Chronic Pain Whatever the cause, support for managing long term or intractable pain.


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Old 09-30-2006, 09:41 PM #21
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Fancylady_2006 Fancylady_2006 is offline
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Fancylady_2006 Fancylady_2006 is offline
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Exclamation Things are no aways like they seem~

Sheryl,
My surgery isn't until October 24. I certainly am not over this one yet. I'm 3 1/2 weeks post op and even tho I have a while to go, it won't be long enough. The new surgery I will have soreness 3 to 4 weeks. I can't even pick anything off the floor yet. It gives me the willies just to think of this other one. If I wasn't alone it would help. I'm fairly sure I will have someone come in at first. As I am planning on moving about that time. I don't know how to get things done. They didn't like me lifting now and the other one has the same instructions. Why I said I could do it, I don't know.

Doc acted like it is important to have it fixed asap. Sheryl you would do the same if you had no choice. That's what happen to me. I do wish my husband and I could of counted on good family support,but it didn't last long. Some treat me awful now and won't even speak. Worse yet thet are my neighbors.
Just call me hurt,
BC
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Old 04-20-2007, 04:41 PM #22
frank frank is offline
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Default pain therapy

Pain sufferer since 86, sinus pain (I can feel headaches, and they are not this). Some thought they are also migraines and cluster, but positive they are neuropathy. "mild" narcs since then, "heavy" since 94 almost continuously. Therapies that have had some effect for me:

1. counter pain. Push a ball point pen into the muscle between your thumb andindex finger (either hand). Continue until the pain from it is really intense. Surprise, your mind is distracted for a few minutes to weeks.

2. Heat packs. Get really hot, put towel between, with enough folds it does not burn your skin- but just barely. visual and feel the heat soak into the head until it reaches the back skin on head (also works on back and any other muscle or skin pain).

3. cold packs do not work for me, they merely increase and prolong the nerves, but other people say they work like 1, above. Trick is to go through the pain threshold you think you have- when it seems like it will overwhelm you, it suddenly goes away.

4. Hot Jacuzzi. Trick is to get in while it is hot, then add hot water (slowly) until it is at maximum heat you can take. Take a cold drink (NOT alcoholic) and keep hydrated for half hour at least. The stronger the jets the better.

You've noticed- above tricks are to experience another sensation that is much more intense than the ordinary pain. The more intense the better, and BELIEVE it is more pleasurable than ordinary pain (yeah, I know it sounds masochistic, but its not, and if it works why do you care? Using psych speak- are you more invested in your pain than curing it?).

5. Reading a book, engaging in a lively argument on a subject you CARE about, accomplishing a task you can lose yourself in- do it WHEN you don't feel like it, not when you do. Make a habit of doing this at the times you don't want to. Key is habit- your mind should automatically turn to these things when pain begins to take over your mind, just like you automatically perform all the steps needed to tie your shoe, just without thinking consciously about it. In fact, it is a habit when thinking about makes it more difficult to do.

6. Find a mental activity that does not require movement. Songs are good, listening to tv that actively engages your mind, learning new things, come up with your own list. Scream with every bit of energy and emotion you have in your body, not just the "I hurt" grunt. (Be warned- my wife put me in the Stress [suicide] Center for doing this all afternoon. But it was good to meet people who really hated themselves.) Or even (this sounds crazy) take the time to shut everything else out, then feel every part of your pain, and the sensations caused by the pain (some people say concentrating on their pain makes it go away!) This should not be habit- instead it is something you give yourself permission to do rather than "more" pressing things at hand that seem to pressure you. In fact, taking care of that pain is probably your most important job- if not, you're probably not on this site.

7. Choose to talk to your family or support staff. Find out what they see in you and how you are coping, what problems they are having in school or work, what triumphs they have had. If you are not totally into it, take notes so you will remember it later- but you will find that the concentration of notetaking will become automatic when you talk to these most important people.

8. Buy a relaxation tape, and use it first when you are feeling relatively good. Get good at it, then start using it when you have some problems, then build up to really bad times, but you now have a basis of believing that it helps.

9. When you have that belief, start trying self-hypnosis tapes. Remember, you must believe what the person hypnotizing you is saying- and in self H, that person is you. Maybe take a course in hypnosis in a classroom setting. When you see a 98 pound gal laying with her shoulders on one chair, and her feet on another, but her untoned stomach is supporting a 200+ man, you will really begin believing there is something in telling yourself not to hurt. Then experience posthypnotic suggestion. You will tell yourself it is not GOING to hurt: and believe yourself. Talk to someone who was in serious war situations, tell them why you need to know what the human will can do, and they will open up with stories they stopped telling other people because they were not believed.

The above are related to the mind's ability to control what it feels and does, but don't despair if it doesn't last forever; you may get longlasting relief, but it may be limited to a couple weeks: isn't that a couple weeks you wouldn't have had otherwise? It can still be effective in acute situations with several hours relief which is enough to handle some breakthrough pain. However, only Peter Pan and Tink can fly, and no amount of willpower causes you to grow a sixth finger.

10. Forgive everyone. Anger and agitation multiplies pain, and you can't afford the energy required. Especially forgive your close ones, and find reasons to believe that they did not mean to hurt you in anyway. They have the most power to prick your ego into reacting. Decide right now that what you initially feel is an insult is really not intended that way, and it is silly for you to react to something that is not intended to hurt you. If you are really hurt (someone intentionally tells you that you are not meeting their expectations and they are disengaging from the relationship in some manner), consider whether their expectations were real or fairy tales, whether you caused it or it was only perceived in you, and if you did cause the hurt (yes, they are almost always acting from feeling hurt themselves), what can you do to change your actions. And if they insist on going entirely, let them go. Loss is part of life, but hanging on forever is not. Living organisms grow. Decide (DECIDE) now to live.

11. Every day, concentrate on doing at least one thing for your close persons that will please, surprise, gratify, etc them. If you do the same thing everyday, you have not concentrated. This will give you a real sense of accomplishment (which tends to crowd out the worst of pain) and seeing someone you care about happy will plant a good feeling in you. (PARENTAL ADVISORY: If you don't believe me, explain why someone who is at first grossed out by oral sex can get really into it when they see the pleasure in their partner?)

12. Think about the world around you realistically. It is not terrible just because you feel chronic and/or acute pain: it is not wonderful just because you feel good. What is different is your perceptions of some of the same events. Everthing has something of good and bad in it. A death means no more pain, but it also means loss of what good that person spread on others. Even the worse evil actions are countered by people who show that they will not be controlled by evil. Therefore, look for the good in your pain, as well as all the things you know to be bad. Do you have more patience now? Can you empathize with other sufferers? Can you help someone because you know what they are suffering, and what they will suffer? Would it have helped you to know somethings others have learned from their experience with pain? Then, USE the good you have found.

13. Find some peace in believing that what you are going through will ultimately contribute to your growing as a person, instead of destroying who you are. If you cannot believe that, consider why you cannot. Is it because you don't want it to be? What is causing that destruction, and what can you do to construct something good?

The above will generally be thought of as "spiritual" bandaids. I think we are all spiritual beings, that choose to love or hate, but our spirit. True, while here we are spirits bound to human bodies, and all of the limitations they impose, such as pain. But if you believe love, or hate, or sacrifice or any other such is real, then you believe in spirits. These things have no mass, no velocity, no gravity, but they really change this world. And isn't that the definition of a spirit? And if there is a Spirit that is so powerful He can speak worlds into existence, even me, but tells me He loves me, wouldn't He give me rules that make my existence work to the better? (Bet you can't imagine what my religious leanings are!)

14. When pain is really unbearable, and all self remedies have come up short of putting it back into its place, turn to someone else. First, try a massage therapist, or chiropracter (with care) or D.O. who can administer to you. I credit a nurse masseuse with saving my life when I was in hospital, all the therapies had been tried, and my numbers continued to accelerate the wrong way. She used healing hands massage, and it was from that point my stats turned around. I also credit a D.O. with a specialty in adjustments who showed me that I had shut down the sensors in my back (severe curvature) and I needed to feel them to know how to correct the problems. After that, I intentionally forced my back to straighten up in the right ways, to the point that when a new doc does a back xray, the first thing he says is "Did you know you have a severe scoliosis?"

15. You all have doctors. If you don't believe in your doctor, find one who does instill confidence in you. I know the drill: you stay with someone because he (alright- or she) is familiar. But the familiar is that you have no hope things will turn around. You must want the help more than the (comfort?) of staying with things that are so bad you do not know if you can go on. Don't be afraid of hurting the feelings of the doctor: they are taught not to feel personally about their patients on any level (think of doctors who unthinkingly do this to their wives or husbands anytime a problem pops up), and they may really want to be relieved of having to see their failure time and again (remember, they don't think of your loss, only the blemish on their ego of not succeeding with you).

16. If you believe in your doctors, try therapies they suggest with the expectation that they told you that because it has helped someone else. Nothing is worse than trying something with the expectation it will not help.

17. Know your individual chemistry. Medicine is now finding that drugs that help someone will not be as effective on someone else because we each have unique chemistry makeups. The majority of human beings may have a chemical process that makes oxycodone more effective at treating pain than hydrocodone, but the minority is sizeable. I personally have opposite effects on a large number of drugs. If I know it, I can advise doctors who are in ER's, or substituting for my regular doctors. I know someone who lived and worked with dying, wasting hip bones for many years on Ultram: I found it to be worse than water. Know where you fit in in the spectrum.

18. Start with anti-inflammatories. In most chronic pain cases, there is an inflammatory component. In smaller words, pain can cause swelling, which then also adds its own pain to the mix. Don't assume an NSAID is for autoimmune problems, and get depressed when it works. But don't despair either if the NSAID is not totally effective. You may need something that prevents the nerve transmissions.

19. If you need synthetic or real narcotics, don't get into the "I'm violating the Just Say No campaign." You are different, and you don't have to apologize. It is hard enough to convince a doctor that his patient needs narcotics, and if he gives them to you longterm, he feels he can easily justify them to the DEA (I've been on the inside- this is no small fear for most doctors). So don't dilute their effectiveness by delaying taking them until the pain is really established, or making yourself feel bad for taking something that makes you feel better. You are a good person for taking care of yourself so you can help the ones around you who are most effected by your pain.

20. On the other hand, give up liquor, especially if you are on any heavy medications. By way of background: I had never drunk alcohol (when a kid, they swabbed my arm with overpowering alcohol, then stuck a very dull, used needle into it every week- it is a sure fire cure for demon rum). But one night the pain had been so bad so long I poured the cooking rum into a two cup measuring cup, then added some punch mix. I tried to sip it, but couldn't get it near my nose, so I downed it in one long drink, not allowing myself to breath. What I found was that instead of deadening my pain, it moved it farther away from me, kind of like I was feeling it across the road. I drank a gallon of water (yeah, I also measured it out) that night, and didn't wake up with anything I recognized as a hangover: little wonder, my sinus pain was throbbing to push any other sensation out of my mind. I know from conversations with fellow pain partakers, we have all tried (some harder than others) to deaden the pain with the legal sedative. But when you add it to prescriptions, your absorbtion may be poor one day (little interaction) but instantly effective on others, interacting to terrible extents very quickly. To avoid aiding suicides, I will not tell you the drugs, but there are pain medications that when taken with alcohol may do nothing one time, but cause complete respiratory cessation in under six minutes. Because it is a sedative, you may simply drift out of consciousness, not awake when your breath stops. Unless someone recognizes the problem within three minutes, AND gives respiratory therapy, the ambulance will not arrive before brain death has occurred. DO NOT stop your pain by adding even small amounts of alcohol to prescriptions. It will cause even more pain than you bore to those you leave behind, whatever the status you think your relationships are in.

21. Even heavy, longterm doses of narcotics can be taken with little effect on health if you follow your doctor's precautions and orders closely. You can get into trouble if you do not have one doctor doing all the prescribing of pain drugs. It seems attractive to be able to get doses larger than one doctor feels comfortable with by getting drugs from two doctors, but it is a recipe for attacking your health. With larger doses, you need different precautions, and maybe even other prescriptions to counter side effects. In addition, you can kill the golden goose by making both doctors distruct you if you are found out. Getting something now is not worth leaving yourself with nowhere to turn later (and don't forget, doctors talk to each other about patients).

22. Talk to your doctor fully, and fill him in on anything related to the pain. Do not exagerate, but also do not take the he-man approach. The doctor needs to know where you are at, and have been, to medicate you correctly. If you do not give him this information, do not blame him when your pain is out of medication control. That means if your pain is out of control now, make your doctor aware of that. They will probably not be able to give you more drugs while you have a script in effect (again, the DEA looks at that very closely- and yes, your doctor has been audited several times, and many times if he is a pain specialist), but they may have the ability to give you breakthrough medications when your scripts come up for refill (yes, that is an incorrect term as far as the DEA is concerned- by law, narcotics cannot be written for a refill).

23. After narcotics, your doctor can also look at medications that block nerve impulses. I am familar with Norontin and Lyrica. Some anti-depressants have an effect that relieves chronic pain, such as some doses of Effexor and Prozac (no, they are not saying it is all in your head). It has been found that the ability of nerves to get impulses to the head is dependent on other factors than blocking the opoid receptor sites with narcotics. Other drugs are in testing that may block the impulses from getting into the chronic pain system in the spine. These can still have side effects, but these effects are felt by fewer patients than with narcotics.

24. It is also possible to inject some narcotic or steriod into the tissue surrounding the conducting nerve, which will deaden the pain without getting into the blood system at levels that cause the unwanted effects.

25. Finally, surgery can, in some limited cases, crush, remove, deaden or otherwise prevent the nerves in the pain area from functioning. This can last forever, but contrary to earlier thoughts, nerves do regenerate in areas of the body other than the spine and brain (at least, doctors now think that- who knows what the real truth is). The side effects of surgery must be weighed against the possibility that relief will be felt. On the other hand, some doctors who treat chronic pain believe they have seen cases where the simple act of touching a nerve that is not normally touched will cause nerve transmissions that are felt as chronic pain from body parts served by that nerve- in other words, cutting and moving inside the body may excite pain from nerves that had been left alone. There is no precise measurement of how many times this occurs in surgery since some doctors refuse to believe it.

I'm sure I'm talking to medication veterans, so the bottom line on medications is take them if needed, and tell your doctor what he needs to know to decide what you need. Some doctors refuse to believe pain can be so bad (except in cases of gunshots or their relatives) as to require narcotics at some or any levels. Some do not want the attention of the DEA and refuse to do anything that conventional doctor wisdom says will cause them to be audited. Some doctors have been indoctrinated into the current JCAHO model that says pain is a condition that doctors can address, and must inquire after it, and then treat it effectively, but without catering to addicts. If your doctor will not treat your pain, or rules out alternatives, you need a second opinion, or a different doctor. Yes, from experience I can say that getting a new doctor attuned to your conditions is not easy, but staying with a doctor who ignores your symptoms is worse. Not many statements can be made as absolutes, but in my humble opinion, that one comes close to it. A good doctor is looking for alternatives to treatments he has already decided on, and if he is not conversant with new procedures or meds, will become familiar with them or bring in a doctor who is.

The one sentence answer to your question of "What can I do?" is to look at everything you have done so far, try them again, and go to the next step wheneever anything does not work. In gentlest, kindest, most sincere terms, you will feel better when you feel you can do something, and stop listing what you cannot do.

I hope and pray this is somewhat helpful to you- it has at least taken my attention to helping you and off my pain!
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