the treatment by those who should understand. Im assuming its much worse when it comes from those who know you in your line of work.

That is a double blow. Your probably right, put that guy in your shoes & he'd be begging for help.

Im thinking if the valium helped you that much it may be the key to better PM for you. I take it when I have to & am so glad its an option for me.

We all hate taking narcotics & I can say for me I dont think I'll ever get used to it but Im working on accepting it. Its the judgement from others that makes it so hard to accept. I dont tell anyone what Im on but as you know medical staff can be the worst, when if anything they should have more uderstanding. Its not impossable to tell if someone is in pain, honestly body language can tell alot. Very often it shows & Im sure you've seen this yourself.

Perhaps attempting to work with the existing doses with valium thrown in may be an option. Instead of 10mgs of oxycontin throughout the day maybe suggesting 40mgs for your first dose along with your breakthrus & valium for your muscle relaxer, just a suggestion & example, then back to a reasonable dose of oxycontin. Perhaps working with what you have & adding the muscle relaxer would make you feel better & hopefully your PM to.

Good luck to you both & Crissy please know that we understand as we've all had to walk in your shoes. God bless, Sammy

Last edited by sammyo1; 01-20-2010 at 07:43 AM.

 
Old 01-21-2010, 11:43 PM   #14
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Re: High tolerance to Pain meds. HELP PLEASE!!!

I don't have much time but I wanted to say to Chrissy that no one has the right to judge you - pm is different for each person. I was stable on 20mg of OC three times a day but am currently going through bad flare ups on an almost daily basis. I don't want to increase my OC because I don't want to increase my tolerance but I may have to. I also take up to 4 oxy 10mg a day for BT (sometimes all at once now, which is ok with my PM - problem is that it leaves none for the small flares during the day). i think communication with your docs is the key and talking to people on HB can really help you sort out what you need to do and the best way to approach your doc. Chrissy it sounds to me like you really need a muscle relaxor. I hope your doc is open to this.

No change, if I were in your position rather than upping the dose at the next appointment, I'd be inclined to ask to increase it to 3 times a day. For me there's no way it lasts 12 hours, more like 6. My PM prescribes an extra 10mg for me to use when I need a boost in blood plasma. It sucks being a fast metaboliser. I think I'm going to ask to go to 4 times a day which is only a 10mg increase and therefore isn't such a big boost.

One comment on the ER. Yuck. I've been through all this too and it is so unfair. Thank goodness there are some good docs out there.

 
Old 01-25-2010, 06:20 PM   #15
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Re: High tolerance to Pain meds. HELP PLEASE!!!

Hi Chrissy,

I too just signed up on this forum. I wasn't really looking for answers of how to deal because I've been there, done that for a long time, but rather trying to find info on the manufacturers of Percocet vs. generic and Medicare info which I will write another post later.

Don't feel defeated. I know how difficult it is (as the rest of the forum, otherwise we wouldn't be on it). I think all of us who are on narcotics have feelings very similar to you at one time or another. We don't want to be on them, but if we are not, we feel like we don't want to survive because dealing with horrific pain is just unbearable. Depression sets in and your world feels like the wall are closing in and those around us really can't understand.

And, trying to get the correct medication treatment is just another hurdle of which we need to get over. I've asked many people about their memory and get the same answer all the time "what memory?" Also, another side effect of narcotics in most people, but lucky you that you can function mentally on the drugs. I can no longer work because of the meds and I had to have a clear mind and memory because I was a hardware systems engineer. I think that's the hardest thing to deal with.

I've been through 3 spine surgeries and 1 shoulder surgery. It took about 16 months until a good medication regimen worked for me. I've had almost every procedure known to back/neck sufferers and they never worked. If anything, they just made it worse. I think in your case, it could be an additional disorder of which I have, Fibro Mialgia. it is still such a mystery to most and very subjective within the medical field as well as insurance companies. It is usually caused by some kind of trauma to one's body (in which mine was rods placed in my neck down to the collar bone). The muscle spasms can be as severe as you are having, may be in only certain parts of your body or your entire body (as I have). A rheumatologist and/or a neurologist can help diagnose it. Originally, I was told it is only in the trigger points, but then my nuerologist told me it can be in any and every muscle in one's body (which I have from head to toe and my back is the worse). One other post mentioned some alternative meds for the spasms and one specific concerns me because of experience. Lyrica. You mentioned that you've had problems with swelling. That is a side effect that I had with it and had to stop taking it. You said that you were given Valium at the ER and you got some relief. That also works for me and I've always instructed the doctor's when I have procedures that I need to have the valium to stop the on coming spasms. The downside of course, is it can make you very sleepy so it would be difficult to take if you are working. I've been on Flexeral for 13 years too. I hope that you can find some relief in knowing that you are not alone with your medical problems (I always felt that way too) and let me know if you have any questions about Fibro Mialgia or other meds (I've been on a lot of different kinds over the years).

LH

 
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