[Chelseabee]

Hi there, my name is Chelsea. I'm a 20 year old woman who suffers from deblitating fibromyalgia, chronic back pain, and osteoarthritis of my right knee. For pain management as of now I am taking 300 mgs of lyrica a day, it overall takes the edge off the aches from the fibro. However, I am still suffering from the knee and back pain. My doctor had me on diclofenac which didn't seem to do much at all. I am also on 5 mgs of valium 3 times a day which also helps my fibro as anxiety triggers pain flare ups. I also occationally use a TENS unit for some relief. So here are my questions:

Are there any opiate derived medications that you very slowly build a tolerance to and dependence on? I was looking into possibly Oxytrex or Remoxy. I allergic to many opiates, darvocet, tramadol, vicodin, codiene and morphine, which really limits my options to oxycodone, dilaudid, fentanyl, opana, or demerol, all of which are pretty strong narcotics that I don't think my PCP will want to mess with and prescribe me, not to mention I don't think something quite that strong is neccesary, I need to be able to function at work and take care of my 2 year old, and they all cause me to have major dysphoria once it starts wearing off.

My next question is I've heard that toradol is an excellent pain reliever that is not opiate based, but can really reek havoc on your stomach. Can it still mess with you stomach if it is injected IV or IM? And can a doctor prescribe it so I could give myself the injections if need be?

My last question is has anyone ever been on cesamet for pain? Did it help? Any suggestions on how to present these ideas to my doc without her thinking I'm just seeking drugs? Thanks for your time.

[Cats Meow]

Toradol really isn't an excellent analgesic, it's just another NSAID, you may as well take Motrin, no by IM/IV it wouldn't harm your stomach, all NSAIDS should be taken with food otherwise it will eat your stomach lining, taken with food stomach upset, ulcers, etc are uncommon. Asking to administer drugs via injection especially for a 20 year old will raise an eyebrow, they're not going to go for it no matter your age, it's a waste of time to mention it. Demerol is actually very weak, it's only one step up from codeine and tramadol, if you have to go opioid based it might be your best option, but first try running the gamut of cox2 nsaids/antiflams (like Celebrex et al), or the plain nsaids like Motrin and Aleve.
Cesamet or Marinol would probably help if you could get a script for it, but you know many doctors don't believe in cannabis, but that's changing.
Hope this helps.
Cats

[PharmClinician]

For fibromyalgia:
As far as pain medications: Toradol does work very well but is only safe for short term use. Toradol IM causes just as much GI upset as the Toradol PO. There are other NSAIDs to consider though such as Celebrex, Mobic, or Ansaid (which actually boasts antipyretic activities). These NSAIDs are much more effective then Diclofenac and would be worth a try. If Lyrica is helping I would definately continue and just find a safe way to treat breakthrough pain. Muscle relaxants may be an option to consider for this I'd recommend Flexeril which also helps with anxiety and insomnia. SNRIs like Savella could help by increasing Serotonin and Norepinephrine levels but take time to take full effect. As far as narcotic pain meds Percocet, Darvocet, or Vicodin. Oxytrex is still in investigation stages and may interfere with other meds you are on. Remoxy might have more information but is still relatively new. Demerol is not for the use of chronic pain causes a buildup of toxic metabolites (It is also highly addictive with dangerous side effects) For GI discomfort from medication you could premed with Reglan or Phenergan. I would suggest also trying homeopathic methods. Mint tea helps with GI discomfort and inflammation. I find it very beneficial to exercise low impact for about 30min a day. Acupuncture can reduce pain and inflammation even promote healing. I would suggest having your blood pH checked, normal blood pH is tightly regulated and should be between 7.35 and 7.45.

For back pain: I would strongly recommend physical therapy exercises to strengthen the supporting muscles.

For osteoarthritis: Not sure what you are using for the knee but I would suggest sodium hyaluronate injection. It protects, cushions, and assists in absorbing mechanical stress and provides a protective buffer for tissues.

The list of allergies seems extensive. A true allergic reaction to medication occurs when the immune system is activated in response to a drug. Vomiting is not an allergic reaction and can be avoided by taking a premed antiemetic.

A Pain Management clinic could be a very good option for you as they monitor your therapy and most do try alternative treatments.

I do want to say that the suggestion to try Cesamet or Marinol would not be beneficial to you at all. These meds are for Cancer and Aids patients who suffer from nausea and vomiting and loss of appetite. Asking for these meds would definitely not be appropriate.

Good Luck with finding the right treatment regimen for you. (Be careful!)

[melinda7.5]

Hi pharm
I have fibro and have been thru them all but I do have to agree exercise is the best thing you can do for your back I have DDD also, but running a mile a day seem to help more than any of the drugs my doctor got me addicted to.
thanks for you input...
Melinda