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Old 07-17-2010, 08:28 AM   #1 (permalink)
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I'm a pain patient that was dropped from my pain doctor

I am new to the forum and hope that I am not out of place here, but I thought this might be a good place to come for help and advice, since my doctor is not helping me.

I have severe, chronic back pain due to a number of issues: arthritis, herniated discs, degenerative disc disease, bone spurs, and scoliosis. I also have human parvovirus, which causes joint and muscle pain.

I have been on hydrocodone for about 4 years, legally. I've been on 15-30 mg (7.5/500). For the record, I am not addicted to them. I use them for the pain, and I don't feel a high from them. It simply feels good to be released from the pain. However, the pain has been worse for the past few months, and my doctor increased the hydrocodone, but it was making me far too sleepy, and I couldn't function. I have a 5 year old to take care of.

So, I had some left over tramadol that i had tried last year (didn't do much for my pain, so I went back to hydrocodone). I asked my doctor about taking tramadol and lortab alternately to help ease the sleepiness since tramadol doesn't make me sleepy. He said no. I asked if there was any other way to treat my pain so I could take less lortab (I've tried everything from natural medicines to acupuncture to massage, etc.). He said there's no other treatment for me but medication.

So, stupidly, and out of desperation to be able to function, I started taking the tramadol anyway - just one in the morning, so I wouldn't be sleepy during the day. On my next visit to the doctor, he did a suprise urine screen and of course it showed the tramadol. He immediately dropped me as a patient.

He gave me to no information about lortab withdrawal, or weaning, or anything. I don't know what to expect. I have called his office twice asking about this, and they haven't returned my calls. Should I wean? I have about 20 lortabs left, but I was thinking of saving them for when the pain is so bad I can't move. I haven't taken any lortab in about 24 hours and I'm in excrutiating pain, and having chills, sweats, vomiting. Will tramadol help with the withdrawals? I have plenty of those left.

Also, because the pain is so excrutiating, I still need relief. I'm seeing another pain doctor in about 5 days. What should I tell him about my history? Should I be completely honest? What if he refuses to treat me if I am honest? But I am uncomfortable with lying or withholding information - that could make me look like I'm just trying to get meds.

I just don't know what to do! And there's no one to help me. If anyone has any advice, please help!
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Old 07-17-2010, 02:26 PM   #2 (permalink)
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First of all, welcome to SR!

I deal with chronic pain from degenerative disc disease, herniated discs, sciatica, and degeneration of the joints on both sides of my jaw.

I also see a pain management specialist for steroid injections into my tailbone area approximately every 6 months. That usually knocks out the sciatica.

I have been through physical therapy several times, and have exercises I use that strengthen the back muscles to decrease some of the pain.

There are medications I cannot take since I am a recovering addict/alcoholic, hydrocodone and lortabs being two of them.

I do take tramadol. I can have 1 50 mg tramadol up to 3 times a day. I don't always take 3 a day. Some days I take none.

There are other medications that help my pain level. I am on Cymbalta for clinical depression, but it also helps the overall pain.

Neurontin is another medication that I take. It's commonly used for diabetic neuropathy.

I have always been honest with all of my medical providers. I can't be properly assessed and treated if I am not honest.

Hopefully some more good folks will be along to respond to your questions who are better qualified to answer your questions about the lortab.
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Old 07-18-2010, 09:12 AM   #3 (permalink)
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Hello painpatient, and welcome to SoberRecovery

Freedom pretty much covered it. Yes, there tons of other medications that will help with chronic pain. I take one called "Depakote" that is similar to Neurontin. Yes there's other things to do besides medication that help with pain, I do yoga. Yes, there are medications that counteract the sleepiness of pain meds, I take ProVigil.

Basically, people that have short term pain can take just one medication for a short while. Chronic pain requires a "recipe" of medications and treatments that balance each other so we can be on them for the rest of our lives. Any one medication by itself is going to have side effects that add up and eventually cause more harm than good. That's why there are doctors that specialize in chronic pain management and even clinics just for that purpose.

I tell my doctors the whole truth. I tell them that I want to be on as _low_ a dose as possible, as _few_ meds as possible, and that the ultimate goal is to keep me functioning at a level where I can keep my job. Otherwise I won't be able to pay their bill

As far as weaning yourself off, my suggestion is you continue to take the meds prescribed by your previous doctor, exactly as prescribed. Changing dosages or meds on your own can cause all kinds of unexpected side effects, never mind that you are in pain.

Come back and let us know what your new doctor says.

Mike
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Old 07-18-2010, 01:17 PM   #4 (permalink)
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thanks for the replies, guys. I appreciate it more than you know. DesertEyes, as for taking my meds as prescribed, well the previous doc said to stop taking them. So I'm afraid to keep taking them when I go see the next doc. If the next doc does a drug screen, I want to be clean. It's going to be a hell of a week waiting to see this doc. I've been 2 days off lortab and tramadol, and I feel like hell. I've actually contemplated suicide, the pain is so bad. But I don't know what else I can do. I just have to tough it out until I can see this next doctor.

I'm afraid that if I'm honest to this next doctor that he won't prescribe me anything at all, or help me at all. But I don't think I really have any choice except to be honest about what happened with the previous doctor.

I will tell the new doctor that I need to be adequately managed though, because I am tempted to misuse drugs when the pain is so severe. I'll do anything to get rid of the constant pain, even if it causes harm to myself. The pain makes me absolutely crazy. Hopefully this new doctor will be more aggressive in finding adequate treatment than my other one was. I told the other one many times how I couldn't function on lortab, but they basically said, "sorry, the only other option is natural methods."

But now I'm learning from many other sources, you guys included, that there are other methods. I should have sought a second opinion long before now.

Keep me in your thoughts this week, as I'm going to need all the strength and courage I can muster to make it 5 more days through the pain.

Thanks again for responding.
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Old 07-23-2010, 01:30 PM   #5 (permalink)
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the appt went well. the subject of medication didn't really come up, and I decided to let it be at that. the new dr is going to do some more tests and possible treat me with injections. Has anyone ever had epidural steroid injections? Did it work for the pain? I'm not certain it will work for me as I think my pain is muscle pain, but I am hopeful it will work anyway. If it does, it will sure beat being on meds!
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Old 11-22-2010, 09:26 AM   #6 (permalink)
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That doctor didnt sound very compassionate. Look, you have every right to live a pain-free life, or as close as you can get to it. I think your doctor went a little over-board here. The hydrocodone isnt even a controlled 2 substance, its controlled, but not to the degree for example of morphine or oxycodone is controlled. And tramadol isnt controlled at all, at least not federally anyhow. It may be controlled in some states however. Nevertheless, I think you would be just as well to dump that doctor and find a more compassionate doctor that cares mainly about helping you live pain-free, versus controlling every aspect of your life for goodness sake!

Good luck to you.
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Old 12-24-2010, 12:01 AM   #7 (permalink)
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I am in a similiar situation. My previous pain doctor stopped prescribing because he thought I had a new pain doctor that was going to start prescribing in November. I was on 60mg a day of methadone for chronic pain for over 5 yrs. It worked well and I had a quality of life. My primary care doctor was so upset that I ended up in detox that she got me on suboxone. Suboxone doesn't help my severe pain (from degenerative disk disease, fibromyalsia, spinal stenosis, facet joint disease and osteoarthritis in my hands, back, and now my left knee has bursitis and needs surgery). The new pain clinic will not prescribe me my methadone so right now I either have to continue the suboxone (to keep from being so sick) or go to a methadone clinic. I managed my methadone properly but my old pain doc had me trying oxycontin then mscontin and I had bad reactions to both (plus insurance won't pay for oxycontin) that I got put back on methadone. I was tried on Fentanyl patches over 1.5 yrs ago but the adhesive burned my skin *2nd degree burns*. I had tried suboxone for a clinical pain trial over 6 yrs ago, I stayed on for 1 yr, but after 8 months the suboxone was increased to the highest dose of 32mg a day and it stopped working so I was released and the new doctor (my old primary care) put me on Methadone, then she closed her practice and I went to a psyc/pain mgt doctor, and now I have none. The new clinic I tried refuses to give me any narcotic even though my previous pain doc recommended it and the doctor before him also gave me a great reference. They said I had a dirty urine (morphine) back in Oct 2010, I cannot remember if I was on a trial of MSContin or not at that point, I don't think so. I checked my med log and I was only taking methadone and hydrocodone. There was a mistake on the test, they said I was positive for a herion metabolite, and I really wasn't so who's to say the rest of the test was right? They said there was no hydrocodone and I have it down in my med log that I was taking it at the time! I did not go to "the street" for anything, methadone worked great for me and now I am suffering. I also have to struggle to get a prescription for celexa and welbutrine (I have been on those since way before I had chronic pain!!). I am very upset! I am not doctor shopping, but I am looking for an understanding pain specialist and a new psychiatrist since I cannot be dumped off my anti-depressants at the same time as being dumped off major pain medication! Its barbaric when doctors do that to people! Hang in there, take what you have left AS PRESCRIBED and be honest with your new doctor, if he/she doesn't understand and won't help you, then you know they would not be a good fit for you, keep trying! Don't go to the street, I did ONCE and because I was honest about using herion ONCE (I don't barely remember I was only 6 days off methadone and I was CRAZY threatening suicide so a "friend" brought me herion, I did not want it, but was coerced by promises of feeling better. It didn't work, I had a reaction to it and had to go to hospital the next day. I am VERY embarrassed! Now that's in my record! Some doctors will understand but most won't, so don't make that mistake! Hang in there and I wish you the BEST of luck. Let us know what happens.

Sincerely;

Jaz
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Old 12-24-2010, 12:05 AM   #8 (permalink)
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I have had over 13 different steriod injections. 3 for neck, 1 for lower back, and 8 trigger point injections and also oral steriods. No effect on my pain, but its because of the arthritis. Plus I had side effects from steriods oral and injected. I got very bloated or swollen in legs and hands, I developed a bad temper and was hard to be around (like 'roid rage or something, my buttons were easily pushed). They were temporary side effects but there can be long term side effects from too much steriods in your system please ask your doctor for a complete informed consent on steriod injections and possible side effects, they do work great for some people, just as long as its not used all the time. Good luck!
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Practice "self-compassion". Let go of those "stupid" everyday trivial things that can bring a recovering addict to their knees. Its more important to focus on yourself and love yourself even if you do "mess-up a bit". :ghug3
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