Discussions that mention valium

Fibromyalgia board


CONTINUED FROM PREVIOUS POST: :)

Spriggy:
I just want to say that you, nor will any of us with chronic pain, ever be 100% pain free. When someone is in Pain Management for treatment, the goal of the doc is to at least reach 50% relief. If you get more than 50% relief, you are doing great. Stinks, I know.
You asked about a "patch" for pain. Well, if you are meaning a patch that lasts longer to where you aren't taking a pill every few hours, there is a Transdermal (meaning it passes through the skin) patch that is called Fentynal. It is one of the most potent pain killers/narcotics out there. And usually it isn't given until all other modalities of pain treatment have been exhausted. This med will usually only be prescribed by a Pain Management doctor. It is highly regulated by the DEA. As are a lot of narcotics these days. The DEA is really cracking down on what they call Schedule II narcotics.

This patch is called Duragesic/Fentynal. It is so potent it is not give in mgs, it is given in mcg's, or micro milligrams. Something like 10 times the medication is distributed through these patches than an oral med. It comes in 25, 50, 75, 100,125,150,175,200,225,250,275,and 300 as far as dosing amounts. It was originally developed for terminal cancer patients. It is meant for people who have chronic pain. Not acute pain. It is a long acting med. It is prescribed to be changed every 72 hours. Some folks change it every 48 hours, because it just doens't last the whole 72 hours. I imagine at a higher does, it would last 72 hours, but usually docs would rather you change it more often than use a higher dose. The only problem with these long acting meds, Methadone and Oxycontin are other LA meds, is that you usually experience breakthrough pain. That is pain that "breaks through" and spikes for more than a couple hours between doses of your LA med. So you end up using a breakthrough med, like Lortab, to use when you feel a spike in pain that is causing you such discomfort you lose your ability to function "normally". Breakthrough meds are meant to help keep your pain at a steady level. People have a tendency to abuse b/t meds, unfortunately. If your LA med is at the proper dose, then you should only be using your b/t med on an as needed basis. So you see why these LA meds would not normally be given out to a FM patient until they have tried all other types of pain killer regimines. I use the Duragesic patch, 75mcg with Oxycodone 30mg 2 X daily for b/t pain. But I have severe lower back and nerve pain.

There is a Lidoderm Patch that has Lidocaine in it. It is a topical transdermal "local" pain med. It only works on the pain it is placed over. It is best for trigger points, sprains, or pulled muscles, bursitis, or any other kind of "localized" pain. You just place the patch over the area that hurts and it lasts for 12 hours. It works by using Lidocaine to numb the nerve endings and block the pain transmitters from reaching the nerves. It is not meant for FM pain, cuz FM pain is widespread.

So, spriggy, I would call your Neurologist and see if he/she will refer you to a good Rheumy. See if he/she knows a Rheumy that specializes in treating FM. Or see if the doc taking over for your GP will refer you. I wouldn't wait a month for your GP to return. As for the anti-inflammatory, it really isn't going to help you unless you have an inflammatory condition, like arthritis or bursitis. That's probably why you don't feel any relief. I would try using Aleve, if you feel you are inflammed anywhere. As for the joint pain and stiffness, that is most likely a need for a muscle relaxant. Most of us FMights use muscle relaxants, like Flexeril, Zanaflex, Baclofen, Valium, and Soma. These all have sedative effects to them. No gettin' around it. Baclofen is probably the most sedative. Soma is an anti-spasm and muscle relaxant and is pretty effective, but it will make you sleepy until you get used to it, some folks never do. It is usually prescribed 350mg 3 X daily, you could use it 2 X daily. Flexeril seems to help folks, especially when they take it right at bedtime. If you feel stiff, find some of that cream that you rub on for that kind of pain. Get it OTC, there's a bunch of it out there. Give that a try. Also, the Lidoderm/Lidocaine patches would work for that, since it is localized. Just try and get your joints moving when you get up in the morning. The morning is usually the worst time for FM pain.

Give the Lortab(Hydrocodone) time. Cut the tabs in half and just take small doses more often. Just don't exceed your daily mg dose.

Okay? I proabably confuse the bajeebers out of you. LOL :) FM is very complex. It's a long journey to find the right treatment for you. Be patient, you'll get there, and come here for support, questions, or anything you may need regarding FM and what goes with it. Read some of the threads, and posts here when you can, to learn as much as possible about your condition. It's become part of your family now, the best way to deal with it is to accept it into your family, give it boundries, and be sure to let it know that you are in control, it is NOT.

Hope to hear from you soon,
tk