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    Old 09-05-2005, 09:46 PM   #1
    myloathe
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    Question Question about back pain and pain meds?

    Ok. Maybe since many of you have pretty much the same problem, you can answer this question.

    My husband hurt his back at work back in Jan of 2003. Since then, he has seen doctors, physical therapists, massotherapists, chiropractors, etc. and nothing has helped. He has broad based herniation at L5-S1, with disc material that is in direct contact with the S1 budding nerve root on the right. He is due to get a facet block this month that hopefully will help alleviate his problems. He also has never taken ANY time off from work due to this injury, and he has quite a physical job (he's an electrician).

    The problem I have is with the amount of pain medication he takes and how he takes it. He has been prescribed Vicodin HP, Ultrams, Talwins, etc. His doctor currently has him on Percocets, (120 pills for 30 days) and he will take ALL of those pills by day 10! He says that he is in so much pain and that all of that medication he takes help it go away for a while. I'm complaining that the script was wrote for 4/day, not 12/day, and that if he has to take that many, they're not working anyway. He insists that the doc won't give him anything stronger (which I'm grateful for).

    I told him that I think he has an addiction/problem to these pills and that he needs help. He says he doesn't and that I just don't understand.

    PLEASE, someone shed some light on this and tell me what you think?!

     
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    Old 09-06-2005, 01:41 AM   #2
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    Re: Question about back pain and pain meds?

    1st let me say that IF your husband has a broad based herniation at L5-S1, with disc material impinging his S1 nerve root = HE IS IN HORRIFIC PAIN.

    I honestly do not understand how anyone could possible think Facet Injections can alleviate this pain....they "may help" facet atrophy or inflamation - but will do NOTHING to help problem listed above.

    As for your concerns that he is an addict - well, that is not for me to say - however, 120 percs in 10 days is TOO MANY - Waaaaaaaaaaaay TOOOOO MANY. How does he manage after 10 days - and all of his pain meds are gone? {does he then rely on the other meds?} it is important that he communicate his pain to his PRESCRIBING Dr and FOLLOW dosing instructions.

    IF his "pain" requires that much medicating ~ then he needs more help and or possibly surgery - you CAN get to a certain point where NO amount of meds will relieve OR control the pain.... But given the strong narcotics you mentioned AND MOST OF ALL THE AMOUNT he is taking - you SHOULD BE concerned - of the amount of meds
    - but more importantly - concerned that he see's a doctor who will recognize - AND TREAT his problem - NOT give him this outrageous amount of narcotics and SELL HIM injections.

    I empathize with the situation YOUR in and admire your concern. I think you are 100% right TO BE concerned

    Do you attend Dr's vist's w/your husband? perhaps you AND YOUR HUBBY can discuss your concerns w/the Dr and explain HOW MUCH medication "he needs" to manage "his pain"

    ~ Frankily I can't imagine a Dr prescribing ALL of these meds to a pre-op pt...especially the Talwins WITH the percs & Vicodin!

    I wish you and your husband all of the best
    Bionic Witch

    Last edited by Bionicwan; 09-06-2005 at 01:45 AM.

     
    Old 09-06-2005, 03:59 AM   #3
    mkf
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    Re: Question about back pain and pain meds?

    Frankly, I would be very concerned about the possibility that he would be injured on the job again from all the pain meds he's taking on the job now! He's certainly risking his safety and that of others, being in the amount of pain he's in, medicating himself and continuing to work.

     
    Old 09-06-2005, 06:15 AM   #4
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    Re: Question about back pain and pain meds?

    There are really two seperate possibilities going on here,one is that he needs to have his pain re evaluated and his meds adjusted as they are not doing the job.The other is that he has become addicted to his meds.I am actually leaning toward the addiction one as even with the worst pain ever, if someone is in that much pain,he would be at least attempting to spread them out at least a little.Knowing that he is going to have to actually deal with the full blown pain for the rest of the month, i really do think that that in itself would be enough to keep him 'in line"If he is actually taking 12 a day he is not only using up all of his meds way too early but he is really doing his liver no big favors here either.even only at 325mgs of tylenol per pill, his liver is most likely getting way too much per day.this can and will cause damage to the liver cells.I have dealt with both sides of this issue.i am an addict who had been clean for over 15 years before i was forced to go back onto the very narcotics that put me through hell many years ago.it was not an easy decision believe me.But i am seeing a wonderful pain doc at a pain clinic and believe me the rules and regs and the contract that I had to sign just to actually obtain any treatment,have really kept things stable for me.my pain is being generated by some very significant damage done to the inside of my spinal cord during a surgery.i have many damaged spinal nerves and spinal tracts that have in turn,generated two of the most godawful pain syndromes known to man.RSD and central pain syndrome.Despite my hystory,I have to be on oxycontin or I would not even be able to move my legs from the bed to the floor when i wake up each day.i have been in total and complete compliance with all of the rules for over two yaers now.so it can be done.your husband is exhibiting signs of a blossoming addition and you are very right to be concerned about this.Is there any chance that he would be able to have some sort of surgery to try and fix his problem?i think at his next doc visit you need to go along but before you go, have a big talk with him about the possible addiction.tell him he really needs to talk with his doc about this and the possibility that his pain may well be way out of control.if he refuses to bring you or says that he wont talk to his doc about this,tell him that you may not have any other choice here but to let his doc know just what is going on.although I only recomend this as a very last resort.He really needs to know just how serious you feel this situation is.and he could also end up losing his job if something should happen because he was 'not all there".He would actually be more out of it while he is going without the meds and dealing with the WDs than he would if he was actually taking them.this just is not a good situation from any angle.
    there are many different types of meds that can be used to try and control pain besides the narcotics.I use anti depressants anti siezure meds plus many therepys that have been offered through my pain clinic.Good pain control should never be just narcotics alone.And a patient should never expect to be totally relieved of pain.Most cases that is really immpossible and very unrealistic.at best, good pain control will take enough of the edge of to be able to help you get through your daily living requirements or actually be able to continue to work.The type of job your husband does and taking high doses of narcotics could present some very nasty scenerios for him and the people he is actually doing the work for.one wrong wire in the wrong place could spell disaster for him and his customers.he really really needs to sit down and think about all of the possibilities that could happen by what he continues to do with his meds.you will just have to be very persistant at trying to get him to see just where he is at and where this could lead.it will be much easier to try and get him back on track now vs later.Trust me on that.i wish you luck with this and hope that he starts to see just what he may be doing to himself.This is not a road that he wants to go down.been there done that and it really sucked.please keep us posted,and hang in there.Hopefully there will be some sort of surgical intervention availiable to fix him up and the pain meds can go bye bye.marcia
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    3-22-01,herniated C-6-7
    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.

     
    Old 09-06-2005, 10:26 PM   #5
    injured betty
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    Re: Question about back pain and pain meds?

    [COLOR=Blue]Feel bad: I am not doing this to hurt your feelings, just doing it so it is easier to read your post.

    You have some great things to say and make some great points, but it is hard to read it all at once, so I broke it down so that others can read it.[/COLOR]

    <<<There are really two seperate possibilities going on here,one is that he needs to have his pain re evaluated and his meds adjusted as they are not doing the job.

    The other is that he has become addicted to his meds.I am actually leaning toward the addiction one as even with the worst pain ever, if someone is in that much pain,he would be at least attempting to spread them out at least a little.

    Knowing that he is going to have to actually deal with the full blown pain for the rest of the month, i really do think that that in itself would be enough to keep him 'in line"If he is actually taking 12 a day he is not only using up all of his meds way too early but he is really doing his liver no big favors here either.even only at 325mgs of tylenol per pill, his liver is most likely getting way too much per day.

    this can and will cause damage to the liver cells.I have dealt with both sides of this issue.i am an addict who had been clean for over 15 years before i was forced to go back onto the very narcotics that put me through hell many years ago.it was not an easy decision believe me.But i am seeing a wonderful pain doc at a pain clinic and believe me the rules and regs and the contract that I had to sign just to actually obtain any treatment,have really kept things stable for me.


    my pain is being generated by some very significant damage done to the inside of my spinal cord during a surgery.i have many damaged spinal nerves and spinal tracts that have in turn,generated two of the most godawful pain syndromes known to man.RSD and central pain syndrome.


    Despite my hystory,I have to be on oxycontin or I would not even be able to move my legs from the bed to the floor when i wake up each day.i have been in total and complete compliance with all of the rules for over two yaers now.so it can be done.your husband is exhibiting signs of a blossoming addition and you are very right to be concerned about this.


    Is there any chance that he would be able to have some sort of surgery to try and fix his problem?i think at his next doc visit you need to go along but before you go, have a big talk with him about the possible addiction.tell him he really needs to talk with his doc about this and the possibility that his pain may well be way out of control.if he refuses to bring you or says that he wont talk to his doc about this,tell him that you may not have any other choice here but to let his doc know just what is going on.

    although I only recomend this as a very last resort.He really needs to know just how serious you feel this situation is.and he could also end up losing his job if something should happen because he was 'not all there".He would actually be more out of it while he is going without the meds and dealing with the WDs than he would if he was actually taking them.this just is not a good situation from any angle.


    there are many different types of meds that can be used to try and control pain besides the narcotics.I use anti depressants anti siezure meds plus many therepys that have been offered through my pain clinic.Good pain control should never be just narcotics alone.And a patient should never expect to be totally relieved of pain.

    Most cases that is really immpossible and very unrealistic.at best, good pain control will take enough of the edge of to be able to help you get through your daily living requirements or actually be able to continue to work.The type of job your husband does and taking high doses of narcotics could present some very nasty scenerios for him and the people he is actually doing the work for.one wrong wire in the wrong place could spell disaster for him and his customers.

    he really really needs to sit down and think about all of the possibilities that could happen by what he continues to do with his meds.you will just have to be very persistant at trying to get him to see just where he is at and where this could lead.it will be much easier to try and get him back on track now vs later.Trust me on that.

    i wish you luck with this and hope that he starts to see just what he may be doing to himself.This is not a road that he wants to go down.been there done that and it really sucked.please keep us posted,and hang in there.Hopefully there will be some sort of surgical intervention availiable to fix him up and the pain meds can go bye bye.

    marcia>>>

     
    Old 09-07-2005, 07:20 AM   #6
    myloathe
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    Re: Question about back pain and pain meds?

    Thank you all for all of your advice and words of encouragement. I do go to some of his doctors visits, just so I can hear exactly what's going on. He has been to see 2 neurosurgeons, one in our area, the other at the Cleveland Clinic spine institute. Both docs told him he is NOT a candidate for surgery. Apparently, surgery is suppose to be meant to help people where their pain travels more down their legs. His pain is fixed right across his lower back. They both said that surgery would probably cause more pain (scarring, nicked nerve, etc). I feel really bad for him. While I know that taking all of those meds is really bad, I couldn't imagine someone telling me that I was pretty much going to be in that pain for the rest of my life :-(

    Hopefully, this visit back to the spine institute for this facet block and possibly a discogram will help. I'm praying.

    Has anyone had any experience with these particular procedures and/or pain in that L5-S1 area? How did you deal with it??

     
    Old 09-07-2005, 07:34 AM   #7
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    Smile Re: Question about back pain and pain meds?

    The doctors told you right. Surgery is usually more successful for the relief of leg symptoms.

    A discogram is not a remedy or treatment it is only a method used to assess where the problem lies. It is usually used when surgery is anticipated.

    Herniations can heal but it takes time so there is a very good chance that eventually he will be on the mend. You are very right to be concerned about his overmedication. Proper pain management needs to be addressed.
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    Old 09-08-2005, 05:46 AM   #8
    feelbad
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    Re: Question about back pain and pain meds?

    if he will have this pain for long term he definitely needs to see a pain management doc who can offer him pain control options that he will need.but he will also have to comply with everything written in a contract that he will have to sign before any treatment begns.he will be required to comply with pill counts and urine tests and will only be rxed the exact amount of meds needed for 28 day stretches.i really think he needs to get off of the short acting meds and onto something that he would only have to take a few times a day at most.He really needs this type of structured care or he will continue to escalate his own self medicating.If he does not get on track right now, I truely see a full blown addiction some time in his future here, really.It might be even possible that he would be able to actually go off of any sort of narcotics if other meds and treatments can do the job instead.But he really needs to see just where he could be headed if certain precautions are not in place.i wish you both luck.have you tried doling out his meds for him at all?This sometimes helps,but not always.marcia
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    Old 09-08-2005, 08:23 AM   #9
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    Re: Question about back pain and pain meds?

    [QUOTE=pooby]The doctors told you right. Surgery is usually more successful for the relief of leg symptoms.

    A discogram is not a remedy or treatment it is only a method used to assess where the problem lies. It is usually used when surgery is anticipated.

    Herniations can heal but it takes time so there is a very good chance that eventually he will be on the mend. You are very right to be concerned about his overmedication. Proper pain management needs to be addressed.[/QUOTE]

    Thanks Pooby,
    Is there really such a thing as a herniation to heal? No doc ever told him that. I think the doc did mention something about that discogram just possibly finding the exact source of the pain. Who knows. His consult is today, and he should be scheduling for the block and pain mgmt.

     
    Old 09-08-2005, 08:37 AM   #10
    myloathe
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    Re: Question about back pain and pain meds?

    [QUOTE=feelbad]if he will have this pain for long term he definitely needs to see a pain management doc who can offer him pain control options that he will need.but he will also have to comply with everything written in a contract that he will have to sign before any treatment begns.he will be required to comply with pill counts and urine tests and will only be rxed the exact amount of meds needed for 28 day stretches.i really think he needs to get off of the short acting meds and onto something that he would only have to take a few times a day at most.He really needs this type of structured care or he will continue to escalate his own self medicating.If he does not get on track right now, I truely see a full blown addiction some time in his future here, really.It might be even possible that he would be able to actually go off of any sort of narcotics if other meds and treatments can do the job instead.But he really needs to see just where he could be headed if certain precautions are not in place.i wish you both luck.have you tried doling out his meds for him at all?This sometimes helps,but not always.marcia[/QUOTE]

    Thanks Marcia,
    This doc does want him to get in the pain mgmt program so this sounds like a good thing. Do they really test to make sure you're taking what you're suppose to? That would be nice. If I was to mention me giving him his meds, he would have a fit. His answer to everything is that he'll just stop taking pills all together, and that's not even what I'm asking him to do.

     
    Old 09-09-2005, 07:13 AM   #11
    feelbad
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    Re: Question about back pain and pain meds?

    Yes indeedy, he will have to sign a contract with very specific guidelines.if he objects to it they will not treat him.If he does object to this it would really indicate that he does indeed have a problem then you need to ask him just what exactly he objects to.The answer could be really revealing as to whether or not he does indeed have an addiction problem.I wouldn't mention the contract thing to him.let him find this out on his own and see what he does.and also tell him at that point that if you don't think you are having any sort of problem with managing your meds then this should not be any sort of problem for you to be able to maintain.if you don't think you can do this honey, maybe you really need to think about it all and ask yourself if you DO possibly have a problem.This could be a little wake up call for him.They will however work with him and try and titrate his doses for the first few weeks until they hit a level that seems to work for him.But once he gets stabilized on a particular dose he will not be allowed to do any sort of changes to it without the docs permission.there are also NEVER ever any sort of early refills for any reason.so if he decides to use up all his meds in two weeks, well, he is outta luck til the next scheduled fill.also he could possibly be urine tested when he sees the doc for that next appt and if there is not the proper level of what should be there they will dismiss him as well.Trust me, if his pain is really that bad he will follow these rules.I know I do as going without the strong narcotics that i have to take,i would not be able to honestly, even get out of my bed to even go to the bathroom as the pain just paralyzes me that badly.I follow all of my rules that are in my contract to the letter as without my pain doc, i just would see no reason to even be here anymore you know?I hope he decides to do this.how it all goes will tell you alot about just where he is actually at with any sort of addiction.please keep me posted,marcia
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