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Posted 2/9/2012 9:15 PM (GMT 0)
I am a 63 year old male in pretty bad health in addition to having chronic pain. My doctor has tried me on almost all of the lower grade opiates (i.e. vicodin, percocet, etc.) and now wants me to make the hard switch to 2 mg of Hydromorphone. I have bulging disks in the upper L and in the upper C and use both a walker and a wheelchair to move around.

My question is, how effective is the Hydromorphone for my kind of pain and also, just how addictive is it?
Posted 2/9/2012 9:21 PM (GMT 0)
Hello Ludlow,

Welcome to HW! I can't say how effective this med will be for you, but it worked pretty well for me for a while (until I developed a tollerance to it).

I can honestly say that you will know almost immediately if it is going to give you some relief or not. It's a pretty fast acting medication (those not exactly immediate). I'd give it an hour and expect to see some changes in the way you feel. As far as addiction, CP patients who really need their meds often become dependant on them for pain relief. I don't personally feel this is the same as addiction because it is no different to me than the person who needs insulin for diabetes. Ours is just a different type of med for a different problem.

Of course, there is no medical basis for my comments and they are only my personal opinion. I am certainly no Dr, but I have been CP for quite a while now.

I hope you find relief. I'm betting you will find some relief.

Good luck!
Posted 2/10/2012 12:42 AM (GMT 0)
Hi there...

Retired mom gave some good advice...

Addiction and dependence are completely separate issues....Everyone who takes any medication....from diabetes, high blood pressure, to pain meds will become "dependent" on them...This means that your body is used to them and you can have physical withdrawal if stopped immediately...

Addiction is an emotional tie to medication and is when people take more of what is prescribed, they Dr. shop, they crush or snort their meds, they sell them or buy them off the street, and most importantly, they take them to feel that high, to block out life, not for pain management...

Unless you have addiction in your family or have a history of this yourself with things like cigarettes or alchohol, then there really isn't any need for concern...People who have addictive personalities can still be treated for pain, they just work with their Dr. closely and will find ways to monitor their pain med usage or even have a family member give them to you when needed..

Addiction runs in my family and I was upfront with my Dr. about this as I always want to be aware.

Also, have you had recent MRI's to show the damage and have they done treatments to help? Traction, PT, acupuncture, injections, muscle relaxers, TENS unit, etc?

Is surgery not an option or warranted in your case?

In regards to whether this will be effective for your pain is really relative...what works for me may not for you...even if we had the same injury...no two people are alike...

It's about working with your Dr. to see how it lowers your pain level...As mentioned...someone with chronic pain is best treated with a comprehensive plan...An opiate is just one small piece of the puzzle and not meant to be the only thing to treat your pain or even eliminate it..

Welcome to the boards...I hope you stick around and share more of your story...it's a great group of people here!
Posted 2/10/2012 2:33 AM (GMT 0)
Hi Ludlow and welcome to the chronic pain forum. I too take Hydromorphone which is the generic version of Dilaudid. It is widely prescribed by drs to treat chronic pain and it is now available in an extended release form too. I use mine for BT pain since I have a pain pump implanted and find it helps me. You have been started on the lowest oral dose available, whether it works for you no one can say. We all metabolize our medications differently so it is difficult to say how you will react.

I do not know how often your dr has said for you to take the medicine. I do know some drs will write on the script to take one pill every 4-6 hours for pain or some will only allow one pill every 6 hours, it just depends on the dr. A good web site to look up medication is Drugs.com. I always go there and look up any medication that is rx'd to me.

Anyway I wanted to welcome you aboard and keep us posted on how you do with the pain medication.
Posted 2/10/2012 3:46 AM (GMT 0)
Until 3 years ago, I probably never had taken anything stronger than an Advil. But, when I was 60, I somehow contracted Bacterial Meningitis and almost died. Actually I did have to be revived twice and placed on a respirator. I had farmed with my family for almost 40 years and though I worked hard 24-7, I never had had any major health issues in my adult life. During my almost 2 month hospital stay, I had lost all use of my legs and literally had to learn how to walk again with the help of physical therapy.

I had numerous falls which resulted in a broken collarbone and a broken hip, both of which required surgery. That was when the chronic pain first began. For the first time, I was unable to take control of my life. I have had numerous MRIs, but my disc problems showed up on a mylogram I had in Sept. of 2010.

Today, my life is controlled by back pains, neuropathy in both legs, migraines so severe that I cry like a baby and short-term memory loss that is so darn frustrating. I guess I'm just plain afraid of drugs that I can't buy without a prescription. I've never before used them in my life and now, all of a sudden, I depend on them for my very survival. The fears of becoming addicted or strung out on these opiates has made me purposely go without medication on numerous occasions. When I mention these concerns to my doctors they just tell me that they will not allow anything like that to happen and that they are on top of the situation. Somehow, that just doesn't ease my mind. So, I would really appreciate hearing from people with similar concerns and especially from people who had meningitis and now have medical issues from it! Thanks for listening.

ludlow
Posted 2/10/2012 4:00 AM (GMT 0)
I'm confused about your statement of being afraid of drugs that you can't buy without a prescription....

When you would ever do this and why? Are you meaning illegal street drugs? Or over the counter things like Tylenol or Advil....

There is no need to fear opiates as long as you take them as directed....that is pretty easy for most everyone to do....

Are you also on nerve pain medication for your neuropathy? Like Lyrica, Neurontin, or Cymbalta?

And then what about medicine specific for migraines for acute use?

I guess I'm not understanding your fears....

As I mentioned...with your back pains...have they done Physical Therapy, exercise, injections, acupuncture, lidocaine patches, TENS unit, massage, muscle relaxers...etc?

What other things does your Dr. do to help you with your chronic pain?
Posted 2/10/2012 5:56 AM (GMT 0)
What I should have said was that I had very rarely ever taken a prescription drug before in my entire life. I think I may have had to take antibiotics several times, but nothing else. Maybe I am/was a little naive, but I felt like if I didn't have to have someone's written permission to use a medicine (advil/anacin/pepto bismal, etc.) I was better off. Let's just say that you can give me a string of bailing wire and I can fix anything. But the idea of taking morphine scares the living crap out of me. It is something that I have always associated with illegal use and junkies. Again, us old farmboys were way too busy working ground and cattle to become involved in the drug culture. Like I said, I am/was a little naive! Hope you understand what I'm trying to say. And btw, Neurontin is one of the 14 daily medications I am taking.
Posted 2/10/2012 7:17 AM (GMT 0)
Ludlow,

Hi... welcome to the board.... I'm sorry to read of your health issues and pain issues. I also understand many of your fears re: your medications.

Re: meningitis... I'm 38 years old... and I've had meningitis twice... and I do think I have long-term issues from it. The first time I got it (bacterial) - I was 26 years old and it was following a wisdom tooth extraction. I spent 10+ days hospitalized... and - it was the most painful thing ever in my life. Horrible. Since then, I've suffered terribly w/ migraines (I also have a host of other health/pain issues).

The second episode of meningitis (chemical) was a few years ago, following the pain pump trial (where they put a catheter in your back...). That time, it took a 32 day hospital stay because of all the complications from the meningitis.

Re: your medications.... I completely get your fears and concerns. People who haven't had to use narcotic medications often hear the word "morphine" (or whatever medication) and it does make you think a certain way.

That being said, many of us here use narcotic meds as a part of being able to live w/ chronic pain. (I also use Neurontin and a muscle relaxer; heart meds; etc).

I've used Dilaudid (hydromorphone) many times on my CP journey. I actually just got off of it because the oral version wasn't helping me any longer. As the others said, it usually works pretty quickly.... and it can be an excellent pain medication.

The bottomline is - it sounds like you are suffering so much w/ your pain.... and I truly hope that this medication (or whatever you ultimately choose, with your doctor, to use) helps you.

Look forward to getting to know you better.... Take care and let us know how you are doing... --Tina
Posted 2/10/2012 8:53 AM (GMT 0)
Using dilaudid or hydromorphone for chronic pain IMO is best when used in the extended release formula called EXALGO and using percocet as a break-thru medication.
Posted 2/10/2012 12:36 PM (GMT 0)
Hello again,

I know I have already responded, but I wanted to first say thank you for all you have done in farming.  I'm from the south and I live in a farming area.  I don't have farm animals myself, but my family did as I was growing up.  My land is listed as a farm, but it's now pecans and blueberries because it is much easier to take care of (by my husband) since he works a full time job too.

Now, with regard to the pain meds....It seems like you are getting a little overwhelmed with the info you are being provided and I know how that feels.  When I first came here, I had no idea what most of the words meant, let alone what the meds were and how they made you feel.

Please do not be afraid to take the dialudid (this is the brand name for the med you have been given).  It really is the lowest dose and I do think you will find some relief.  As so many have mentioned, it's impossible to know what works for each person, but considering that you have never taken prescription pain killers unless they were given in the hospital (except for short periods of time...I would guess), I can certainly understand your nervousness.  Also, given the fact that you seem to be an honest, hard working person, I don't think you need to worry about having addiction issues.  You are not being fair to yourself if you are suffering all of the time....and I think you may be.

Pain has a way of controlling who we are because we can only think of how badly we hurt and nothing else.  If you control the pain, then you have the ability to think of other things. 

Your doctor is apparently insisting that you take pain meds....this says a great deal!  Most dr's never want to give anything.  He/she can see what you are going through and knows that you need some relief.  Please give yourself a chance.  If you don't like it or find out that the pain is not better, then simply go back to the doctor (bring the remaining pills) and they can try something else. 

Any reasonable Dr will not prescribe something that is really, really strong to a person who had no experience with prescription meds.  This one seems to have your best interest at heart.

I wish you luck with the pain and we do understand here.  The site is filled with many people, from many walks of life and we often have different views and perspectives.  It is actually very interesting to see things from someone else's perspective for me.  I hope you will find that we can help you along this path and that you will have enough pain relief to be able to continue your life as you would like to.  Be aware, however, that there is a "break in" period with dilaudid (at least for me) when it seems like it is a little strong.  It wears off pretty quickly....within a day or two and you can then tell what you really think about the med.

Good luck!

Posted 2/10/2012 7:09 PM (GMT 0)
Ludlow I understand what you are saying about being on prescription medication. It is very hard for someone that has never been really sick a day in the life except for the usual colds and sore throat type of thing. Pretty much any kind of ailment was helped with Tylenol of something over the counter like that.

Now suddenly you are plunged into the world of taking a strong pain medication and for some people taking pain medication is taboo to that person. I have a sister just like you, always healthy as a horse and never had problems, She hurt her back and ended up with a pinched nerve. She refused pain meds because she thought it was a bad idea to take them. She was afraid she would get hooked on them. So, like you she suffered because she would not take the medication. Maybe its the age group that has this stigma they have attached to medication but I see this in your age group.

None of us here want to be on medication, but for many of us this is the only way we can have any quality life is to take the medication. It really is not fair to you to let yourself suffer when there is something within reach that can help get the pain level down. I would much rather take pain medication and be able to enjoy my grandson and bbe able to do things with him that suffer silently and not be able to do much of anything.

Most people will become tolerant at some point to the pain meds. But, that also happens with any medication that we take long term. I have to have my BP meds changed after being on them for awhile, they just quit working.

People that take medication to get high and have no medical need for them are your drug seekers. These are the people that can make life miserable for me and you in the medical community.

It sounds like you have some very caring drs onboard to help take care of you and that means a lot to a patient. Not every member here can say they have a good dr in their corner. Try to focus on how to get yourself feeling better so that you can remain active. I do hope you can come to terms with all of this.

Take care....Susie
Posted 2/10/2012 10:22 PM (GMT 0)
I apologize for misunderstanding the one sentence as you were saying that you are nervous about prescription medications like this...

I agree with the others....going slow...working with your Dr...should be perfectly fine...

I just wanted to show that addiction and tolerance/dependence is completely different..And usually not any reason for the majority of us with chronic pain with which to worry ourselves.

It really is hard when our bodies start failing us and our life changes based on our pain...

Many times it's even good to see a counselor for a bit to get to a good emotional mindset if the pain is going to be chronic...

Also...I was just mentioning in my other post that along with medication, there are many other tools we can use to help lower our pain...So it's good for you and the Dr. to be realistic on the medicine as it's not meant to get us to 0...

As Stray wrote...having a caring Dr. which it sounds like you do...is the biggest hurdle....You are in good hands and hopefully will continue to post here as we have been where you are and can truly empathize...

Take care..
Posted 2/13/2012 4:00 AM (GMT 0)
I really hate to sound like a young schoolboy, but I really don't know what to expect when I start the hydromorphone tomorrow. I have taken vicodin and percocet off and on for the past 3 years and it never controlled my pain like what I expected it to do. It would definitely take the edge off for about half an hour and help me get to sleep, but if never effectively managed my pain with any continuity. The idea of using morphine sort of brings back images of opiate houses of the latter 19th century where people went to do drugs and lose contact with reality. Can someone who is/has used hydromorphone explain to me what I might expect. They are going to start me on 2 mg. I just seem to have this fear that it is going to overwhelm my body.
Posted 2/13/2012 5:01 AM (GMT 0)
I take dlaudid/hydromorphone to help manage my back pain. I was started at 2mg every 8 hours as needed. For me it did very little good. I would get some relief from it for about 20-30 minutes and then my pain was quickly back to where it was before taking anything.

Once I convinced my doctor to up the dose to 4mg every 8 it was like night and day. I would have decent pain relief for 5 hours or so and it would then start wearing off and the last 90 min to 2 hours I would be in a fair amount of pain.

I am currently on 6mg every 6 hours as needed and have had really good results. I actually rarely take the full 6mg and usually only take 4mg every 6 hours.

This, like most oral medications, takes about 30-45 minutes to really start working.

I have been on taking hydromorphone for probably a year and a half now or so and I have never felt high, loopy, etc from it.

I have not read through all of the previous comments, so pardon me if I repeat anything.

Pain medications have a very low occurrence of actual addiction when taken to help control real pain and taken as prescribed by a doctor.

Just to give you an example. I used to take 15mg of morphine tablets up to 4 times per day. I was on them for well over a year when I lost my doctor. For almost a year I was off any pain medication while trying to find another doctor to handle my pain management. I went from up to 90mg per day to nothing in a single week. The only thing that I suffered was diarrhea for 3 days. Why, because I only took the amount of medication I needed to on any given day.
Posted 2/13/2012 7:12 AM (GMT 0)
Ludlow,

People's experience w/ dilaudid (or really an pain medication) is going to vastly differ from person to person... Jim did a great job of sharing his experience, which is similar to my own. Pretty good pain relief in the beginning (when it used to work for me); no "high" or euphoria, etc; no real side effects at all for me, except maybe a little nausea in the beginning; etc.

It's a pretty quick acting medication, 30 minutes or so.

You are starting at the "starting" dose... to put it in perspective (and I'm not a doctor... and this is just my "research" as an experienced patient)... I just looked at the opiod conversion chart... and 2mg of dilaudid (oral) is about the same two 5mg percocet.

But, again, you won't know how it will affect you until you give it a try. Hopefully, the result will be quick pain relief... with no side effects. If you are very worried, you might have a loved one stay w/ you while you take the first 1 to 2 doses. Also - and just my experience - it may take a few doses to see how it actually helps you. Good luck!

--Tina
Posted 2/13/2012 10:50 AM (GMT 0)
The main thing is to not drive the first days/week with taking any new medication just in case it hits you strongly.....If you feel at all dizzy which can be a side effect....also be careful with any stairs..

If you have only taken Vicoden and Percocet sporadically through the years...this should help you greatly with your pain...

I know the word "morphine" sounds scary...but it's not the same as in the hospital in IV form...that is about 100 times the strenght of pill form....

Many of the medicines that we all take for pain are derived from morphine....so even your Vicoden and Percocet....

The Dilaudid is just a different mix...

I actually take morphine pills which are time released...30mg Morphine Sulfate....90mg a day.....

Again...it "sounds" like a lot....but that is absolutely not the same as when you get this in the hospital..

So...we are all trying to help you not fear this particular medicine..

Most of the side effects are "nuisance" ones that most always go away after a few weeks...A bit of nausea, fatigue, or dizzyness...

Another thing to watch for is constipation...So make sure you are drinking adequate water and upping your fiber intake..

We certainly hope it puts a dent in your pain...keep us posted..
Posted 2/14/2012 12:51 PM (GMT 0)
Hi Ludlow and welcome. You've been given great advice so far, probably not much I can add to that.

If it helps to reassure you - I've been on most opioids, trying to find the one that is 'right' for me - especially in combination with my other meds. I now take oxycodone, which is another similar medication. I take 30mg of slow release 3x a day and anything up to another 30-40mg of short acting spaced through the day when I have breakthrough pain. Obviously it's different for different people, but I've never had any 'highs' from my meds - the higher doses make me a little tired and nauseous, and flare my gastroparesis (a semi-paralysed stomach because of problems with my nervous system) - but as Snowbunny said, most of the side effects are nuisance ones.

Laura
Posted 2/14/2012 6:27 PM (GMT 0)
I want to thank everyone for their help in addressing my issues with hydromorphone. I am now on day 2 and I can report that my new pain medication has been a real blessing. Last night, I actually got out of my wheelchair and walked some with my cane. It felt wonderful to be about 80% pain free for a little while. I was started on 2 mg and if I don't have any reactions, they plan to up my dosage to 4 mg in a week. Again, thanks to you all for your help!

Ludlow
Posted 2/14/2012 7:52 PM (GMT 0)
Ludlow,

I'm so glad you checked in; I was going to ask how the meds worked.

When I hear of a medication actually working for someone and reducing their pain - I can't tell you how happy I am. That IS a huge blessing!

Thanks for letting us know how you did,

Tina
Posted 2/14/2012 8:23 PM (GMT 0)
Ludlow that is awesome that you are getting some relief with the pain. Please do come back and keep us posted on how you are doing. I am so excited for you. Even though I have 8mg of Dilaudid, sometimes I cut my pill in half because I will not need the full 8mg. My dr is ok with this and says I am the best judge on how bad the pain Please take care.
Posted 2/17/2012 5:17 AM (GMT 0)
I just wanted to give one last update on my experience thus far with 2 mg of hydromorphone or dilaudid. I am currently on day 4 and I have been overwhelmed with the relief I have felt with my chronic back pain. Maybe it is because of the low dosage I am on, but there has been no euphoric high like on the percocet or lortabs. It works almost exactly like 800 mg of Motrin, but without the burning stomach or nausea.

Thanks to all of you for your kind and informative words and suggestions. I hope someday I can be equally as helpful to all of you.

Ludlow
Posted 2/17/2012 12:23 PM (GMT 0)
Hello Ludlow,

Thank you for letting us know how you are doing. I have been watching your post for a while to see if you were getting any relief. Back pain is sooooo bad and dilaudid (hydromorphone) was the first thing that gave me any relief from mine. I have since had to change meds because it stopped working as well after quite a while, but for a very long time that was my med of choice.

I hope you will have a long term relief from this problem and can have that well needed pain break that makes you feel like a "human" again.

Just a quick caution though....please do not tell family/friends what you are taking and keep all of this med out of reach and perhaps even locked up. This is a med that is stolen quite frequently and sold...please know that there are many people who will befriend you simply because they want this med from you and will do anything to get it. Even though your dose is low, it is something the scavengers will seek if they know you have it. I keep my meds locked up in a safe so noone can see what I have. Only what I need is left out for me to take and even that will have to be locked up as the people start working in my house today. I hate to even suggest family might take it, but I know someone personally who did this to his mother-in-law on the day she passed away. It was horrible and it nearly killed him. He is about the same age as you...so it is not just "kids" who do this.

Please do not think I am being condescending in any way, but I know you are new to the chronic pain medications and I don't want you to be another victim. Most doctors insist you file a police report for any stolen medications and that can cause some serious family problems, as I'm sure you are aware. Of course...that also leaves you without pain medicaitons because most doctors will NOT replace lost or stolen pain medications of this kind because they are so often abused or illegally distributed/sold.

I wish you luck. Please continue to read and check in. Someone is almost always here to answer questions and to help give support. We're certainly not doctors, but we are a well informed bunch of people from just about everywhere.
Posted 2/17/2012 2:06 PM (GMT 0)

RetiredMom said...
Hello Ludlow,

Thank you for letting us know how you are doing. I have been watching your post for a while to see if you were getting any relief. Back pain is sooooo bad and dilaudid (hydromorphone) was the first thing that gave me any relief from mine. I have since had to change meds because it stopped working as well after quite a while, but for a very long time that was my med of choice.

I hope you will have a long term relief from this problem and can have that well needed pain break that makes you feel like a "human" again.

Just a quick caution though....please do not tell family/friends what you are taking and keep all of this med out of reach and perhaps even locked up. This is a med that is stolen quite frequently and sold...please know that there are many people who will befriend you simply because they want this med from you and will do anything to get it. Even though your dose is low, it is something the scavengers will seek if they know you have it. I keep my meds locked up in a safe so noone can see what I have. Only what I need is left out for me to take and even that will have to be locked up as the people start working in my house today. I hate to even suggest family might take it, but I know someone personally who did this to his mother-in-law on the day she passed away. It was horrible and it nearly killed him. He is about the same age as you...so it is not just "kids" who do this.

Please do not think I am being condescending in any way, but I know you are new to the chronic pain medications and I don't want you to be another victim. Most doctors insist you file a police report for any stolen medications and that can cause some serious family problems, as I'm sure you are aware. Of course...that also leaves you without pain medicaitons because most doctors will NOT replace lost or stolen pain medications of this kind because they are so often abused or illegally distributed/sold.

I wish you luck. Please continue to read and check in. Someone is almost always here to answer questions and to help give support. We're certainly not doctors, but we are a well informed bunch of people from just about everywhere.

Well said, I didn't think it was the least bit condescending if that means much.

I take Percocet and get 120 a month and live in a dorm with 5 guys...luckily I trust most of them but I leave the big 120 bottle underneath my underwear drawer! Better safe than sorry because allot of doctors will NOT refill anything lost. I also do not carry excessive amounts of the medicine on me, just enough for the day and then some in a much smaller bottle from a previous script, its a bit worn but it doesn't say "OXYCODONE" in big letters for the whole world to see...that said I still end up having to explain that I have chronic pain. Opioids are a very big target for theft, I've seen blatant theft and the result it has on someone who has unimaginable pain so BE cautious.

Good luck with your health! Pain can really be psychologically destructive so just be honest with the level of pain relief you need as always.

EDIT: I should post that I have a traction machine at my house that I used to use when the bulging disk in my neck was really bad...it helps insanely well for me! It was my "retreat" when the pain was ridiculous, I can't use it now but I can attest to it being great. TENS unit didn't do anything for my back but I have nerve damage in my right pinky/hand from a bad break and the TENS unit was excellent with a nice hot towel. Massages are great as well, I tend to tense my shoulders when I get stressed which aggravates the AS in my neck so I usually get someone to massage my neck/upper back first before I take any pills.

Post Edited (Medicalkid2) : 2/17/2012 7:12:46 AM (GMT-7)

Posted 2/17/2012 3:32 PM (GMT 0)
I am fortunate in that I have a wife that monitors every med I take whether it be dilaudid or baby aspirin. If it weren't for her, I would most likely forget to take anything at all. I realize how much some of my medications are worth on the street and that is why other than my wife and doctors, no one else at all has a clue what meds I take or has access to them. I know that some people get off on prescription drugs, but for the life of me, I just don't understand why anyone would want to "fix what ain't broke" and to feel so out of control.

Ludlow
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