[Pmb (OP)]

I was wondering if anyone here has chronic pain. If so how do you handle it? How is it being treated? Is it being treated or do you just "suck it up"?

I have degeneraive disk disease and live with terrible chronic pain. It has driven me over the edge several times wherein I did some crazy things. I want to avoid that so I'm looking for ideas. I'll be starting pain medication in a few months. My pain specialist wants me to see a shrink for at least 3 months before he puts me on narcotics. Not sure why though.

All thoughts welcome!

[cheryl j]

I teach anatomy and physiology and it always amazes me how little information is included about pain. Granted they are basic text books, but many of the students taking these courses will be in health care where pain is a huge, huge issue. People can often adapt to many of their symptoms, find different ways of doing things, but severe pain really stops people in their tracks. The other thing that amazes me is that we are still using many of the same pain medications, like opioids, that we were using during the civil war. There are new and powerful anti-inflammatories, but still, I would have expected more progress in the last couple of hundred years. The problem with narcotics is they are addictive. I don't care if you're the ministers 70 year old mother. It's a side effect of the drug, the same way liver damage or weight gain or rashes are side effects of other drugs, and narcotics are difficult to manage.

In a course I took on the sensory system the professor said that combining pain strategies often has a greater effect than the simply the benefits of both added together, for example, pain medication and meditation or massage. The feeling of helplessness tends to intensify pain, so researching pain on the internet and experimenting with things you can do for yourself may make you feel a little more in control.

I have arthritic vertebrae in my neck that occasionally  press on nerves, and one time the pain lasted for months and I really started to panic - "what if this never goes away!" Finally out of desperation I went to the gym and found the biggest arm weights I could pick up and would just stand there for an hour, one in each hand. Oddly enough it helped. And every time my condition flares up, that's my routine, ice, anti-inflammatory, and the weights. Your condition may be more serious than mine, and quite different. I only mention this because I was surprised it worked at all, but at that point I was really freaking out and willing to try anything, and to be honest a little pissed off at my doctor.

[Pmb (OP)]

Thanks cheryl

I had an ulcer so I can't be on any NSAIDS. After I posted that question I found this
http://www.bostonpaincare.com

I live in the area so I called and left a message. Here's hoping!

[Minerva]

John Hopkins have a dedicated pain management centre see here:

http://www.hopkinsmedicine.org/pain/blaustein_pain_center/index.html

They have found some visualisation techniques to be extremely effective.  Also has anyone checked your Vitamin D3 levels? - us Westerners rarely get enough D3 from the sun and deficiencies can cause extreme joint pain. 

Having a good diet free of sugar and processed foods is also beneficial.

[CliffordK]

I had an ulcer so I can't be on any NSAIDS. After I posted that question I found this

When was the ulcer diagnosed?
Have you been tested for H Pylori?

[CliffordK]

As far as chronic pain....  it is a complex issue.

You didn't say where your pain is.  Back pain?  Elsewhere?

Many people find ways to avoid pain.  I've had chronic low grade back pain for a very long time.  I don't ever remember "throwing my back out", but the aches kind of come and go, but are never too far away.  I try not to let it affect my life too much.  Here are a few things that I've discovered.

• Belts make my back pain much worse.  I avoid wearing belts as much as possible, although I haven't resorted to suspenders yet.
• A soft, or saggy bed is really hard on my back.  I'm better off sleeping on the floor than a soft bed.
• I hate to admit it, but lately I've found that sleeping in a recliner actually reduces my back pain.  I'm not quite sure why.
• Stretching is good, although I must admit that I don't do it as much as I could.
• Many things in life are "use it or loose it".  Pain is tough because it tends to slow a person down.  However, there are advantages of getting out and moving around some.  Especially things like walking, bicycling, or perhaps a hobby such as gardening.  This is especially true with morning pain.  Get out and start moving, and it will be reduced during the day.  I just try to not let a little stiffness overly affect my life.
• Personally I don't take many pain meds.  But, if my knees are acting up, I may take a couple of aspirin both before and after activity.  Aspirin, of course, being in the NSAID category mentioned above.
• Personally, I'm not a big fan of pain meds that aren't also in the anti-inflammatory category.
• Weight.  It is easy to let the weight creep up, especially if activity levels fall.  There is certainly a relationship between extra weight and lower joint pain (hips, knees, ankles).  But, it probably also affects the back.  Dieting is tough if activity levels are low, but it is important.

Now, with medications.  Aspirin is packaged in 325mg and 500mg tablets.  There is essentially no difference between taking 3 x 325 mg, or 2 x 500 mg tablets. 

There is a difference between taking a med chronically, and occasionally.  Some meds, especially narcotics cause a tolerance when taken chronically.  If taken occasionally, then you may have a greater effect from a lower dose.  However, I'm a firm believer of taking a loading dose of meds.  The idea is that at the time of the first dose, your body has no meds.  Later doses, it may only have eliminated, say 3/4 of the meds, so less is needed to return the levels to a clinical amount.  So, with aspirin, I would be likely to take 4, 325 mg tabs for my first dose, followed by 2 or 3 later.  Obviously overdoses are an issue, and you should discuss medication regimens with your physician.

No matter what the pain, DO NOT PLAY GAMES WITH NARCOTICS.  Do not get prescriptions from multiple doctors, and such.  It can kill people.

My vitamins include:
Calcium
Vitamin D (for calcium).
Magnesium (also good for bones, and offsets constipating effects of Calcium).
Glucosamine & Chondroitin.  I can't tell if it does anything, but doesn't seem to cause harm either.  It is hard to do a good longitudinal long-term study on oneself.

[cheryl j]

There is a difference between taking a med chronically, and occasionally.  Some meds, especially narcotics cause a tolerance when taken chronically.  If taken occasionally, then you may have a greater effect from a lower dose.

The professor in the course on the sensory system I took also said the problem of tolerance actually extends a bit beyond the time period the drug is used. He said that when people take narcotics for a long term condition, the nervous system up-regulates its over all sensitivity to pain. Even when the injury has healed to the point that strong pain medication should not be required, the patient still feels quite a bit of pain, more than he ordinarily would, which makes getting off these medications difficult. They may also experience other kinds of pain that other people wouldn't, until the body has adjusted to not having the medication in the system.

I also heard an interesting personal story from someone that seemed to describe this. He was in a car accident and injured his knee, went on oxy long term. After a while his doctor cut him off because his injury looked better on x ray, he had good range of motion, etc. But he still had pain, so he started buying it on the street. Ended up in rehab, successfully got off the drugs, and his knee pain eventually improved. A few years later, he injured his shoulder, went back on meds for a while, got off. But he said the really weird thing was that while he was weaning himself off the second time, his knee pain came back for a while, which hadn't bother him for years.

[CliffordK]

I'm surprised that someone who fell into rehab for narcotics ever got them again, although I suppose there is no substitute when they are needed.

Keep in mind that there are two basic categories of meds, water soluble and fat soluble. 

The water soluble meds are quickly cleared from the body once you stop taking them.  Perhaps at most a day or two.

The fat soluble meds can stay in the body for a very long time, contributing to low levels of the medications in the blood for months.

[cheryl j]

I had always assumed tolerance was purely metabolic, since doses of narcotics will kill some people but not others who have slowly increased their levels over time. I assumed it had mainly to do with increased levels of enzymes that break down substances (which does happen.)  I hadn't considered the idea of the nervous system itself also up-regulating or down regulating. But the body does have many feed back loops that maintain set points or homeostasis, so it kind of makes sense. People withdrawing from alcohol and CNS depressants tend to be jumpy, shaky, irritable, and have trouble sleeping. Where as people withdrawing from coke, amphetamines, and other stimulants tend to be sleepy, and sluggish. It makes sense that the result of withdrawing from pain medication might be a temporary increased sensitivity to pain.

[Pmb (OP)]

John Hopkins have a dedicated pain management centre see here:

http://www.hopkinsmedicine.org/pain/blaustein_pain_center/index.html

They have found some visualisation techniques to be extremely effective.  Also has anyone checked your Vitamin D3 levels? - us Westerners rarely get enough D3 from the sun and deficiencies can cause extreme joint pain. 

Yes. I'm on supplements now.

[Pmb (OP)]

I had an ulcer so I can't be on any NSAIDS. After I posted that question I found this

When was the ulcer diagnosed?
Have you been tested for H Pylori?

About 1.5 years ago. I had an endoscopy done last month. It showed a hiatal hernia, a failed Nissen fundoplication and there was a black spot inside my stomach that I don't know what it is. I'll post a photo tonight. Maybe someone here can tell me what it is!

[CliffordK]

Ok,
H Pylori has been known for over a decade.  I would think if you had an ulcer diagnosed recently, the doctors would have tested for it, but it never hurts to verify.  It is believed to be associated with a large number of tumors. 

Hiatal Hernia, of course, is a different issue.

[Pmb (OP)]

Ok,
H Pylori has been known for over a decade.  I would think if you had an ulcer diagnosed recently, the doctors would have tested for it, but it never hurts to verify.  It is believed to be associated with a large number of tumors. 

Hiatal Hernia, of course, is a different issue.

What is H pylori? I had an ulcer. I'm just not sure if it's still there. After the endoscopy I was still too drugged up to recall what they told me.

Here's a photo of inside my stomach. http://home.comcast.net/~peter.m.brown/stomach.htm

What's that black thing in the bottom right??

[evan_au]

Helicobacter Pylori is a bacterium which lives in the acidic conditions of the stomach. In some individuals, it can cause stomach ulcers, and is associated with an increased risk of stomach cancer.

The story of its discovery is an interesting one - at the time, the prevailing theory was that stress or spicy food caused stomach ulcers, and the discovery was met with disbelief by the medical profession. One of the discoverers dosed himself with H.Pylori, and developed an infection.

See: http://en.wikipedia.org/wiki/Helicobacter_pylori

[Pmb (OP)]

Helicobacter Pylori is a bacterium which lives in the acidic conditions of the stomach. In some individuals, it can cause stomach ulcers, and is associated with an increased risk of stomach cancer.

The story of its discovery is an interesting one - at the time, the prevailing theory was that stress or spicy food caused stomach ulcers, and the discovery was met with disbelief by the medical profession. One of the discoverers dosed himself with H.Pylori, and developed an infection.

See: http://en.wikipedia.org/wiki/Helicobacter_pylori

Thanks!!! When I saw my surgeon Tuesday she mentioned this and had me tested. I should call and check it.

[Karen W.]

I was wondering if anyone here has chronic pain. If so how do you handle it? How is it being treated? Is it being treated or do you just "suck it up"?

I have degeneraive disk disease and live with terrible chronic pain. It has driven me over the edge several times wherein I did some crazy things. I want to avoid that so I'm looking for ideas. I'll be starting pain medication in a few months. My pain specialist wants me to see a shrink for at least 3 months before he puts me on narcotics. Not sure why though.

All thoughts welcome!

 After reading all of your thread I felt the need to post some of my experiences over the last six years. I am gathering some information for you and will come back and post later in the
morning. We have a lot in common!

[Karen W.]

Whoops I was waylaid with my response.. another problem with my medical issues that disables me and screws my good intentions up! I apologize for my delay.. about  7 years ago I was a happy  go lucky California girlie with a lot of dreams and basically never a cross or angry thought at least rarely.. I had lived my life with congenital heart problems that had been operated on several times during childhood and adult hood .. having 3 heart attacks by 1 year old and dying on the table three times but being given many wonderful chances to live by some very amazing doctors who had been practicing in San Fransisco at the time, from the late 50's, 60's and 70's...I was fairly good through adult hood with an occasional surgery to update old surgeries and correct problems as medical procedures changed over the years.  Having had heart attacks as both an infant and an adult I felt blessed by the fact that I was still very active and very much alive and living a relatively normal life... I had become involved in this forum and had made many new friends here and was enjoying my life very much! I was happier then I have ever been in my entire life.. I felt fulfilled and strong! Everything was going wonderfully and I had the world by the tail so to speak...then one day I woke up with a really bad headache and some pain which started in the e of from the middle of my tongue and then just tingles or felt a tad numb on the left side of the tongue.. That was a Friday I think.. anyway I went to work anyway and by the time I went home I had a killer headache and the numbness had spread to the top of my head and only from the center over to the right and my shoulder was tingling a bit.. I stayed up and posted in the forum to ask my wonderful new friends if any of them had ever had such a weird feeling like that happen before? Need less to say I was tired kinda out of it.. bedraggled feeling so I went to bed.. I can"t remember the time .. I woke up Saturday morning to find that all of my left side was feeling much more numb as well as having spread  down my side farther,, and I signed into the forum and was typing and I can"t remember well at that point if I was on a while before I saw a reply to my post or not but a very sweet friend Iko had left me a message that basically just said to do him a favor and check into the nearest ER/ hospital and have them check me out.. I read it and thought that is odd but for some reason I thought well, Iko is a good guy... Okay! So I signed out and drove myself to the hospital.. where within a very short time they had me temporarily admitted and said that I was having a stroke or a TIA... Turns out that my friend saved my life... I am and will be forever grateful! After that Tia or before it Cant remember I had had a D.N.C. and Cutterage due to heavy blood clotting in my menstrual flow. Anyway those were close to each other within about a month or so approximately, TIA was may 26th I think? Things went down from there and I became ill and so tired as well as constantly crying and depressed then happy I was all over the place My shoulder began acting up in pain it became excruciating over just a short time...and my hip had already been hurting for over a year but it also rapidly declined! My body was completely wracked with pain and I become weak sick and unable to walk without passing out. I was loosing air and unable to get enough to do simple chores.. I was having issues with my heart that blew up into multiple heart issues  including aneurysms in both the ascending and descending aorta with excess aortic regurgitation as well as other valve issues, My heart enlarged, and my left ventricle had failed or was failing causing blood clots to form in valve and be blasted loose into my bloodstream every time the left ventricle was overloaded when my blood pressure rose. Soon I was in heart failure and the smallest of exertions sent me into diastolic heart failure which came on as an attack which started in my back and worked its way to my chest as a severe pain with extreme heaviness.. that moved up around my chest .. I had another heart attack and my doctors found many other problems with severe unstable angina. Other diseases as lupus, and Lyme disease among a few others were added to the list..  My immune system was compromised and the Lyme had destroyed my hip, knee, shoulder, and elbow joints and Like you I was suffering from degenerative disc disease also with 3 collapsed discs in my upper neck as well in the lower 4 in the lower lumbar area and  two down lower.. I feel your pain and that from the chronic Lyme I also have COPD and have never been a smoker! I was also diagnosed with Toxic Bio-Toxin Illness and Mold poisoning, my toxin level is coming in at 18,700 markers I think it should be around 7000. My Doctor says that it is  close to the point of no return which is 20,000.. I have been told already that I was lucky if I had a year and that was before everything got worse and I have been in and out of the hospital for the last 7 years and do not intend to give up.. All of them are currently telling me at the rate of decline I will be lucky if I make the fall.. but in the same breath they said that I have been their anomaly as well as their miracle.
 Last week I had gone for x-rays on my hips to try to start pre-op for hip replacement but instead they found something new that had never showed up in the x-rays before. The doctor called me at home to tell me that  I had necrosis  as well as Avascular Necrosis which has basically killed off the whole bone hip joint.. and pelvis area. A hip replacement would be the fix except thats its gone beyond the bones in my hip ..its the entire femur and down my leg that is dead.. my right ankle has become rather bluish in color with my foot changing texture also.. and the doctor tells me that the necrosis is the cellular death of the tissues in my leg and that the Avascular Necrosis is the cellular death of my femoral bone and that is because the blood and oxygen supply has been cut off for far to long and as a result  my portions of my pelvic area and the whole femur bone is dead, leaving my  my lower extremities in really bad shape..The blood has been blocked by injury or dislocation or the breaks involved.. I am not a smoker or a drinker so that takes me out of those reasons and I do not think I have cancer.... A new MRI is scheduled to confirm the extent of the damage, we had hoped a hip replacement would suffice but with the damage they have found I may loose my leg/legs. I am already confined to a wheel chair for the majority of the time unable to bear weight on the crumbling bones..

I  get frustrated and am in so much pain that there are times I am just out of it... I have been on pain meds every 3 and 1/2 hours for the last few years! I have just this last month switched over to morphine.. to try to combat the pain...It is unbearable to try to handle  without the meds.

I do use alternative methods of mind over matter, with matrix energetics as well as time line therapy script to help resolve pain issues. I have just begun with a musician friend of mine who comes and works with me to ease my pain..I also belong to a chronic pain group which helps to bounce ideas off from one another as well as having the support of others dealing with the same issues and deep depression as well, that also helps us to partner up with each other as then we know we are not alone.
   
     Over the last few years I have experimented with a therapy called Rieke and found It actually put me to sleep but Other then that I felt drained afterwards.

I also have a membership to Healthsport and am once again about to reenter the aqua aerobics class for seniors I hope.. It has helped tremendously over the years .. We will see what the MRI says!

I broke my arm in several places in end of Aug/Sept.2012 on labor day..or memorial day..LOL Cant remember which one is at the end of the month.lol I fell out of the slider door of my Mini van ...so had to leave the pool until February after my 4th cast was removed!
   
     Support groups are good but honestly my best advice is to sleep as much as you can.. it really helps you to deal with the pain.. I have had insomnia for years so I sleep any time the feeling hits.. If I am on the road I pull over climb in my bed in the back of my van after locking the doors and I sleep for however long I may be able to do so.. I take what I can get when I can get it.. as I have Sleep Apnea which makes it harder to sleep also!

One more biggie never underestimate the power of keeping your hands and mind busy... researching and learning new things about your illnesses help you to be less frightened and focused on the pain and discomfort! It helps to do things.. I crochet Knit and write .. I also do a lot more reading these days .. which helps my brain as I am extremely forgetful which is part of my illness.. I have literally forgotten some of my friends names and had to be reminded,, I also will wake up or just suddenly look up from something and not no where I am.. very frustrating.. so do try to stay busy exercise as much as your illness allows..

     I do not understand why they are putting you off for so very long about getting you some pain relief... I do see a therapist every week sometimes twice when things are really bad with my depression..  It is good to learn about your meds though so you understand you will be dependent on them for relief, and that it will be important for you to understand that..likely you will need them for the rest of your life unless you are able to gain relief through surgery!   I have waited and put off as long as I possibly could as I did with my other pain meds for fear of having to use stronger more powerful meds but I have been in so much pain that I would rather just close my eyes and never wake up.. and this medication has changed that for me.. I feel like I have breathing room again.. I am sorry to be so blunt but There has not been a single day in the last 7 years where I haven't winced in pain... I felt as if there were no other reasons for me to be here but the last few weeks have given me some freedom from the constant throbbing pain and  and ability to lie back barely feel and pain.. of course when I try to move around there  is still pain but It is now better managed instead of every 3 and 1/2 hours a pain med now its 1 pill every 12 hrs so much more doable with less frequent bleed-through's and the long wait to get the pain back under control because the dose was topped out but did not hold out for the whole 3 and 1/2 hours about 2 and 1/2 leaving an hour of terrible build up of pain which would take a couple hours to get in control especially if you had missed a scheduled dose!
Its very important to keep a very tight dosing schedule.
Don't do what I did,I waited till the pain was so bad I couldn't take it.. I was miserable! Now That I am on a regular schedule I feel human again which is a huge huge burden lifted and I feel so much better all around just being out of the constant pain!
     
      I still have pain but much less often and way better managed thats the key.. The Morphine really is a good long lasting pain reliever.. I don't feel like I am a popcorn machine with the pills... and I can sleep through the night without getting up in pain to take meds... so on the nights I can sleep it feels great to sleep through those scheduled pill alarms  to kill the pain.  If you have any other questions or think I might could help please let me know...

[Pmb (OP)]

Thanks Karen. That's a lot to read. Sorry I can't make it all the way through it though. It's too traumatic for me to read right now. It was messing with my head reading it.

Good news today. I was able to get a script for pain medication today. It's supposed to last me until I see the pain specialist on Thursday. Hopefully they'll place me on opioid therapy then.

What a horrigic week/weekend I had. I pulled a muscle in my neck in my sleep last week. I've been in terrible pain since then. It got better at the end of the week and then my tooth starting killing me. It's broken with a nerve exposed. Terrible pain. I have to have it pulled next month. Then my sciatica got extremely bad. When I went to Boston today the ride made it much much worse. I was in severe/extreme pain by tghe time I got there. The ER doctor was nice enough to put me on oxycodone at 5mg. That's too small to be of much good. When I saw my oncologist he did me the favor of taking that script and writing me one for 15 mg every 4 hours. When the med kicked in the pain subsided to very mild. I was able to concentrate and started having a positive outlook on life. I was having terrible suicidal ideations over the weekend, thoughts of running myself through with a knife into my heart the pain was so bad. Now I'm thinking about physics and am able to study and concentrate. It's wonderful. And hardly no euphoria or goofyness, no slurring of speach. This is ideal.

It's good to be alive when you're not suffering!

Yay for me!!

[JimBob]

It's good to be alive ANYTIME !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I have never been able to do this. The pain manages me. That fine distinction being made, I will tell you that most of it these days is done in my mind. My attitude defines my day. Pissed at the pain - BAD DAY!  Good attitude (indifference) - OK day.

I have taken narcotics for a long time. They take the edge off the pain.  But meditation is the best resource. I can place the pain in the box and leave it there to be whatever it wants to be. I does not need to be part of me.

I have had sever rheumatoid arthritis since 1965.

[Pmb (OP)]

It's good to be alive ANYTIME !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I wish I felt like that. Most people who know me, even my own family, have no idea of the hardships and battles that I've had to deal with and survive through. Last night was a good example. During the day when I came back from a walk I had the worst headache of my life. I was also sweating buckets. I checked my temperature and it was 92.7F. It's never been that off in my entire life that I'm aware of. My doctor insisted tghat I get to his office ASAP. I went there and they also found I was hypothermic. After an examination and discussion they called an ambulance and took me to the ER. For some strange reason by the time I got there I had a terrible pain in my groin. After a while they gave me some morphine. Then the cat scanned my head. Then I had to swallow a huge amount of barium and then have another cat scan of my abdomen. After that they did a lumbar puncture (Eek!). And of course the usual blood and urine test and more morphine when the last wore off. All that for nothing. They couldn't find a damn thing wrong. They were expacting to perhaps find a bleed in my brain which might have required brain surgery or meningitis. I'd been through this mill before so I wasn't bothered by it too much. This kind of thing is a no-win situation. Either they find something wrong with me or they don't and it was a waste of everyones time. I feel silly when they find nothing. Not a rational response, is it?

I have never been able to do this. The pain manages me. That fine distinction being made, I will tell you that most of it these days is done in my mind. My attitude defines my day. Pissed at the pain - BAD DAY!  Good attitude (indifference) - OK day.

Then I'm glad I found you. You can teach me a lot. Please PM me and tell me your approach to chronic illness.

I have taken narcotics for a long time. They take the edge off the pain.

Exactly! I'm on oxycodone right now but I'm still in pain. But its such that I can live with it.

But meditation is the best resource. I can place the pain in the box and leave it there to be whatever it wants to be. I does not need to be part of me.

That sounds a lot like how I fight it too. I learned that when I studied marshall arts in my youth.

I have had sever rheumatoid arthritis since 1965.

Eek! Sorry to hear that.