how to tell if pain meds improving quality of life.

Well KSD that is something only you can answer really but how was life at 10 versus life at 5-6? Can you do more things? Do you spend more time with others instead of closed away in pain?

Most of us at some point realize we will never be pain free again and this is just the price we pay for having medical disorders and diseases. We then go for the best we can get without being in a coma or brain foggy all the time or sleeping more then we are awake and with the least amount of with the least amount of side effects from meds.

By doing all we can above and beyond and thinking outside of the box pertaining to meds we all use different things and what works for one of us may do nothing for others. I love my hydro therapy and it has been a real god send. I go 2 times a week now but would go everyday if medicare would pay for it. Lol I use heating pad,I may use a sports rub from time to time, I sleep in the recliner and recall the discussion about beds? Another way we are helping our pain without adding more meds.

I have severe bouts with my sciatica some times and you will find me in a kitchen chair with it tilted back and my leg pressing against the wall for 15-30 mins, dont laugh as long as I am doing that,pressing my foot against the wall it must be releiving whatever is pressing on the nerve and it brings relief?? Sounds dumb but hey whatever works!!

I know before I found a good level of relief with my meds and this took years not months, and devised all the ways to help myself and listened and asked for advice from the forum members and tied all of those together I really had no life outside of the pain,it controlled my every waking moment. I ate it,drink it,slept with it,and even thought about not living with it. So once you find the right amounts of everything that suits you and you realize hey? I can do this and you can smile and even laugh again without it hurting you will just know its the right place and your quality of life is ok.

Vickie

We are all different but when Im at a 5 or 6 I am a happy camper!!!

On a few occasions I can even get to a 3or 4 and I then panic,run out and do all the things I cant normally do and then back in bed the next day wondering what the heck did I do that for? Lol

I hope you get some good relief out of the blocks and I know you read alot of negative here as well as ok but nothing works the same for all of us. I get great relief from injections in my knee but not so good in my back and not every time and the amount of time they last varies as well.

Vickie

When I'm at a 10, it almost feels like an out of body experience.

I hurt so bad that it's overload on my mind or something. It also throws me into a panic attack sorta situation because with my type of pain- the spasms and nerve misfires and tightening- it feels like my chest is like a vice and I cant get a full breath.

I experience a lot of different types of pain in a lot of areas, so my pain levels vary a lot, but usually with my pain meds working and as long as I havent done too much I can sit at a 6-7 on most days. Some days its as low as a 4-5, but thats as low as I go these days.

Even going from a 10 to a 7 is a huge improvement for me, because EVERYTHING hurts, if that makes sense.

hello KSD, my pm doc has just recently increased my doseage. i was on hydro 10/500 twice a day for bt now its 3 times a day as needed for bt. i dont have to have it everyday but if i ever decide to make a bad decision and do something i know i have no business doing then i have to take it more often.

it does give me a better quality of life. if i didnt have the meds, i would be hurting to the point where i snap at the people i love the most. i know how to tell when the pain is getting to me and i need something for it. right when i start getting a short temper with my husband or the kids i raise, i know its time.

normally they know its coming too. i try my best to stay to myself until it subsides a little. i dont want them growing up and having bad memories because of me being in pain. my daughter is 22 and married and she hates to see me in pain. i hide alot. the two kids im raising because their mother, who was my best friend, died a couple years ago, to me have been through enough pain loosing a parent at a young age. i dont want them to have to see me in pain and i definitely dont wanna take it out on them.

thats the way i know if i need an increase. when its gets outta control. i hope this helps a little
janet

Same thing for me re: Level 10.... There's only been a couple of true, level 10's for me.... 2x w/ meningitis... and the night of my surgery w/ the twins.

My pain level is between a 5 (on a REALLY good day, not very often)... averages about a 6 to 7... and is an 8 on the very bad days.

My sciatica when it comes is a level 8. Vickie - I truly know what you mean.... I do crazy stretching.... use of a tennis ball.... I look ridiculous, lol... But anything to change that miserable pain.

When my meds haven't been stable - I'm at a continual 8.... and that's just unacceptable, as it makes life VERY difficult.

KSD.... so it all varies.... but it sounds like the med is getting your pain down - and, to me - that's a huge improvement in the QOL. :)

--Tina

KSD,

I totally get what you are saying.... On my bad days, it feels like a 10, too....

Here's a link to a pain chart that has helped me many times over the years:

www.wemsi.org/painscale.html

Take good care --Tina

Oh and vickie, sleeping in a recliner actually can and will make your pain worse. My doctor scolded me on this when I told him I did this. It puts more pressure on your discs and muscles and even though it feels good at first, once you get up from the chair it is much worse. One of the worst things you can do. If you can try to limit your time in the chair to 30 mins at a time with breaks.

It's funny how we all score our pain, isn't it? My '10' is pain that causes me to lose consciousness - I've walked on a shredded knee, tried to walk on a spiral fractured tibia, so I know my personal pain tolerance is very high.

Something else I have found in my cp journey is that new things cause me to revise my pain score. When I first developed CRPS - I used to rate my pain at about a 5. The pain I felt then - if I was subjected to the same degree of pain now, I'd probably rate only a 3. My pain now is around a 7 or 8 on a daily basis - it spikes higher very frequently - because my nervous system is so sensitised by the CRPS and any pain signal gets amplified, even a little knock can have me in agony - but those spikes are usually pretty transient. It would be VERY rare for me to visit the ER, just because I dislike them so much, but a week of sustained flare would have me calling my PM for advice.

Laura

It also depends on how affected your quality of life is. Some people start seeking treatment for nagging injuries that cause them daily, but not constant pain. A constant 3 can make some people berserk.

What you consider your daily activity varies as well. Someone who is still working, especially in a manual labor job still has to navigate stairs, lift 50 pound items from the floor, crawl around on the ground, climb ladders, etc.

Someone who has reached the point of disability simply wants to be able to wipe themselves when they go to the bathroom. Or walk through the grocery store. You have to plan each move out ahead of time, taking body mechanics into effect, and asking for help to carry certain items, or at least get them into a grocery cart. I know myself, I can handle a 24 pack of sodas, as long as everything stays at about waist level. Above or below that, I really have to plan an attack.

And Laura, what you are talking about is a phenomenon called hyperalgesia, which means your body registers everything at maximum level. It's like a dimmer switch going bad. You only get on or off, nothing in between.

Where something like a TENS unit overloads specific areas with small amounts of information to try to get it to temporarily shut down, this makes everything feel like a 3 alarm fire.

It's interesting how different pain scales can be. The Mankowski scale, the one in the link above, goes up to unconscious while the Baker-Wong scale only lists "hurts worst" as the top. The latter is the one often used with the pictures of faces. When I'm asked in the hospital for my pain level they seem to mean the B-W scale. When I was asked by the IME doc, he wanted the former scale, but I don't know what scale he was going to use writing his report.

For me, pain is different depending on location. Tooth pain needing a root canal and not responding to opioids is 9 for me. Abdominal post-surgical pain isn't nearly as intolerable. The pins and needles in my legs and feet make me limp, but I know there's no point in taking meds for it. I still reserve 10 for rolling around not being able to talk. If I'm moaning after surgery, that's as much as I can express. I have never screamed, just can't bring myself to do it, although screaming might get attention where moaning is ignored.

I gave up on hydro and other opioids. I get tolerant to them within a week or two, and they never did much for pain. Morphine is like water. I don't know how you get people to understand it doesn't work for everyone. Tramadol, while not supposed to be a big pain reliever, Helps me more than anything else. I think it's the serotonin raising effect. I don't know why Elavil doesn't seem to help though.

NSAIDS work for some people. I get nearly nothing but stomach upset from Tylenol. Aspirin helps, also Advil, but not much. I get nothing from naproxen. Celebrex is better than nothing. I've tried the rest with little relief.

I get muscle spasm relief from my TENS. It's supposed to help with post-surgical and injury pain, but I have no experience. It did not help my torn rotator cuff, doesn't relieve the nerve pain from pinched spinal nerves.

I used to get relief from epidurals; then they quit. The first caudal was great; now they don't do anything. I had a facet injection a week ago which helped a lot for a few days, but now the bilateral stabs everywhere in legs and feet and sciatica are coming back along with the pain in the entire lumbar spine. I've got a few weeks to wait to see pain doc again, but he'll definitely do nerve testing again (ouch!!!) and maybe another facet block. I'm keeping a journal. I expect ablation in the future.
I had that for ribs. It worked the first time, but not the latest.

My point is we all feel pain differently and react to treatment differently too. Treatment may have to be changed when it stops working. Where it's hurting makes a difference. Keep a journal of procedures, meds, reactions.

LivingColor, with CRPS it actually goes belong hyperalgesia to another - even more torturous - phenomenon called allodynia. You might be aware of what it is already, (you're very knowledgeable about all of this - just because of your conditions and pain, or is it your background?) in case you're not it's where central sensitisation - and it's proposed changes to the microglia - mean that even non-noxious stimuli may be perceived as excuciatingly painful. For example - a strong breeze can hurt, I can't shake hands with anyone without pain. I think it's a good four years since I've slept under a blanket - because the weight on my body is such an irritant.

CRPS, I have my own personal experiences (fairly well documented here), and medical training as an Emergency Medical Technician and physical therapy assistant. Mom's a retired RN, Dad's a combat decorated and wounded former Marine Corpsman and a retired Respiratory Therapist. I grew up around hospitals and the medical community. I read Gray's Anatomy and mom's other nursing books when I was a kid.

I like crusty old doctors that shoot straight and tell the truth, and I adore little nurses with big attitudes and bigger hearts who can run an ER or ICU efficiently, while having the stones to put anyone in their place with a look or two words.

I am familiar with allodynia, as it happens to me sometimes. Thankfully, rarely. Usually with me it's tied to migraines.