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In pain, but affaird to say anything to the doc.

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Posted 2/21/2014 10:15 AM (GMT 0)
So Let me give you guys a little back ground on my condition. I'm 20 years old, almost 21. I've had two knee surgery's. which they gave me initially Vicodin 5mg. That was not strong enough after 2 ER trips and another knee surgery later, they gave me perkecet* 10mg for my knees. Now me knees are all fixed and strong as ever. After several MRI's and X-rays they find I have a herniated disc in my lower lumbar spine and an impingement in my S1-nerve route. Let me tell you it hurts something firece. I'm on vicoprofin now (7.5 vicodin/500mg ibprofen?) and a anti-inflammatory that I can't quite remember the name of.

I've never been good with pain, but I feel like I'm taking an advil when I take a vicoprofin, it has little to no effect on me. Even when I was on the perkecet 10mg it didn't take the pain away very well. I'm on other medications for bi-polar disorder. Could they be effecting how these medications work? Or making them less effective? As far as I know perkecet 10mg should put a large man like my self down and out for the count. I'm nearly 6 foot 4 and about 290lbs. But I have had friends and family larger then me on lower doses and they would be asleep half the day from a 5mg perkecet tablet.

I have a doctors appointment with my pain management doctor on Monday the 21st/14. I am kind of afraid to ask him for anything stronger for fear of him thinking I'm drug seeking or something of the like. That and for what my condition is my current medication should be more then sufficient if I'm not mistaken. I have been told to "man it up" but it feels like every time I bend over or sit to long someones taking a hammer to my back.

When the medications do decide to work, I also feel as if the effects of them go away in about 1-3 hours of taking them. I'll give you guys a list of my current medications. Any advise on something to try would be wonderful. Just a side note the doctor said get an inversion table, but I'm not t thrilled about the aspect of hanging upside-down and having my spine pop.

Thorizine 100mg once a day at night
Celexa 30mg once a day at night
Abilify 25mg once a day at night
Topamax 200mg once a day at night.
Vicoprofin 7.5mg every 4-6 hours as needed for pain.
Posted 2/21/2014 3:00 PM (GMT 0)
Good morning d99. Welcome to the forum.

I'm more than 3 times your age and way less than half your weight and Vicodin (similar to your Vicoprofen) barely lasts me 4 hours and isn't really enough either. My problem is having to have pain meds for a long time and getting tolerant. You've been on pain meds a long time too, and it counts even if there have been breaks in the treatment.

I see you're also on Topamax. Is your doc giving you that for nerve pain or just the bipolar? I was on that one for nerve pain and never got any relief from it. If you don't know what it's for, you should ask about it. There are lots of other things that are also non-narcotic you could try for pain (prescription of course).

I've been on meds so long that I have to first keep a journal and second, keep a list of meds I've tried and the results or side effects with each. If you're scared about talking to your doc, you could write down what's happening and give that to the pain doc. There are "pain charts" online too. I just find it easier to keep a good diary/journal with date, time, what I take and how pain and side effects are every few hours.

I'm with you on inversion. No way. But if you research spine pain, it seems that most disc pain will go away within a year or so as the disc dries up - if you can just manage the pain long enough.
Posted 2/21/2014 3:05 PM (GMT 0)
To check for medication interactions you can check www.drugs.com list most of the reactions.
At your appointment on Monday, just speak up and say your having a hard time of it and the pain seems to be getting worse. A MRI might be in order to see if your disc is getting worse...Physical therapy might be worth a try after getting an updated mri...maybe a moist heating pad could help or ice...
Others will come by with better advise, but you do need to speak up on Monday and tell your doctor the pain is worsening, who the heck told you to "Man it up"?
Makes me mad that someone told you to "Man it up"...pain indicates something is wrong and is nothing to Man up about, you need to talk about it with your doctor....
Posted 2/21/2014 3:15 PM (GMT 0)
Hi D99 & welcome to the forum. Alcie gave you some very good tips about the upcoming drs appt. Keeping a journal is really helpful & it can some times help you show the dr that you take your situation serious. We are seeing more & more pain mgt drs not giving meds on the first visit, with some its the 2nd visit before they will script something.

I would suggest letting the dr know how much pain you are in, what makes it better or worse. Also let the dr know what you do to try to get the pain down on your own. Drs do not like to see patients relying on pills only. Just be honest with the dr & you should be fine.

Inversion tables are something I would stay away from. I know of people personally that ended up worse off after using one of those.

Others will pop on & give you some more thoughts on this. Take care.
Posted 2/21/2014 3:56 PM (GMT 0)
I agree with Susie. Tell them you are still in a lot of pain despite the current treatment plan. I wouldn't ask for percocet 10/325 by name though... You can tell him that the vicoprofin isn't sufficiently covering your pain and ask if there is something else you can try. You can mention that in the past percocet helped with your leg and brought your pain levels down... But I wouldn't ask "Can you give me percocet?" Let them decide what they want to give you based on your past experience, your current pain levels and their knowledge.
Posted 2/21/2014 4:01 PM (GMT 0)
I'm up for journaling as being a very important tool. I learned about it the hard way, sort of, when I started writing notes about my condition a number of years, and was keeping track of all of my falls and trips, not making the connection my neurological problems.

I'm still going through all our books which we have in boxes and canvas bags still in the basement and the first floor,...and I came across some of my earlier notes. It did me good to read them, and remind myself not only of where I was, but also that I began listing medications I was being given, and the results.

I evolved. My journaling evolved. It became more detailed. Reflecting back, I'm thankful I did because it reminded me of triggers (the ole memory isn't always up to snuff), bad reactions to meds, really bad reactions to meds, doctors visits, what made me feel better or worse....

It's easy to think we'll just remember, but it's surprising. I kept all of mine, and I still do it. I think being able to demonstrate your own situation in your own writing, provides a lot of information. I hand-wrote mine and you could tell by how my writing varied, those times when the pain was unbearable.

It is one tool, it is one place to start.

And super huge ^^ditto^^ on saying "no" to the inversion table. I've used them (about 25 years ago when my problems were just getting beyond irritating), and as Susie mentioned, -- same here, -- I was much worse for the wear after that thing. I'd never get on another one, ever. Just me, though....




M.
Posted 2/21/2014 7:47 PM (GMT 0)
Welcome D99 to the chronic pain forum at HW. First allow me to say WoW no wonder your knees are bad, thats a lot of height they carry!

The vicoprofin nor even the percocet are what we call LA or long-acting meds, they are designed to hit fast and clear your bloodstream even faster! They're primarily used and successful for acute pain. They have very little success maintaining chronic pain. Thats not to say many here dont use them but do so for b/t or breakthrough pain in conjunction with a LA med.

LA meds are ones designed to cover 12-24 hour segments releasing doses in increments over the course of the day. There are a few transdermal meds that are designed to work 3 or 7 days.

These are the meds we generally use in the treatment of chronic pain as they have a much smoother and even pain relief. It's this I would be steering my questions towards my Dr about.

Simply by letting him know the SA meds are leaving you with up and down relief and you would like to know if it's possible to get something thats not necessarily more in strength but will last longer and work more evenly throughout the day.

For instance only percocet 10 is a SA med and will be wearing down in about 3-4 hours. Oxycontin 10 mgs, same med, same dose is designed to release slower therefore peaking at 5-7 hours and not wearing out for 10-12 for most folks.

I hope this helps you to understand why your meds not seeming to do much?

Again welcome!
Posted 2/22/2014 2:43 AM (GMT 0)
Have your drs mentioned surgery ? I may be wrong, but I doubt they are going to want to put someone who isn't 21 yrs old yet on anything that is really strong for very long, if at all.
Posted 2/22/2014 5:07 AM (GMT 0)
Welcome d99,

I have found an effective way to communicate your complaint is something along the lines of "I am getting breakthrough pain on this drug about xxxx frequency. Would you advise, allow, and/or consider it safe if I took 1.5 or 2 at a time?" I think you should also ask about an epidural.

as said above, most discs will heal and be OK for awhile, maybe decades. I personally consider surgery an absolute last resort if you can no longer function.

The biggest thing is you are going to need the PM to trust you. You need to follow their instructions, live up to the contract, communicate any other relevant info. Don't go in and point at the 10 on the pain scale. They know you're there because your in pain and most will work with you to get you comfortable. Try their suggestions first and honestly and do so for at least a couple of weeks each.
Posted 2/22/2014 2:44 PM (GMT 0)
Hello and Welcome to the CP forum!

Great advice from everyone!….the only thing I would add,…. is if you can take a family member with you who can acknowledge your suffering. My nephew also has horrible back pain, and was complaining to me about his lack of care from the pain management Dr. I suggested that he take his mother with him, and it made all the difference in the world on his next appointment.

You are young, and many Dr's have a reluctance to treat those who fall into this category,….so you too may need all the help and support you can get during those appointments. As suggested above, let them know that the meds you are on, are not helping much. Chronic pain cannot always be treated with just one medication, and in many cases it takes a combination of them before seeing acceptable results for the patient.

Good Luck!

SE
Posted 2/23/2014 4:21 AM (GMT 0)
I second ScreamingEagle!

Bringing in my wife helps a ton when I need to get it across to my Doc and/or PA that I'm in a really bad spot when it comes to pain.

Recently, I had some horrible flares lasting for upwards of a month! Meeting them with my wife resulted in a prompt game plan...med changes and a couple of injections :)
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