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-   -   Increase in pain, need a med to rotate with Tramadol. (https://www.neurotalk.org/peripheral-neuropathy/206352-increase-pain-med-rotate-tramadol.html)

Marty SLC 07-05-2014 07:37 PM

Quote:

Originally Posted by Dr. Smith (Post 1080235)
Marty, I don't know of any prescription pain medications used regularly that don't produce dependence eventually. Even the antiseizure meds (gabapentin, pregabalin, topiramate) and the SSRI/SNRI antidepressants do that. Rotation may help retard tolerance, but dependence will still be there.

It may be a choice of the least of many evils. I realize you're in SLC, but have you been following the CBD thread?

Doc

No I have not been following it.

Ouchiefeet 07-06-2014 11:32 AM

I am pretty new to this Neuropathy thing, mine got really bad in July of last year and it took til October for them to diagnose and then another few months in pain management to get some relief to the point I wasn't in a ball in my bed sobbing to my husband.

From July 13-Mar 14 I was in so much pain I was like a crazy woman who begged every single doctor I saw to please help me. I never knew until then that your brain can be so consumed pain to the point it was all I thought about was begging for help.. If you knew me you would understand that that is waaay out of character for me. I am generally a very independant suck it up type of person and I was a mad woman. I soaked my feet in ice, plunged my feet in snow piles, kept buckets of ice next to my bed to soak my feet in when I woke up in the middle of the night (if I slept at all) I tried using sunburn gel with lidocaine in it to try and numb the pain. I was literally bathing in sunburn gel lol. During that time they had me on many different meds and kept raising the doses of my gabapentin to max dose of 3600mg.

My pain doctor asked me to try Nucynta ER. After the first week on it I was still begging for help calling them telling them it wasn't working. They told me to wait it out and if it wasn't working by my appointment date we would try something else. Like I said before after about 3 weeks the pain relief was so much better than any of the other treatments I had tried so far. I have been on it since March along with now Lyrica and that combo seems to help enough I can actually function most days to the point I can even go grocery shopping and for small walks where I couldn't before.

You have to understand that with any drug there is a chance of dependency. I know I have to be on these types of drugs for the rest of my life. I know that this neuropathy is never going to get better doctors told me that not long ago, so I needed to decide the risk of the med vs dependency and other side effects and I have chosen to give it a try for the relief it gives that allows me to function at least a little bit.

zorro1 07-07-2014 04:30 AM

Quote:

Originally Posted by Ouchiefeet (Post 1080406)
I am pretty new to this Neuropathy thing, mine got really bad in July of last year and it took til October for them to diagnose and then another few months in pain management to get some relief to the point I wasn't in a ball in my bed sobbing to my husband.

From July 13-Mar 14 I was in so much pain I was like a crazy woman who begged every single doctor I saw to please help me. I never knew until then that your brain can be so consumed pain to the point it was all I thought about was begging for help.. If you knew me you would understand that that is waaay out of character for me. I am generally a very independant suck it up type of person and I was a mad woman. I soaked my feet in ice, plunged my feet in snow piles, kept buckets of ice next to my bed to soak my feet in when I woke up in the middle of the night (if I slept at all) I tried using sunburn gel with lidocaine in it to try and numb the pain. I was literally bathing in sunburn gel lol. During that time they had me on many different meds and kept raising the doses of my gabapentin to max dose of 3600mg.

My pain doctor asked me to try Nucynta ER. After the first week on it I was still begging for help calling them telling them it wasn't working. They told me to wait it out and if it wasn't working by my appointment date we would try something else. Like I said before after about 3 weeks the pain relief was so much better than any of the other treatments I had tried so far. I have been on it since March along with now Lyrica and that combo seems to help enough I can actually function most days to the point I can even go grocery shopping and for small walks where I couldn't before.

You have to understand that with any drug there is a chance of dependency. I know I have to be on these types of drugs for the rest of my life. I know that this neuropathy is never going to get better doctors told me that not long ago, so I needed to decide the risk of the med vs dependency and other side effects and I have chosen to give it a try for the relief it gives that allows me to function at least a little bit.

Your last paragraph is important. Its acceptance. I know there are many who dance around medication never fully committing just in case one day they wake up and the PN is gone and I used to think like that and didn't want to be dependent to much.

There are also a host of other ailments that we get as we get older and these to are masked by pain killing drugs so when we try to stop its hell.

There is a also a psychological factor both with antidepressants and pain killers like tramadol that help us deal with the disease by numbing the senses and telling us sure we are sick but I don't care to much about it, now there is a big dependency right there. I cant see how anyone with serious pain issues can not become dependent.

Dr. Smith 07-07-2014 11:55 AM

Quote:

Originally Posted by zorro1 (Post 1080564)
Your last paragraph is important. Its acceptance.

Good point, and conversely, those more toward the beginning of their PN (and the stages of grief for chronic illness)—who believe it may one day go away/be gone—may be in denial.

Doc

KnowNothingJon 07-07-2014 05:40 PM

I am at the beginning. I am thankful that between the two medicines I take I get marginal relief. Some days are good and they seem to allow me to make it through my work day with enough energy to get mobile quality family time in. Some days- stretches of days- I have to take more the secondary medication than I might want to.

I have made significant lifestyle changes that leave me at the odd life juncture of- best shape of your life since you were an athlete (20 years ago) while having a chronic condition that is often extremely dibilitating.

These ebbs and flows left me reeling earlier this year. I thankfully had a secular Road to Damascus moment and decided that I had to keep positive. So I do my best to lead with that. Results, as always may, er do vary.


I have lowered the intake of one medicine while increased the other. I no longer wait to see if I can withstand a bad day. I have been caught behind the curve of the pain that way. It takes five minutes of stretching to know which day it will be. I know it may come to a day where it takes five minutes of trying to get out of the bed to consider stretching.


It is a tough decision on how to handle it. Such an individual one too. My wife is in on all of it. I have my kids to consider and they are both young.

Thanks to many of the suggestions here- Salonpas - I have found some OTC stuff that at least helps take some edges off a tad.

It is a matter of degrees at times.

My best to all.

Jon

KatLC 07-07-2014 08:17 PM

Quote:

Originally Posted by Marty SLC (Post 1079777)
Main thing is I don't want to become dependent. If I ever had to stop them cold turkey it could be a painful experience. I know a week or two is my limit because after being on them for two weeks due to a big event in my life that needed my full attention, the passing of my father. Then stopping once I didn't need to stand and things the withdrawals were not pleasant at all. I can't even imagine how bad it could be if I had been on them for a long time at large amounts.

I need to find something else to get me through the hard painful times from events out of my control.

Withdrawals are awful. I hate taking drugs so I periodically go off painkillers and even though I taper off I get bad withdrawals. I have not had luck from pills in general. My doctor gave me a topical cream I can use multiple times a day that does help ease the pain. But my pain is mostly in my foot and lower leg, if yours is more widespread that may not be a realistic solution.


Quote:

Originally Posted by Dr. Smith (Post 1080619)
Good point, and conversely, those more toward the beginning of their PN (and the stages of grief for chronic illness)—who believe it may one day go away/be gone—may be in denial.

Doc

I know I'm still in denial. I refuse to accept that I will have to be on painkillers for the rest of my life. As someone who works in bio-med and does research on the mechanisms behind regeneration I'm hopeful that one day we will be able to fix PN instead of just managing the symptoms.

Marty SLC 07-08-2014 09:40 AM

Quote:

Originally Posted by KatLC (Post 1080693)
Withdrawals are awful. I hate taking drugs so I periodically go off painkillers and even though I taper off I get bad withdrawals.

This has been my practice now for several years and have done OK at managing my build up tolerance to tamadol. It is vary difficult to do this or rather impossible it seems when I'm busy with life and commitments out of my control. I view pain killers as a way for me to get what I have to do done, like the passing of my father or traveling to see my in laws in Finland. But at this point I have pretty much avoided taking pain med's just to lower my pain when I can get through the day without them. Get through easily? No but none the less possible. The mental game is in my view the most important and without it things start slipping. My weight, my exercise, my food quality and so on. Once this happens the pain increases incrementally. But I have to wonder is my pain increasing only because my healthiness has decreased? It's a combination of health of body and mind. If I can be strong enough to control what I eat, how much sleep I get, my exercise and so on I seem to strong enough to deal with pain better which in turn makes it seem like it's less. Less because mentally I'm stronger and less because I'm controlling my habits better.

Sorry for the rambling.


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