[mandee500]

Hi everyone! It's me Mandee again. You've been so helpful with my first thread I wanted to start a new one regarding whom you all recommend to see for your pain management treatment. Currently my rheumatologist is handling my p/m but he did mention in my last visit that he only deals with this so far, if we can't get this under control he may refer me to his collegue who specializes in p/m. Now I don't know if this means she practices within a 'pain clinic' or are there doctors that practice in regular doctor offices that specialize in p/m?

For those of you who may have not read my last thread I am 29yr old w/Fibro and currently taking WAY too many norco along with Topamax and ativan. I've developed a massive tolerance to the hydrocodone over my three long years of use. It is time to switch up my narcotic medications and I was happy when my rheumatologist agreed. BUT I was very disappointed when he prescribed fentanyl patches along with norco for b/t. I was shocked he went strait for the patch w/o trying something extended release but less potent such as oxycontin or mscontin. As young as I am and with Fibro being a lifetime disease, and because we all will develop tolerances eventually I most definitely do not want to skip and rungs on the ladder so to speak.

So here is where I am, I have patches but refuse to put them on In the meantime I'm running through norco like there's no tomorrow and barely getting any relief at all (and probably slowly killing my liver). I need to make another appointment, do I come out and ask for oxycontin? Or will that make me look like a seeker? You know, asking for something specific? If I ask for a referrel should it be to a clinic or a specific doctor?

ANY suggestions / comments / ideas will be GREATLY APPRECIATED!!!

[Freedom4me]

Hi Mandee,
I am so sorry for your pain. I have heard from others here that fibro is really rough. I just wanted to mention the "skipping the rung on the ladder" that you talk about. Please be careful. I don't think that ladder is one you want to climb. It will only lead to bad things. I don't want to preach and I truly am not judging you. I am just worried for you. If you have a huge tolerence for the norco, you will eventually get it with the oxys. There is no happy ending with that. Have you tried everything else? Please post to Melinda and Robert. They both suffer from fibro and can manage it without narcotics somehow. I think they can help you with other things that can work. I really think you should try it. I am so proud you didnt use the patch!! That is awesome. This whole narcotic ladder is nasty business and I really want you to be happy. There is not a happy ending with narcotics. It's the nature of the drug. Your tolerence just builds and builds. I have been there. I found when I eliminated that option, the pain was not as bad as I thought and I can deal with it. There is more pain in the pills. Just my opinion and I sincerely hope you take my post in the spirit that it was intended. Take care, and I really do care about you.

[caughtagain]

Hi Mandee, I tend to agree with Free and would offer a story that I lived through first hand. Many years ago when Pain Clinics were new and diagnosis was not as exact as they are today, Pills would be tried and so forth. In any event, I was young and had a non union of my ankle, which meant My broken ankle never healed. I was given what I wanted and there were rungs that were skipped in an effort to try to "help" me. I too took to many narcotics and my ability to figure out what worked got clouded and I would not accept anything unless it had the word narcotic in it. IT was and IS not a good road to go down. My Doc's diagnosed me with Reflex sympathetic Dystrophy which gave me a word that would get me what I wanted, pain meds.... One Dr wanted to do a Below the knee amputation, One wanted to put a morphine pump inplanted into me in order to "relieve the pain" The point is, PAin sucks but you would be surprised how resiliant the body is and how much it DOES NOT NEED in the way of narcotics. Free is right, when you start down the slippery slope of Opiates it is a no win situation. I NEEDED them, we all Needed them, but at some point you are going to wake up and say UHOH. Fibro is a tough one, but so is Reflex sympathetic dystrophy. My humble opinion would be to look for alternatives to opiates. THe Patch, in my opinion is a huge rung jump. Be careful with it. I am 44, I live with pain that sometimes is unbearable, but having my life back after abusing opiates for a long time.... Well, I will live with the pain. I wish you nothing but the best and hope for you....... CA

[mottam]

mandee:
I had several C-Spine sugeries, and still have considerable pain at times.
Here is the dangerous progression you speak of:
I started on oxycodone (Percocet) 5 mg for pain.
That went to 7.5 mg. for pain.
That went to 10 mg. for pain.
That went to 10 mg Oxycontin for pain.
That went to 20 mg. Oxycontin for pain.
That went to 40 mg. Oxycontin for pain.
That went to 20 mg Oxycontin for pain, and Percocet.
That went to 20 Oxycontin and Roxicodone 15 mg. for pain.
That went to 20 mg. Oxycontin and Roxicodone 30 mg. for pain.
And so on, and so on, and so on...

See the progression - it NEVER comes back down. Then you find yourself in mega-pain, tolerant to the opiate pain relivers, and addicted to "the 9's" to opiates.

I am NOT a Pain Doc. However, there is only ONE place you will wind up in the end if opiates are the ONLY choice - pain and addiction. Both are a horrible place to be. Have you exhausted ALL other avenues? Hybrids - some meds, mediation, p/t, nutrition, etc.?

I wish you the best of luck - be very careful of that opiate "ladder".

Kindest Regards
mottam

[supermomhelp]

Mottom,
Seeing it like that, out in plain sight for your eyes strikes a chord for me. It truly is the path that so many of us I would guess have followed. I have fibro too, and moderate degeneration of my discs....funny thing is? My pain today...mind you, with only 1 Advil in me...is not bad at all. Our minds are such an amazing organ, it absolutley astounds me sometimes. I have been using alternative meds, herbs, relaxation, etc....It's just amazing to me how I hurt soooooo bad with 3 vics in me a month ago, but today with none and I'm still alive, still ok.
By NO MEANS do I mean to parallel my struggles or pain with you Mandee....I guess I'm just realizing that my pain wasn't as bad as I really thought it was, or maybe it was rebound pain. Either way, I wish I would have NEVER gone to my pain management doc. How did I ever think I could walk out of there with 120 vics at a time and REALLY keep it controlled??? I was fooling myself, and my body and my mind.
I have family with RA, and I know how bad it can get. I do hope that you get some relief. But please keep in mind that your brain is so much stronger than your body....HEALING THOUGHTS and HUGS dear!