advil has a bad effect on lining in tummy and you can get ulcers....be careful with that one...I take alieve and my shrink told me before that perscription strength is 4 per day....I started to take four all at once then went to PM dr who told me to stop all four at one time and do two at a time....12hrs apart....so I use that at times...I have also had vicodin after my knee surgeries...I too have had 5 of those....

so just be careful with advil...

Naproxen, which is generic Aleve, often works better than ibuprofen (Advil) The prescription strength of Naproxen is 500 mg, the strength OTC is 240 mg. It seems that some people are also taking tylenol, some their drs are telling them to take it, some are taking it on their own..

Your last sentence is very distressing to me. You have NO reason to be disappointed in yourself. No person can expect to handle all the issues and procedures that you have had without a lot of professional help.

First, are you seeing a pain doctor or a primary care doctor? If at all possible where you live, you need to see a pain specialist. A pain doctor is much better trained to help you with the proper medications.

You are taking a large amount of NSAID medication IMO. The side effect profiles of all NSAIDs are very concerning to me and my wife. We both suffer with chronic pain and try to avoid, or limit, NSAIDs if at all possible. IMO, opiate pain medications are less concerning in many ways than NSAIDs. However, opiate pain meds are not effective for pain caused by inflammation based on our experience. So in our case, we are caught between a rock and a hard place. Which is the worse (more dangerous long term) opiates or NSAIDs? There is no good answer that we have found over several years, but probably a mix of both.

I did not see you mention acetaminophen (better known as Tylenol). If you are going to try to stay on OTCs, I would add that medication since it is very effective for pain. Just stay below 3 grams (I think that is the recommended max, maybe 4 grams). Also add any to your total that may be included in other OTC (and Rx) medications. People forgetting to keep track of their total acetaminophen intake per day is one of the reasons for the FDA cracking down in this medication.

Whoever you choose as your doctor, you need to be totally honest about all your pain issues and what you are taking especially ALL OTC medications. I have all my medications, Rx & OTC, on an EXCEL spreadsheet along with other medical history things that always come up. You would surprised how much it helps just to hand your doctor a complete, easy to read, piece of paper with all information that they need. I update it every time I am going to see any doctor.

I wish you the best of luck. However, do not expect a quick answer. It will probably take some trying different combinations of medications to find relief.

Thank you everyone. I spoke to my pharmacist today and she suggested trying nuerontin (gabapentin). She said since I've been on Nexium for 10years the advil isn't good (deep down I knew that). I will see my doctor this week and see if he will try that. I deeply appreciate all the thoughtful responses. I knew y'all would understand.

Nuerontin is for nerve pain and has been discussed many times here on DS.4 You may want to search around for it. Many people use it and many others cuss it LOL. My wife has severe nerve problems and tried it for awhile but did not like the side effects and stopped it. I tried it briefly without any results so I stopped it. My doctor later told me I had not taken it long enought to know for sure. Oh well, cannot win.

If it was me I would never mention a specific medication to a doctor. Tell your story and let the doctor make suggestions first. If you do not like the suggestions, then slip in a comment to see what response you get. Kind of a game sometimes with doctors and pain meds, I do not think they like the patient knowing more than they do. We are lucky, we can give our pain doctor a tough time and we always have fun, but he is unusual (in a good way) IMO.

Sptrout...I am lucky I have wonderful doctors. I've seen both for around 10 years. My PCP handles my bipolar stuff and my hemotologist-oncologist works down the hall from me at the cancer center where I am a radiation therapist. They know I research everything and am very vocal. I'm very blessed.

Voltaren is an anti-inflammatory cream and, from what I understand, care should be taken when using oral anti-inflammatories on top of it. Because the cream does get absorbed into the blood stream. I was on Voltaren gel years ago and my doc advised me not to take oral anti-inflammatories. Just want to make sure you don't have any negative side effects from taking oral and topical anti-inflammatory medications. Even though 1,200mg isn't an extreme amount of ibuprofen. I have heard, for arthritis, naproxen works very well for many. I don't know if my body just got used to ibuprofen and naproxen or what but I didn't find additional relief with it and, for me, naproxen caused more stomach discomfort than it was worth and I've stuck with advil...but mostly my pain is managed with hydrocodone.

Pain isn't always a mind-set. I am a redhead and have an incredibly high pain tolerance. I actually had a fractured wrist but didn't know it until years later when a cyst grew because the fracture didn't heal properly. This was while I was still in the Army and doing push-ups daily. I was shocked that my wrist was fractured until the orthopedist showed me the x-ray. Who has a fractured wrist and doesn't know it when they are using it every single day?!?

Sometimes our pain gets worse because the problems have gotten more severe. By the time I started going to get my knees investigated, they were too far gone for any conservative therapies. So don't beat yourself up for having a high pain tolerance...you are obviously in severe pain because there is a lot going on.

My advice is to talk honestly with your medical care team. Tell your doctor your pain is not being managed and it is affecting your quality of life. If they don't want to handle pain management "in house," they can always refer you out to a PM clinic where you can work to get your pain under control...but don't suffer...it's just not worth it...especially if you've done all you could at home.

(((HUGS)))...I hope you are able to get your pain under control soon!

~Michelle