AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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hello all,
i am in a situation. my doctor usually prescribes me Tyl#3s for my back problems... 45 for a month, even though the label says i can have 3 per day (yes, i've done the math). i know it's not near enough sometimes but i don't complain, just happy to get anything at all. the thing is every so often he cuts me off... so i don't become dependent. during this time every night i take a bunch of OTC Tylenols (the regular kind) and a few shots of vodka in tomato juice (i'm not a drinker) and it gets me through the night. i realize that it can't be great for my liver, but i don't know what else to do...
i have a doctors appt. coming up in about a week to discuss this with him. should i tell him how i self medicate? w/the otc and vodka? i don't want him to think i am a drinker because i am not. any advice would be most appreciated! thank you for your time reading this.
love to all!
cheers, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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dsmmcm
Board Addict
Reged: 11/08/03
Posts: 391
Loc: southwest US
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One of the many functions of the liver is that it breaks down toxins into non toxic chemicals which are delivered to the urine for elimination. It happens that the liver uses the same biochemical pathway to degrade alcohol and APAP (both toxins as far as the body is concerned). If you take both, the biochemical pathway can be overwhelmed, and incomplete digestion results. These partially broken down products are quite toxic to the liver.
I do not believe if anyone knows what a safe does of APAP and alcohol is. There are claims that this threat is overplayed, but I say why take the chance? There is one safe dose: zero. I never drink if I'm on APAP. Try ibuprofen, or even aspirin. They are not counter indicated with alcohol, and they are both better pain relievers than APAP. They are harder on the stomach, but since you're only taking them when you're out of T3's, that should not be an issue.
D
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efffbeee
Member
Reged: 10/22/02
Posts: 115
Loc: usa
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to reduce the damage you are causing it is highly advisable for you to take NAC - N=acetyl-cysteine, a supplement available at health food stores or online. its actually used in acute acetaminophen (tylenol) toxicity in the hospitals and also would reduce damage done by alcohol. if youre gonna be doing this damage either way, at least reduce it as much as possible!
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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Hi angelwolf,
The other posters gave you great info and the NAC is a good idea if you absolutely have to do this.
Does the OTC Tylenol really have any impact at all on your back pain and it's not just the alcohol? A high dose of Aleve or Advil doesn't get you through the night, mixed with Benadryl or some other sedating antihistamine?
But about talking to your doctor...
I would tell him you have to self-medicate, but not with alcohol. I would say that on some nights you need 3-4 Advil and 2 Benadryl just to get to sleep at night. I would also say you are concerned for your stomach doing that all the time, and is there another solution that the two of you could come up with.
If he is the kinda doctor who will only give Tylenol 3 and cuts you off, he may not be willing to rx anything stronger regardless of the circumstances. If you can't work with him, after making your case about the self-medication, you gotta find a new one.
-yawkaw
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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thank you for the great info! you guys are really something!
oh, and yawkaw,unfortunately, i can't tell my doctor that i take, say, advil and benadryl because for one, i can't take benadryl because one of those and i am no good for the whole next day. (the only thing that ruins me more is flexeril. just half of those and i am no good for the next two days.) i have the kind of doctor that would tell me that if the advil and benadryl works for me then keep on taking them. he's one of those doctors that would rather see his pateints live with pain than prescribe anything for it. i had to practically demand a prescription for tylenol3s before he'd write it. i asked him what could be done to fix my back and he said, it's something you have to learn to live with as there is no "cure". i cannot remember exactly all the things he said was wrong, i remember scoliosis being one of them, i would do almost anything to get an MRI done, i will ask him when i have my appointment next monday. i am so afraid of changing doctors because i don't want to be accused of "doctor shopping" (even though he is the only PCP i have ever seen in maybe 5 years). we'll see. i'll be back w/the verdict on monday !
thanks again to all who have replied to this post/pm-ed me. i love you all!
sincerely, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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angel,
You can't go on like this- this doctor is no good for you. You won't be accused of doctor shopping as long as you don't have two prescriptions for the same controlled substance for the same purpose within the same time period.
-yawkaw
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vastchoirs
Enthusiast
Reged: 08/05/02
Posts: 287
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Change your Dr. If a dr. tells you have to live with the pain, there is no help, and will not prescribe anything to assist you with the pain then he is a criminal in his own right.
Basically, find a good PM Dr in your area. Not all PM's are good simply cause they are in such a field. I used to have one that simply did not believe in narcotics for pain. So I left him in the dust.
Bottom line, this Dr. just wants your daily visit cash and nothing else. Find another Dr. willing to give a MRI, willing to listen to your needs and give you something so you can have a "normal" life.
Just as a note. Most Dr's that are PM's etc etc that are young...that are white, or are women are more than likely going to shoot down any narcotic med relief. Don't mean to profile but, it seems this is the case.
Good luck.
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Doc, you're a pain in my pain
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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let me just first say, "you people are the best"!! not a lot of people i can, or actually feel comfortable, discussing this with...
i have had one really, really bad experience with a doctor that i became a little "gun shy"... one day i'll post the experience, perhaps, but it was so humiliating that, though i probably could have legally persued the matter, i did not...
be that as it may, the one fear that i have is finding a doctor like that monster i ran across before and i was wondering... i can keep my PCP while i look for another PCP, right? i feel like i am betraying my PCP. sounds silly, i know, but he is a nice person- never mind, it is silly......
oh, and about profiling, vastchoirs, i normally don't stereotype people as everybody is different and there are always exceptions to the rule, but you have an absolutely valid point!!! in hawaii, my doctors (cooincedentally) have always been male, old(er), and middle eastern and i had absolutely no problems with them- didn't even know problems existed in the system... perhaps, geographic location makes a difference too, a lot of people i know have problems with doctors here in ventura county (so cal) but not a single person i knew in hawaii had a problem there. profiling means the difference between wasting time searching in great detail the little old lady at the airport (who just happened to have her fingernail cutters in her carry-on) and searching the non-native middle-eastern (looking) male (who just happened to have box-cutters in his carry-on) with the US pilots license (who also happens to be totally innocent). always exceptions to the rule (both ways!!!), but i don't think i'd care to spend too much time on what might be a long shot. thank you for your unput. you have all been wonderfully helpful, i'd like to express my appreciation. God bless you all!
cheers, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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P.S. update to my last post....
i called my mom last night and (re)discovered that moms always seem to offer great advice. i am always hesisitant to tell mom about my problems, i hate to worry her (another "mom" thing), but i told her i hadn't called her in a while because lately my back seems to be getting worse.
her advice...
tell my PCP to definitely get an MRI done (or whatever tests need to be run), refer me to a neurosurgeon or neurologist, and communicate with my PT (which would be a tremendous help to me)..... and if he disagrees or is "too busy" then i should, as you all have avdised me, get a 2nd opinion/new PCP and/or to call my provider and tell them exactly what's happening. and to do it NOW before it gets worse/more permanent. i see my PCP on monday. will update you all then, in case you're interested... might even learn something about our system. hmmm....
moms rule!!! 
cheers all, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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oothibo
Newbie
Reged: 07/13/04
Posts: 28
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Angelwolf,
I am so sorry to hear about your experiences with physicians. I can absolutely sympathize with your experience as I have seen many physicians look me over and tell me there is nothing they can do for me. Also, I am a doctor in training and can tell you with 100% assurance that you should find another physician. If you are telling the doctor you have pain and they are not addressing the issue, by either treating your pain or trying to find the reason your in pain, they are not abiding by the oath they have taken.
I wish you the best of luck!
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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thank you, oothibo, you are so kind, you would make a wonderful doctor, i am envious of your patients-to-be! are you going to specialize?
all the best of luck to you in your endeavor and may your practice flourish and your personal well-being/safety never be compromised! God will surely bless you.
best wishes, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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to make matters worse, i fell the other day taking with me a couple of boxes and a stratocaster. clumsy me! now i really hurt! Best if kept off the board. i'm all bruised up on my left side, looks like i got beat up. when i was a kid i used to fall all the time, but i'd just get up, brush myself off and be on my way. nowadays, when i fall i stay fallen! sux getting old but it's better than the alternative.
my doctor's appt. is tomorrow, so if any of you read this post, please keep me in your prayers. i thank you in advance. will update tomorrow.
much love to all!
cheers, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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mikevx
Enthusiast
Reged: 02/06/04
Posts: 282
Loc: LV-426
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Angel, I sure wish you the very best and I will keep you in my prayers. 
Docs these days are sometimes watched too closely or have some they know who gave out too much meds and were fined or got into trouble, so now they are stricter. Which makes us hurt more needlessly
Hence the need for a site like this, DB.
You hang in there. k 
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"cowards die many deaths, the brave only one"
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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thanks mike!
also thanks to everyone else on this board and all who sent me a pm.
i went to me PCP today. he refilled my rx, no problem there  gave me an rx for PT and specified the physical therapist i asked for, took x-rays, and scheduled an appt. 2 weeks from now to discuss the x-rays and the possibility of getting an MRI and/or referral to a neurosurgeon/neurologist. he said my back was really spasming on one side. i guess i grew so accustomed to it that i don't even notice it anymore. all i know is that my back is killing me. but when i placed my hand on my back, oh yeah, i felt it jumping... that was weird... BUT it seems i am finally on my way to a better quality of life... it's a start anyway... will update again when the time comes...
i really beileve that it was your prayers and well-wishes that made my appointment a success. plus, your support and advice gave me more confidence to really discuss my situation with him as i am usually very timid of doctors.
i thank you once again! 
sincerely, c.(angel)
p.s. this post will take me out of newbie-dom.
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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AngelWolf13
Board Addict
Reged: 07/07/04
Posts: 342
Loc: w/ my '91 CE-24 in SoCal....
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oh yeah, i forgot to mention..... i did also ask my doctor if he was familiar with NAC. he advised me against taking it. he said that the possible side effects outweighed any potential benefits that might be gained with its usage. i wasn't aware that NAC had unwanted side effects, but i suppose that just because a product is natural or is available through a health food store doesn't mean that it is automatically free from adverse reactions (ephedra is a good example). for now, i will just follow my doctors instructions, but i wanted to thank you nonetheless for your caring feedback and advice. as i have mentioned before, you people are the greatest!
sincerely, c.(angel)
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"Some mornings, it's just not worth chewing through the leather straps."
Emo Philips.
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