Going to pain doc tomorrow
 

Yay? I'm just wondering what I need to ask for to deal with the breakthrough pain. I'm worried about going through more med trials. Maybe somebody here can offer a suggestion of a really good drug that will work for me. Here is what I've dealt with already (during this or in the past).

Currently taking:
Oxcarbazepine, Wellbutrin, Zoloft, Levothyroxine, B12 combo w ALA and some other stuff, Magnesium, medical marijuana, mirapex

What hasn't worked:
Gabapentin (made me too stupid),
Tramadol (horrible reaction that involved puking),
Vicodin (either doesn't work or if I take enough for it to work it does my stomach hurts even w food),
Percocet (I got addicted in hospital off half what I was told to take, took 6 weeks to ramp down and stop, but man that was a good high)
Advil (I can take it on a case by case basis, but not continuously or my stomach will hurt)
Despiramine (took it at night, woke up all sweaty and feeling horrible at a really low dose, had to stop it)

I have to work, I already have a harder time concentrating on work. I can't be all spaced out all the time. The pot works to help me deal with most things, but I can't use it at work, and it only helps so much. I need something for breakthrough pain and also when I'm at work. So I'm guessing maybe two things. I also have a generic only rx plan, at least until Nov when it renews. I can't afford anything out of pocket right now, at least for a few months from now.

I'm kind of afraid to take more opiates considering what happened with the percocet. I need something that works, doesn't make me "high" (I could have one that does that as long as I have another option for work, I can be as high as a kite the other 16 hrs in the day as long as I'm good for work), doesn't upset my stomach, and something non-addictive.

So what are my options?

ordinarily you don't get high unless you are taking more than you need. Have you tried Morphine? Methadone?

I've had morphine twice, both times in the hospital via IV. The first time was when I was induced to have my daughter, I felt like I was going to puke until I actually fell asleep. The second time was when I was burned, I don't remember what happened then, it helped obviously as I was in extreme pain.

I have not had methadone. I read it's a synthetic and my brother mentioned he has a hard time with synthetics, so I don't know how it'll affect me. I have thought about it, maybe try it on a day I don't have to do anything and see how I feel. It'll either work or it won't.

And yeah, the percocet did get me high off a low dose. I read about an enzyme CYP2D6, that I might have a hard time with some opiates because of this enzyme. This might be what caused me to get addicted off the lower dose and feel the euphoria from it. I still need to understand this part of it and talk to the doctor about it.

I have a couple hours until I go if anybody has any suggestions.

If you worry about addiction, I would really stay away from methadone.

I have seen people trying to kick that habit, and it's plain horror. It's easier to kick off heroïne...

I would really only consider it as a last resort IMHO.

Yeah, so much fun trying to find something to help me that won't make me addicted, will actually work, and not make me totally sick!

Well, she wants to do an MRI to make sure I don't have MS. She was really surprised it hadn't been done yet. She got me a prescrip for Lidocain and Capsacian creams. Gave me info on a stimulator implant. I'd love to hear from any of you who have one of those. She went over med options, but I think I want to look into the stimulator first.

We have a forum for the SCS implants. There have been some
posters there using this implant for PN pain.

http://neurotalk.psychcentral.com/forum118.html

For a bit of fun you can also make your own capsaicin cream, and experiment with the strength that works best for you:

For example:

2 Tablespoons Habanero Powder
2 Cups Olive Oil
¼ cup Beeswax

You'd heat this up to melt the wax, let it cool, and put it in a jar. A little sting when applying is normal, but it shouldn't burn, so you may need to experiment with the ingredients.
This would make a high strength cream with only natural ingredients. For even more fun, grow your own peppers. :cool:

(Warning: always wear gloves when handling the powder or peppers.)

I use Cayenne pepper I get in large size containers to keep rodents out of the flower pots and plantings. I sprinkle some on the soil, and they get a snoot full once and never come back!

I can't stand the pepper creams on my skin however, so I don't use them.

Oh sure, it doesn't work for everyone. Could this - in your case - be linked to not digesting nightshades easily?

I should have added that in case of skin reaction, the cream should be disused immediately. I only mentioned it because Chaos doc. recommended them.

Yes, that is really possible. Nightshades and I do not get along well at all. I do miss the spice of life at times... but the aftermath is so horrible, I have incentive to refrain! ;)

I do take nightshade fruits and veggies well. I can usually put as much hot sauce on my food as I want. I eat a lot of tomatoes. I actually eat a ton of mexican food, at least a few times a week. So I think I'm good there. Thank you though for warning me.

Stop and think.... you eat tons of nightshades and have tons of pain? Could this be connected? You'll never know unless you stop the nightshades for at least 2 wks or more to see if your levels change. There has to be SOMETHING causing your pain...which you have so far not found. So whatever it is you need to be a detective to see if it is something simple, which can be avoided.

I did think about that over the winter. I grew my own tomatoes, and over the winter I didn't eat many at all. I ate mostly comfort food (soups I guess). I don't eat much potatoes, but yes I do have hot sauce often. My grocery trip yesterday included potatoes (because we're going to mash them with the turnips in the garden), peppers (because they were on sale for 33 cents each) and a tomato because the lettuce was on sale too and I'm going to make tostadas, oh and pizza because it's frozen and easy. Sigh.

I'll see what the MRI says. If negative I'll try the two week nightshade trial. But they're SO good. As long as I can keep cheese :)

There is a general rule in allergy/intolerance medicine...

People are often intolerant, and crave the very things they cannot
tolerate biologically. Doctors will use this rule when interviewing you to determine testing directions to take.

I do have some GI intolerance issues with nightshades...chili peppers especially. And green/red peppers. But the potatoes cause terrible burning in my feet, and no GI intolerance.
I don't eat eggplant very often. But I seem to have problems with
paprika at times too. If I avoid them all, my life is so much simpler, and comfortable.:rolleyes: I can tolerate a little tomato but not every day or large amounts. (one of those large Rachel Ray tomato salads would do me in).

I got the capsaicin and lidocaine. The capsaicin was helpful, but I didn't feel the burn AT ALL. The first night I put lidocaine on my wrist, then both lidocaine and capsaicin on the other wrist. Both helped enough that I wasn't sitting there miserable and was able to move on with the night. They still hurt, just not horribly. Last night I went ahead and put the capsaicin on the bottom of my feet. No burn. I know that there was peppery stuff in there because I got the smallest amount on my lip (don't know how) and I felt that. I felt my feet pulse, I know that blood was going down to them. I put socks on after a while to allow me to walk around. This morning when I woke up my feet were not totally freezing. I can still feel a little something around my toes, but it's not burning, just a little warmer than normal.

So yeah. This is good.

I think I'm going to keep the lidocaine and a couple gloves in my purse to use at work or when I'm out, so I don't have to worry about getting peppery stuff on anything. I can pop it on my wrists if they get sore at work. And then use the capsaicin when I'm at home. Does that sound logical?