How do I know?

[karabear77]

Hi, I have been reading posts here for about a year ( and once upon a time posted with another question). I will give a short version of what is going on and then will try to quickly get to the point. I am 31 years old, when I was 24 I was diagnosed with Uteran Cancer. I did the treatment and in the end had a hysterectomy. I have been free and clear since...Thank God! I found out about the cancer because I was having severe pain in my abdomen. About 6 months after my surgery I began having the pain again. I went to the Dr scared to death that the cancer had returned. My OB decided to do and MRI and I was shocked when she called me and told me I had multiple herniated disc throughout my L and C spine. She said that this pain could be referred pain from my back. My guess is that the pain I felt before was never from the cancer, but indead my back. Well, I did the therapy, the injections, and the surgery. I was great for about 3 months after my back surgery and then low and behold, not only did the discs reherniate, but my spine began collapsing and I have brachial plexus lesions now. Fun, fun stuff. Ok well to make a long story kind of short. I am on Norco 10/325 - 4 a day (sometimes I have to take 6 for breakthrough), I am 40 mg Oxycontin - 3 a day, and 50 mcg fentanyl patch (one every other day). The reason I am on here is because I get alot of "God, you are on a lot of meds!" even this from my new doctor who even after that statement feels that I need all these meds. I have no doubt that I am physically dependent on these meds. I have tried to stop just to see what happens and become sick as a dog. I dont take them to get high..actually hate that feeling. My question is, how do you know when it is a problem? I have been on these meds for 4 years and my pain dr says I will never be off of them. I have read so many of your stories and it makes me extremely scared. I am considering the morphine pump, but dont know if this will be a bigger problem. Does anyone know the difference of dependence and addiction and also has anyone had any experiances with the pump. I pray someday that they will come up with an answer, but until then...well, I guess that is where I am right now. Questioning and scared. Thank you for your advice.

[Sara9009]

Welcome to SR. I strongly recommend this book. It is very helpful and discusses a lot of alternative therapies and the use of narcotics safely.

Amazon.com: Living with Chronic Pain: The Complete Health Guide to the Causes and Treatment of Chronic Pain: Jennifer Schneider: Books

Your Doctor has probably told you not to abruptly stop your medication because you will have w/d symptoms because your body has become physically dependent which is completely different than addiction. When pain medication is taken properly and for a legit reason it is very rare to actually become addicted.

Opioids: Addiction vs. Dependence

Prescription Drug Abuse - Preventing Abuse Of Prescription Drugs And Pain Medications

As for Doctors comments on the amount of medication you are on. I can see a Doctor that will say "Wow, for all of your health problems you are on very little medication." and I can walk into another Doctor's Office and get the "You are on a lot of medication." It really is just a flip of the coin and of course the ever annoying "You are too young to have this many health problems." Like I chose them from a basket or something. LOL

Anyhow, I hope this helped a little. I hope your pain levels stay as low as possible today.

[DesertEyes]

Hello there karabear, and pleased to "meet" you.

I hear you about docs who think we're on too many meds. I get the same reactions as Sara. Some docs say I'm on too many, other docs say "Is that all?".

How to know when it's a problem? There's several ways, here's how I do it.

I keep my meds as _low_ as possible. I don't _stop_ 'em altogether. I tell my doc first, and then I slowly reduce the med little by little so I know what is the _minimum_ I need. When I get to that minimum I start reducing another med, until I have the lowest amounts that still allow me to get along in the day.

I keep a written log of the meds I take, what time, how much, and what for. It helps me see if I'm starting to increase the meds without knowing, and I show it to the doc so they know how I'm doing. This log also keeps me honest. I know I'm taking the med because I hurt _physically_, and not because I'm feeling _emotional_ pain.

Every year I have me docs "rotate" me to a different pain med. This year I got off Lortab and instead I am on Tramadol. That keeps my body from getting too used to any one med, and from developing too much tolerance.

Taking the meds for emotional reasons is where addiction starts. So I take special efforts to take care of my emotional needs. I do yoga, which helps me maintain serenity. I have a hobby and I make sure I do a little bit of it every day. I get out with my friends even when I'm lazy and would rather stay home. I get interesting books at the used book store or the library and when I'm too sick to go out I make a litle time for _me_ and read something fun.

I step outside the back door to my place where they have a few trees and some grass in the alley between the buildings. Early in the morning when the birds are chirping or at sunset, and I say a prayer of thanx that I'm alive and able to enjoy birds and sunsets.

I have a few very good friends that know me well and I tell them when I'm feeling emotionally down. They know how to cheer me up quick, and how to spot when I'm just on the "pity pot".

There's a few ideas, see if any of those work for you.

Mike

[lizw]

I take 4/5 different meds each day and to some of my recovery friends this is 'heaps' but then compared to another I was with the other day who takes like 20, it is nothing.

I have MS and fibromyelgia and I take my meds as directed by the doctor and don't try to 'doctor' myself, which as an alcoholic I am tempted to do because I know everything. Not.

I think for myself addiction is more about behavior and attitudes rather than the actual eating of medication. My body is probably physically 'addicted' to taking the meds I take (i.e. I can't just stop taking them) and this would be the same in a non alcoholic too, as at the end of the day we are all made of fleash and blood.

But like yourself I don't take my meds to 'get high' and the times when any meds have affected me in this way, I've gone back to my doctors and told him ASAP, rather than kick back and enjoy it.

In some way as strange as this may sound, I am grateful I have some actual choice over how I treat my illnesses as I am sure was I still drinking, I would not have any diagnoses as booze is quite good at covering up everything.

[karabear77]

Thank you for all your advice. It is so nice to know that I am not alone. I felt stupid asking and felt like if I had to ask then it is probably a problem. I just get so much crap from not only my new dr but also my pharmacist. I am very good at handling pain and believe that a good outlook can be just as healing as anything else. So, I continue to work my 40 hours a week and try to be as active as possilbe. I fear that if I went on disability and allowed myself to surrender to the pain that I would shrivel up and in the end I would allow the pain to consume my life...and in turn so would the meds. I have tried to explain to many people that if I didnt have the pain meds, I probably wouldnt be able to function normally because I would be in so much pain. But as all of you probably know, if you havent experianced chronic pain then it is impossible for understand what all of us go through on a daily basis and the struggle it is to do "normal" activities. it is really nice to have others who know what I am talking about and understand the "balance" that we all must obtain. Thank you all so much!
Just a little update on me, the Saturday before last, I was laying on the couch and very suddenly got a tremendous pain in my stomach right under my ribs. I thought my hubby was going to have to take me to the hospital. It was probably the worst pain I have ever felt in my life (even more than delivering my son). This "attack" lasted for about 2 hours and then it started to subside. I have had a lot of little "attacks" in the past week but nothing like that first one. Since I work in healthcare, my first thought was that it was my pancreas. This scares me to death as I dont want to have to live on insulin the rest of my life and pancreatitis patients rarely live past 7 years after diagnosis. I am going to the dr this afternoon to get some tests done, but I wanted to ask for your prayers. I am really hoping it is just my gallbladder or something. I will let you all know what I find out. I am just scared and nervous right now.

[Freedom1990]

You have my prayers! :ghug

[MROBI]

hey its o.k. you know. i hate the opiate stigma and fears of this country and the dirty looks and attitudes of the pharmacist when i go for refills. screw um. these meds really help me to live a decent life that i and you deserve. if i could trade my position i would but cant.
i know im physically dependant on the meds and thats o.k. im working with the dr. and letting him be the dr.
the difference between addicted and dependant i like to say is like this: we are physically dependant on water to live but that doesnt mean we are addicted to water.
i hope this helps.

[karabear77]

That does help MROBI! I am so sick and tired of being judged by not only my new doctor, but also the pharmacists. I thought it was illegal for the pharmacist to ask any questions about the meds my doctor prescribes??? I have been going to Safeway for my medications for 3 years now, they ended up getting two new employees in the last few months and both of them have reamed me up and down about the narcotics I am on. I even had one tell me that she totally disagreed with my doctor and tried to argue writing my fentanyl patch for every 48 hours...she kept saying "does your doctor know these are supposed to be changed every 72 hours..not 48". I was like "Lady, of course my doctor knows..she has been writing for my meds for the past year, but of course. Your 25 year old ---- knows so much better than either my doctor or myself!!!" Give me a break! I felt like that lady in the movie "Magnolia" who goes off on the pharmacist when she goes to pick up her meds. I did maintain my composer and just knodded my head...
Thank God I have all of you to vent to. Thank you so much for being here for me.

[ImStayingSober]

Hi Karabear. I had a little bit of back surgery myself, implantation of titanium at L-4/L5 fusion for a fracture. Missing disks too and all that so yeah, know sort of what pain you're talking about. For 9 years, I took nothing but ibuprofen. Because I didn't want anything narcotic. (I'll get to that part later about how long term high doses of ibuprofen can cause strokes) In the hospital they had me on a morphine pump and I didn't want it, the nurses hit it a few times because they were tired of hearing me groan. Afterwards they sent me home with a bottle of 60 flexeril and 60 darvocet. When I went for the staples out a week later, they asked me if I needed a refill yet. Huh? Not me! No i only took half of what they said to take every 8 hours instead of double that every 4 hours. Everyone is an individual with pain tolerance, mine is high. But, when they asked me if i wanted a refill i thought, "hmm i have a lot left, more is better right?" (to myself). so that is why i said no, because when i am thinking that way, it means i'm thinking there are other uses for it, such as getting high when i'm not feeling so great about some situation besides back pain. All through the surgical recovery and physical therapy, I didn't have a refill and in fact didn't finish the medication that was in the bottles. I depended on solely ibuprofen, 800 mg tabs a couple times a day. Well, that's bad for you too, turns out. I would just caution you against taking high doses of that for your pain if it's going to be a long time. Not sure how long, definitely 9 years is too long.

Anyway yeah the watch word for me is when i reach for the pill bottle is it because my back hurts, and the time on the clock says it's time to take one... or does my mind hurt and i just want some relief. Good luck to you.

[karabear77]

Yes, Imstillsober - The whole ibuprofen thing is terrible on your stomach, your liver, your kidneys...god knows what else. I work in healthcare and far too often do I see people in liver failure because they ate tylenol or ibuprofen like candy. Alot of people refuse to take meds because of the physical dependence, but there is a place for narcotics. The doctors dont want us to fry out insides with the tylenol, that is why they write for narcotic pain medication. There is a fine line and I guess that is where I get stuck. My pain meds are a 24 hour, around the clock thing for me, so I am sure I am physically dependent. I am just so sickened with the way I get treated by those people who dont understand chronic pain. I am the poster child for all the other therapy out there in replacement of pain meds. I have done it all..water therapy, pallates, injections, massage, tens unit...etc, etc. The only thing that has allowed me to continue working and taking care of my family is the pain medication. I dont take them for any other reason than pain, but I am on them 24/7. I just wish there was a way for me to find a doctor that would treat me like a human instead of a drug seeker. I worked in the ER for 7 years and I know what a drug fiend looks like...I have never gone to the ER because of running out of meds too early, or for something stronger so why the attitude from my doctor and now the pharmacy?? Like being in pain isnt stressful enough!

[aasharon90]

What's so neat about being in
recovery is.....You Never Have
To Go Thru Anything Alone or
By Urself.

As silly or stupid as it might seem
to ask, ask away. You will be
surprised at the answers, suggestions
that you will recieve.

Most people are kind, caring and
considerate and ready, willing
and able to help you.

If u cant get one person, try
another.

Me I can come here to my SR
family and ask away...

All the way from what to cook
for supper, to how to move with
ur pets, to how to fix ur car and
most of all ....members sharing
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hopes in recovery.