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Old 02-28-2012, 09:25 AM #11
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Default Hi saffy

I have issues with this as well. I have been weened down on morphine, with all the side effects you described. I am a pain patient. I don't quite know the difference between addiction and this situation either. I was told I would not become addicted because I don't over use it, and take according todirectins at all time. My dr. just increased medications as I really do have a joint that needs to be replaced, and I am afraid to take them, because after the surgery, I will be taken off them with the whole terrible experience. I am afaid to up medication even though my pain has gone way up. I am always afraid he will begin to ween me down again. I feel like I am on a roller coaster with this. I know I need the mediation, but scared to take it, not knowing what my doctor will do. So instead I am shopping for a wheel chair. It seems i really do not have a good option. My ability to walk is compromised all together if I do not take these medications. The doctor only gave me enough of this new one percocet until I get the surgery, which I don't want to begin with. I am stuck not knowing what I should do. I know I am venting here, I am just plain scared, and can't seem to make any decision at all. ginnie
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Old 02-28-2012, 12:29 PM #12
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Quote:
Originally Posted by ginnie View Post
I have issues with this as well. I have been weened down on morphine, with all the side effects you described. I am a pain patient. I don't quite know the difference between addiction and this situation either. I was told I would not become addicted because I don't over use it, and take according todirectins at all time. My dr. just increased medications as I really do have a joint that needs to be replaced, and I am afraid to take them, because after the surgery, I will be taken off them with the whole terrible experience. I am afaid to up medication even though my pain has gone way up. I am always afraid he will begin to ween me down again. I feel like I am on a roller coaster with this. I know I need the mediation, but scared to take it, not knowing what my doctor will do. So instead I am shopping for a wheel chair. It seems i really do not have a good option. My ability to walk is compromised all together if I do not take these medications. The doctor only gave me enough of this new one percocet until I get the surgery, which I don't want to begin with. I am stuck not knowing what I should do. I know I am venting here, I am just plain scared, and can't seem to make any decision at all. ginnie

How often we are told, we are not addicted; but dependent on the narcotics to get thru each day of pain.

I am scared as well, because I see no end to this. The Oxycontin has caused some anxiety in me as well. When I had my spine fusion/lamnectomy about 5 years ago, I was given Vallium, along with the Oxycodone and was told that these two together help with the pain. I have been using these two together for the past few years for breakthru pain. I also use the Oxycontin every 6 hrs for continuous relief and the Oxycodone 7mg-325 (tylenol), along with the Vallium for breakthru pain.

The thought of going into withdrawal is frightening. Often, the 6hrs before taking the Oxycontin 60mgs, I reach my "end of dose" as the doctor put it too soon. This mean the dose is not enough to see me thru 6 hrs. and if it sometime am an hour or so late, I do begin feeling some withdrawal. Also, while in the hospital, about 3 years ago, for bladder surgery, the nurses only gave me the meds for that type of surgery and not in addition to my usual....WOW..... did I go into withdrawal. My Pain Specialist is on staff at the same hospital and immediately had them give me the proper dose to stop the withdrawal and to continue with the necessary meds.

Withdrawal is awful. I don't like being on these meds; but unable to be without them. Scarey indeed.

(Ger)
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Old 02-28-2012, 01:05 PM #13
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Default Hi Ger

I had the same problem in the hospital after my spinal fusion. I was not getting enough to cut the pain as I was not receiving my usual amount to begin with. I wound up shaking, shivering, sweating, sick, the works. My surgeons nurse walks in and trys to tell me I am doing this to myself. I was too much in pain to respond to her much at all, I was furious! I thought hospitals had an obglitaion to make sure their patients are at least comfortable?. That night, I cried to my night nurse, a nice male nurse, He looked at my records and came in and said he understood why I was having so much trouble, that I had been on this medication for years. He gave me a shot of morphine, that allowed me relief, and I also watched the picture in front of me dance! He was the only who had mercy on me. It taught me a real lesson, that I need to address this with any physician before I submit to more surgery! The whole thing made me very angry. My pain was not controlled very well other than this night nurse. I now don't trust the hospitals to do the right thing by me. ginnie
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Old 02-28-2012, 04:51 PM #14
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Default Ginnie

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Originally Posted by ginnie View Post
I had the same problem in the hospital after my spinal fusion. I was not getting enough to cut the pain as I was not receiving my usual amount to begin with. I wound up shaking, shivering, sweating, sick, the works. My surgeons nurse walks in and trys to tell me I am doing this to myself. I was too much in pain to respond to her much at all, I was furious! I thought hospitals had an obglitaion to make sure their patients are at least comfortable?. That night, I cried to my night nurse, a nice male nurse, He looked at my records and came in and said he understood why I was having so much trouble, that I had been on this medication for years. He gave me a shot of morphine, that allowed me relief, and I also watched the picture in front of me dance! He was the only who had mercy on me. It taught me a real lesson, that I need to address this with any physician before I submit to more surgery! The whole thing made me very angry. My pain was not controlled very well other than this night nurse. I now don't trust the hospitals to do the right thing by me. ginnie


Ginnie,
I made sure I had the bladder surgery done with a doctor from the same hospital as my pain specialist. The surgeon had given my doctors name as the doctor to handle my pain meds. Unfortunately, the nurse didn't look and when I had asked for some of my regular meds, she said she would lower the IV she was giving me. I tried to explain things to her. Luckily two of my adult children were there and hurried to the desk to have my doctor called. This was immediately taken care of.



I didn't go as far as the chills, I just was starting to scream with pain. It happened so suddenly. One minute, I was jokiing with my family and then in a split second; the pain went out of sight. I try to make sure my pain doctor is at the same hospital; but you need the staff to read instructions.

I think one of my biggest fears is being rushed to some hospital where they do not understand the circumstances and allowed to go into withdrawal. As you know, I am on very high doses of Oxycontin (continuous) and Oxycodone (percocet) immediate breakthru. That is very frightening.

(ger)

Last edited by ger715; 02-28-2012 at 10:21 PM.
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Old 02-28-2012, 06:03 PM #15
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Default afraid too

I have to have surgery to replace a joint. I am afraid of the same thing happening this time. I am going to make sure the staff and my doctors know ahead of time to give me the regular dose. There is poor communication between fields of medicine thats for sure. I did the screaming and full blown withdraw, they told me I was doing it to myself. I wanted to throttle somebody but hurt to much to do anything. My son asked for intervention. Why is all if this so hard for the hospitals to understand? take care of yourself! ginnie
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Old 03-05-2012, 01:00 PM #16
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AMEN! i am sorry it happened
this is a problem we are given special
term when dealing with patients
as such

shame on them!
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Old 03-12-2012, 09:29 AM #17
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Originally Posted by Saffy View Post
The funny thing is, I said I felt I had been addicted to it .. He said, when you have chronic pain there is no such thing as addiction, just dependency. I thought they sounded both the same ..
They are not.
Quote:
In 2001, the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine jointly issued "Definitions Related to the Use of Opioids for the Treatment of Pain", which defined the following terms:[3]
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical dependence is a state of being that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

Tolerance is the body's physical adaptation to a drug: greater amounts of the drug are required over time to achieve the initial effect as the body "gets used to" and adapts to the intake.

Pseudo addiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may "clock watch," and may otherwise seem inappropriately "drug seeking." Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.
A definition of addiction proposed by professor Nils Bejerot:
An emotional fixation (sentiment) acquired through learning, which intermittently or continually expresses itself in purposeful, stereotyped behavior with the character and force of a natural drive, aiming at a specific pleasure or the avoidance of a specific discomfort.[4]
http://en.wikipedia.org/wiki/Substance_dependence
To say it more succinctly, pain patients don't want to take their meds - they have to for a medically therapeutic reason. Addicts want to take/abuse a drug for its effects without a medical reason, and can't wait for the next/higher dose.

Everyone must make their own decision whether to take/continue with a medication, but there are better/easier/safer ways of discontinuing dependence-producing meds. Our doctors can/will help us with this too, without going through that hell.

Doc
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Old 03-12-2012, 05:08 PM #18
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Default Hi Dr. Smith

I go to the pain specialist this thursday. What other meds could I possibly be put on that would help with my cronic pain?. I take morphine 30mg. twice a day, and it is not enough. I am close to not being able to walk. I also got percocet that as you know I have not been taking because I don't want another medication to reduce from. Is there anything that does not have an dependant nature to it? I hate to be on this stuff all my life. At this point I really don't know what to do. ginnie
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Old 03-12-2012, 11:30 PM #19
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Quote:
Originally Posted by ginnie View Post
What other meds could I possibly be put on that would help with my cronic pain?
Ginnie,

Morphine is the "gold standard" for long-term chronic pain, and has been for over 200 years. Because it's been around for so long, morphine is probably the best-studied pain medication, and relatively inexpensive compared to most others. Most other opioids are based on or derived from it. All opioids cause dependency when used long-term; that's one of the trade-offs for pain control/relief and having some quality of life.

I don't know of any long-term pain medications that do not produce dependency (though some less than others, e.g. cannabis/derivatives, but that's not yet legal where you are), and/so I don't understand your thinking with regard to not taking the percocet prescribed for breakthrough pain. If you're dependent, you're dependent; it's not additive that I'm aware of. I think your fear is really fear of the unknown and what might happen (not what is or is likely to happen), and the best weapon against that is knowledge.

Google: talk doctor pain, review a few articles, and be candid with your doctor about your concerns/fears; I know you have confidence in him. He may want you to try the percocet before making any changes/increases, but ultimately that may be what happens, and medically in order (in the doctor's judgment - not mine ).

These are just the facts of chronic pain treatment. Nobody likes it, but in those 200 years, nobody has been able to find a safe & effective pain medication that isn't dependency & tolerance producing (not that they haven't tried).

Doc
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Old 03-13-2012, 08:39 AM #20
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Default Hi Dr. Smith

Thanks for your response. I go in on thrusday, and will write down the questions. Yes I am afraid of forming another dependance on percocet. Since the weaning down on morphine was so traumatic, I was afraid to take the percocet as often as he recommended. We will have to talk about this surgery he wants me to do, as the other foot and toe is acting up too, same way as this left one is. Its like they want me to fix the battery in a car when the engine is broken, it still won't run, so why put the battery in? I am so sick of surgeries I could scream, in fact I have, a number of times. I just want to be left alone for awhile. I have enough trouble right now with my family, and keeping a roof over my head. I will talk to him about both issues. I got a hold of my ankle specialist, and my x-rays, in hopes he will understand that the ankle is shot, and nothing short of a replacement ankle, is going to keep me on my feet. I guess I was hoping for a miracle, where I didn't have to take these drugs all my life. I would try THC if it were legal in my state, and I am kind of angry they don't permit it. Some time back in floridas past, they did have a compassionate law about it, but our new governor squashed it. I know for sure that stuff won't cause the withdrawls that these others do. That is my real fear. He has lowered my does to the point I have little quality of life, and my walking is very limited now. On a higher dose, I was able to get around better. I am always afraid, he will put me on a higher dose like he did with the percocet, and then decide to lower them again, so I go round and round with withdrawl. If he would just leave it alone, that fear would go away. He likes to go down, and I get little say about it. He is a nice guy and all, but I don't understand why he is not allowing me to stay at the same steady dose. Between my neck and ankles I am fairly miserable. Since my cervical fusion, it has been a one way ticket down, even though my pain has increased. Maybe I need to find another doctor even though I do like him. I am very confused, and I get stressed every time I try and talk to him about this. Last time I had my PCP intervene on my behalf as he didn't listen to me. Sorry to Vent, but this is a real problem for me that I am not sure what to do about. thanks Doc, for being there for me. ginnie
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