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Old 01-22-2011, 03:00 PM   #1
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Ouch

Hello All,
I had a surgery 5 years ago that put metal screws in both of my hips due to a disease (bilateral slip capital femoral epiphysis). This greatly damaged my range of motion and caused me a great deal of pain and i got fed up with it a few months ago. I am now 18 and was told I have arthritis in both of my hips. I had to get another surgery done to get the metal out and reshape my femur one leg at a time (surgical dislocation and osteoplasty). after surgery they put me on percocet and oxycontin, which dulled the pain, but never eliminated it. the morphine they gave me in the hospital did not have any negative side effects on me, but for some reason i have a very high natural tolerance to vicodin, percocet, and oxycontin and they did not prescribe me any morphine. I can no longer sleep more than a few hours if that, and stretching my leg out only helps for a couple of minutes and then the pain returns. is there anything stronger that i could take? preferably something that does not have tylenol in it because that doesnt do much for me either. I know that some of the soreness and pain will go away as my leg heals more, but the arthritis is irreversible and is only going to get worse according to my surgeon. I want to be completely pain free for the few years that i am supposed to have left with my natural leg joints so i can be a kid a little while longer.

 
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Old 01-23-2011, 02:20 PM   #2
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Re: Ouch

Quote:
Originally Posted by Smash7 View Post
Hello All,
I had a surgery 5 years ago that put metal screws in both of my hips due to a disease (bilateral slip capital femoral epiphysis). This greatly damaged my range of motion and caused me a great deal of pain and i got fed up with it a few months ago. I am now 18 and was told I have arthritis in both of my hips. I had to get another surgery done to get the metal out and reshape my femur one leg at a time (surgical dislocation and osteoplasty). after surgery they put me on percocet and oxycontin, which dulled the pain, but never eliminated it. the morphine they gave me in the hospital did not have any negative side effects on me, but for some reason i have a very high natural tolerance to vicodin, percocet, and oxycontin and they did not prescribe me any morphine. I can no longer sleep more than a few hours if that, and stretching my leg out only helps for a couple of minutes and then the pain returns. is there anything stronger that i could take? preferably something that does not have tylenol in it because that doesnt do much for me either. I know that some of the soreness and pain will go away as my leg heals more, but the arthritis is irreversible and is only going to get worse according to my surgeon. I want to be completely pain free for the few years that i am supposed to have left with my natural leg joints so i can be a kid a little while longer.
Hi Smash, sorry so much for your pain troubles, especially at such a young age. Since you seem to be having constant pain and it is effecting your sleep, you should consider a long-acting medication. Since morphine worked in the hospital, those would be good to look at. My long-acting drug is Kadian. It is a brand name formulation of morphine and I take it every 12 hours. It stays in your system all day and has a very slow release mechanism. I have found it to be quite effect at lowering the baseline of my pain on a daily basis. The only problem is that some insurances won't cover it now because it has gotten very expensive. There is a generic MS contin long-acting. IT probably lasts about 6 hours, so you would take it 3-4 times per day, whatever your doctor thinks is appropriate. Considering that you have a condition that is not likely to resolve itself, you really should consider long-term pain management. IMO, the biggest component of this is a long-acting drug, such as I have described above.

Are you seeing a pain management doctor, or just your PCP or surgeon? If you are not, you should ask for a referral to a pain management clinic. They will be well versed in these issues and hopefully can help you tremendously. Make sure you are honest with them about how the pain is interfering with your life (especially sleep). Some docs may be reluctant due to your young age, but you didn't ask for this at 18. Try to find a doctor that is compassionate for your situation and is willing to try multiple approaches.

In addition, you might want to try one of the non-narcotic medications that help with pain such as Lyrica or Neurontin. Neurontin is generic and cheap and it has helped my nerve pain. Also, the addition of something like Cymbalta helps a lot of people. IT doesn't manage the pain on it's own, but can be an important component of your pain management regimen.

Let us more about your situation and what you have tried thus far. and most importantly, GOOD LUCK. -B

 
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Old 01-23-2011, 03:19 PM   #3
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Re: Ouch

I am only seeing my PCP and my surgeon at the moment, but I have an appointment with my PCP tomorrow afternoon. I will talk to him and see what exactly he is willing to do for me and I will add another post. They had me on celebrex for about a month and I didnt notice much of a difference, is that the same as Lyrica and the other non-narcotics you were suggesting?

 
Old 01-23-2011, 04:22 PM   #4
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Re: Ouch

Smash,

I am sorry you have such severe pain at such a young age, but you need to accept some of the facts about pain management.

It's intended to MANAGE the pain, at a level where you have some sort of life. It is not intended to make you pain free and allow you to do everything you used to do or want to do without pain. No responsible physician is going to agree to prescribe enough narcotics to make you pain free, nor is a responsible physician likely to let you depend entirely on narcotics for pain management. You are going to have to consider and try alternative pain meds like anti-convulsants, anti-depressants, muscle relaxers, and anti-inflammatories, and some other adjunct medications that can help the narcotics work better to reduce pain. You are also going to need to work with your Dr. to find alternate therapies for times when the meds just aren't enough, things like injections, physicial therapy, massage, ice, heat, meditation, accupuncture, and a host of others. Most primary care providers and pain management doctors consider treatment to be successful if your pain is reduced by 50% or to a level of 5. A 5 is about where you can do basic things for yourself (shower, fix a sandwich, do laundry, go to the grocery), work if your physical condition allows, and engage in some social activities as your physical condition allows.

I don't mean to sound too negative, but if you go in wanting to have your pain completely gone 100% of the time it's going to make a negative impression on the doctor and make him/her suspect you are a drug seeker especially given your age. Celebrex is a very good medication for those with arthritis, but it does tend to take some time to feel the full effects. If after a few weeks it doesn't seem to help there are a number of other anti-inflammatory medications that you can try.

Good luck,

Tigg.

 
Old 01-23-2011, 05:04 PM   #5
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Re: Ouch

i understand the likelihood of me being completely pain free are slim to none, but i dont feel that it is unreasonable to want to be at a 3 or lower on the pain scale given my age. i am not seeking narcotics, i am merely seeking something that will work, whatever that may be. i have accepted i will not be some sort of great athlete or anything of the sort, but i feel like i should be entitled to a little bit more youth than has been given to me. I am not sure whether or not the celebrex worked or not, they only gave me about 3 weeks worth.

 
Old 01-23-2011, 08:49 PM   #6
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Re: Ouch

Quote:
Originally Posted by Smash7 View Post
i understand the likelihood of me being completely pain free are slim to none, but i dont feel that it is unreasonable to want to be at a 3 or lower on the pain scale given my age. i am not seeking narcotics, i am merely seeking something that will work, whatever that may be. i have accepted i will not be some sort of great athlete or anything of the sort, but i feel like i should be entitled to a little bit more youth than has been given to me. I am not sure whether or not the celebrex worked or not, they only gave me about 3 weeks worth.
Okay I can empathize with you, I've had 13 knee surgeries on both knees in the last 11 yrs, the last one being on my left knee, it was rebuilt with all bones severed, my tibia raised one inch, cadaver bone inserted beneath and all screwed back together with 2 metal pins and 4 screws. Believe me pain is a major part of my life especially when it's cold. I was born with a degenerative cartiledge disease, my leg pain became a hindrance to my daily life starting at 16. I finally gave in and started on the heavy narcotics 11 yrs ago. You DO NOT want to start on narcotics at 18 and be on them for life, trust me on this. The pain will get better as you heal and you are young so with time and PT and excercise it should get much better. If I can keep mine at a 5 with MSContin(morpine), Percocet, Lidederm patches, and Voltaren Gel, which is for the Osteoarthritis, yes I have osteo in my hips and knee joints, I consider that a good day.

You're already on one of the strongest meds out there, Oxycontin, if that's not controlling your pain, then anywhere you go from there is a lateral move. The reason you have such a tolerance is because you've been subjected to such high amounts of pain meds at such an early age and for so long. The tolerance will just keep getting stronger, it doesn't reverse itself. And it most likely won't matter what narcotic you try, it will be the same with them all. As for the arthritis, narcotics aren't going to control the arthritis pain, they aren't designed for that. You can try the Voltaren Gel, which is a prescription, you can ask you Ortho. for that, and then an anti-inflammatory.

Let us know how it turns out, what you decide to do. Just a question, I presume you live with your parents since your only 18, what do they think about this?

kat

 
Old 01-28-2011, 05:55 AM   #7
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Re: Ouch

I went and saw my PCP five days ago. He upped my dosage of Oxycontin to 30mg per day and also started me on the muscle relaxer called cyclobenzaprine. I dont feel any different. it still feels like someone is pulling my hip bone and knee cap out while at the same time someone is giving me a "dead leg." I have tried doing every stretch possible, and it all fails to give me relief. any suggestions?

 
Old 01-28-2011, 05:59 AM   #8
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Re: Ouch

My dad has degenerative disk disease and has been on narcotics since before i was born. he understands wanting to be pain-free and trust me to make the right judgment on when i am and am not getting pain relief. my mom just wants her youngest son to not look like an old man in pain.

 
Old 01-28-2011, 06:42 AM   #9
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Re: Ouch

I recently started taking Embeda 2x a day.. PLUS they have a copay card that makes it FREE..This is extended release Morphine. I like it better than MS Contin as it does offer better pain control.

 
Old 01-28-2011, 09:39 AM   #10
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Re: Ouch

Is Embeda a patch? My doctor was telling me that the next step he would take would be to give me a patch that would release painkillers into my body over a certain amount of time, but i cant remember what the name of it was. what is your pain level when you are taking your Embeda?

 
Old 01-28-2011, 04:21 PM   #11
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Re: Ouch

I believe Embeda is still an ingestable pill. If you doc is talking patch, then he most likely means Fentanyl. The only problems with patches are that they are a pain in the rear to keep on, and you have to deal with skin irritation, etc. The companies that make the patches claim that they stay on for the recommended dosage time, but most people I know that use or have used patches, including me, have to use some sort of patch cover so that it stays on throughout your regularly daily life, i.e. bathing, sweating, etc.

 
Old 01-28-2011, 05:22 PM   #12
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Re: Ouch

at this point i dont care what they give me as long as it works even a little bit

 
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