[Nicholis]

I am at the end of my rope here. I have decided stupidly this month that I was going to detox again and go with no pain medicine. I calculated what I needed for a slow taper over nine to ten days to nothing. This is where my trouble is starting this time.

The whole story is this pain in my lower lumbar and thoracic region of my back started exactly two years ago. When it first started I of course took tylenol, advil, etc until I could not take it anymore. When I finally got into the doctor the pain in my right leg and left buttock was so severe I was literally soaked in sweat as the doctor examined me. I was prescribed hydrocodone 10-500 at up to one every six hours. At first this got my pain level down to a tolerable level. What I would consider a 4, which on MY scale is annoying pain with some impact on lifestyle. After being referred to a pain specialist I went through three lumbar epidurals with no help. Zero from that series. I eventually ended up in with a neurosurgeon who looked at my mri films and said that operation would leave me in the same pain or worse and he would not do it but as I learned is a trend he upped my pain medication to 5mg oxycodone pills with zero tylenol. These worked very well but I could not leave work to pick up prescriptions from him as he was a three hour drive away and he would not refill without seeing me which I could understand. I spoke with my GP and he put me on oxycontin 40mg and oxycodone 15mg. The oxycontin I take every twelve hours and the oxycodone as needed for breakthrough pain or at the very closest together, 6 hours. I was on this medication regiment for almost a year when I finally ended up off work for four months and found a great neurosurgeon. I had alot of the steroid epidurals from him which actually worked great instantly. He asked me how I was doing after the shot and I told him I was doing quite a bit better. Come to find out later he had added something to the injection that would ease the pain for a short length of time instantly. For the life of me I cannot remember the name of the drug he added. He did tell me that he knew I was telling the truth because of that. I almost didn't go back after that but his injection did help. He done a total of fifteen or seventeen in the last year or so. With his help I told my GP I was ready to drop the oxycontin and oxycodone. My GP stated we would taper 5mg down per month or two weeks if I could handle it. I refused that and told him I would do it in a month as I only had a few days of meds left.

Not to lie, those two weeks were hell but my back felt better. This lasted about four months (back feeling better) until the anti inflammatory medication I was on started to cause me to vomit bloody bits that looked like chewing tobacco and I was also passing blood in my stools. That is when it started again. With no other choice since my docs pulled the anti inflammatory meds I tried going with tylenol with no luck. I was told no advil, ibuprofen, aleve, etc. Of course without the anti inflammatory meds my back was acting up again so I went back to my neurosurgeon that I had luckily found and he put me back on hydrocodone which I did not want but was told there was no choice. We resumed the injections again responding a bit less to the first series of three. In the end, I ended up where I was going anywhere from 72 to 120 hours with no sleep even when taking my xanax sleep dose. Needless to say, right now I am back on the oxycontin oxycodone mix again at the same doses listed above for the third month now. I took what I thought I needed to taper and flushed the rest as I know if I have them around I'll take them instead of using ice or heat or combinations which do help some but it is not feasable to do at work. I throw in my TENS unit but I find it to be like pain meds, the more I depend on it the more used to it I get. It's going to be a long road as I have around 11 days before I can refill (I know I need something but would like to kick the narcotics out of the loop). Right now I would rate my pain at a 7 or 8. I have been to the pass out level of pain with my back so I do consider my scale to be fair as a coughing fit, vomiting, etc can and still does cause me to pass out. I need something to control the pain but want to know any options out there besides pain killers. To top all of this off, my lucky find of a neurosurgeon with which I had a plan worked out with for treatment with surgery being the last option, went on sebatical and is retiring afterword...... So now I am left between needing something for pain and finding a new neurosurgeon which I am working towards right now. From my last neurosurgeon I do know that I have degenerative disk disease, bad arthritis, spinal stenosis due to the degenerated disks if I recall correctly and I have spinabiffida that leaves the bottom of my spine open instead of closed. My neurosurgeon who I had been working with said this could be the cause of my very frequent and disabling migraine headaches(the spinabiffida).

As to a history for my back problems, I have been in a highway speed rollover end to end, in the neighborhood of seventy five plus hard falls in motocross, one street bike accident that ended up in a sixty mph or so high side which I came off the bike and landed on my arm and tore it out of socket. I did hit hand first but still landed hard enough to split my helmet. It is put together with several bone anchors and nylon type rope to form a new socket. The final thing is I have been smashed between a backhoe and a pumping unit in the oil field. The driver misread my signal to back up as go forward and kept doing so while I was trying to put the horses head on the unit so I could not use hand signals once I had it picked up. He stopped moving forward when I started to pass out from not being able to breathe.

Does anyone out there have any suggestions for pain control of this level? My GP says there is nothing except an opiate. I hate taking them and in fact the whole time I had the streetbike accident I didnt take any and even put my arm back in socket myself. I did take two days worth of hydrocodone after the surgery or a total of 8 pills but took none in the six weeks I spent with 90 percent of my socket sheared off trying to find a surgeon. I have a high pain tolerance but the back pain is to the point of almost having me bed ridden. I cannot sit up too long, I cannot stand too long, I can however get somewhat comfortable laying down with the pain meds. I am in the condition that it is very hard and most of the time impossible to even be intimate with my wife as I hurt to bad to perform at all at times and rarely ever climax. Without the pain meds I am up all night in pain and withdrawal. I know I can kick the withdrawal, it is just a rough week. The vomiting is the worst part however as at times I pass out from the back pain.

I guess I am just looking for some advice on pain control and maybe an encouraging word to get through the withdrawals even though there is not a thing I can do about it. Also, is there ever a time that I should trust the doctors and take the pain killers? I think passing out when I vomit or have a coughing fit means I have a need for something, but I just want to know the options of what that can be. I do have more symptoms if I need to explain them such as shaking legs when I sit or stand to long, etc. Thanks for listening and thanks for any advice.

[Robert_325]

Have you talked to the dr about going on methadone? There can be situations where a person legitimately must have pain meds forever if you want any quality of life at all. If this is your situation and if it's going to last for life then methadone is a very good choice and probably the safest route to go long term. You don't want to start on it if it's going to be for a six months or a year, but if you need the meds for life then you should discuss it with a pain management specialist. Let us know how it works out for you. God bless.

[Nicholis]

Thanks for the input. I just want to make sure there is not some drug out there that is being overlooked by all of my doctors. I do need the pain medicine for quality of life. This is what is making things so hard as my workplace does not allow opiate use of any type on the job. I CAN however take it when I am at home. I cannot get a straight answer on what "at home" means. Does that mean at HOME before work? At HOME for lunch? You get my point.

I am reluctant to even up the dose of medication I am on. My GP who works directly with my neurosurgeons has stated both times that I could need to increase dose quite often. I have been in a very depressed state for quite some time. I have a wife and two wonderful children and my life revolves around a couch and my pills. I just don't want the pills anymore but I am not sure of the benefits of treatment by methadone or if it would even be possible with my career. I will have to research it, but from what I have read it is the end of the road opiate for pain management. Meaning that once it no longer works there really isn't much you can do. I have gone through this for two years which I know to some of you is very little, but honestly it is almost all i can handle. Seeing my kids and wife is the only reason I am still here right now, I do know that. I do know that the detox this time seems impossible compared to last time. I think that might be because I just cannot deal with the pain. Either way, I have eleven days with no pain management in front of me due to my "great idea" to flush what I didn't need and taper off. I knew as soon as I dropped that first 15mg pill I had made a mistake. Either way eleven days doesn't sound like much but it seems like a year away right now.

The two pain management clinics I have visited here only prescribe narcotic pain medicines to cancer patients. The only thing I could get was spinal epidurals (these were the three that were totally ineffective).

[Robert_325]

I have an observation for you. If the dr says you need opiates and your job says you can't be under the influence at work you're in a fix. You can't take opiates at home and pass a drug test for days. Opiates would always show up in a drug test.

I still say methadone should be seriously looked at for your situation. If doses of opiates have to be increased over time it's safer doing that with methadone than anything like percs, vics, oxy or whatever I promise. God bless.

[Nicholis]

I will look into the methadone. I do however want to see what this new neurosurgeon has to say. I am hoping he will fuse the four disks, one lumbar, and three thoracic.

As for work, I have been told by the corporate doctor that taking the meds at home is ok. I have it in writing in an email correspondance through an ombudsman. The nurse at the location I feel is kind of trying to help me through the blind spots in the system by saying "as long as you take them at home". I explained the half life of the drug is not such that I can just take it in the evening and be drug free at work. Their response is they cannot deny me treatment while at home. If I need the meds I need the meds and they support that. I can also take all the meds I need if I know I am going to be in the office all day that day and not in the field, I just need to let them know. At that point by access HID badge will no longer scan me into the work area which is guarded at each access point so no slipping by with someone else with me. If I decide not to use the meds at work then I am fine, if I use them while at work it has just been stated as said "at home". That has been how I have held my career in place as without it we will be down the tubes. I have a wonderful career, have been recognized company wide at several locations for work done that has earned me many bonuses, company awards, etc. Until this time I held it together. The pain and sleepless nights turned me into a real ass in which my supervisors said go home, take as long as you need, get better and come back, your job will be here whenever you are ready to return. So I am on paid leave at this point. I plan to continue to use the meds as I need. If told to stop I will file for work disability. Also just as a point, I am not included in the random drug test pool as are any of my co workers. The only time we are or would be tested is during an accident/injury.