Re: Medications for Chronic Pain

From: Em (ewaa@earthlink.net)
Wed Apr 24 22:34:25 2002


Hi Helen and all, I am writing this to ease my own mind on the life that I now am able to have thanks to the availability of drugs. Before I had ever heard of adhesions, I was limited to occasional migraines, but was usually able to deal with them with high doses of NSAIDS. Now that I not only know about adhesions, but live with the pain that they can cause it is an entirely different story. I could list what I have tried for the pain, but the list would be incredibly long, so I shall just say that being treated with adequate opiod medication I am now able to function. When I say function I literally mean doing the laundry, vacuuming, bathing my small children, making beds, cooking, mopping my floor(which for about six months was not done), and attending college. The one item that has not returned to normal is that I still have some pain, but have learned to live with this, or I should say that I am learning to live with it AND I have not returned to work. I thank my heavenly spirit each an every day for the opportunity to have this DRUG, which has given me back my life. I am not proposing that NSAIDS are not a good way for many people, but quite frankly they did not a bit of good for myself, and I believe this to be true for many people. Nor, did massage do a thing for me. I did however, find some relief in a hot bath for about two hours at a time, but this was not condusive adequate pain relief, just a resource for calming my pain. I fully believe after being told my many different specialists that, "narcotic medication will cause pain," or, "the medications you are currently taking are the source of your pain." To this I say #@@$%^^&%^ ! I was taken off medications until finding a physicain familar with treating the pain adhesions can cause. I did not take pain medications for about six weeks. During this period my life plunged into an abyss that I wish never to visit again. The lights were not only turned off for me, but I lived in my house, I never left, because I never knew when I would faint from the pain, or when I would violently vomit, and I did seriously consider ending it all, I even went so far as to plan a place for my children to live after I did "do it." It was horrid, and I can't imagine anyone believing that with correct dosaging of opiod medications one can have their life back. I was a guinea pig for medications, and these medications made me violently ill for months, and for all I know my kidney and liver will never regain normalcy from the toxins that many NSAIDS contain. It was not until I chose to stand up for myself, and refused the ever desire of the surgeons knife for curing my pain, and the menage of drug cocktails that would solve the problem. These did nothing for me except prolong the pain and suffering I lived with. I hope you understand why I needed to write this. I wrote it because there is never an easy answer to anything in life, and everyone will have different experiences, not only with medications, but with surgeries. It is of upmost importance to support each other in the choices we have made. I appreciate all whom post here, and without this site I certainly would not have made it through so many trying days and nights. em

At Tue, 23 Apr 2002, Helen Dynda wrote: >
>Medications for Chronic Pain
>http://obgyn.uihc.uiowa.edu/Patinfo/CPP/meds.htm
>
>Many people believe that taking drugs for pain problems is not a good idea. They worry about treating the symptom and not the cause. However, we know that for many types of chronic pain, no one fully knows the cause, or even if they do find a cause (such as arthritis), a cure for it may not yet exist. Some believe that many factors work together to produce chronic pain, rather than a single disease or medical problem. Sometimes we can treat the cause of the pain (for example, trigger points or irritable bowel syndrome), though this often reduces rather than cures the pain. Medications treat pain problems very well. We also urge you to follow all the other suggestions made to you by the pain team. Just as no single factor causes your pain, no single treatment can cure it.
>
>Not all drugs work well for chronic pain. The "ideal" drug would get rid of pain, not cause side effects, would not cost much, and would not become addictive. This drug does not exist, of course, but let's look at some common drugs and see how close they come to being "ideal".
>
>1.) NSAID's (non-steroidal anti-inflammatory drugs -- a large group of drugs that includes many that you likely have heard of, for example, Ibuprofen, Naprosyn, Toradol, Anaprox, Relafen.
>
>a.) How well do they work? Responses to the drugs vary from person to person and drug to drug. What works well for one person may not help the next. Having so many NSAID's to choose from, we have found that we can almost always find one that will work for a certain patient. Research has also shown that NSAID's work better if taken on a routine basis rather than just when the pain becomes severe.
>
>b.) Side Effects: Most people have no side effects. The most common side effect is nausea. In rare cases ulcers may develop, most often with high doses. Doctors should use these drugs with caution in patients with kidney disease.
>
>c.) Addiction Potential: None
>
>d.) Cost: Variable; some are low cost and some not.
>
>2.) Tricyclic Antidepressants (TCA's) -- for example, Imipramine, Doxepin, Amitriptyline
>
>a.) How well do they work? Again, responses to the drugs vary. These drugs work in two ways. First, they improve sleep. Research has shown that improved sleep causes an increase in levels of "endorphin", a natural pain killer. The second way they work is by causing an increase of a brain chemical called serotonin. We find low serotonin levels in both depressed and chronic pain patients. Often antidepressants help both mood and pain problems. It does not surprise us that many persons with chronic pain (at least half) also complain of depression.
>
>b.) Side Effects: With the low doses that we use, most patients have few side effects and they improve with time. Feeling groggy in the morning, dry mouth and constipation occur in some patients.
>
>c.) Addiction Potential: None
>
>d.) Cost: Most are fairly low cost.
> 3.) Narcotics -- for example: Tylenol #3, Codeine, Darvocet, Percodan
>
>a.) How well do they work? Narcotics work very well for short-lived pain. But for chronic pain, research has shown that they tend to make pain worse, causing the patient to need larger and larger doses. Taking narcotics impairs the body's ability to make its own painkillers, endorphins.
>
>b.) Endorphins increase with sleep and aerobic exercise and decrease with lack of sleep and narcotic use. Also, they can interfere with thinking and job success.
>
>c.) Side Effects: Constipation, dizziness, nausea.
>
>d.) Addiction Potential: Moderate. With routine use such as with chronic pain, it is just a matter of time before one becomes "tolerant" of narcotics, needing higher doses. They also can become habit forming.
>
>4.) Tranquilizers -- for example: Ativan, Xanax, Valium
>
>a.) How well do they work? Not very well, since they are not really designed to reduce pain. Also, over time they tend to cause sleep problems and increase depression.
>
>b.) Side Effects: Sedation, dizziness, weakness.
>
>c.) Addiction Potential: Moderate. As with narcotics, with constant use, patients can become addicted.
>
>d.) Cost: Moderate
>
>IN SUMMARY: NSAID's and antidepressants appear to be the best choices for treatment of chronic pain. Both narcotics and tranquilizer agents cause addiction and can make pain worse over time.


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