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Corrie
Board Addict
Reged: 07/16/02
Posts: 362
Loc: Southeast US
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Firstly, I want to state that I've seen several doctors re: my condition, a herniation at L4/L5. I've tried everything including meds to help with the pain, but now I'm at a crossroads where I cannot deal with the pain anymore. I know that at this point, a re-assessment needs to occur, with perhaps a longer-acting medication prescribed, but my husband and I just switched insurances to an HMO, and they frown upon the use of opoid therapy. That's fine, WHATEVER will help me I will gladly do, but NOTHING seems to help (sorry for the caps, but I'm on my last leg here).
I've been through PT and am exercising daily. I have been given injections that last for several days, then the pain worsens. I cannot use steroids (allergic) and I can't use anti-inflammatories because of an ulcer that is now flaring because I've been forced into using Ibuprofen for pain, because the amount of pain meds prescribed is not touching the pain. And these Able brand 10/325's are about the WORST pain medication I've ever taken. Unfortunately, I'm also taking more benzo's to ease the pain and this is something I do not want to do (I don't go outside of my prescription dosage).
So my options are to tough it out for awhile (I need at least 1-2 months without hydro for it to effectively work at lowering my tolerance, and this is only to lower it for perhaps 1 month). My primacy care physician referred me to an Osteopath, who will prescribe Vioxx, Robaxin and Aciphex for the stomach upset. I've been going through this for close to 3 years now, and it just seems to be getting worse. I've tried to exercise, eat right, no alcohol, no smoking and that doesn't mean if I did do these things I would be any worse off than I am, but I cannot afford to go outside of my insurance ($10 Co-pay). I've maxed out all of my credit cards just trying to find relief.
I'm going to take a trip to see Dr. Watson (I believe that's her name) who is a pain specialist in Texas.
To be honest, I'm more afraid of tolerance than anything at this point. When you're taking medication of this type for almost 3 years off and on, your tolerance rises quickly, and I'm finding it really hard just to get out of bed in the morning and get anything accomplished. My personality is also changing. I know I've written about this before, but it's getting to the point where I don't know where else to turn. I had a list of doctors who prescribed Subutex, but I don't find that to be a good pain reliever.
Mostly, I just want to hear of your own experiences. I truly appreciate OP's and what they do for us that our own doctor's and specialists won't, but would any of you recommend a regimen of buprenorphine for 2-4 weeks, then back to hydro for several months, or switching over to Ultram for 2 weeks, then back to hydro? I've heard that when you replace one pain reliever for another, that it can help with tolerance issues.
I'd love to hear how chronic pain patients deal with this. Thanks so much. . .
Corrie~
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NJ_Hoss
Enthusiast
Reged: 10/29/03
Posts: 263
Loc: USA
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Corrie,
If you have an inherent aversion to some of the side-effects associated with opioids, which represent the most effective pharmaceutical analgesics, you may want to take a step back an apply a wider view to your options.
Have you considered a TENS unit? These have been a Godsend to many. Other physical or therapy-based approaches can offer relief over the longer term or at least greatly improve an individual's ability to cope or slow degeneration. Medication can be a wonderful front-line tool, but it is not necessarily the only one; and a specialist is likely to be the best person to present and help you evaluate the various options.
Congratulations for seeing the specialist you need.
Godspeed.
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Corrie
Board Addict
Reged: 07/16/02
Posts: 362
Loc: Southeast US
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Thank you NJ Hoss for your reply. I think I've exhausted many of my other options re: pain management, and I was told about the TENS unit by my Osteopath, but my insurance company only covers a certain percentage.
I'm thinking about switching over to Tramadol. I had an unfavorable reaction at the beginning, but tried it again since the initial reaction wasn't really bad, just strange, and I can now take it with really no side effects that are negative and it does relieve my pain adequately. It's easier to obtain than Hydrocodone, and I will be only taking 4-6 per day.
Thanks again for the information.
Corrie
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kimbell1
Enthusiast
Reged: 08/20/03
Posts: 274
Loc: Route 666, Painville, Texas 6...
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I had the same problem with hydrocodone. My doctor who si a DO and not a pain spcialist in Texas (I beleive yoiu mentioned you were in Texas) started giving me Avinza with is time release morhine sulphate (not to be confused with oxy products). This is supposed to be a realitiviely new drug that I read came out last summer here.
It is DESIGNED for chronic pain paitients. I used caps because this is the first pain killer designed for long term use.
I started on 30 mgs a a 10 day sample but gradually over the last 3 months, I am up to 120 mgs. This medication can go as high as 1660 mgs. So I am on the low end of things. But it is a class 2 drug..
It does not give me a 'buzz' like hydrocodone used to when it did work. It just makes the pain fade away for about 18 hours. i have yet to find a 24 hours pill work 24 hours.
You might mention Avinza to you pain doctor. If the doctor wants to use injections, I had those too and they don't work on me or a few other I talked to. And a bad side efect 9I heard) is that they (the cortosone or whatever they use in the shots) will eat up your back.
I have tried accupunture, chiropractor, and a lot of other things and the Avinza works well for me. hope this helps
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Paranoia is just hightened awareness.
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wren
Enthusiast
Reged: 06/01/02
Posts: 284
Loc: up north & homesick for the di...
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Hi Kimbell what did you mean about the cortisone shots for your back? I had someone else mention that to me about it being hard on the spine.Any info is appreciated as I am scheduled for that and like to be well informed.Thanks for your time....Take Care all......Wren' 
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Corrie
Board Addict
Reged: 07/16/02
Posts: 362
Loc: Southeast US
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Thanks so much kimbell for mentioning Avinza. I doubt highly that my Osteo will Rx it, since he is Opiaphobic (I think I read that term on here recently) and will only prescribe Ultram...nothing else for pain, except Vioxx (which I have 100's of sample of). He prescribes Xanax 3x daily, which confuses me, because this, to me, can induce much worse side effects (this is in my medical history).
Anyway, I hope I can find something soon, as I don't have anything right now and am using Clonidine, Valium and Soma only with a small amount of buprenorphine that I had left from some time ago and I'm feeling really awful. Sick, shaky, but mostly in pain. I have to use the back of my knuckles to try to get the knots out of my back for half an hour or more before getting out of bed every morning, then, it's hard to walk. Sorry to whine, but I know everyone here knows what I'm going through. Thanks for the information, I'll definitely ask him about it.
Corrie
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Hi Corrie...
Have you considered methadone as a long-acting medication? In 7 years I never had to increase the dose and I have not had problems with tolerance as I did on MSContin (which is similar to Avinza, except it is an 8 hour formulary.) Morphine also causes serious constipation--worse than methadone has. Methadone is also VERY cheap. Put it this way, my monthly prescription costs less than my insurance co-pay.
If you are with an HMO, I would think you would need a referral to a PM group. My PM group won't even take patients who don't have a referral.
If tramadol works for your pain, though, I'd stay with it. In my opinion, the least amount to do the job is the best.
Good luck with your upcoming appointment.
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Never underestimate the predictability of stupidity.
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