My family doc has referred me to a pain management doctor. I have been taking Tramodol or Ultacet plus for about 10 days.
I have been reading the posts here and I have learned soooo much, in about 3 hours. I have my first appointment with the PM doc tomorrow. I am taking all of my medical diagnosis's with me. I am very nervous about this appointment. I am tired of living with pain and at the same time I am worried about addiction.
I told my doc that I was self medicating with alcohol and had been for about 3 weeks. I don't expect to live for a long time, but I don't know what an addiction would be like. I do have a friend that became addicted to pain medications and now he is taking methadone, and has for years. I asked him if he could ever see himself stopping the methadone and he said he didn't want to think about it.
Addiction may be a taboo subject here, but I hope not. I know and understand pain all too well. My heart goes out to all of you.
I hope that some of you could give me some guidance here. I am at a crossroad it seems.
Thanks for your time and any thoughts on this matter.
Hi Brad, Welcome!! You didn't mention why you are taking the meds or why you are in pain? Don't feel bad about resorting to alcohol--I think a lot of people have done that at one time or another in their lives. If you can, now that you are seeing a pm doc, see what you can do to try to quit drinking, you really don't want to mix the two.
Getting addicted to pain med's is a huge concern!! I think it's great that you've even worried about it, but as long as you are seeing a pm doc, they are pretty good about not letting you get too hooked. Up until this last week, most of my meds went untouched for feer of getting hooked myself--then I had some new problems that I just couldn't handle and the doc finally talked me into taking them. Right now I'm taking Ultram which is supposed to be pretty non-addictive, but a good pain killer. I'm still being a baby about it and only taking half of my dose
Just be sure to be honest and open with your pm doc and let him know that you've been drinking and tell him that you are afraid of becoming addicted--he will work with you accordingly.
There are a lot of people on these boards who know a lot about meds, so they can give you all the advice you need. Or if you just need to talk, we are here for you. Good Luck!!
Hi Brad - Welcome to the pain management board. Your concerns about addiction are very valid. If you've been reading the posts on this board you've probably seen many about the difference between addiction and tolerance. Someone will come along shortly, I'm sure, to give you a better explanation about the differences between the two. The fact that you've been self medicating with alcohol and taking Tramadol at the same time (correct me if I'm wrong here) isn't a very good idea. It's never safe to mix pills and booze. But it does show how desperate you must be for pain relief. Like BlueSteam said, I'd encourage you to be very honest with your new PM doc so that he/she knows your drug/alcohol history. I think you'll find that most PM docs are very good at what they do and hopefully you'll get the right treatment for your pain. I'm also interested to know what your diagnosis is and where your pain is coming from. Hang in there - we are all here to listen and to lend support. KathyMac
Last edited by BrittleBones; 07-13-2006 at 10:08 AM.
Welcome to the community, although I'm sorry there is another person who is living in pain. I too have to ask what kind of pain you are having that has required referral to pain management. If it's not my business, or something you'd rather not post, no offense will be taken. Some things are personal and we can all understand that.
Your concerns about addiction are valid. Just as KathyMac & Blue said, I think all of us who have been referred to pain management have concerns about this. But also, as mentioned addiction and tollerance are two totally different things. A reputable pm doctor understands this and takes this kind of thing into consideration with all patients.
Tramadol (non narcotic) is addictive, and so are most of the medications used in treating long term pain, BUT when these meds are taken appropriately and are monitored by a good pm doctor, the chances of becoming phychologically addicted are usually low. The main thing is to only take medications as prescribed, and never self medicate.
You did the right thing in being honest with your doctor about the alcohol. It's best to be totally upfront with them and building a trusting relationship is going to benefit you in the long run.
I'm so glad your doctor has referred you to pm. I think you will be pleased when you begin seeing the results of having your pain managed appropriately by doctors who specialize in improving our quality of living. As always, I wish you the best. Please do let us know how things go at your appointment.
Well you guys are so kind. I am overwhelmed by your replies. I am sorry that I didn't explain my physical problems. I didn't read where you described yours, except for very serious spinal problems. Oh yeah, I am not an alcoholic at all. I am sure that I could become one though. I stopped the drink when I got some pain medications. I took a few hydrocodone doses but had to stop due to the fact that they made my headaches worse.
Today is the first day in about 11 days that I have not taken any Tramadol. I have pain, but it is tolerable.
3 years ago I had a heart attack that also caused a stroke. I had another stroke 7 months ago. I have 2 lesions in my brain. I have been in and out of hospitals for 3 years. I have had 8 cardiac catheterizations. This past March, they wanted to do bypass surgery on me, but I took an option that many do not have, or do not ask about. I had rotoblation arthectomy and 2 very large stents inserted in to my Lad. I have 4 stents so far. I have an inherited condition called hyperlipidemia. My cholesterol and triglycerides are unbelievably high. I have deadly reactions to all types of statins. I have congentially small coronary arteries. I have small vessel disease that affects my brain and heart.
I have white matter disease that is causing degenerative brain disease. This has caused peripheral neuropathy, per the neurologist. I am developing a seizure disorder due to the strokes.
I was diagnosed last fall with CFS. I am becoming allergic to long tolerated heart medications. 6 weeks ago, I started to have pain in both of my arms from my shoulder to the tip of my fingers. It involves bone and muscle pain. Neurontin did not phase it.
I have developed arthritis, which is probably rheumatoid. I had my 1st appointment with a rheumotologist about a week and a half ago. My joints were swelled when I went to see my family doc that started me on a nightmare 13 day steroid treatment plus strong antibotics. I had my last heart cath 1 month ago due to chest pain. All was clear. I found out that RA can affect the heart and lungs.
The nurse for the rheumatoligist called 2 days ago and said some of my bloodwork showed abnormalities that required me to come in earlier than previously scheduled. She said my Igg and Igm antibodies were low and probably nothing to worry about, but more testing will be done Monday. I did a search and read about leukemia and multiple mylenoma being associated with this condition.
See why I didn't mention my problems, lol. Whew, what a mess.
Thanks so much to you guys. Hope you have a great day
You will find as you read through many here deal with multitude of docs to treat the various problems in some cases lots of troubles.
We do have one thing in common which is chronic pain. Not all meds work the same way for the same folks so having a doc well versed in pain managment can be a asset in adjusting doses and getting you what you need to be more tollerant. I hope your appointment goes well and don't forget to ask question and say what has worked for you and what hasn't worked.
Hi Brad! Welcome to our pain management 'family'! although I agree with the other poster, I am sorry to see another person in pain. We have all dealt with the problem of should I/ should'nt I take opiate painkillers, and the descision is best reached after you and your doctor have tried a number of other less invasive techniques to help deal with it. I sounds like your health problems might be severe enough to preclude some things, so I will only address the opiate question here. Dependence is something we all have, it is the bodys natural way of becoming accustomed to anything we put in it on a daily basis. people who abruptly stop caffine, sugar, and cigarettes have 'withdrawals' that can include headaches, bowel discomfort, sleep disorders, ect. Its the bodies way of getting used to not having it. Dependence is a normal side effect of taking pain meds also. withdrawal is to be expected, if you no longer need them, but the doctor can help keep you comfortable by slowly tapering your dosage down to nothing. ADDICTION is behavior driven, it includes things like taking more meds than prescribed on a regular basis, doctor shopping, using illegal methods to obtain extra medication, everything from nicking a few pills from auntie's medicine cabinet to buying from illegal internet pharmacies. The VAST majority of people prescribed pain meds NEVER have trouble with addiction, although there are doctors out there that don't know the difference, and see people in withdrawal as 'addicts'. This is unfortunate, but thats why we see the pain specialists, they are trained and understand the difference, as do the vast majority of posters on this board. (BTW, the self medication for pain with alcohol doesn NOT make you an addict!) So just be open and honest with your pain doctor, and you should be able to find relief. best of luck and please let us know how it goes, we care! Hugs, Fabby
First at all, studies show that only a small % of CP patients become addicted.
Secondly, look at it this way. If your life is falling apart because of the meds like you lose your family, job and the quality of life is getting worse from the meds, you might be addicted.
On the other hand, if the meds help you regain a qual;ity of life that is an improvement, and they help you get around, then you might be depenedent. We all become dependent which means that if our meds are stopped abruptly, we will get w/d.
There is a major difference between addiction and dependence. If you are in pain, and the Doc has rx'ed you these meds, you should try them to see if you get any relief. Good Luck!
I too worry about addiction. I've been having pain for many years but it's gotten to the point where I would cry everytime I tried to turn over, could not sit up alone and couldn't reach across the table to pick up a napkin. My doc gave me Neurontin, many side affects, but it's been worth it being able to sit up in bed and turn over by myself. The only problem is that the pain is so bad, I cry.
I guess the Norontin is supposed to handle nerve issues but the other pain is still there. I've taken Flexeril for a few years, can feel the spasms again; take Ultram four times a day - may as well chew tic tacs. I'm afraid my big mouth will get me thrown out on my ear.
I'm so afraid of being in a drug-induced stupor that I don't know what to do. Lifestyle changes have become a factor too. I'm finally at the point where I have to admit I need help. Between my pride and my addiction/dependence fears, I'm a real doodle.
Thanx for letting me vent. Luv to all, Rosa
Last edited by Rosieposie1; 07-14-2006 at 07:36 AM.
Hi again Brad! ( I will address this to Rosa too ) If you are on the correct dosage, after a while, you will not feel any kind of drug stupor, that 'drugged out' feeling will go away fairly quickly, and you are left with just the pain control. Everyone reacts differently, but this is the case for most of us, IMHO after reading posts here for several years. Good luck! ~Fabby
Well I had the strangest experience ever at the pain management clinic today. I did all the paperwork and was taken to an exam room by a physician's assistant. He took my picture and blood pressure. We went to an exam room. He asked me why I was there. I said I wanted medicine to help stop my pain. He said we do not just write prescriptions for pain medicines. We give joint injections, epidurals and give physical therapy. I said that I only needed medicine for pain. He said again we don't do that. I said well I guess there has been a misunderstanding. I will leave and not see the doctor. I left and felt relief.
I told him that I thought that "non-pain treating doctors" got into trouble with the DEA for writing too many pain medicine prescriptions. He said that is not true, any doctor can write as many pain medicine prescriptions as they need to.
I live in Alabama and that may be the problem, lol.
Thanks again for all of your replies and help. This is by far the most compassionate and helpful board section at this site
Wow- I think maybe you should get another refferal. Maybe to a pm doctor that uses multiple types of pain treatment methods. No, it's not always just about medication. There is usually a good balance between theraputic methods accompanied with medicinal methods that can be employed to help treat chronic pain.
The very first pm doctor I was referred to told me flat out, I rely on the "Western" type approach which only includes things such as accupunture, trigger point injections, prolo therapy, etc. I do not prescribe medications. I tried all those things and they made me hurt so much more than before I started seeing her, so I told my referring doctor who proceded to refer me to a different pm.
My new pm uses a healthy combination of both. He doesn't just prescribe pills, he evaluates each patient and comes up with a treatment plan according to what type and level of pain they have. If meds aren't needed, he doesn't use them, but if they are needed, he is aware of that and does prescribe them.
Can you get in with another pm doctor? One who isn't dead set against the use of medication if that is what's needed?
Hi brad,i think you may have given this doc the 'impression' that you were only there for pain meds not exactly there for pain control,you know what I mean?going into any ,espescially new,docs office and just telling them"i am here for drugs",well,can you kind of see why he may have had a little red flag go up inside his head?
now say,if you went into this with the additude that I am here for help with my pain,that might have gone over a bit better.its only because there are sooo many drug seeker pain med addicts out there that all docs,espescially pain clinics really really have to be soo careful about who they Rx some really strong pain meds for.there is also the diversion factor to consider.you also just happen to live in a part of the country where the crack down on pain clinics and the Rxing of thigs like oxycontin just gives most docs the heeby geebies.do you know what I mean?
from the conditions you have described here,I am certain that you must suffer with some pretty severe pain at times and really DO need to have some possibly very strong painmeds to try and get at least some good quality of life for yourself,but I think with this particular pain clinic,after what occured at that visit,it probably is not going to happen there.going to another pain clinic with a bit less rush to the pain med conversation would be the best way to go.most clincs will do a very in depth evaluation of your pain,and ask you to rate it and what makes it worse or better,and also discuss what has or has not worked for you in the past.then they discuss options.you really DO need to have your pain fully evaluated by a pain management doc who knows the type of pain you are suffering from and at that point,he will decide a pain management plan for you.you see,its all a process that you really need to go thru in order for them to really do whats best to try and treat your very specific types of pain, and what they feel would be the best way to try and treat it.
what you encountered at that appt is pretty standard,and if you want to avoid the possibility of any addiction issues popping up down the road,the pain clinic is really your best bet.but in order to avoid the addiction that you are concerned about here brad,you do have the rules at the pain clinic that you need to follow to the letter,they will also have you sign a contract with them that spells out all of the expectations.this is also standard.the PMs are only trying to help pain patinets live better lives but at the same time,because of the addicts and the seekers who are looking to make a quick buck off of selling the pain meds they are Rxed,the clinics have a huge responsibility to protect themselves and their continued ability to Rx those very badly nedded meds to the rest of their patients.
there are,unfortunetly,people out there who are only seeing the pain docs for reasons onther than pain management,which makes things much more difficult for those of us who are truley suffering with intractable chronic pain.but we go thru what we need to and jump thru those hoops in order to have the privledge of being able to actually be treated with the stronger meds and other modalities the clinics offer us.as you now know,going thru a pain clinic for treatmentis a whole different animal than just seeing your primary doc.but unfortunetly,it has to be this way.
but quite frankly Brad,if your addiction concerns are there,a pain clinic is truely the absolute best place to go for pain care.they make sure you stay totally compliant.it would be much more difficult for someone going thru a pain clinic to become addicted to their meds as opposed to seeing your primary doc for pain meds.ther just isn't that same level of control going thru your family doc as what you will encounter at a good pain clinic.just find another clinic and don't be too eager to get to the pain med conversation.just follow the process.once the evaluating doc actually has had time to speak with you regarding the severity of your overall pain and sees all of your medical records,well i am sure there will be a good pain care plan worked out for you.just let the process do its job,thats all.
I do wish you luck and hope you can find a good clinic to handle your pain care.please keep us posted on how things go.marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
I posted before I read your post. What you say is true, I know. I never got to see the doctor though. I saw a P.A. or a nurse, I couldn't tell. My wife had typed a note (2 pages, lol) to the doc, listing all of my diagnosis's and the local doctors who had made them. I also had all the "diagnosis sheets" from all the doctors. She had made it very easy for the "whole picture" to be seen fairly quickly. Fraud would also have been ruled out quickly. Plus I am an old gray headed man that can't walk just right from a stroke an arthritis, lol (53 going on 93). I am sure that even wobbly old gray headed men probably sell their medicines. Maybe to pay for food?
I think that if I would have seen the doctor, things would have been ok. I just didn't feel like playing any games. I was/am at my wits end with pain. My wife and I had worked really hard in gathering all of my medical records, and she had typed a chronological record of my ailments, which included dates and doctors. The official medical records backed up all she had listed. I drove 50 miles in 98 degree weather, lol.
Thanks for your explanation. I see the rheumy tomorrow. I am anxious to see if he suspects cancer from my abnormal blood work.