Gastro Problems

[Bardda1]

Hi, I just found this site and from reading everything I'm sure you all will have some good advice.
My husband has had several back surgeries over the past three years including a fusion and a spinal nerve stimulator implant. He is still in tremendous pain and has been diagnosed with "failed back surgery symdrome". He has been taking Vicodin for a long time and about 18 months ago was referred to a PM who tried him on Methadone that didn't help much and then switched him to Oxycontin. For the first few months the Oxycontin helped a alot, now not so much.
Our problem now is that since the spinal nerve stim was implanted last March, he has not been able to keep much food down and has lost over 40 lbs on an already slender body. He is 6'1 and has gone from 185 to 144. Not only does he not have any desire to eat, but when he tries he usually throws it up. Our GP has been looking for other reasons for the weight loss and his upper GI showed just inflamation which he said was caused by the pain meds. He takes Compazine and Protonix for nausea and stomach pain, but it really doesn't help much. He feels weak and sick much of the time. When I asked our GP's nurse what do we do now, she said "talk to the PM, he's the one giving him all this stuff". The PM's only thought is to increase the amount of pain meds which just makes his stomach problems worse.
Any advice here? He is literally wasting away. Is there a patch or something that might be helpful and not irriitate the stomach?

[jbot]

Hi Bar and welcome. I have almost the same problem but don`t throw up. I just stay sick to my stomach all the time.When the dr ran the tube to look he said the same thing they told your hubby.He put me on librax (sp) and OTC medicine for gas. There is a pain patch but it caused me to be sicker and didn`t help with the pain.Alot of people on this board use it with great results. It does by pass the tummy so it looks like it would be better. Codeine is very bad on my stomach so I take OTC Prilosec and that does help but has to be taken every day for months to keep working. It sounds like the GP don`t want to deal with your hubby because he thinks the PM dr did it. But no matter who gave the meds the bottom line is your hubby needs help. My friend has been having chemo and the dr gave her something that keeps her from being sick.I sure hope you find help and maybe some one else on the board will have better information then I have. Maybe look for another GP. Good luck dear.............

[vamp36]

I also had this problem. I now have anti nausea meds that my doctor prescribes for me. I take them when I start to feel nausea and then it goes away. Stops me from vomiting. they are Reglan, phenergan and Zofran. The Zofran is VERY expensive so I only use it when I am really bad. I also am on Nexium for my stomach. The protonix didn't do much to help me. The Reglan I take an hour before breakfast and supper and I can eat then without throwing everything up. Good luck to you and your husband. Tina

[Streetcar]

Hi Bardda,

Welcome to the PM board, I don't know anything about the spinal nerve stim, but from the symptoms and the the time line you've placed events on it sounds to me like its the stim implant that is causing the nausea. Is that something that is easily reversible? If it was, I'd see about doing that and resuming the PM where it was pre-implant until he got stable and then begin exploring other means of treating his pain.

I'd definately be looking for another PCP. It may very well be that your PM dr got your hubby into this mess; but, your PCP is supposed to be your ADVOCATE in all things pertaining to your health, not a finger pointer or "I told you so" person. It sounds to me like your PCP is very anti-opiate to come out and say the the inflammation is caused by the pain meds based sloely on an upper GI. There could be any number of causes for that inflammation and the PCP should be doing more test to pin-point the cause rather than basically saying "you got yourself into this mess, now get yourself out". How rude and non-compassionate for any dr, let alone your PCP. PCP should at least, the very least advise you to see a different PM dr. Here I am assuming that the PM dr did the implant, you didn't say.

I don't know if the state that you live in is one that has legalized marijuana for medical purposes but if it is, at this point I would probablly look into that as part of the overall treatment plan. From what I understand, it has proven be somewhat affective where there has been an on-going weight/nuesea problem. I'm not a pot head or anything close to it but at this point I'd do just about anything if I were in your hubbies shoes.

Sorry to rant, but I can feel the despair that your going thru and it makes me mad that chronic pain sufferers (or anybody else for that matter) get this kind of treatment from a medical proffessional.

I'll be praying for your husband that he gets the proper treatment.

[Bardda1]

Thanks very much for the replies. My husband saw the GP again yesterday. He's lost 15 lbs in the past month since he saw him last. He got a referral to a gastroenterologist and he will see him on Tuesday. Maybe he'll have an answer. He also prescribed Reglan (thank you to the person who told me about that. The doc thinks that might be a good idea). I am waiting for a call back from the neurosurgeon who put in the nerve stimulator. I want to ask him if he's every seen this as a side effect of the implant. Everyone we've talked to so far says no, but I still want to ask.
I have another question...my husband is so fearful of being dependent on pain meds, although he knows he already is. His PM doc wants him to take 20 mg of Oxycontin 3 times a day, but he usually only takes it once a day, maybe twice if the pain is especially bad. And sometimes he'll take 10 mg instead of 20, especially if his stomach is having problems. He worries that if he takes 60 mg a day, it won't be long before he'll require twice that amount to relieve his pain. I'm thinking that maybe his body is withdrawing on a daily basis because he has 8 or 16 hours of pain meds in his body and 8 hours of no meds? Everyone keeps saying the stomach problems are caused by the pain meds, but maybe it's caused by not enough pain meds??
Thanks very much for replies.