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redhill
Member
Reged: 06/02/03
Posts: 178
Loc: There's a NEW England???
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My liver hurts. I think. I don't even know if the general liver area will hurt if the liver's compromised, and I do not seem to be looking jaundiced, however, my upper abdomen seems to be in some discomfort.
I've been taking lots of Tylenol and Ibuprofen lately. Both are in the 3000 plus realm, on a consistent basis.
I see a pain doctor for back pain as well as lower left quadrant abdominal pain, which was a bout of diverticulitis, but which still gives me lots of pain after a surgery. My back has two discs that are degrading, and it hurts.
Even though there is an MRI showing some bulges, my doctor says it's not serious-looking enough to cause pain and warrant serious pain treatment.
I believe in Occam's razor, and prefer to believe that the most obvious answer is what you see in the MRI - damage, bulging disks, ergo pain. Maybe my logic is off?
Still, he has been gracious enough to medicate me. Not as well as I had liked, but he didn't leave me in the cold.
Till now.
He's lowered my Roxicodone, and as a result pain, discomfort and stomach problems are up. Also, I ran out of meds early, ONCE, and had to sign a statement that I was in violation - some SS-type scare tactic they use to keep you from overusing narcotics.
Based upon my transgression, my crime, I was condemned to regular steroid shots as well as spinal shots. Painful, and not helpful. My doctor says they should be. And my pain meds are now down, so basically I have to choose which, say twelve hours, I want to be out of pain. When I asked to be put back on my old dose, he simply said no, two times.
He always preaches that pills aren't the answer, but when I ask for my old dose, he tells me to take Tylenol or IB. This from a guy who SPECIFICALLY put me on Roxi to avoid the APAP!!
So for a month I have been taking SO much APAP to dull the pain, and so much IB, that I am close to having an ulcer, and I am afraid for my liver. My regular doctor says my liver enzymes were already up last time he saw me, and to stay away from NSAIDS.
I am so scared that I have buggered up my liver for good. I have ordered NAC online, to counter Aceta- damage, but is it too late? And what in the world am I going to tell my pain doc? I want that last quarter of the day taken care of by Roxicodone too, not by someting that may end up killing me.
I am desperate, I am afraid, and I am extremely angry. I feel my pain doc has been rigid, and disrespectful to me as a consenting adult with a right to have my pain taken care of in a responsible way. It is my conviction that an extra ONE tab of oxycodone a day (granted, they are 15 mg ones, but I am opiate tolerant) is preferable to all the rubbish I have been taking, and I feel I can function and operate as a responsible adult without becoming a danger to myself or others and without overdosing.
He is becoming more rigid, to the point of admitting that, even though we disagree on some things and I may be right, he is the one with the prescription pad, and his cavalier attitude towards my pain just drives me nuts!
I grant you that my taking way too much OTC meds isn't responsible behaviour, but that is all that is within my power.
It may sound like something out of 1984, or a Twilight Zone story, but:
I, a consenting adult of sound mind and body, do not legally have the power, the possibility, to administer stronger and safer medication to myself in order to combat pain in my body. Just think on the absurdity of that in a free country.
Night all, be pain-free, if you're allowed.
Red.
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For every prohibition you create you also create an underground.
-Jello Biafra
There ought to be limits to freedom.
-George W. Bush
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PAIDFO
Member
Reged: 02/01/03
Posts: 106
Loc: southeast
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This just my 2 cents(and it won't even get you a cup of coffee)but here it is,I'd try to find another Dr.The attitude concerning the prescription pad is way out of line.If that is not an option maybe you could get him to change the roxie to a time released med that would last longer.He could put you on a time released med with the same amount of oxycodone.I hope this makes sense,Good Luck Have a Great Weeekend...P
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"The difference between Ordinary and Extraordinary is the Little Extra"
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mas
Stranger
Reged: 04/06/04
Posts: 21
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well, this will be my first post on this board, but i have been a lurker for a long while, and a regular on 'other boards' for some time as well. so i hope it is acceptable to just join in...
i myself would KILL to have anyone prescribing anything at all right now, even just 12 hours per day. i was abruptly yanked off my meds in February, which was only 6/7.5 hydro's per day to begin with, after 6 months of consistent (under)prescribing by my osteo, one of the 'best doc's in the world', blah, blah blah...
she just decided 'it was time' and i 'was ready', as pain medication does not actually 'help the condition'. so starting *that day* she dropped me to 5 pills a day, and then 4/3/2/1 over 5 rapid weeks of hell... and here i am in agony, with NO presciber at all. my new pain docs put me on tramadol, which is useless for me.
the condition is, like you, chronic neck and back pain caused by degenerative arthritis, bulging discs, spinal stenosis/spondylitis...
and now, since September, Fibromyalgia.
I believe the Fibro was brought on by inadequate pain management to begin with.
I have been in a flare of fibro hell for the entire 7 months solid, and there is no relief in site. i am forced to order exclusively from op's to mother my 2 year old, and function as a wife and person. it's to expensive for us to really afford, but what choice do i have?
my point is, please be grateful that you have someone helping you at all, especially with long-acting med's/stronger meds like you are getting. if i had to live with just the neck/back pain again, i would be in heaven if only prescribed for 12 hours a day. as it is, life often seems not worth it, to suffer like this with out anyone helping you. so many of us have NO MEDS from our docs at all, are considered drug-seekers, treated like Best if kept off the board, simply cause some doctor decided it was 'time' for us to be yanked off the one medication that gave us back *some* of our quality of life. you have that. you cannot have perfection all of the time, but be happy you have anything at all right now, and remember how many of us have nothing at all to help us without vastly expensive op's. just a look at the 'other side', sometimes i find that helps me, to realize what i *do* have, instead of what i don't.
feel better, mas
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mas
Stranger
Reged: 04/06/04
Posts: 21
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oh, and please do not misunderstand, the doctors *should* be treating us, with medication, and respect and dignity, but in this political climate, i say take and run with anything you are lucky to 'get' from these jerks. i wish i could find a compassionate doc as well, in fact it is my sole and entire goal right now. please know that you have my total empathy and understanding as far as the pain and undermedicating. just do not want you to think i was negative with you!
mas
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redhill
Member
Reged: 06/02/03
Posts: 178
Loc: There's a NEW England???
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I understand you are being supportive, and so I have to say I appreciate your first message on the board is directed at me in support.
There was a time when I couldn't get a med for pain, and all docs thought was that I was just trying to get opiates in order to have myself a gay old time. Well, to me a gay old time means that I don't have to feel pain.
I have been at the stage where I was without a doctor, and I will be there again, should the politicians have their way.
But I want to take what I can. One reason is, and I am lucky, is that my wife and I happen to have terrific health insurance, and a very good income. What I mean by that is that I am grateful daily for these blessings, and I know we have it good. I guess it's human nature to complain when, as you put it, you don't have it perfect.
A time is coming where only the extremely rich (which we are not even close to being) will be able to get the meds they want. The rest of us can go to jail for doing just that, and it doesn't appeal to me.
But here, in our little community, we get to grumble, compain, commisserate, and seek support. And that's what I am doing. As badly off as any of us is, there's always going to be someone worse off.
I've been where you are, and I hated it. But I hope that in my quest for being pain-free, it's ok that I complain, that I ask for advice, and that I look for better help, as long as I am able to. Soon it will be against the law to.
Red
ps you say you think your being undermedicated might lie at the root of your fibro. I have never considered fibro, but I have been undermedicated for years, and I hurt all over, most of the time, something I never had to worry about. My regular doc alluded to that possibility when I told him I get pain all the time. Two years ago, before all my pain started, you could have run over me with a truck and I wouldn't have said a thing, but today you could probably slap me in the head and hurt me.
I mean, isn't it funny that people call pain sufferers a 'pu$#y' (sorry - really not to be offensive, but I've been called one), when, at one time, you were probably a whole lot tougher than they will ever be.
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For every prohibition you create you also create an underground.
-Jello Biafra
There ought to be limits to freedom.
-George W. Bush
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redhill
Member
Reged: 06/02/03
Posts: 178
Loc: There's a NEW England???
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Quote:
This just my 2 cents(and it won't even get you a cup of coffee)but here it is,I'd try to find another Dr.The attitude concerning the prescription pad is way out of line.If that is not an option maybe you could get him to change the roxie to a time released med that would last longer.He could put you on a time released med with the same amount of oxycodone.I hope this makes sense,Good Luck Have a Great Weeekend...P
It makes sense, except they don't prescribe "that medication" because of its controversy. Silly reason. I am thinking of finding me a new clinic. Even if they want to take a completely different approach, I hope at least they will start me on the same medication so as to avoid me having to go through withdrawals.
Have a nice weekend!
Red
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For every prohibition you create you also create an underground.
-Jello Biafra
There ought to be limits to freedom.
-George W. Bush
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1004
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Yes, it is possible for your liver to "hurt."
There is a capsule surrounding the liver that has pain receptors. If your liver is inflamed or quickly expanding for some other reason, you could experience pain. It would be felt in the upper abdomen, towards the right.
There are many reasons for abdominal pain, and having it does not mean anything's wrong with your liver, but going just by what you told us, that's the likely culprit. Especially with all your already elevated liver enzymes.
Have you had any excessive nausea or fatigue (moreso than opiates cause on their own)? Or loss of appetite?
I'm not going to criticize the doses you take because I believe pain relief is the ultimate goal. You are an adult and will do what you want regardless of what the doctors tell you, but...
PLEASE get on NAC. At this stage, it's not too late, but it could get that way some day, possibly requiring a liver transplant. You need to start some kind of harm reduction- NAC would be perfect for you.
As far as 3000 mg of ibuprofen a day....wow, that's all I can say. Your gastrointestinal system's days are numbered with that one.
My advice to you is to get on compounded meds. You could get 15 mg hydro with DXM instead of apap/ibu. Use that to supplement whatever meds you can get, and keep trying PM docs.
Good luck.
-yawkaw
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starchild
Newbie
Reged: 03/02/04
Posts: 31
Loc: Northeast
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Yawkaw,
Please explain NAC and how much one would have to take vs the APAP they take daily.
Thanks!!!
-Star
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"All who wander are not lost" - J.R. Tolkien
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TR6
Newbie
Reged: 08/27/02
Posts: 48
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Here's a good resource for information on apap poisoning and ways to treat it. The protocol near the end of this article lists various treatments includng NAC and dosages.
SAM-e is also very helpful and has been shown to reverse damage to liver cells from apap (better than taking plain glutathione).
http://www.lef.org/protocols/prtcl-001.shtml
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dmoe
Stranger
Reged: 03/25/04
Posts: 9
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Quote:
oh, and please do not misunderstand, the doctors *should* be treating us, with medication, and respect and dignity, but in this political climate,
mas
I completely agree, doctors in this country undermedicate pain and it is all because they all afraid of addiction or their licenses. I have been to pain web site by the top pain specialist in the country and every site stated that doctors under treat pain and that they should not do this. They say that having to take pain meds does make you an addict if taken as directed, afterall what kind of quality of life do we have if we suffer so much and the doctors do not care.
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BlackCat
Board Addict
Reged: 09/22/03
Posts: 342
Loc: Bed
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to answer your NAC questions...
As an amino acid and antioxidant, NAC is a precursor to the antioxidant glutathione, which is produced primarily by the liver and helps your liver break down APAP.
In terms of dose - it varies on your dose of APAP...some folks have told me to always take a 500mg capsule of NAC with each dose of APAP, but you can take it every other dose if you are on the low end of APAP usage. Conversly, 1,000 mg (2 capsules) NAC per 3,000 mg APAP is another ratio I've read for higher APAP usage...
NAC is really cheap and available at GNC or other similar stores...I buy it online and found a good supplement store that sells it cheaply on yahoo shopping...I get Jarrow brand (they make alot of supplements) #100 count 500mg capsules for $8.50 per bottle (pretty cheap compared to your hydro and well worth the help it does for your liver)...search on NAC in the store and you can see other brands they offer....
http://store.yahoo.com/americasvitaminstore/nacetyllcysteine.html
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sam001
Newbie
Reged: 02/03/04
Posts: 38
Loc: Nordstroms
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I agree that NAC is helpful in preventing liver damage. However, I'm unaware if NAC protects the kidneys in any way. Although less common than liver damage, tylenol can also cause kidney damage. The most common recommendation I've seen is to keep long term tylenol therapy to under 2.6gms daily. Below is the link to the Kidney Urology Foundation. They estimate 10% of new cases of chronic kidney failure are as a result of pain medication. They included NSAIDS in this group.
There are additional recommendations to have blood test for kidney function monitored.
Hope this is helpful.
http://www.kidneyurology.org/Patient_Resources/PaR_Lib_Painkillers.htm
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1889
Loc: Northeast Texas
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Redhill, I agree with Yawkaw, if I were you I would try to transition to compounded hydro. If you can't find a new doctor, which I definitely would - you could try Fed Ex Meds or Doctor_Appointment.com for the compounds. These two OP's will probably be the cheapest, as far as OP's go, I know you can get compounds from Madison Pain Clinic but I've heard they are terribly expensive.
I also have liver pain from time to time, it always happens when I've taken too many in one day, usually a bad pain day when I have a lot of physical activity to do. So, I'm thinking of changing over to the compounds from Norco just for my liver's sake. You might want to do some reading first, some people say the compounds aren't quite as effective for pain, but they are definitely better for the liver. I also take NAC, Milk Thistle and any supplements I can for the liver and kidneys. Best of luck, we can all feel your pain!
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BlackCat
Board Addict
Reged: 09/22/03
Posts: 342
Loc: Bed
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And don't forget about Vicoprofen if you want to cut the APAP back and add some Ibuprofen....as long as you can "stomach" it I guess....
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redhill
Member
Reged: 06/02/03
Posts: 178
Loc: There's a NEW England???
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I am seeing a new Pain specialist tomorrow. I heard they were reasonable with meds from what I've heard from people who've gone there, until I read their list goals, which includes "reducing your opioid intake".
My gastrointestinal days are numbered probably. Funny enough it was one of my opiophobic DOCTORS who told me point blank that I can take 3200mg of Ibu every day. Took about a month of that to give me terrible problems and pain.
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For every prohibition you create you also create an underground.
-Jello Biafra
There ought to be limits to freedom.
-George W. Bush
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trixxie
Stranger
Reged: 05/23/03
Posts: 21
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I fill out a patient survey every time I go to my PM doc, and one of the questions is, what are your goals? Mine is painfree, opiod free, because, well you all know the answer to that one....
I don't think thats an not unreasonable attitude for them to take. There are people that have to have opiods to have a semblance of a "normal" life and I truly believe that some understand that....believe that! Hang in there, you will be just fine. Just jitters...fingers crossed that all goes well for you.
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