Does your pain med give you or increase your depression?
 

If so what pain med have you found to have least amount of effect in causing depression?

Hi,
 

Most all of the pain meds did cause more depression for me. The only one that didn't was the Methadone. It actually made me feel like getting out and doing things. My dosage was very low but it did the job.

As far as depression meds, I couldn't take them either. Prozac and Zoloft made me more suicidal and I just couldn't take the others.

I do believe a lot of the pain meds do add to the depression. It does come though with the RSD, it just multiplies with the pain meds.

Ada

Good morning dreambeliever, I can only speak for my wife in that she received no help in controlling her pain when she was diagnosed with RSD. This lasted almost 4 years and was was losing it rapidly towards the end. That all changed when two doctors named Doctor Quint and Doctor Chin aggressively put forth a plan to control her pain using pain meds first, then other meds, PT, ketamine, lidocaine etc, Suzy has been able to cope a thousand fold. These doctors saved her life. :)

Hi Jim,
 

I honestly believe that the key to dealing with RSD are two things. Finding the right Drs., which is a feat in itself and learning all you can yourself about the RSD when you have it and use that knowledge to help yourself.

When my PCP couldn't diagnose me with TOS and RSD and the Drs. he sent me out to other Drs who couldn't, he ask me if I would buy a computer and help him diagnose me. It took us 3 years to finally figure out the TOS. My PA snapped his fingers when I told him and said he should have thought of it. He was a genius too.

I have worked my butt off to get better. I have ran up on Drs. that got mad at me because of what I knew, but the ones that were ok with my help, I still have.

I didn't just have the RSD to deal with though so we had to take things one at a time to get them better. My PCP is always saying," let's take one thing first". We get it calmed down and then start on the next. The RSD was the hardest though.

I was losing it too. I was to the point of suicide. The pain is overwhelming for us.

I'm glad your wife has you and the good Drs. to help her. That's what we need to get there.

Ada

Ada
I wasn't sure if I was understanding your post correctly - are you saying that your doctor asked you to buy a computer and essentially do your own diagnosis or help him to diagnose you? Three years later when you figured it out he actually told you that he should have thought of that diagnosis?

I appreciate that you may feel indebted to this person becuase you did get a diagnosis but if I have understood your post correctly I am stunned - that is breathtaking gross medical negligence in any country!

I hope that I have just misunderstood you - please tell me.

Hi,
 

What I said is that he sent me out to Drs. that couldn't diagnose me and since he and my PA only had only one case each of TOS in their 20 years each they had trouble diagnosing the TOS. TOS is as hard to diagnose as RSD.

As far as being indebted to my PCP, I know I am. The man got me surgeries when I couldn't pay for them, he took care of me 5 years free due to me not having any insurance, once we got the diagnoses, he knew where to send me and what to do. He sent me to Neurologist, Ortho's and other Drs. and none of them could diagnose my TOS. I've had 24 surgeries in 15 years to deal with cancer issues, TOS, other arm issues and lots of tumors inside of me. I have no doubt what I owe him. He took care of Bill also and was friends with him. He spoke at Bill's funeral, he takes care of my kids and grandkids.
I consider him one of the smartest Drs. I have ever met.

It is not gross negligence. How many Drs. have you seen that couldn't diagnose the RSD? Don't we hear that all of the time on here? How many of the people on here have been able to diagnose themselves with RSD due to no Dr. being able to do it? It happens.



Ada

What my wife and I witnessed dealing with the diagnoses and treatment of RSD from many doctors, Ada's computer episode is tame in comparison. It was shear hell for my wife and unbelievable for me to fathom. I was totally dumbstruck. The search for compassionate knowledgeable doctors took years to seek out. Almost every doctor we went to said they treat RSD only to find out they don't because it became very obvious.

Hi Jim,
 

I believe there are two reason's Drs. don't want to treat RSD. It is a time consuming disorder and narcotics have to be used to help a person. A person has to be seen often if they are on narcotics and some Drs. are afraid to even give them nowadays due to the laws they are governed by.

It is a matter of finding the right Drs. that are willing to go through it with you. I'm glad your wife did. We sure can't get through it by ourselves.

I'm glad mentally she is doing better. That means she is finding her way back from the beginning of the trip with RSD.

Ada

You are correct of course. I also believe strongly ones health insurance policy helps motivate a doctor's course of action or non-action. A few years ago not far from me in Mclean, Va. a well known pain doctor was thrown into jail because a couple of bad patients were caught selling prescribed drugs on the street prescribed by him. This hampered Suzy's treatment big time. The doc won his appeal and was released from prison after a couple of years.

Ada,
I agree completely,
I spent Seven incredibly painful and frustrating years and saw over 100 doctors trying to find out "What was wrong with me". I have a tape recording (pocket recorder) of an orthopedist, telling me that I was "Malingering" because I hadto be cured with everything he did.

Years went by. I got to the point that I started "Interviewing" doctors, asking them questions, and just walking out, because I'd been there, done that. "Ya got no clue!"

Finally, Finally, a Chiropractor whom I saw up to 5 times a week, recognized RSD from another patient who was seeing Dr Schwartzman. This Chiro, Got on the phone, and BEGGED me an appointment, SOON!
BAM!
That was it. RSD & TOS, but, Dr S, sent me to the Hand Center @ Jefferson, to Dr Jim Hunter, to confirm the TOS.

I just broke down in tears when Dr S told me he "Knew what I had".
(Not because I wanted it, but I had a non supportive spouse, two children and a business to run). I was doped up on stupid meds that weren't strong enough and had too many side effects. (Thank God for the Methadone). I was So Happy to "Not Be Going Crazy"!

A Good University Hospital setting is Always your best first bet, nowadays.

After I got my TBI, I was away from my current doctor who is wonderful.
Small town USA. Went to see a new Doc.
I took him my records, and my med bottles. He was an RSD "expert".
I needed my methadone! (that, is one of the worst things about it, you don't just STOP taking it!):eek:
He must've thought I was drug seeking. I asked him to call Dr Knobler, my hands were so mottled, and dripping sweat onto the floor. He denied any sweat, and any mottling.

It's a VERY Difficult atmosphere out there to find help for this disease!

Personally, I don't want a Roger Ramjet doctor who's gonna operate, install a pump, take out some ribs. No.
I want a compassionate, educated, understanding doctor who will treat me as conservatively, and effectively as possible. Because, this is a LifeTime Experience! Don't forget that.:(

Thanks Ada!

Pete
Asb

You guys in the US have a radically different system from the ones we have here in the UK so doctors here can't treat patients in the same way they can in the US. We don't have insurance companies to wrestle with (unless you have a private health policy which are much less common here and don't stop you going to the NHS as well). We don't have anything like the issues and red-tape your US doctors have about prescribing narcotics nor do we have the issues of conflicts of interest where doctors "push" certain drugs, tests or surgeries even where it is questionable for them to be in the patient's best interests.

Please don't misunderstand me - I am not saying anything other than I am stunned that a doctor would tell a patient to go and buy a computer to help the doctor figure out the diagnosis. If a doctor even suggested that in the UK they would be up before the General Medical Council to answer for it before their feet touched the ground!

I have no doubt that doctors on both sides of the Atlantic are poor at diagnosing CRPS and other conditions. I understand that you saw a lot of other doctors who couldn't give you a diagnosis. That wasn't what I was commenting on in your post - it was the comment about the computer that shocked me.

I guess you have a whole lot of other experiences with your doctor that you are very pleased with so that will make you feel differently than I would when I only read about one small thing which would not happen here.

i think that the depression and meds goes hand and hand because some make it worse for me and others have just driven me over the edge and that was scary.
but like everyone has said, finding the right docs are the key and its very hard to do with RSD. i have seen close to 100 in 11 yrs and most told me i was a dumb kid who wanted attention when i was a teenager with RSD. and to get up and go back to school now mind you couldnt walk by this point because my rsd spread to all my limbs so fast. but having the docs that i have now it make me rest easier knowing that they will always do what is right for me .

i know that some are still tryin to find that right set of doctors and the best thing is to keep goin till you find that one that will treat you like a human being and not just some patient number. and be compassionant

carrie

There is a thread on our Bipolar forum about "resistant depression" and a specific opiate that works for it:
buprenorphine...

http://neurotalk.psychcentral.com/thread54633.html

This thread is bringing in readers from all over Google on the net and is pretty interesting.

I think the subject is very subjective. Some people actually feel better on opiates, and I have seen it on OCD forums as helpful.

But people who tend to be dysphoric (as opposed to euphoric) on opiates, don't respond that way to them.
I can't stand opiates for more than 3 days....I get very very depressed and morose. So I can't really use them except for one at night every month or more when I am in a very bad way.
I have some T-3's from the doctor--- she gives me about 12/year! (I don't have RSD, I have arthritis pain with some muscle involvement and PN).

I'll confess what I do use, and that is MAGNETS. VERY STRONG magnets. If you search PN we have several threads about them.
I've used them for years, on and off when I have injuries, a broken toe, bad knee, now my tendon injury etc. You can PM me for details if you like. (even my podiatrist recommends them for certain things).

Hi,
 

I just got back from PT.

Pete, I have seen over a hundred Drs. too. Like you I got to where I could spot a loser a mile away. His ego was bigger then his knowledge.

I also went to the a learning hospital. I never got the help there I needed but from one Dr.

I saw many PM Drs. there, the ortho was good with my ulner nerve surgery, I saw a TOS Dr., a Urologist, and none of them did anything for me. I think I actually made a good guinna pig for them. Even when they diagnosed me the treatment was poor. At the time, I was so bad off, I didn't care what they did to me and I would have let them had I not got help elsewhere.

I would rather have a Dr. that will listen to us, be compassionate as carry says and thinks we are not so crazy that we can give suggestions in our own care. It's better to have a Dr. that will learn with you then to not want to learn and help you at all. There are some that come out of school and you wonder what they were taught in their own field.

Ada

The US system is very good when you work for a large company, when you are young and healthy.
--Translation--
"when you work for a large company" Advantage is the employer provides group health insurance to their employees at a good monthly rate and may provide several choices to the employee.
"young"
Your rates are low
"healthy"
You do not use your insurance
My wife and I were all the above but not anymore, because:
My wife who worked for a large company was terminated because she was ill forcing me to pick up insurance at my work which costs close to $1000 per month out of pocket. We are now middle aged which raises a red flag and penalties with insurance companies. And my wife is now ill which means she is a liability to the insurance company so its a matter of time, as far as I'm concerned she'll get dumped one way or the other from this racket. Americans are divided about the way the US dispenses healthcare because of where we work how healthy one is and how young. But not for long.

Hi Jim,
 

Has your wife put in for SS. That might be something for her to do so she can get medicare or medicaid or both.

I agree on the insurance thing. I can get the medical care I need, it's just the meds I have to fight for. The Govenor has helped me several times get my meds through my insurances.

Colorado has some of the best care for the elderly and disabled going. I am happy with my medical care, home health care, and PT. It's just getting my meds as I said.

What I have noticed around here is a shortage of PCP's. A lot of them won't take certain insurances and that makes you have to move on to the next. We are seeing a lot of them retire or move on around here. I do believe it's important to have a PCP so you can be sent out by him to other Drs if you need that and also, it's a base for other medical issues we tend to deal with.


We have some here that won't take a patient who has too much wrong with them also. I had a friend that got dumped by a PCP just a month or two before she died. He sent her a letter saying she has too much wrong with her. There are some here also that wants to know what's wrong with you before they take you. They don't want to deal with Cronic Pain patients not just for general medical care.

Ada

Hi Fewdalord,

I'm not on any medications at the moment other than Ketamine when i'm in a really bad pain flare as they didn't help me at all and made me very depressed!

I felt so anxious and sad whilst on the meds and wouldn't leave my room at all. I just sat in bed all day not wanting to do anything. I remember having to go to the hospital with my mum and I would kick and scream the whole way there even whilst she was driving as I was so depressed and felt as though she was doing something wrong even though she was trying to get me help!! I felt SO bad afterwards but at time time, I couldn't control it!

I still get depressed sometimes but it isn't as bad as it was from the meds thankfully. The only med I have really found that doesn't make me depressed is Ketamine - it seems to have the oposite effect and makes me feel more positve about life!!

Do you see a Psychologist?? It might be worth speaking to one due to the depression to see if they can help you. RSD affects your life in lots of ways and no one can expect you to go through it on your own so never be afraid to ask for help!

I'm sorry that you're dealing with this also! I wish I could help you more but just know that you aren't alone and if you ever need to talk, I am here for you!!

Take care of yourself and I hope you find something that helps you soon and doesn't cause any nasty side effects!!:hug:

She has filed for SSDI 2.5 years ago and has been denied twice. I've contacted two congressman to help and hired a lawyer. She does not qualify for medicaid or SSI because I'm in the picture and we have assets. She worked for 30 years and is entitled to her SSDI now not years from now. That way she can move into medicare taking a big load off the both of us. My biggest fear is if I get sick (I am perfectly fine but you never know what the immediate future has in store) we'd end up in big trouble very quickly.

I've had some severe bouts of depression for a few months now, and I have wondered whether or not my meds contributed to it. During that time I was suffering from increasingly high pain levels, which I couldn't get under control until I went on Methadone (5mg x3) 2 weeks ago. Additionally, I've been unduly harrassed by WC since the "probable" RSD diagnosis last June. Included in my cocktail of meds is Topamax, which can cause suicidal thoughts.

In the anti seizure family of meds, I've also tried Gabapentin and Lyrica. I didn't tolerate either one of them well, and because head pain is my primary complaint I decided to try the Topamax. It has not caused weight loss for me, as it reputed to for many others (just the opposite, I've gained about 5 lbs). I think I was much more grumpy (for lack of a better word) on the other 2 meds than the Topamax.

I haven't found any problems with depression with either Methadone or Percocet, the other drugs I take for pain on a regular basis. I also take Cymbalta and use Catepres (clonidine patch) for hbp.

Sandy

Yes Ada,
You're certainly correct about the teaching / university hospitals.
So I should "couch" my statement, that they are a best bet.

I think they're a best bet for a Diagnoses.
But, don't let them start "tinkering under the hood right away", and NEVER without another opinion.
(unless it's an obvious break, or like that).

Like I said earlier, I don't want some doc to diagnose me, then start installing a pump, and taking out ribs....

I want a Doc to diagnose me (Still difficult after all these years for RSD & TOS), then, treat me as conservatively, yet completely as possible. (If simple meds don't work, we'll consider other options as we go).

AS Far as depression and pain meds go.

I think a straight out pain med, be it aspirin to opana to methadone, not any of the "fancy neurological meds like topomax, zonegran, KEPPRA, etc".,
Will reduce depression.

For me, Pain = Depression. Eliminate my pain, so too my depression.

Unfortunately, these disabilities cause other stressors in life.
Ins Co battles, Family battles, Divorce, Financial worries, and these can all add up to depression.

But a "Straight Up" pain reliever, is a depression reliever also, for me.
(Not counting all the extraneous detritus that comes along for the ride).

Pete
Asb

This is an intersting thread.
We know chronic pain in and of its self causes depression. Excercise, PT and a GOOD phsycologist have helped me keep my depression under control. I took cymbalta for 5 years I just went off last Nov. I wanted to loose a pill in my "cocktail" so after talking with my PM and phsycologist we decided I didn't need it.

Something else we all know is that the medications we need to manage RSD have all kinds of side effects. Just a few of them are joint pain, weakness, fatiague and the side effect of these feelings can lead to depression.

As for the comments on doctors. I agree insurance, laws for narcotics and just having or wanting to take the time to deal with the complex nature of RSD turns a lot of doctors off to our need for help. I feel some doctors are owned by insurance companies and some are obligated to suppliers of drugs and medical equipment. For example the doctor who did my SCS was under contract with the supplier to implant so many SCS'S over a period of time. So now it becomes more about his obligation to the supplier than the true concern for the well being of the patient.

Finding a doctor who understands RSD is hard. If you find one you trust and he/she may not know a lot about RSD but is willing to take the time and learn and work with you toward managing your pain IMO he/she is a keeper.
I reached a point after so many doctors I started asking point blank. Do you understand RSD and are you willing to commit the time it will take to find what works for me? I don't want an endless supply of prescriptions and I don't want to live a haze. I want to be a part of what is going on around me. If they couldn't answer that question then I didn't keep them on my the medical team.
RSD was and is out of my realm of intelligence I need willing doctors to help me with my quality of life.
Take care,
Sherrie