Pain Medicine and being young...

sunnyhours

Hi Everyone!
I'm having a pretty **** day pain wise, and although reluctant to the idea, started thinking about narcotic painkillers being an option...
However, I know it is rarely prescribed to young people for fear of addiction and diversion. I've been taking an arsenal of meds to "take care of the pain", so twice a day I open my "secret" medicine cabinet and take 1 Celebrex 200mg, 2 Tylenol 500mg, 1 Lyrica 75mg and 2 Advil 200mg, with 35mg of Amitriptyline at bed time. And somehow this not enough! I've been trying to fight the pain and the severe depression issues it's been causing. Not being able to get my morning bike ride, not being able to run with my dog, also abandoning snowboard is also gonna be requirement since I am not sure my knees or my back could endure these straineous activities. The pain gets to a point now where it causes tension in my neck which in turns gives me the worst debilitating migraines one could endure, the which makes you think twice about whether or not life is worth living, living in this deep, dark and thickening pains...
I have now gathered all my courage to talk to my gp about getting these atrocious pains under control by whichever means possible, even though this might get me "expelled" from my doctors office for "drug-seeking behavior" which would not be a first time for me...
I've been reading about pseudoaddiction and since I've almost never touched an opiate in my life except for the once-in-a-while broken bone, I don't see how I could be addicted...

So with this decision in mind, I've came across 2 questions which seems crucial in determining which way to illustrate the situation to my GP.

For you, who made the decision to use a narcotic painkiller? was it you or was it your doctor who made the decision?
How was it brought up and how did he/you react with the decision as I understand I'm probably not the first to be reluctant, but I'm getting desperate for relief...
What type of relationship do you have with your doctor? Does he do all the decision making? Do you chime in? Do you make your own suggestions (for those who have a medical background or for those who make their research) ?
Thank you,
Fred (SunnyHours) :?

bubbles

Hi Fred, good to meet you.

As for the pain relief, it is an individual as you are. As a lot of people will agree, it can be a bit of trial and error in order to achieve a tollerable level of pain control.
I am from a medical background, but, that would not stop my GP or my Consultants from asking my opinion on my treatment regime. Personally, it has taken about a year, to find a combination of medication that works, to a point. Some days, it seems that nothing short of anaesthesia would offer relief from the pain of arthritis, or the surrounding problems that is leaves in its wake, such as chronic fatigue, fybromyalgia, depression, anxiety, the list goes on.
The dose of Lyrica you mention, of 150mg a day, could be reviewed and perhaps increased, whilst keeping an eye on how well you tollerate the drug.

Tylenol, I assume that is paracetamol, on its own and this is only my opinion, it does little to alleviate arthritic pain, hence it is often used in combination with codeine. Perhaps that combination would work better than advil or ibuprofen.
You mention the dose of amitryptiline at 35mg, which is an odd and quite a low dosage. You could ask the GP about increasing this slightly and or adding another antidepressant to help with your low mood.

Opiate based drugs are used and with great effect, in many patients, you have to weigh up the pro's and con's of taking a medicine that can cause dependency, versus pain that cannot be controlled by any other means.

Your Dr should not be making a statement that you are there simply to seek opiate drugs. Many of the treatments already mentioned carry some level of dependency, just by the nature of the drug and its chemical action in the body.

Have a good chat with the Dr and see if you can try different regimes and doses of the current drugs you are taking, with the addition of others that may help your pain relief.

Keep us posted as to the outcome and take care, XX bubbles

sunnyhours

I'm a future student in pharmacology/pharmacy and everything surrounding the action of diverse drugs on the body I find very interesting...
And so far it seems that only Lyrica and Celebrex have made a difference, although the difference isn't even enough to "take the edge off". They are pretty expensive though...
Also the amitriptyline isn't used as an anti-depressant but more as a sleeping aid. My depression being due to the pain, fighting the underlying condition might be a more worthwhile answer to the problem.
The need for some kind of relief has been increasing substantially since I have, for years been dealing with migraines and back problems, and never found any type of pain relief...
Now I've been dealing with continuous pain in my lower back, knees, hands and my neck which gives me some tension migraines...
Trying to find a job along with studies coming up is pretty hard to deal with pain at the same time...

dreamdaisy

Oh I feel for you, sunnyhours, on two fronts: a) your gender, (males do feel pain mmore acutely than females) and b) your youth. I have graduated from cocodamols (paracetamol and codeine) to tramadol (morphine-based) but even that doesn't get it really under control. As far as I am concerned 'pain killer' is a mis-nomer, it always comes back (truth be told it never goes, it's just dulled). I think you do need something stronger, but not too strong. Find out about some coping strategies, visualisation and relaxation techniques, do you have pain clinics there?

One does learn to adjust, one has to. Pain is a constant feature of life now, in the same way as breathing. I wish you well. DD

sunnyhours

The other problem might be my metabolism...I've tried many different opiates throughout my life due to me being so lucky...broken clavicle = percocets, broken ankle (maleole) = morphine, debilitating migraines = hospital IV morphine and to finish this off wisdom teeth and alveolitis = dilaudid 4mg twice a day...
And I'm guessing since I was in pain I didn't feel the medicines, just a light relaxation and major relief of pain...especially the dilaudid which at first made me a bit loopy but relieve me from the pain.
My tolerance for any meds seems very exaggerated and it's kind of pissing me off...

woodbon

Hi, I have oa in the spine and neck and multiple joints. My medications are Amatriptilne 30mg at night, slow release tramadol, diazapam for muscle spasm and I can take paracetamol if the pain is really bad. As someone else said, it took about 18 months to find the drugs that suit me best. I can't take nsai drugs like diclofinac or ibrufen, as I've had tummy ulcers in the past, one of which perforated and I was in hospital for a month! YUK. I'm 55 and my doctor did mention opiates but, said she wanted to wait to prescribe them as he body gets used to them and soon they don't work. I have been to the pain clinic, but that didn't help very much, mainly because everything was rushed and the appointments were so far apart, but some people find them very good. Do go and talk to your doctor asap, their are things that although can't cure you, can make life easier for you. love Sue

c4thyg

Hi Fred,

I take it that you're in the US from the drugs you named. I lived there for a year and know how expensive the drugs can be as well. Another thing we have in common, I'm a pharmacologist and a physiologist!

I think with regards to your GP/PCP, tell them what you've told us. I would urge you to look at different doses and combinations of what you already have though as not only would it keep your costs down, narcotics will make it extremely difficult for you to focus on your studies. I've come off all narcotics (unless suffering a flare) and prefer to deal with a level of pain as I can then think straight. This might not be best for you but bare it in mind when you talk to the Dr. What you need to aim for is a combination of drugs that works for your stage of life.

I wish you all the best and let us know how you get on. Good luck with the studies. I loved it.

frogmorton

Hi Fred

Tyleonol!! It's been a while since i heard that mentioned. Think it was when my back 'went' in Florida - in the end I had more scary stuff than they licence here in the UK.

Here you can but paracetamol (tylenol) and codeine at a low does over the counter - I tried these and tehy weren't strong enough so I saw the GP and added other stuff to the mix such as arcoxia (a cox2 anti-inflam) and more recently I have added butrans patches. I like them as they are a constant dose all the time and dont give me that HIGH which makes me queasy.

i agree with the others - you explain it very well, but maybe need to be succcinct with your doc. Tell him/her if you can't sleep or drive/whatever because of your pain. I also like the idea of going to a pain clinic if you have such a thing?

Good luck

Love

Toni xx

sunnyhours

I saw a doctor for my hand and mentioned my Arthritis and he started asking me who diagnosed me, I really like this doctor too, and it turns out he went to school with my family doctor...gets me wondering if they are all nice in their school year LOL
Anyways, I have a hairline fracture, he prescribed me Tramacet for the pain and mention he gave me more than just for the hand to help out when the Arthur pain is too great and unsupportable.

I'm very curious about the Butrans patches, I keep hearing a lot of good about them, I also like the fact it lasts a week and what makes me even more curious of them is that the active ingredients in them (Buprenorphine) is also one of the main (along with Methadone) drug used as Maintenance/to ween heroin addicts...very interesting drug indeed hehe

My experience with opiates hasn't always been positive though...codeine for example doesn't do anything to me, which my doctor said might be an enzyme problem (10% of the population have no effect from codeine because of that..), also morphine orally didn't do much for me in the past...I must say there's something about my metabolism that makes me very resistant to certain drugs, the Amitriptyline for example (my doctor was very surprised he had to take it from 10mg to 35mg for sleep purposes...)
Anyways,
I hope everyone is having a not so bad day like me

c4thyg

Butrans is an interesting drug. Don't worry too much about it being related to morphine though. As you have a constant dose and no highs or lows with it it's nothing like an addict getting a fix. I used them for a while but again, I stopped them because I couldn't think straight or focus on anything. It might be worth asking about though as not everyone gets this problem and they do come in 3 doses. I used the lowest dose and then the middle dose during a flare up before dropping back down again.