Chronic pain

Discussion in 'The Watercooler' started by Just keep swimming, Feb 2, 2007.

  1. Just keep swimming

    Just keep swimming New Member

    Hi family,

    Not sure I have posted about this, my mind is a bit loopy right now. UGH!!

    Anyways, I have had ongoing, never changing, chronic back and leg and foot pain since a minor car incident back in July.

    Well, finally found a Primary care doctor and saw her on Tuesday. She changed up my medications (1200mg Motrin, Hydrocodone, Soma, Amitryplinine, Xanax) and my usual Paxil, Prilosec and Estradiol.

    Also set me up for PT, pain management and a neurosurgeon consult. I have NO reflexes in my right foot and very little in my right knee. My right leg gives out all the time and I end up on the floor more times than I care to admit!! :smile:

    I will probably be looking at another back surgery, probably a fusion, L4-S1 in the near future. I am scared but cannot even drive anymore, can't tell whether my foot is on the gas or the brake!!

    Anyways, I know we have some members here that are suffering from chronic pain. I am wondering if any of you have any good suggestions to keep the depression down. This is the pits, I am not supposed to bend, lift or twist (BLT, LOL!!) so that pretty much leaves everything OUT!

    Suggestions would be most appreciated!!

  2. dreamer

    dreamer New Member

    NO ideas, just hugs. I was not very successful keeping depression at bay when I was so ill for that 2 years. I barely even remember that time, and what went on......BUT I am MUCH MUCH better now, if that helps any at all? Have hope.
  3. hearts and roses

    hearts and roses Mind Reader

    Your situation sounds like my sister's - she is in constant pain.

    I'm sorry I have no answers, but am sending some positive vibes and prayers your way~ :smile:
  4. Lothlorien

    Lothlorien Active Member Staff Member

    Your pain management physician may offer trigger point injections and/or facet joint blocks/epidural injections. If you have one or two of these and are not getting relief from it, do not continue that line of treatment. If it doesn't work after one or two injections, it's not likely to work at all. This is in the August Journal of Orthopedic surgeons, 2006. I have seen too many times than I can count where patients are subjected to months of injections that have absolutely no worth.

    Also, if you are going to have any kind of spinal surgery, go to a really good specialist at a well known hospital meant for spinal surgeries. I've also seen many times where patients suffer from "failed back surgery syndrome" (yes, that is an official diagnosis).

    If you haven't had therapy, consider doing a few months of intense physical therapy first. Please be careful with the medications. Hydrocodone is moderately addictive.

    Good luck. I hope the pain management physician is a good one. The ones in my area are nothing but quacks.
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Well...welcome to the club nobody wants to join...chronic pain.

    The pain/depression cycle is a vicious cycle. The more you get of one the more you get of the other. Just checked your medications again and they started you on elavil...some have luck with that. causes weight gain. You may have better luck with trazadone or even with cymbalta though I think that has a slight weight gain potential.

    I will be honest and say that I wouldnt worry about the addictive properties of pain medications for chronic pain. The studies out there show that people in chronic pain have a very small chance of becoming addicted to opiates. There is a world of difference between addiction and dependence though I have found I never even became dependent on pain medications.

    I feel for you. I end up on the floor often. I trip up the steps, walk into walls, fall over my own shadow. Everytime my family hears a thud they come running. LOL.
  6. hearts and roses

    hearts and roses Mind Reader

    [ QUOTE ]
    I end up on the floor often. I trip up the steps, walk into walls, fall over my own shadow. Everytime my family hears a thud they come running. LOL.

    [/ QUOTE ]

    Sounds like my easy child, though she does not have chronic pain, she's just klutzy. :smirk:
  7. Marguerite

    Marguerite Active Member

    Janet & Nomad are so right on the addiction issue. I researched it thoroughly after one of my doctors said something about me being addicted. I finally worked out that his definition was not the standard one and he was wrong.

    In Britain they actually give people with severe pain heroin, so they can cope. It's usually people with terminal cancer, but they found that with the pain under control the heroin helped them actually live an active, productive life without the problems we associate with addicts. One woman I remember seeing interviewed on a documentary on the subject - she was hanging out the washing and moving around really well, in the final stages of cancer that would have had her doped up on morphine, if she hadn't had heroin available.

    I've been in chronic pain for 22 years. I've learnt a lot of what to do and what NOT to do. I live as active a life as possible, but I also have legs that give way on me sometimes, especially when I put my weight down on them hard without bracing my joints first to not collapse. My doctor saw me getting around in my usual shuffle and told me - "You've been given crutches - use them. If you don't you will ruin your joints and have osteoarthritis before you're fifty."
    I use canada crutches - the ones with the elbow cuffs and the handle to grip - because I can use one, or both, as I need. I can relax my leg muscles a little more and not stress my joints so badly. Using the crutches I walk more normally. I got myself assessed by an Occupational Therapist (OT) to make sure I had the right tool for the job.

    Pain medications - never expect them to eliminate the pain entirely. I've found that if you do, you then get the side-effects of the overdose 'wooziness' etc. I take enough so I can function. And yes, as the pain persists long term, the amount you need will increase. It happens. Take what you need but stop before you feel groggy. You will soon get a f eel for what you can tolerate.

    Another important thing about pain medications - if you have pills where you have a choice to take two pills every six hours, or one every three, and you are in A LOT of pain, take two. Then, if you have successfully knocked the pain back to tolerable levels, take only one pill six hours later and see if you can maintain on the lower dosage.

    Basically, really bad pain (such as when you wake up after a night of no medications) often needs to be hit hard and then maintained.

    Keep an eye on the basic ingredients of what you take. For example, NEVER go over 8 x 500 mg of paracetamol in one day. Keep it lower for long-term use as much as you can. And when you get bloods done, get your doctor to check your liver function. Some pain medications can knock some people's livers more than others.

    The best bit of advice I got from one of my doctors - keep a diary. Don't write much per day, just what you took, when you took it and anything important. Score each day from 1 to 10. Keep the record. If you're getting a drug reaction, the record can help. That's why the doctor wanted me to do it. But I found - it also helps you to NOT have to hold this info in your head, you can get on with living and not obsessing.

    About driving the car - check into getting it fitted (and you trained) with hand controls. If you're not sure enough about your foot, then use your hands to do the same job. If you get better you can take the hand controls out.

    And one last piece of advice from a long-term fighter - DO THE BEST YOU CAN WITH WHAT YOU'VE GOT.

    Print it out on cardboard and live by that. Some days you will feel ghastly and want to crawl into a hole; other days you will feel a bit more charged. Don't feel bad about what you can't do, just count up all the things you CAN do and succeed in doing and put them down as notches on your belt.

    For me - I've got to be a big mess before I can't use the phone. And you can get a lot done over the phone. I often have to work from my bedroom - I have my laptop, the radio, the TV, a DVD player and the phone. I can even see the front yard from my window and get an advance warning of visitors. I drive an electric scooter to get around, I've even taken it right into the heart of Sydney. When we were on holiday in Queensland we flew it up on the plane to the Gold Coast - free. It is the same for me as walking round the place. I get to say "G'day" to everyone in the street which helps me feel more alive. In my scooter (or back when I used a wheelchair) I could hold the hand of one of my kids and 'run' with them, hand in hand. It's the only way I've ever been able to do it, with my younger three kids. They have no memory of me before disability.

    Oh, and one more thing about canada crutches - ANY crutch or walking stick made of hollow aluminium - if you take it to the beach and go paddling, make sure you tip it up and empty it out before you get back in the car. They can ship a lot of water!

    I'm still a Warrior Mum and a fighter. I've been a charity president, an advocate for a number of issues, a community representative - all sorts of things. I've been interviewed on TV and radio. I've had two kids since becoming disabled. I've published books. I teach. I write.

    The best therapy for the inevitable depression is to write. Put your feelings, your anger and your grief down on paper. Own it - you're entitled. But as you do, recognise that the day will come when you will be through it. That's when you realise you still have a lot more than mere existence - you still have a great deal of life too. Only now, you're walking slow enough to spot the four-leafed clovers.

    Hang in there, take what you need to feel in control.

  8. dreamer

    dreamer New Member

    I have to agree with Marg- stay active. I also used an electric scooter for several years- and yes, I used it to keep up with my kids. LOL- I chased them in it, gave them rides, "carried" some of their stuff....ran all around the amusement park with them, and the zoo......I used a wheeled walker, too, depending on how I felt and what our plans for the day were etc.
    It is not as easy to slip into depression if you can stay busy and use your imagination to find ways to keep on with your activities.
    I did not fall often, mostly I could not stand to begin with- and my hands also gave me great problems. AT first i would sob when I could not hold my toothbrush. Or hairbrush........but then I involved the kids and we made it a game or a joke.
    My girls remember me ----mom in the tunnels and tubes at chuckee chese etc.....and chasing them all over, crawling on the floor etc, but my son, nope. BUT he does remember hitching rides on my scooter and me chasing him down in it playing tag in it......and he remembers making a mess with me while we brushed MY teeth......they remember us all trying to figure out how to drain the pot of pasta when I was too afraid they were too young, little, not strong enough and my hands could not do we had watery pasta while we brainstormed to figure it out. each week we would try again....made it a game.....
    made it a game, made it a challenge,
  9. transformtriumph

    transformtriumph New Member

    I agree with you. There is a lot of info out there.

    "A traditional concern about narcotics use has been the risk of promoting addiction. As narcotic use continues over time, the body becomes accustomed to the drug and adjusts normal functions to accommodate to its presence. Therefore, to elicit the same level of action, it is necessary to increase dosage over time. As dosage increases, an individual may become physically dependent on narcotic drugs.

    However, physical dependence is different from psychological addiction. Physical dependence is characterized by discomfort if drug administration suddenly stops, while psychological addiction is characterized by an overpowering craving for the drug for reasons other than pain relief. Psychological addiction is a very real and necessary concern in some instances, but it should not interfere with a genuine need for narcotic pain relief. However, caution must be taken with people with a history of addictive behavior."
  10. transformtriumph

    transformtriumph New Member

    I have been dealing with chronic pain for over ten years. It has helped me to have a comprehensive pain management plan. This includes meditation, stretching, recreation and other relaxing outlets, in addition to traditional medications and treatments. I also see a homeopathic physician/acupuncturist, which is very helpful.
  11. Marguerite

    Marguerite Active Member

    Stretches are great. What can happen with long-term illness - you tend to draw yourself in, and down. The stretches force you back out and up. They're a better way to keep flexible if exercise is difficult If you CAN exercise, stretches before and after are really beneficial. But stretches alone are still a lot better than nothing.

    And one more thing on painkillers - there have been times when I've been pain-free for various reasons. I was able to cut back or stop painkillers I'd been taking. Of course I got some withdrawal symptoms, but they were nothing compared to the pain I normally experience. If you take pills for pain and the pain keeps coming back when the pills wear off, you keep taking the pain killers. If the pain eases or comes and goes, you cut back to match the pain. If the pain magically stops (ie they remove a diseased organ) then you can find a number of ways to painlessly withdraw. But unless you become psychologically addicted as well (which only happens when you find yourself taking the pills mainly to enjoy the 'high') you'll have nor problem. If you can match the medication to the pain level there should be no psychological 'high'. Of course, this will vary from person to person - if you have a good pain management specialist they will guide you through.

    Physiological dependence is very different to full-on addiction.

    I've had to get used to seeing my pain specialist at a hospice clinic. Most of the other patients are terminal. I've got to switch that off in my head and only deal with my problem. I've met some lovely people there, though.

    I've also developed some really useful meditation/visualisation techniques which can enhance the pain killers. When I goofed a week ago and missed taking my medications for the day, I was using the visualisation to deal with the pain (until I checked my pills and discovered I hadn't taken them). Then as the pills were beginning to work, I used visualisation again. If you time a visualisation so that the mental imagery is at its strongest just as the medications kick in, you will develop a mental conditioned response where you can, with your mind, trick your body into thinking it's been medicated. I've also linked medications with coffee, too, and when caught out without medications I've had coffee (decaf) instead, to hold the pain under control until I can get back to my medications.

    Thinking laterally is good. And whatever works, as long as it is legal and not doing you more damage than what you're trying to treat.

  12. Just keep swimming

    Just keep swimming New Member

    Awesome replies, thank you all so much! I am going to print them off so I can remind myself as I am going through this.

    Today I start PT. Praying I get to use pool therapy as swimming is the best therapy ever for me.

    I see the neurosurgeon on March 2, seems a long way off but much better than the 6 months I have heard others waiting! The Pain Management doctor is sending in a request for authorization for some epidural injections to my insurance company and they estimate it will be about 2 weeks till they can see me.

    This weekend we had family over, it is J's 3rd b'day today!! I was up and around and BLT wayyyy too much and really feel it this morning. But we had a blast all weekend long!!

    Anyways thanks for all the ideas!!!

    Hugs and love,
  13. susiestar

    susiestar Roll With It

    I am in the chronic pain clinic. And just got my stomach scoped to see what the deal is there. Treatable issues, no bad biopsies for me!!

    My pain started at age 14, so it has been 23 years, eeeeeekk! Find little things to take pride in. I even have my kids tell me, hey you made coffee, that is something! Or "You read to me, that counts as an accomplishment!" - this last said in very indignant terms by my thank you when I fussed over not getting anything done around the house.

    I have to pay close attention to my priorities. Kids and hubby first, house way down the list. If I get into too much of a fuss about the house I land myself in bed and then feel even more depressed.

    focus on physical solutions to physical problems. If pain keeps you from bending over to get stuff out of the dryer, then get a kiddy rake to help pull the stuff out of the dryer. If you NEED to feel you have cleaned something, find a drawer or what-not you can clean in a few minutes while sitting down.

    Take it easy on yourself.


  14. Just keep swimming

    Just keep swimming New Member

    Thanks Susie! I am sorry you are "part of the club", the chronic pain club!

    Today is just horrible. Had my first PT appointment yesterday and they did a tiny bit of traction. The first time in 6 months I had zero pain!!! But today, I seem worse than ever. And my depression is off the charts!

    Hoping a stop in to my favorite crafting class tonight will lift my spirits a bit. I HATE the place I am in right now. Just want to curl up and wake up some day wayyyyyy in the future where pain does not exist!