Chronic Pain ideas, can anyone help?

[mservant]

Thanks @bigperm20  I can check that out at the chemist but medications here tend to be different to those in the US.  The one I've been taking recently is Solpapiene which is paracetamol with caffeine and codeine.  I hate taking anything with caffeine in as really messes up my sleeping, but having said that I don't want anything that makes me more sleepy as I feel really tired before, during and after migraines but need to be able to work and not take time off sick.

 

[cocheezie]

 
Thanks @bigperm20  I can check that out at the chemist but medications here tend to be different to those in the US.  The one I've been taking recently is Solpapiene which is paracetamol with caffeine and codeine.  I hate taking anything with caffeine in as really messes up my sleeping, but having said that I don't want anything that makes me more sleepy as I feel really tired before, during and after migraines but need to be able to work and not take time off sick.

The drug companies have to add caffeine. Why? Mostly caffeine is added to the codeine and paracetamol (acetaminophen) because drug legislation (in Canada, anyway) requires that most narcotic codeine combinations contain 3 drugs. The added caffeine is beneficial to some, and it is cheap. It is possible to get codeine and acetaminophen without the caffeine, but you need a darn good reason, i.e. a connection between caffeine and benign breast lumps. It is rarely prescribed in Canada. It all depends on the Controlled Substance Act in your country.

@MsServant You say you are taking codeine pills, have you ever tried Fiorcet? It's been really a lifesaver for me. It doesn't make me feel like a zombie either, a little sleepy maybe. It does contain Tylenol, but that's not an NSAID.

I use these rarely for migraines. They work but  because Fiorcet contains a barbiturate as well as codeine (+ caffeine + acetaminophen or aspirin), it can become habit forming very quickly because the day after a migraine/headache, you think you have another migraine when really you mostly likely have a hangover from the Fiorcet. Be careful. When I worked may years ago as a pharmacy tech, I saw a number of people who had become addicted.

 

[bigperm20]

They make Fiorcet without Codeine, and yes I do realize Butalbital (the barbiturate ingredient) is habit forming but no more so than codeine.

I have a chronic migraine pain, as I'm usually effected at least 4-5 days a week. I personally had to weigh the relief the drug provides vs my quality of life without taking anything.

Before I found the Fiorcet I was so bad off, I was considering unthinkable things. Today life is at least livable, when it wasn't before.

 

[bigperm20]

Oh I forgot to mention the Fiorcet here in the states is exempt from the controlled substances act. That means it's not regulated as a narcotic, even though it has a narcotic in it. The preparation I take has
325 mg Paracetamol (Tylenol)
40mg Caffeine
50 mg Butalbital

 

[cocheezie]

I've never tried plain Fiorcet. I've only seen Fiorinal-C in Canada, but then I haven't worked in pharmacy in years.

butalbital, USP . . . . . . . . . . . . . 50 mg
aspirin, USP . . . . . . . . . . . . . . . . . 325 mg
caffeine, USP . . . . . . . . . . . . . . . 40 mg
codeine phosphate, USP . . . . . . . 30 mg

Also, I forgot to mention that for some reason, caffeine helps the pain reliever part of the drug work better.

 

[bigperm20]

As far as traditional headaches go, caffeine is a good way to get some relief. Migraine pain imho isn't touched by caffeine.

This combo, at least the 3 drug combo I take, was designed for "tension headaches". It is prescribed "off label" for migraine and cluster pain.

I have often wondered if Cannabis might help my migraines? I haven't used Cannabis in 10 or 15 years, and quite frankly I just feel too old to be involved with it nowadays. I have however heard some promising things about pot and migraines.

The bad news is that even with the govt relaxing the laws against medical studies with it, it will take 20 years to get a Miracle Cannabis Migraine drug to market.

 

[mservant]

My understanding is that even Codeine on its own is addictive, and take care with any medication I use.  

I worked in health care for most of my life and that included many living with chronic pain.  Much discussion around canabis esp for people living with MS but for me I would only go near such things if both legal and in regulated prescription form, and checked for drug interactions.   The increased risk from current sources / stronger preparations than used to be made of mental health issues  - primarily psychosis -  is something I certainly do not want to experience (along with being on the wrong side of the law).

 

[stewball]

If you think that's bad, get a load of this: about a year ago I was in the hospital for a month and a half. I had a MRSA infection/abscess on my spine. I became infected from one of my epidural steroid injections. I almost died basically. I was in the worst pain I've ever experienced, and I've been through lumbar fusion surgery.

When I got out of the hospital, I went to fill my pain medication at Walgreens. I was on a high dose as I was in tremendous pain for a month and a half. The pharmacist accused me of "Doctor Shopping" b/c the specialists at the hospital were different doctors than my regular regular pain Management docs. He refused to call the hospital. He told me to leave and not come back. I was so shocked and in so much pain from standing so long, that I just left. Haven't shopped there since.

This is what our tax dollars (aka the DEA) are doing. Scaring healo care providers into becoming "police".

Have you not thought of writing to the manager of this Walgreen to complain and demand an apology?

 

[stewball]

I sent a nasty email to their corporate office. I would have pursued it further, but at the time I could barely get out of bed to bathe, cook, and clean. I really wasn't in the right frame of mind to go to war with Walgreen"s. I really doubt there's much that could be done, other than trying to get the guy fired. I was so upset about it, I just let it go. That kind of negative energy isn't good when you are very sick.

He deserves to be fired. He has no right speaking like that to you or anybody else.

 

[bigperm20]

I just fail to see how getting this guy fired does anything to correct the problem. Yeah, I probably would have said differently the day it happend, but I understand where he was coming from in a sense.

I don't blame him, I blame our government for criminalizing drug abuse. It's that criminalization that created the situation between he and I. They think by locking addicts, and scaring health care providers that they can fix the drug problem.

The war on drugs was lost before it even got started. If we spent money on treating addicts instead of locking them up, we might start getting somewhere. But no, instead we have the world's largest prison population, and our streets are overrun with gangs whose primary source of income is illegal narcotics.

I think at this point the boys at the DEA know it's a lost cause. They also know that arrests and locking up people get them more funding and job security from Ol' Uncle Sam. Which path do you think they are going to travel?

(Steps off soap box... )

 

[denice]

I don't know if it's still happening but doctors who treat a lot of patients with chronic severe pain get into trouble with the DEA.  Many had their prescription writing privileges pulled.  I know a group of them got together to fight what the DEA was doing, their contention was that what was being done was causing people with chronic pain to be under treated.  I haven't heard anything about it in awhile so I don't know what became of it.

 

[bigperm20]

Basically what happened is doctors stopped writing prescriptions for chronic pain, period. They will still treat acute pain, but if you need more than just enough to get past an injury, they refer you out to a pain management clinic. Which is very expensive, especially if you don't have insurance. It's also a big hassle as the places were inundated with new patients as their doctors will no longer treat them.

It just blows my mind that our government agencies have more say in my medical care than my doctor does.

My father who's 75 years old has a bum knee. He was in the Paratroopers with the 82nd Airborne Divison at Fort Brag. He tore both MCL and ACL in a jump, and had to be honorably discharged it was so bad. He needs a full knee replacement, but doesn't want to have the surgery.

He's been prescribed Hydrocodone for years. He gets about 90 per prescription and only takes maybe 15 of them per month. So he really only fills it twice a year or so. He really only takes it,when he's in agony.

His doctor has refused to provide his medicine any longer and tried to refer him to a pain clinic. So far he's just said to heck with it, and is just "toughing it out".

This is the garbage our government is spending our tax dollars to do. Because a small portion of the population is getting high off prescription drugs everyone must suffer.

That doesn't sound like liberty to me.

 

[mservant]

Basically what happened is doctors stopped writing prescriptions for chronic pain, period. They will still treat acute pain, but if you need more than just enough to get past an injury, they refer you out to a pain management clinic. Which is very expensive, especially if you don't have insurance. It's also a big hassle as the places were inundated with new patients as their doctors will no longer treat them.

It just blows my mind that our government agencies have more say in my medical care than my doctor does.
...........................

Perhaps a topic for discussion in the IMO Forum?  There are both political reasons and medical for the changes in medical practice and referral to specialists in pain management I think.  The political reasons vary considerably from country to country and I feel are they are less appropriate for debate here in this thread.  

Pain is an area where a lot is still to be learned and only recently started to be taken seriously in terms of medical research.  I suspect there are many medical and allied medical professionals who are not up to date on current findings.  Unless I had a very good general doctor I would prefer to be seen as soon as possible by a specialist if I did have chronic pain developing for any reason e.g. musculo-skeletal or post trauma - that way I believe I would have the best chance of a breakthrough in stopping or managing the pain experience with minimal medication.

 

[peaches08]

Basically what happened is doctors stopped writing prescriptions for chronic pain, period. They will still treat acute pain, but if you need more than just enough to get past an injury, they refer you out to a pain management clinic. Which is very expensive, especially if you don't have insurance. It's also a big hassle as the places were inundated with new patients as their doctors will no longer treat them.

It just blows my mind that our government agencies have more say in my medical care than my doctor does.

My father who's 75 years old has a bum knee. He was in the Paratroopers with the 82nd Airborne Divison at Fort Brag. He tore both MCL and ACL in a jump, and had to be honorably discharged it was so bad. He needs a full knee replacement, but doesn't want to have the surgery.

He's been prescribed Hydrocodone for years. He gets about 90 per prescription and only takes maybe 15 of them per month. So he really only fills it twice a year or so. He really only takes it,when he's in agony.

His doctor has refused to provide his medicine any longer and tried to refer him to a pain clinic. So far he's just said to heck with it, and is just "toughing it out".

This is the garbage our government is spending our tax dollars to do. Because a small portion of the population is getting high off prescription drugs everyone must suffer.

That doesn't sound like liberty to me.

Actually, there's a lot behind it.  No medication (even natural ones) is without side effects, possibilities of addiction (even natural remedies), and there are many new advances in pain management that your average GP can't keep up with.  Throw in comorbidities and the GP is setting themselves and the client up for failure.  Then throw in insurance and what a hassle they can be, and it's no wonder that most healthcare consumers' heads are spinning.  I understand and feel for you father and others on the pain management thing, but I would rather go to pain management and look at options of treatment that might even be safer from an expert in pain management than just continue on a path that may not have hurt me (yet).  Does that make sense? 

 

[bigperm20]

I totally understand your point @Peaches08. I'm sorry that I went off on a political rant. That wasn't my intention. My point is that using government agencies to interfere with medical care in order to curb addiction is pointless.

It keeps legitimate pain sufferers from being treated and the addicts who are caught simply change doctors or buy drugs on the street.

I don't have a problem with pain clinics in general as the one I used to go to helped me tremendously. However I as a patient should have a choice in my medical care. Also even with insurance pain clinics are expensive. I personally racked up thousands of dollars in coinsurance, copays and deductibles on procedures for my back. None of which helped at all. In some cases in fact I got much worse. I did all this to try and mitigate the need to take pain meds, and hopefully postpone fusion surgery.

I still ended up having to have surgery so to be honest they didn't help me much. I know that's not everyone's experience though.

 

[peaches08]

I totally understand your point @Peaches08. I'm sorry that I went off on a political rant. That wasn't my intention. My point is that using government agencies to interfere with medical care in order to curb addiction is pointless.

It keeps legitimate pain sufferers from being treated and the addicts who are caught simply change doctors or buy drugs on the street.

I don't have a problem with pain clinics in general as the one I used to go to helped me tremendously. However I as a patient should have a choice in my medical care. Also even with insurance pain clinics are expensive. I personally racked up thousands of dollars in coinsurance, copays and deductibles on procedures for my back. None of which helped at all. In some cases in fact I got much worse. I did all this to try and mitigate the need to take pain meds, and hopefully postpone fusion surgery.

I still ended up having to have surgery so to be honest they didn't help me much. I know that's not everyone's experience though.

Nah, no apology necessary.  You're absolutely right that pain is very real to the sufferer, and pain management in some form is real and necessary.  I think it is horrible that people like you and the OP have to search for help as y'all do, and sometimes have doors slammed in your faces.  And you're right that the government has dug their claws in, I just wanted to present some of the other stuff going on behind the scenes as well. 

@Nebula how is your situation?  Are you getting some relief from pain?

 

[stewball]

Back to the pharmacist
What bothers me is the way he spoke without giving her a chance to explain not that I think she owes him any explanation. Does it not say on the the prescription that it comes from a hospital?
I'm sorry. It blows my mind just thinking about it. It's been nagging at me ever since I read about it

 

[bigperm20]

@Stewball I'm a man. Big Perm is a nickname I was given in HS, and occasionally I use it as a user ID. I'd love to be able go change it but unfortunately I can't.

As far as the pharmacist, I still had on a hospital wristband, I had literally just been discharged. I don't think the prescription was on the standard hospital printout. I literally had a team of doctors while I was there. The infectious disease specialist they called in (MRSA Infection) had his offices outside the hospital.

I agree that all the guy had to do was pick up the phone, but he refused to do so.

 

[jodiethierry64]

@Stewball I'm a man. Big Perm is a nickname I was given in HS, and occasionally I use it as a user ID. I'd love to be able go change it but unfortunately I can't.

As far as the pharmacist, I still had on a hospital wristband, I had literally just been discharged. I don't think the prescription was on the standard hospital printout. I literally had a team of doctors while I was there. The infectious disease specialist they called in (MRSA Infection) had his offices outside the hospital.

I agree that all the guy had to do was pick up the phone, but he refused to do so.

I hate Walgreens!! I have a funny story. My son was injured and given a narcotic. When he got home he realized they shorted him. ( Everyone one I know, including me, they do that to. On all kinds of meds) Anyway he went back and told them. They said to bad. You should of counted before you left. So the next time my son had a prescription he made them stand there as he counted each pill. Boy were they mad!! He reminded them what they had said before. There were customers behind him but oh well. I will never use Walgreens!!

 

[stewball]

@Stewball I'm a man. Big Perm is a nickname I was given in HS, and occasionally I use it as a user ID. I'd love to be able go change it but unfortunately I can't.

As far as the pharmacist, I still had on a hospital wristband, I had literally just been discharged. I don't think the prescription was on the standard hospital printout. I literally had a team of doctors while I was there. The infectious disease specialist they called in (MRSA Infection) had his offices outside the hospital.

I agree that all the guy had to do was pick up the phone, but he refused to do so.

I apologise for thinking you're a female, perish the thought.
Did you get your medication in the end?