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Pain Management board


Hi Agy, I doubt there is anyone on this forum that just uses opiates and nothing else. The reason why they keep trying other modalities and methods is so that you only method of dealing with pain isn't opiates. What happens in 4 months when you start developing tolerance, Just increase your dose because it gaurentees more relief. What hapenes whe you hit your own ceiling and can't tolerate the side effects of an increase but no longer get relief if you have nothing else to supplement or fall back on.

Unless your terminal, there aren't many docs that can use opiates alone and expect to keep their licence. They all want to find something that adds to the opiates, even if it's only an additional 5% relief. Whether it's self hypnosis,Bio feedback, Guided imagry, Yoga breathing techniques, nerve blocks, trigger point injections, myofacial release, nerve ablation, Botox, Robaxin or lidocaine infusions or any adjunct method of pain relief. Something else will add to the relief opiates give. Not wanting to try anything else or feeling it's not worth trying can be construed by a doc as someone that must not be in that much pain if they aren't willing to try anything and everything to relive that pain.

Even when you have tried everything there is to try, and trust me you haven't. You still have to learn to deal with some degree of pain. Unless your terminal they aren't going to increase your dose everytime you become the slightest bit tolerant and can no longer report low pain scores.

When they implant a morphine pump, a trial or pump is considered succesful if it relieves 50% of your pain. With nothing else to supplement that, 50% is a tough number to live another 40 years with.

I don't think I have met anyone in the last 15 years that takes the exact same dose or combination of meds and uses the exact same adjunct modalities. What works for me doesn't gaurentee relief for anyone else. My dose may kill you and not touch Directors pain or vice versa.I couldn't tolerate more than 120 mgs of meth per day, so what good does it do to know someone out there can take 3 times that? What I take or anyone else takes really has no bearing on what you should try or take.

Alot has to do with expectations. If you expect complete pain relief because you know there are people taking a higher dose or there is a stronger med out there you haven't taken, you will run into the same wall where the meds become more disabling than whatever reason your taking them for. Your taking 6-8 times what Morgy is taking and 1/3 of what Director is taking. What insight does that really give you? Those numbers don't even mean they are getting better relief or less relief. It's what tjey can tolerate, what their docs are willing to prescribe and their all using the adjunct meds that your tired of messing with. There is no majic dose or med that works for everyone.

I've known Director long enough to know it took years to get to the point he's at and he's been around long enough to watch the last 5-7 years of my struggle with chronic pain and that's only half the time I have spent trying to manage it and a fraction of the time Director has been involved in PM. He knows I've been through 3 month long PM boot camps and tried every method I mentioned and the ones you mentioned. The purpose behind trying everything available is to see what works for you, if ity helps, stick withit, if it doesn't you move on to the next thing.

Your PA isn't doing anything that anyone elses doc hasn't tried or done. These are the basics and you should thank god you didn't have to try 30 different methods that didn't work before you were given anything at all for pain. You didn't even mention interventional procedures, surgery or psychological methods to cope with pain that opiates simply can't manage.

There is no secret handshake, short cut or gaurentee that if you take X it will relieve 90% of your pain and still leave you functional, able to pee without a catheter, Function without Viagra, stay awake without amphetamines or walk without bouncing into walls.. It's all trial and error and the meds themself can become more disabling and impairing that the the reason your taking them. That's why docs want to try other methods aside from the gaurenteed relief your assuming can be found if your doc would just give you a higher dose or stronger meds.

Good luck, Dave