What is Chronic Pain

Chronic pain becomes chronic when it persists longer than 6 months and is resistant to medical management. Millions of Americans are chronic pain patients and some exper...

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Discussion:
Cut off my Pain Meds
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I've posted about this before, but it's been along time. I was wondering if there were any new members that could offer some advice. Also, older members who might have missed my post. It's been since October, I believe.

Well- to start things off, let me introduce myself. I'm Stefanie, I'm 24 years old, mother of two boys and wife to my husband of 5 years, been together for 9. I have went through pure hell beginning in 2005.

I got pregnant with my first son in July 2004. It was a pretty uneventful pregnancy until about 24-26 weeks when I developed a horrible (and I mean horrible) bout of kidney stones. My left kidney was literally filled with stones, ranging from 5mm to almost 2 1/2 cm. I was in excrutiating pain, and could barely stand at some points. I was hospitalized for a week, and had my kidney drained and tried to stay as hydrated as possible (which did help, a lot, with using the bathroom). Finally I had to get a stent placement for a week because my urine was backing up. Miraciously, the stones began to break up and pass on their own. The bigger ones stayed though. They were not blocking my kidney or urine from passing, so they "left them alone", but they never broke up on their own, and occassionally I would get pain in my back that would take my breath away.

Well, my son was born February 13, 2005, premature by 6 1/2, almost 7 weeks. He, thankfully, was fine. His lungs were developed and had to stay in the special care unit only due to a case of jaundice. The jaundice wasn't very bad, but he had to stay under the billi-ruben light for 4 days, and had a 7 day dose of antibiotics because I had tested positive for Group B Strep (a bacteria that lots of women get during and before/after pregnancy, that can not harm the mother, but can harm the fetus. Therefore, they administer antibiotics during labor for precaution, and also if not treated can give the baby a strep infection, usually in their lungs) Well, needless to say, my son did develop a strep infection at 6 weeks and had to be hospitialized also.

Anyway, to make a very long story a little shorter, at about 4 weeks post-baby I began to feel very ill. I started running a temperature ranging from 101-104 at times. I was constantly on Tylenol and Motrin switching off during the day to keep my temperature somewhat regulated. I was hot, then I was cold, then I was hot, then I was cold, etc. This went on for about 2 weeks. I visited 2 hospital emergency rooms only to be sent home with a "kidney infection", or as the last doctor said, "your white blood cell count is very elevated, and you have some kind of infection somewhere inside your body that we can't pinpoint at this time." That was after I was forced to drink contrast for a CT scan, that I violently threw up the contrast before they could perform the X-ray. It tasted like banana chalk. For one, I loathe bananas. For two, I was already nauseated out of my mind. Why would they think I could possibly drink contrast that tasted like total ass. Anyways..

They still performed the x-ray hoping that some of the contrast would have stayed within my body and that they could possibly see something that was making me sick. The doctor examined the reading and said there was nothing he could see, but that I was clearly in pain, so he gave me two doses of demerol while in the ER. Drew more blood, and sent me home on some Levaquin and Mepergan for pain. While although mepergan is strong, didn't touch my pain in the least. Something was seriously wrong with me, and they did not figure it out. Anyway, before I left I was asked to sign a paper stating that a radiologist on the next shift would review my x-ray reading and I would be contacted if anything else was seen on the x-ray and if I needed further evaluation. Needless to say, I never got a call.

Two days later, after 2 more doses of the Levaquin (plus the IV dose I got in the ER), my pain was even worse. My fever was still not under control, and I literally felt like I was dying. I had a newborn baby, our first baby, and it was hard for me to take care of my son, thank God I had my husband and mother to help me during this process. Otherwise, I don't know what I would have done. Anyway- two days later, when my husband got home from work, he woke me up out of the bed, I was drenched in sweat, my face was as red as an apple, I was burning up and I began throwing up in the trash can I was keeping at my bedside. He said no, this is not working, there is something seriously wrong and they don't send someone home in this type of condition. So, he called 911.

When the ambulance arrived, I was so weak they had to carry me, place me on the stretcher, started IV fluids and put ice cold rags all over me. My fever had reached 104.6 by this time. I was taken to the emergency room, where at some point, I passed out when I got up to use the restroom. I woke up, with half a dozen doctors staring at me asking me "if I could breathe". I looked at them in horror, because on one of the lab coats under the doctors name it said Pulmonary team. I had just turned 20 years old, what was a lung doctor staring at me for? I was being pumped with demerol, zofran, and 2 antibiotics, the strongest ones they administer. I can't spell it, but one was Roseffin (sp) and they said they only give it to very ill patients, and burn patients. I begged for answers, wanting to know what was wrong with me. Where my husband and son were, where my mother was, I was horrified. I had oxygen going through my nose and also a mask on. My hands were also restrained, I guess so I couldn't take the oxygen off. I had never been so scared in my life.

After a few minutes of the doctors consulting with each other, they FINALLY decided to tell me what was wrong. I was almost in congestive heart failure, and my left lung had completely collapsed. They told me I must have contracted pneumonia while I was pregnant and it had got undetected because I was not showing signs or symptoms of pneumonia. No trouble breathing, no weakness (until my lung had already collapsed), no wheezing, nothing. Only fever. So initially, they thought it was a virus. I kept returning to the hospital, get this, 8 TIMES, once via ambulance, because the pain was SO bad in the left side of my chest I literally felt like I was dying. Of course I dont know what dying actually feels like, but it's the closest thing I've came to it. And the doctors in the hospital I was brought to (not the same one I had went the other 7 times) told me that if I had waited a few more days I'd most likely would have been on life support fighting for my life. Because I was literally, no joke, drowning myself. And remember, I was only 20 years old!! I had JUST turned 20, this happened in April 2005 and I had turned 20 on March 12th 2005.

So on to the point, more or less, lol.. I'm just trying to let everyone have a feel of why I hurt so bad and so constantly at such a young age. I was, of course, admitted immediately, and to my downfall my mother, brother, and some of my immediate family was at the beach at the time of my admittance. Because here where I live (Augusta, Georgia) there is one week in April (usually the 1st or 2nd, depending on the dates) that a major golf tournament comes here for the week. Most of the locals who are either A) not interested in golf, B) can't stand the traffic, or C) rent their houses out to travelers (can make big $$ doing this); and my brother's birthday falls on April 11th so every year my family would take a trip to the beach during this week to get away from all the chaos of the town.

So, I am a new mother, a newlywed, and here I am lying in a hospital bed, being told my lung had collapsed, that I was going in for immediate surgery in less than 1 hour and I couldn't get ahold of my mom to save my life (no pun intended). I was scared out of my mind, I didn't understand what was going on because A) the pain was so bad it was making me delerious, also the pain medicine leaking through my veins wasn't helping me to be coherent, but thankfully helping me to cope with the pain, and B) I'd never even been sick in my life. Plus, I had my newborn son at home with my husband (he left him with his mother and came to my side when he found out how serious it really was) and I was worried sick about how they were feeding him, if they were changing his diapers enough, was he getting enough sleep and comfort without his mother, I was a complete wreck.

So, the next thing they told me is that I was going to have to have an immediate surgery to "drain my lung" and that it was going to be very painful, and that i would have to be awake for the procedure. So I was laid on a very, very cold table, had a pick line placed through an artery (hurt like the devil) and then had another catheter placed in my back inserted into my left lung cavity and then the pain began. I could absolutely FEEL my lung expanding. I have never experienced such pain in my entire life. I've had two children and I'd have them again in a heartbeat with no pain medicine or help at all, rather than go through that painful lung procedure again.

So after that surgery, I was wheeled back into my hospital bed and was told to "wait" until tomorrow when I'd have another chest x-ray and CT scan to see if enough fluid was drained (they got 3.7 liters, it was orange, so nasty looking, and I made them stop because I just couldn't take it anymore. They said they thought they got enough.) Well, after the new x-rays it was determined they did NOT get enough, and that the fluid had been in there soo long that it had scarred my lung, and left lots of scar tissue that they had to get out. So I went in for a thorocotmy surgery. I have a 9 1/2 inch scar across my chest where they ripped my chest down and I have two scars in the form of X's where I had two chest tubes breathing for me during and after the surgery. I had an epidural placed in the top part of my back to prevent me from feeling myself breathe. They said THAT pain would have hurt in ways words can't even explain.

So, I stayed in ICU for 7 days, and the hospital a total of 52. When I got home, life was horrible. I had to sleep in a recliner chair, I couldnt lay back from the pain, even after all the pain meds given to me I was still in excrutiating pain.

3 months later, I got a nerve block. They determined that I had nerve damage and two broken ribs from the surgery (which I was never told about). The nerve block was unsuccessful. 2 months later, I had another. Again, unsuccessful. So I started with the aquatic therapy. Then the PT. It was getting harder and harder for me to maintain a normal life. I couldnt even lay down without shooting pain in my side. To this day, where my scars are, is numb. The pain is INSIDE. I can feel it radiating from inside my body. And to top this all off, I began to get kidney stones again.

I had two lithotripsy surgeries, 11 more stents, and 4 years of hell. I am never pain free. Ever.

I finally got sent to a PM doctor by my pulmonary specialist. When I had to go in for my 11th stent and last kidney surgery is when they gave me the extra meds. My PM doctor dismissed me as a patient because I accepted the extra medicine that I needed for post surgery pain.

Does this sound fair to you?
Posted on 06/27/09, 02:06 pm
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Reply #21 - 07/03/09  6:33pm
" yay tipper well said.....im so tired of people including uncaring drs makin us feel like we r down on the corner buyn crack....and i wish my pain on no one but if they had to deal with it for 5 minutes they would instantly understand, that is after they got up off the floor and stopped cryn lol "
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Reply #22 - 07/03/09  6:33pm
" I guess I need to make myself a little bit clearer. I too depend on my medication to get me out of bed and get me through my day. But, what I realized recently, is that my oxycontin, wasnt working as well anymore, so my Dr. kept upping my dosage, and finally I decided to try some alternaatives, cause 200mg of oxy/day, was making me depressed. So, when I weaned myself down, I realized, that I had been having these "Phanton Pains", it is not true for everyone, but phantom pains are a real occurence, which is how your addiction gets fed. I am addicted to pain meds, but I am not an addict, opiods are addictive by nature, and I have never met anyone who is immuned to that. All I was suggesting, is if you are taking large doses of pain meds, and your pain seems to increase, even though you havent re-injured yourself, than maybe you are experiencing phantom pains. And, that comment was simply added, to possibly help. I still take pain meds, and I am not talking down to anyone else who does, opiods saved my life, and help take my massive pain away. But, each of us are different, and if you have been taking pain meds for a long time, than possibly, you should take a moment to reevaluate your situation, and see if there is something else, that is causing an increase in pain. Like the other poster said, it cannot be generalized, each case is different, and this idea of phantom pain, should be looked at on a CASE BY CASE BASIS. Thats all. "
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Reply #23 - 07/04/09  10:55am
" About what SoCalMike said...I was reading a thing on chronic pain the other day and it talked about "hyperalgesia": "neuroplastic changes in pain perception in brain after chronic narcotic use can increase pain sensitivity or pain intolerance; this can occur within a week; manange by decreasing the dose of offending narcotic, change to a different narcotic and/or add adjuvant analgesics eg. gabapentin, tricylic antidepressants, etc."

But then it also goes on to talk about tolerance to opioids and how over time someone controlled on a certain dose of narcotic may need a dose increase because the body's pain receptors get "up-regulated"; ie they compensate for the chronic pain-dulling effects of the narcotic by becoming more numerous and/or more sensitive.

It's interesting but very confusing too, eh? "
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Reply #24 - 07/25/09  6:21pm
" R&K'sMom:

things here have been nuts lately, i was in a cab accident, then a week after that in the hospital for a week and a half, then out of town, blah blah ... and i have not been on DS.
so here i am, trying to catch up on some posts,
and i find this!

i had NO IDEA that this was what you had been through - it's HORRIBLE! for a young newlywed
and first time mother to go through so much is unbelievable. for *anyone* to go through that is unbelievable, but especially in your case ... it's just mind-boggling. i am so truly sorry to learn that you have been and continue to go through SO much.

after reading everything, here are my thoughts
(come on, you know you want them!):

- while it's true that most PM's have strict policies like yours, it seems to me that their patients should KNOW it. my PM left a university setting to go into private practice, and it was CRAZY how much drugs/prescriptions/etc. changed. while before there was never a problem if you got this mes AND this med, now she has to watch it and only give you the one bc they're similar to eachother and blah blah ... most importantly, however, were the new pain contracts. i was made VERY aware of the fact that i COULD NOT accept prescriptions for pain meds from ANY other doctor, or i would be out. even when i had teeth pulled and needed
extra meds, she wrote for them for me, but she spoke to my oral surgeon first. so you need a little give and take there; if your PM is not the kind who will make sure you're aware of the policies and explain them to you, and won't make him or herself available to talk to other docs who want to prescribe you narcotics, AND he/she would drop you so quickly when he/she KNOWS your story and your pain, screw 'em. they could have at least kept you on as a patient until you found someone else, or something like that. :(

-methadone is totally helpful, but i think you'd do better w/a prescription of it. if you go to the clinic, you run the risk of a new PM thinking that you DO have a drug problem. that being said, i hate games - you know why you're going, and if absolutely cannot find any other way to combat your pain,
do it. as long as YOU know your reasons for doing something, everyone else can go to hell.
(also, i'm almost positive that there is no difference between the methadone used to treat
addicts and the methadone used for pain management, the exception being that methadone given out in a clinic is a liquid form, and PM prescribed methadone is usually pill form.
when my PM put me on it, i was like 'whoa, whoa - i'm no addict!' bc i didn't know anything else about it. she told me, though, that it is first and foremost a pain pill and that it was later discovered that it also helped heroin users stop using.

oxyCONtin is *so* strong. this is one that i would never ask a PM for off the bat, because i just don't see a way that it WOULDN'T raise a rad flag. after you've climbed up the chart of pain meds your PM might prescribe it, but it seems like i'm *always* hearing people suggest to others that they ASK their PMs for this, w/no thought as to how their PMs would react to that. i've been on it, and it helped, but definately at a price - i was never 'with it,' if i took it too late i was in withdrawl, a million things. you never know, though - this might be the perfect thing for you. but there are lots of other things between what you've been taking and that!
* i'm not suggesting that i think you were going to do this, i just wanted to write this anyway, after the suggestion was made ...

-malpractice is a possibility! i would talk to a lawyer, and asap. my uncle and i were just talking about all of this, but he practices in michigan, so the laws are different there. what law are you in? if that is literally what that file said, and no one called you (plus you went in complaining of pain in the area of your left lung SEVEN TIMES -hello!) ... i would look into it. i can't hurt, and you can most likely talk to someone for free, and find someone respectable who would take the case on contingency.

i'll stop rambling now, but i really am sorry to hear all of this. i hope that you have a wonderful weekend, and that you start looking for a new PM stat!

xoxo,
misa "
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Reply #25 - 07/26/09  11:03pm
" I didnt go through all those posts but I dont think you broke your contract and those contacts are a bunch of shit as far as I'm concerned...if I were you I wold look into legal recourse not only against the hospital but this so called PM doctor who, I think was in the legal wrong to dismeiss your meds after they were given to you by the ER> What if you went into several withdrawals that aggravated your conditions from the surgeries. I say find a lawyer who does medical malpractice suits on spec and go get them. "
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Reply #26 - 07/27/09  4:18am
" I'm also quite sure that methadone is methadone. Whether it's a pill, a liquid, or a disk dissolved in liquid, it's all the same. A small problem might be that at the clinic the dose is once a day, and methadone taken for pain may be more effective in divided doses (after a few months at a clinic you could receive some take-home doses and this wouldn't be as much of a problem).

Clinics realize that some of their patients are there are pain, not for addiction, and some are there for both. There are a lot more drug tests, and usually group and individual therapy are a required part of the program. But a person does not have to be addicted to opioids to benefit from the therapy. We can all use improved coping skills, communication skills, etc. The stigma of "heroin" is fading in most places because more and more people are coming to the clinics because of addictions to prescription painkillers rather than heroin. In some communities, because of the "War on Drugs" (an obscene and unconscionable waste of money, IMO) and perceived prescription drug abuse, the only option a person in chronic non-malignant pain has is the methadone clinic. It sounds like it's not that way everywhere in the country, and that's good to know.

We need to remember the difference between physical dependence and addiction. Many people, even some doctors, confuse them and the average "man on the street" thinks they are one and the same. Virtually anyone who takes opioids long enough will become physically dependent. It is this dependence that results in withdrawal symptoms when the medication is abruptly stopped. Addiction is the compulsive use of a drug, usually more and more of the drug, with no medical reason for the drug use, and despite adverse consequences from its use.

I'm not sure about malpractice, because of the statute of limitations, but I would definitely make a complaint to your state's Board of Medicine.

I am shocked by what your pain doc did, yet it doesn't surprise me. They do mean it when they say that you cannot seek or accept prescriptions from opioids from any other doctor. Hopefully if your kidney doctor TALKS to him that will make a difference.

I wish you the best. It's so sad that this wonderful time with your husband and your two little boys has to be so clouded by pain and illness (especially when so much of it sounds like it could have been avoided or at least greatly reduced). "
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Reply #27 - 07/27/09  5:22pm
" There are basically two types of "Methadone". One brand/type is called "Methadose" and the other is "Methadone". I have taken this before, only for one week, and it had withdraw effects 10 times worse then Oxycontin, and the withdraws last much longer. Both of these brands come in several different forms, wafer, pill or liquid. I would stay away from this med, as it has a nasty addictive nature, terrible stigma, and if you get it from the clinic, then you will be labeled, "drug addict". But, you do have to do, what you have to do, and thats all that really matters. "

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