May 25th, 2013, 06:44 PM
I edited the opening post in this thread. I'm mainly interested in details (statistics) about the development of tolerance to opioids. Unfortunately my distaste for doctors made the thread appear to be about something I didn't intend it to be.
Does anyone know where I can find information about opioid tolerance? Thanks.
Last edited by PhyMan; May 26th, 2013 at 05:44 PM.
I've used many types of narcotics to relive my pain. I was given the option of having surgery or the pain meds, I choose the pain meds because I know I won't die on the operating table as some of my friends have.
I 've had the morphine pump and gave up on it being to much medication and as needed while after awhile it was "needed" constantly because the more I injected the more I needed to use to reduce the pain the next time I needed to "relieve" my pain.
Then came all sorts of other pain meds but I finally went with Oxy for various reasons, I can control the pain without become addicted to it unlike morphine or others I've tried. There were a few others that were similar in helping but this one seems to be more "manageable" if you understand what I'm talking about. I do have to increase its dosage , up wards , but I can do it incrementally unlike others which seem to need adjusting almost every time I use them.
As for the development of them I guess you'd be better off trying to Google each of them individually to see when each was developed and why.
I find this post very interesting.Originally Posted by PhyMan
Thanks for the response. It's refreshing to see that someone understands all this. Too many people incorrectly believe that everyone because addicted to pain meds. When used for pain you're much less likely to get addicted to it as opposed to those who use if for recreational purposes. I'm on oxycontin myself. The so-called pain specialist claimed that I'd become tolerant in a a day or two. Little did he know that I was on if for a week already with no changes in benefits. I was on if for two years before. But that nutty doctor claimed that the pain was all in my mind when in reality his boss was pressuring him to take his patients off it. The other doctor had the wide spread reputation for being a real jerk.
Thanks. People don't know this part about doctors. Doctors seem to have little empathy for patients when it comes to chronic pain. If you say this to doctor he'll object of course but when it comes right down to it their actions speak louder than their words. They seem to show no sign of concern or empathy for their patients who suffer horribly from chronic pain. I've seen it for myself. I know of only one doctor who understands it and that's only because he has chronic pain too. Note that I'm talking about chronic severe pain. Mild chronic or temporary pain you don't want narcotics for.
There is something I should make clear since it seems to be something that most people don't know about this subject. The euphoria an sedating effects that one gets when first going on such a medication is only temporary. It doesn't last. After being on it for many months at a theraputic does all you'll get is the pain relief with no euphoria or sedation. If you're an addict then you chase the high taking more and more to get that euphoria. But that's far about the theraputic level.
Last edited by PhyMan; May 25th, 2013 at 08:45 PM.
My only experience with morphine made the pain worse. And I didn't have to fight to get the morphine either. I asked for ibuprofen and the doctors in the hospital said the only thing I was allowed to have for pain was morphine. I felt tingly, then my scalp felt as if it were suddenly pierced with a bazillion red hot needles, then mild pain free euphoria that lasted about 10 minutes and then what had previously been a throbbing headache became the worst pain I had ever felt in my life, I thought I was dying, having an aneurysm, or possibly suffering from some sort of meningitis. So they gave me more and more. It only put me to sleep at one point but after that I refused to allow them to give me any more and I had to do intense meditating to get control of the pain. There is no way in hell I will ever let any doctor give me morphine again.
What is really sad is that all I asked for was an ibuprofen and theyforcedaggressively encouraged me to take morphine. I tolerated the throbbing headache for 3 days before finally agreeing to the morphine. The headache was likely being brought on by my anxiety of not knowing what was wrong with me and the doctors not communicating any information about why I was sick or when I could go home.
But I am just one person. I can't speak for the experiences of others. I just found it very odd that they would encourage morphine when I told the pain wasn't intense enough to justify a drug that strong.
Last edited by seagypsy; May 25th, 2013 at 09:18 PM.
How do you know this?
Perhaps because s/he actually feels for you?
Said actions including attempts to alleviate your suffering whilst preventing your becoming an addict? Are these the actions you are referring to?
What, exactly, would they have to do to show such signs? And again, what basis do you have for your assumptions?
Ahhh... Eye witness you are. Any evidence beyond personal anecdotes?
So you have encountered at least one empathetic Doctor. What was your sample size again?
Is this bit supposition or did the other physicians you encountered assert that they had no chronic pain in their lives?
"Mild" - maybe not. "Temporary" pain can be another story altogether. Severe temporary pain often indicates a need for opioids - e.g. dental surgery.
Exactly. Which is a major contributor to opioid dependency and why so many end up as "junkies" - they chase that euphoria. This ranks as a major cautionary indicator when prescribing potentially addictive pain killers. Careful lest the cure is worse than the disease...
True, if only that were the typical case. However, many "ordinary" people become addicted. In addition, higher dosages are often required just to achieve the same level of pain relief.
Did you also read Why Doctors Prescribe Opioids to Known Opioid Abusers, N Engl J Med 2012; 367(17):1580-1?
You can read the same article reproduced here....the patient’s subjective experience of pain now takes precedence over other, potentially competing, considerations. In contemporary medical culture, self-reports of pain are above question, and the treatment of pain is held up as the holy grail of compassionate medical care...
It should be easy to shop around for a chronic pain management physician willing to prescribe opioids.
I worked with opioid addicts for several years and I have studied narcotics addiction, and regardless of why people use opioids, it is simply the nature of the brain that they will develop a tolerance to it. The brain cannot be tricked; when the person takes an opioid, the brain senses something is wrong, and it compensates by "turning up the volume" in its pain circuitry, which remains active longer than the effects of the drug. If the person stops using the drug or tapers off too quickly (or merely wakes up in the morning having gone too long without a dose), the person will experience more than the normal amounts of pre-treatment pain. In this sense, the (extra) pain really is "in their heads".
I don't know you and I'm not speaking to you when I also say that I have no sympathy for those chronic pain sufferers who are also chronically overweight or obese. My personal experience has shown me that these two chronic conditions all too often go hand-in-hand. It boggles my mind that they can look me straight in the face and complain about their back or their knee(s) or whatever when their 50 to 100-plus extra pounds is obviously throwing their weight-bearing joints out of kilter as well as overloading them.
Oh really. No sympathy .... before you know anything about their circumstances? Those failing weight bearing joints might be the reason why those people are unable to maintain a decent metabolic rate by reasonable exercise.I don't know you and I'm not speaking to you when I also say that I have no sympathy for those chronic pain sufferers who are also chronically overweight or obese. My personal experience has shown me that these two chronic conditions all too often go hand-in-hand. It boggles my mind that they can look me straight in the face and complain about their back or their knee(s) or whatever when their 50 to 100-plus extra pounds is obviously throwing their weight-bearing joints out of kilter as well as overloading them.
Personally I'm sick to death of people, including doctors, who recommend exercise/ weight reduction as a way to reduce pain. What clothing size do you think people might have worn at the onset of the condition causing pain, joint difficulties, whatever? How surprising is it to you that people with crook backs, knees, hips, feet are unable to walk very far, let alone run or manage stairs. If such a person puts on some weight in much the same way as other people do, they have little chance to work it off or reduce the weight in the way that others can. A temporary weight gain in a non-chronic pain sufferer becomes a permanent weight gain in someone unable to exercise.
I'd personally agree with the notion that a lot of doctors are "unsympathetic", but it's really more about their training to identify and solve problems. They hate dealing with, let alone admitting it, that they haven't any way to make the pain go away. Their very human response is to deny the severity of the problem - by making ludicrous suggestions about pain management that the patient has tried a million times already. They are also extremely afraid of people faking it to get prescriptions for addictive drugs. In the end, at my last visit, my doctor gave me a prescription for a drug less effective than an OTC medication I've been using ever since I became allergic to Tramadol. He also suggested that I should take anti-inflammatory medication only once or twice a week. At least he's now thinking that maybe a referral to a specialist physician who can juggle all my various maladies and conditions might be a good idea. We'll see later this week.
From talking with people. I don't know it as a fact since I haven't spoken to everyone that exists. It's merely the impression I've formed from speaking to many many people about this. It's obviosly not true for everyone. I said it as a generality like I would say that people should walk at least a mile every day when I know that not everyone can do that.
That's the kind of thinking that they're using as an excuse and it's invalid. Most people who use narcotics for pain don't become addicted and its very easy to make sure that the patient doesn't become addicted by monitoring them and controling their meds by using a visiting nurse who keeps the meds in a safe otherwise.
Experience with many doctors. Most of them won't prescribe narcotics for chronic pain and neither will most pain clinics. However the literature indicates that they should.
etc.
You're right, I do have some sympathy for the reciprocity of the cause-and-effect relationship.
Still, I believe most people look at loading-bearing joint pain and overweightiness/obesity the same way they look at lung cancer/emphysema/etc and smoking. What also shifts the perspective in our direction is the two-step process of buying and then consuming the food/tobacco products. It looks like they load the gun AND put it to their heads and pull the trigger, and then complain about having a headache.
Unhealthy weight (both too light and too heavy) have made health news headlines for some time now. Unlike smoking, heaviness is something impossible to hide, and I believe it will become hotly debated as the start of Obamacare nears and afterwards regarding high-risk categories and the cost of healthcare insurance premiums. America simply will not want to foot the bill for people who "refuse to control themselves" (the same as car accidents), and I'm sorry, but I think that's the way most people perceive overweight/obese people.
I also think that someone will devise a simple breathalyzer kind of test for nicotine as well as a more accurate kind of body fat test — both for use by doctors during routine exams for use in determining healthcare insurance premium categories. Nicotine is now under control of the FDA, and I hope to see it's production and use prohibited in my lifetime.
No, I haven’t. Thank you very much for posting that reference!! I’ll read it asap.
Absolutely. I know that what worked for me ten years ago to control my pain won't work now. However since I'm not one to bury my problems with drugs I didn't become addicted. I have friends who have substance abuse issues though. They gave me one of their pamphlets from NA called In Times of Illness which explains
It states that being in NA helps when an addict is being treated for pain because They remind us that taking medication as prescribed for illness is not the same thing as using. and We learn that pain shared is pain lessened. It's imporant to know what they also say as far as abuse, i.e. [i]...some members abuse their medication and relapse. However they go on to saySome medical professionals may misunderstand us ad atttempt to treat our addiction. Or they may be overly cautious and reluctant to prescribe medication when they learn we are addicts.
Pain is really an odd duck. I've been told by many many doctors that they really don't know understand what causes pain. I read whatever I can get my hands on regarding this. Psychology - Fifth Edition by Wortman, Loftus and Weaver. McGraw-Hill College, (1999) state on pages130-131Our experience shows that many NA members have been successful in taking medication as prescribed for chronic pain and keep their recovery in fact.
With me I know that when I'm having an anxiety attack are am just experienceing a lot of anxiety the pain is greater. It's for this reason some doctors prescribe valium to help with pain.What causes pain? That remains a mystery. Although pain often results from certain types of physical stimulation (pressure, damage), pain is generally considered a perceptual rather than a sensory phenomena. That is, the same physical stimulus might be interpreted as "pain" in one situation but not another.
I have to admit that I'm saddened to hear that. Obesity is often percieved as a weekness in character when in many cases it’s cause is genetic. We don’t think of it in these terms but someone who’s obsese has a highly efficient metabolism in that what little food they take in goes into the energy that they need to survive and the excess goes into storage (e.g. as fat). People with high metabolism, i.e. the skinny people who can eay anything they want and not gain and ounce, have most of their energy intake wasted by the inefficiency of their metabolism. Little of what they eat goes into maintaining homeostatis and doing work etc. but a great deal of it is wasted and flushed out of the body. So when we lived in caves it was very good to have a slow metabolism but in society when we can eat alll we want and do little work and spend most of the day sitting down, that’s bad. Nature simply hasn’t caught up with us yet. And since evolution has most likely come to a standstill for humans may never will.
Why do you think you’d do better if you had their metabolism? I’m the same person I was 20 years ago but my metabolism has slowed down a great deal. I now eat a great deal less than I did then but now I weigh more and am having a hard time loosing it.I’m not fat by any means. I just like to stay fit and trim. Due to degenerative disk disease I’m not able to exercise like I used to in my 30’s even though I love to.
Regarding my comment above about temporary pain and narcotics. I suppose I wasn't clear enough. If I sprained my ankle or pulled a muscle in my neck I wouldn't go to the ER nor would I want to take narcotics for it. If I had a second degree burn on my hand then I wouldn't want to take pain meds for it. I'd simply take it easy and wait for it to heal. If I broke my leg then I'd want to go to the ER and want to take narcotic pain meds. Next month when I have sugery to fiz a heital hernia they'll give me a short supply of pain meds for surgical pain. That's what I mean by no narcotics for short term temporary pain. Their are exceptions to that rule. The idea being that some kinds of pain we just need to suck up and deal with it.
Yeah, but see that is exactly the point, Pete. If you suspect that the pain is a symptom of a problem, isn't the most logical course of action to find the cause? So if addiction is the cause, the logical course is to be treated for it in order to relieve the necessity for the costly drugs.
It doesn't mean go untreated but it also doesn't mean half-treat or keep throwing drugs at a problem without trying to resolve the root cause.
For example, if I have a severe pain in my leg, wanting the pain alleviated is secondary to wanting to know why there is a severe pain in my leg and fixing that. If the cause is addressed, I may not need to rely on pain relievers.
There is also the point that having pain does not cause one to gain weight. Neither does inactivity. It is act of consuming more calories than you burn. I know a guy with rickets who is in extreme pain all the time, but he barely eats and is thin and frail. He is in pain and hates to move around but he can within limitations. He can move enough to go to the kitchen and get food. The only reason he is not overweight is because he doesn't choose to eat and eat and eat. He nibbles, consciously acknowledging that he does very little and so requires very little. I don't think being underweight is any better than being over weight and it's likely his rickets is caused by him being a shut in and avoiding going out during the day. But his life is extremely unique making it nearly impossible to function in daylight where he can be seen.You're right, I do have some sympathy for the reciprocity of the cause-and-effect relationship.
Still, I believe most people look at loading-bearing joint pain and overweightiness/obesity the same way they look at lung cancer/emphysema/etc and smoking. What also shifts the perspective in our direction is the two-step process of buying and then consuming the food/tobacco products. It looks like they load the gun AND put it to their heads and pull the trigger, and then complain about having a headache.
Unhealthy weight (both too light and too heavy) have made health news headlines for some time now. Unlike smoking, heaviness is something impossible to hide, and I believe it will become hotly debated as the start of Obamacare nears and afterwards regarding high-risk categories and the cost of healthcare insurance premiums. America simply will not want to foot the bill for people who "refuse to control themselves" (the same as car accidents), and I'm sorry, but I think that's the way most people perceive overweight/obese people.
I also think that someone will devise a simple breathalyzer kind of test for nicotine as well as a more accurate kind of body fat test — both for use by doctors during routine exams for use in determining healthcare insurance premium categories. Nicotine is now under control of the FDA, and I hope to see it's production and use prohibited in my lifetime.
On the other hand, caring for a woman and her grandson who are both obese and constantly in pain, as little as either of them are willing to get around and do anything, No amount of pain is enough to stop them from going food shopping, going out to eat, or simply standing at the fridge and eating the most fattening foods known to man. Sure she buys low fat or diet foods, but if you eat 3 times as much as you should of that stuff, it kinda cancels out the effects of it being low fat or diet.
So in order to get fat while in so much pain that you can't move, would require that someone else is bringing you food. If a person is feeding themselves then they are making a conscious choice to eat more than is necessary given their amount of physical activity.
I'm sorry, but you're confusing me with someone else. If that person has chronic pain then note that it's not all that rare for men my age.
Anxiety always makes pain worse, regardless of the cause. The cause of my chronic pain is quite common in men my age and is due to a herniated disk that is pressing/scraping against my spinal cord causing terrible pain.
I don't follow you. Where did this whole addiction sideline come from? There's nothing about me or my medical history to even suggest addiction. I've never taken opioids to get high and have no interest in doing so. I have friends who've abuse opioids, that's about as close as I've come to it. That's where I got that information from but that's about all. I mentioned anxiety because there is a mental component in pain and it gets worse, but is not caused by, anxiety, anger etc.
Last edited by PhyMan; May 26th, 2013 at 01:21 PM.
That's all a side issue at this point. What do you have to say to the commentary I made?Who's Pete? If he has the same problem then I'd like to talk to him about it. What handle does he post under?
I made a full commentary on it. I was very clear about it. Didn't you see and read it? The pain is not in my mind. It's caused by a herniated disk pressing against the sciatic nerve. That's what the MRI shows. That's what all those epidural injections into my spine were for. That's why the two pain specialists recommend oxycontin.
It's not as simple as that. People can take in a number of calories and burn a number of calories but it's not the difference that gets stored. Two people who have the same body mass and activity can take in the exact same number of calories and yet one can gain weight and the other remain the same. Their metabolism is a key factor and changes with age and between different people. Thinking that obsese people are just people who are lazy and eat too much in all cases is just plain wrong. Sure. Some obsese people are like that but not all of them.
And this answers the question as to who Pete is. Pete M. Brown, formerly PMB on here. Do not insult everyone's intelligence and deny it.I made a full commentary on it. I was very clear about it. Didn't you see and read it? The pain is not in my mind. It's caused by a herniated disk pressing against the sciatic nerve. That's what the MRI shows. That's what all those epidural injections into my spine were for. That's why the two pain specialists recommend oxycontin.
Now your contributions to physics were very good. If you've returned with a sock puppet with Moderator approval, then I think you would be wise to stay in the physics areas where your contributions can do a lot of good. All I ask is that you be honest about it.
Now, you're well aware that we've been round and round on this topic. More than anything, you're using the thread as a sounding board for how you feel about the issue.
The only thing that can really be said is- find another doctor.
I am truly sorry for the chronic pain you suffer. No matter what is the cause of it. I truly hope that you can get the attention for it that you need.
I suggest this thread die on the vine.
If you're going to be posting here again, it would behoove you to stick to what you're best at: Physics.
If you're assuming that because of my response that I'm on the same meds and have the same back problem than someone else then you've made a serious mistake.
Not all people who have chronic pain and/or take the same med are the same person. I'm sorry to see that you don't understand that. I started this thread maily to see if someone could tell me where to find information on opioid tolerance.
I was going to leave but I see that this forum has an ignore list so I'll use it and remain for now.
Last edited by PhyMan; May 26th, 2013 at 05:46 PM.
Hell of a coincidence:If you're assuming that because of my response that I'm on the same meds and have the same back problem than someone else then you've made a serious mistake. And then you've compoinded that mistake by driving me away because you made a false asssumption.
Not all people who have chronic pain and/or take the same med are the same person. I'm sorry to see that you can't see that. I started this thread maily to see if someone could tell me where to find information on opioid tolerance. If you're going to insist that I'm someone else and then bother me about it then there's no point in staying here. Stating that I'm insulting your intelligence won't change who I am.
Goodbye and please don't follow make false accusations in the future.
Same medication, same exact problem, same exact spelling errors (See my post where I said I found your post interesting), same style, same attitudes toward doctors, same denial of addiction, same stance as to medicating if addicted, same time spent as a physicist and so on...It's caused by a herniated disk pressing against the sciatic nerve. That's what the MRI shows.
Yeah... If you are claiming I've run off an innocent man, I cannot be blamed for it.
No doubts.
And this answers the question as to who Pete is. Pete M. Brown, formerly PMB on here. Do not insult everyone's intelligence and deny it.I made a full commentary on it. I was very clear about it. Didn't you see and read it? The pain is not in my mind. It's caused by a herniated disk pressing against the sciatic nerve. That's what the MRI shows. That's what all those epidural injections into my spine were for. That's why the two pain specialists recommend oxycontin.
Now your contributions to physics were very good. If you've returned with a sock puppet with Moderator approval, then I think you would be wise to stay in the physics areas where your contributions can do a lot of good. All I ask is that you be honest about it.
Now, you're well aware that we've been round and round on this topic. More than anything, you're using the thread as a sounding board for how you feel about the issue.
The only thing that can really be said is- find another doctor.
I am truly sorry for the chronic pain you suffer. No matter what is the cause of it. I truly hope that you can get the attention for it that you need.
I suggest this thread die on the vine.
If you're going to be posting here again, it would behoove you to stick to what you're best at: Physics.This is not an effort at cruelty, but a demonstration that the shoe most definitely fits.
Your full commentary was made after Neverfly had responded to you. It's not really fair to imply he ignored it when you clearly edited it in about 13 minutes after he had responded to your original response which was only a comment asking who Pete was.I made a full commentary on it. I was very clear about it. Didn't you see and read it? The pain is not in my mind. It's caused by a herniated disk pressing against the sciatic nerve. That's what the MRI shows. That's what all those epidural injections into my spine were for. That's why the two pain specialists recommend oxycontin.
Notice:
Your post# 15 was originally posted @ 1:03pm cst
Neverfly responds with post #16 @ 1:08pm cst.
at 1:21pm cst you edited post #15 adding in the "full commentary"
Then you post # 17 at 1:27 cst pretending as if the "full commentary" had always been there and that NF ignored it.
We weren't born yesterday.
When I said they take in more than they burn , the word burn was referring to metabolism. If it isn't burned, its stored. I never said they were lazy, I said they take in more than they burn. This is a choice. Even a person who works hard can take in more calories than they burn and get fat. I had a friend who was very active but hate huge amounts of junk food on top of normal amounts of regular food. He got fat. I had another friend who was lazy bum but they were even too lazy to eat so they stayed skinny because they ate less calories than it took for them to just breath and click the tv remote. Fat does not necessarily equal lazy. Fat usually means bad eating habits. Sometimes though not nearly as common as just bad habits, there is thyroid issues, but proper medical treatment can control that.It's not as simple as that. People can take in a number of calories and burn a number of calories but it's not the difference that gets stored. Two people who have the same body mass and activity can take in the exact same number of calories and yet one can gain weight and the other remain the same. Their metabolism is a key factor and changes with age and between different people. Thinking that obsese people are just people who are lazy and eat too much in all cases is just plain wrong. Sure. Some obsese people are like that but not all of them.
pmb was banned back in January. But yesterday he attempted to log in. It shows in his profile that his last activity was May 25, 2013. Then suddenly PhyMan shows up with the exact same physics credentials and chronic pain issues as pmb. That really is a helluva coincidence.
If you are pmb, the ban was result of a heated argument between you and I. I don't have any grudge against you. And I am willing to give you another chance. I won't argue with you but I will not hesitate to report you if you start repeating old habits.
Feel free to go ahead and put me on ignore as well.
Neverfly didn't say what meds pmb was on or what condition he had. How would you know that you both shared the same meds and cause of pain?If you're assuming that because of my response that I'm on the same meds and have the same back problem than someone else then you've made a serious mistake.
Not all people who have chronic pain and/or take the same med are the same person. I'm sorry to see that you don't understand that. I started this thread maily to see if someone could tell me where to find information on opioid tolerance.
I was going to leave but I see that this forum has an ignore list so I'll use it and remain for now.
I don't know it. I deduced it just like you claim that I must be pmb because you think that because he attempted to log in (to a place he was banned from) must imply that we're the same person because there are too many coicidences and if there are two coincidences then I must be pmb. I can see why you get into heated debates with that kind of attitude and logic.
Neverfly read my posts and when I stated what pain med I was on his/her's next post was the claim that I must be pmb. After all, how many people have herniated disks and out of those how many are on oxycontin (a very popular drug).
The reason I edited my post was when I saw what was quoted I saw I spelling error that I made. All you have to do is look to see what the post reads now and what was quoted and you'll see where I corrected my spelling error. And he/she did make those accusations even though I explained everything before he/she posted that. So yes. You do seem like you were born yesterday with that kind of reasoning.
Frankly, while your advice on putting you in my ignore list is very good advice I only joined here to seek information on opioid tolerance and for no other reason. I was told that this place had people who treat posters like you two have treated me so far. I have no need for paranoid people in my life. Adios muchacho!
Last edited by PhyMan; May 26th, 2013 at 08:59 PM.
If it was a moderator, they can ban me. If it was a member, they can piss off.
"people who act this way..." You gotta be kidding me. Exact same situation, complaints, style and even the same spelling errors but I'm "acting this way."
Could I be wrong? Sure. Helluva lot of coincidence though.
What you are failing to realize in regards to the editing bit, is that I saw his response to you almost the moment he sent it, and you had NOT edited the post to add any commentary at that point.I don't know it. I deduced it just like you claim that I must be pmb because you think that because he attempted to log in (to a place he was banned from) must imply that we're the same person because there are too many coicidences and if there are two coincidences then I must be pmb. I can see why you get into heated debates with that kind of attitude and logic.
Neverfly read my posts and when I stated what pain med I was on his/her's next post was the claim that I must be pmb. After all, how many people have herniated disks and out of those how many are on oxycontin (a very popular drug).
The reason I edited my post was when I saw what was quoted I saw I spelling error that I made. All you have to do is look to see what the post reads now and what was quoted and you'll see where I corrected my spelling error. And he/she did make those accusations even though I explained everything before he/she posted that. So yes. You do seem like you were born yesterday with that kind of reasoning.
Frankly, while your advice on putting you in my ignore list is very good advice I only joined here to seek information on opioid tolerance and for no other reason. I was told that this place had people who treat posters like you two have treated me so far. I have no need for paranoid people in my life. Adios muchacho!
Wow, so you came to a forum where you were WARNED bout people like us. huh?
That makes me so sad. Oh wait, no it doesn't.
Also, I didn't accuse you or come to a concrete conclusion that you are pmb. I strongly suspect it. And I acknowledged the coincidences. You can however show that you are not him by simply not acting like him in every way imaginable. Just be you. If you are not him, surely the differences will emerge in time.
I honestly doubt that if you are pmb you can keep up the charade long, but don't worry, I won't bring it up again. If you say you aren't pmb, I'll just treat you as if you are anyone else. If you say something reasonable, I will support you, If you ask a question I will try to answer you, If you act like a jackass I will call you out on it. Sound fair to you?
Then small loss if you fulfill your threat to leave.
Paranoia? Possibly. It's irrelevant, really. If you stay or remain, S.G. put it perfectly- any differences will emerge in time. If you're not PMB, I'll be the first to eat humble pie and tell you I'm sorry for the accusation.
It is curious- as to who it was that warned you about the mean people...
Other than that, it's all way off topic. It's become and angry fight that didn't need to be. I say let's drop it for now.
I've decided not to let two unhappy campers drive me off this forum because they confuse an improbable with cause and effect. It’s not as if rare coincidences happen here every week, or do they?
May I ask you which ones? If you don’t mind sharingl, that is? I’m only familiar with oxycontin and ms contin. What others have you used that you found helpful? What were the side effects? If you don’t wish to post it in open forum then please send it to me in PM
If it ever got too bad or you became tolerant of opioids would you consider surgery if the pain was too intense?
Thank God I didn’t leave. I’m not familiar with such a device. I never would have learned about this. Thank you very much for sharing that with me!.
This is what you had, correct? Morphine Pump - Treatments - For Patients - Neurosurgery - University of Rochester Medical Center
How did they refill it if it was surgically implanted?
In what sense was there an addiction concern? Was it the physical or mental component that you’re referring to?
Not really. The only concern that I ever had was being in too much pain and being tempted to take more than was prescribed in order to control it.
May I ask how long you’ve been on it? If possible could you describe quantitatively, as best that you wish to that is, the details of how the dosage varied over time?
Thank you for sharing. Please feel free to respond in PM if the exchanges here bothered you.
I've decided not to let unhappy campers drive me off this forum due to confusion over improbable events with cause and effect. It’s not as if rare coincidences happen here every week, or do they?
May I ask you which ones? If you don’t mind sharing that is? I’m only familiar with oxycontin and ms contin. What others have you used that you found helpful? What were the side effects? If you don’t wish to post it in open forum then please send it to me in PM if you're more comfortable doinig it that way, if at all that is.
If it ever got too bad or you became tolerant of opioids would you consider surgery if the pain was too intense?
Thank God I didn’t leave. I’m not familiar with such a device. I never would have learned about this. Thank you very much for sharing that with me!.
This is what you had, correct? Morphine Pump - Treatments - For Patients - Neurosurgery - University of Rochester Medical Center
How did they refill it if it was surgically implanted?
In what sense was there an addiction concern? Was it the physical or mental component that you’re referring to?
Not really. The only concern that I ever had was being in too much pain and being tempted to take more than was prescribed in order to control it.
May I ask how long you’ve been on it? If possible could you describe quantitatively, as best that you wish to that is, the details of how the dosage varied over time?
Thank you for sharing. Please feel free to respond in PM if the exchanges here bothered you.
So you are claiming now that you didn't intend the thread to be about bashing doctors even though this post shows that you clearly were more interested in the behavior of doctors than the issue of tolerance to opiates.
(quoted in full before you edit it beyond recognition)Thanks. People don't know this part about doctors. Doctors seem to have little empathy for patients when it comes to chronic pain. If you say this to doctor he'll object of course but when it comes right down to it their actions speak louder than their words. They seem to show no sign of concern or empathy for their patients who suffer horribly from chronic pain. I've seen it for myself. I know of only one doctor who understands it and that's only because he has chronic pain too. Note that I'm talking about chronic severe pain. Mild chronic or temporary pain you don't want narcotics for.
There is something I should make clear since it seems to be something that most people don't know about this subject. The euphoria an sedating effects that one gets when first going on such a medication is only temporary. It doesn't last. After being on it for many months at a theraputic does all you'll get is the pain relief with no euphoria or sedation. If you're an addict then you chase the high taking more and more to get that euphoria. But that's far about the theraputic level.--Last edited by PhyMan; May 25th, 2013 at 08:45 PM.
[QUOTE=PhyMan;426255]I've decided not to let unhappy campers drive me off this forum due to confusion over improbable events with cause and effect. It’s not as if rare coincidences happen here every week, or do they?
May I ask you which ones? If you don’t mind sharing that is? I’m only familiar with oxycontin and ms contin. What others have you used that you found helpful? What were the side effects? If you don’t wish to post it in open forum then please send it to me in PM if you're more comfortable doinig it that way, if at all that is.
I've used the fentanyl patch, Dilantin, Dilaudid and Codeine
If it ever got too bad or you became tolerant of opioids would you consider surgery if the pain was too intense?
Depends upon many things, my health would be the primary thing to consider which I mean if I only had the pain in one area I would not do surgery but just take the pain meds to manage the pain as best I could.
Thank God I didn’t leave. I’m not familiar with such a device. I never would have learned about this. Thank you very much for sharing that with me!.
This is what you had, correct? Morphine Pump - Treatments - For Patients - Neurosurgery - University of Rochester Medical Center
How did they refill it if it was surgically implanted?
Yes, it was implanted inside my back which every so often I had to go to the doctors office to have it refilled, they do it with a syringe.
In what sense was there an addiction concern? Was it the physical or mental component that you’re referring to?
Not really. The only concern that I ever had was being in too much pain and being tempted to take more than was prescribed in order to control it.
May I ask how long you’ve been on it? If possible could you describe quantitatively, as best that you wish to that is, the details of how the dosage varied over time?
I'm not going into that because it has been many years since I've had that pump removed and I just do not recall what dosages I was giving myself.
Thank you for sharing. Please feel free to respond in PM if the exchanges here bothered you.
Thank you very much for responding. How long ago did you start opioid therapy? I ask because I'm trying to get a sense of how long I can be on it and have it be effective? E.g. could I be on opioid therapy for, say, 25 years and have it still relieve pain? That's why I ask how long you've been on it. Thanks again very much.
I've been using this pain management for about 12 years now.
Thank you. That helps me a great deal. I had a feeling that my old pain specialist was full of it. He claimed that I'd become tolerant to opioids in a day or two. A real fibber/ignorant person that one.
Thanks for your assistance. It was more help than I can tell you.
[QUOTE=PhyMan;426843]Your welcome and remember that I only am using the medications to manage the pain to bring the level of pain down but never completely getting rid of it. I have trained myself to be able to tolerate up to a 4 to 5 level without to many meds but over that I've come to use enough to bring a level 8 down to the 4 or 5 levels so that I can tolerate it and manage to live with it. You'll never relieve the pain, I've found, but you can bring it down enough to get by with doing daily things without to much discomfort but with pain that you get use to.
Thanks for your assistance. It was more help than I can tell you.
He may also want to remember that you are one person. And each person's medical profile is unique. We don't all have the same response to medications as other people do. I take effexor xr for anxiety and have for years. Normally, the full dosage is reached within a few months of starting. that average full dose, if i remember being 150mg/day. but I reached a comfortable, manageable range of anxiety at 75mg/day and it has remained at that dosage for over 10 years. Sometimes they even start to ween me off of it and unless I have some traumatic event or some long term abnormal stress taking place in my life I can make it on 32.5mg/day for a long time.Your welcome and remember that I only am using the medications to manage the pain to bring the level of pain down but never completely getting rid of it. I have trained myself to be able to tolerate up to a 4 to 5 level without to many meds but over that I've come to use enough to bring a level 8 down to the 4 or 5 levels so that I can tolerate it and manage to live with it. You'll never relieve the pain, I've found, but you can bring it down enough to get by with doing daily things without to much discomfort but with pain that you get use to.
Thanks for your assistance. It was more help than I can tell you.
But my doctor says I am an enigma in many ways. It could be that I have a distaste for taking medication and I choose to accept that there are somethings about the process of living that are simply inconvenient, unpleasant and painful and it is healthier for me (psychologically) to learn how to cope as much as possible without medication if possible. So my tolerance levels for pain are much higher than many people and my method of dealing with emotional stress, though not always effective, is by simply suppressing my emotional responses and dissociating emotionally, though not logically, from what is happening. You can say I go Vulcan at times.
I have had therapists tell me not to do this and that I will end up regretting it at some point and that I will lose my ability to empathize with other people, but i pointed out that i don't see that as a problem since I generally don't like people much anyway. But that's a side track.
The point was, that cosmic's situation should not be a litmus test for your own. Cosmic has his own unique medical history and every aspect of his life, even his psyche, will effect how medication works for him vs how it may work for you.
I really don't think it is a good idea to outright dismiss a doctor's advice just because you meet one or even a handful of people tell you they had different experiences than what your doctor is telling you. The doctor has access to your full history, unless you conceal something from him, your entire blood work up, all your tests, all previous and current meds and all the statistical data involving patients around the world being treated with your condition. He also won't make any money if you end up leaving his practice. So to deny you the care you think you should have just out of spite or ignorance would cost him money and his reputation. I don't think most of them would risk their income and reputation out of malicious intent. If they are denying you a particular medication they are likely certain that it would have a negative affect on you based on your medical history. And whether they care about you personally or not, they certainly don't want a malpractice suit for prescribing medication to someone who's history indicated it would be bad for. Look what happened to the doc that treated Michael Jackson's pain.
I think you should get multiple opinions from doctors who have reviewed your medical history rather than that of people's individual experiences given that no two people have identical body chemistry.
Last edited by seagypsy; May 29th, 2013 at 11:05 PM. Reason: fixed a quote tag
Well understood. My previous primary care physician (PCP) told me that he wanted to keep the pain at 3 or below. I read the medication descriptions which says that its for mild to severe pain. As I understand it, perception is a major component of pain. That’s why when my old PCP said I’m taking you off this medication. I think the pain is all in your mind. I knew I had to get a new PCP. My therapist told me that pain specialists sometimes prescribe valium for pain. I think that’s because you percieve greater levels of pain when your anxious of having an anxiety attacks. I’m going to check into that to see if its worth having. I’m reluctant to take anything that dulls my senses though. The week before last when I was seeing my therapist she told me that I seemed sedated. That greatly disturbed me. I hate the idea of seeming gonzo or loopy in any way. But this turned out to be something different. The oxycontin makes my itchy. So I take diphenhydramine (aka benadryl) for it. The mistake I made was to take 50 mg, which is the amount I’m used to taking to go to sleep, for the itching. Clearly a dumb mistake.
How do you work with it? E.g. I have to be very cautious when I leave the house. I have to think out every pathway that I might have to take and determine if it’s safe or not. E.g. today I took the a few subways and then walked about a mile. That ended up being too much. The pain went from 3-4 to 7-8. So bad that I ended up in the ER. I hate that. I hate going to the ER for pain. I need to keep clear of it but, as you mentioned, it can be tempting to reach out for help when you’re in pain and in my case it wasn’t more meds per se but going to the ER. They have the bad habit of looking at you suspiciously when you go there for pain (sigh). These doctors can’t understand what chronic pain is like. I only know one doctor who gets it and he only gets it because he himself has it. He explained it to me one day. He’s a peach of a man. I made the ER doctors today call my PCP to make sure that whatever they did that it was okay with her. I wasn’t taking any chances.
Tomorrow is the new pain clinic. Wish me luck [or if you're the spiritual type please pu in a good word for me.
Been there, done that.The old pain clinics were merely epidural injection shops.
When I know that I'm going to be walking awhile I will always take a pain pill before I leave to insure that my pain level won't sky rocket while I'm out and about. I also take at least 2 more with me just in case something weird happens which a few times did. By now you should know better than to go outside anywhere without taking a pain pill or two with you and taking one before you leave.
Just tell them what you have for pain and as I have done ask them if they want you to get an MRI of the area that is problematic so that way they can see where it is you're having the problems. Mine show up very clearly in that 4 discs are almost non existant in my spine and neck plus both rotator cuffs are ripped apart. Both can be seen with the MRI.
I went to a physiatrist who wants me to have an MRI. She already found a loose joint and torn ligament. My new pain specialist wants to try more injections and if that fails a spinal cord stimulator. If all that fails then he'lll put me back on opioid therapy but at a higher level than I was on so that I don't have to take breakthrough meds. My gastro sugergeon also found a problem with my spine too when they were doing x-ray on my stomach. I bet that's why I have so much upper back pain.
Finally things are looking up for once. I finally have some real hope!
A friend of mine is a chemist whose wife is a biologist. They explained a lot about the subject to me recently. They told me that there is not a quick easy answer questions on opioid tolerance - the variables in pain and types of pain make it very hard to compare pain management techniques.
First, our bodies make natural opioids which it releases when you cause pain - this is one reason why runners get "addicted to running" their brains release natural opioids to relieve the muscle pain, on days they don't run the miss the "natural high". Second, there are three types of opioid receptors in the body - mu, that morphine acts on are located in the spinal cord and prevent transmission of pain; kappa that dynorphin acts on, also prevents transmission of pain signals. -both act on the neurons which release pain signals and on the post synaptic receptors for these pain signals acting to hyperpolarize the membranes to prevent pain from being transmitted.
They said that less is known about delta interactions but it has been shown that if you develop tolerance for mu receptors you do not develop a cross tolerance for kappa receptors so you could theoretically take a drug regimen which would allow you to switch from one to another so as to avoid dependence produced by the euphoric aspects of the drugs. The euphoria is a separate effect from pain mitigation but is of greater concern for drug addiction. Tolerance seems to be very variable depending on the type of pain. They suggested that the easiest thing to do would be to take the doses prescribed and see if they alleviate the pain and if the same does continues to alleviate the pain - if you find that the same does decreases in efficacy you might ask for a drug working via a different opioid receptor.
It seems that very few people I’ve spoken to know about this main mitigation without euphoria. I learned if from experience but I wasn’t sure about it since I never heard anybody mention it before my friends just did.
There was a news story the other day that some people with slipped disks may get permanent relief from pain from a course of suitable antibiotics. I'm afraid I didn't pay much attention so I don't remember any more details about where the research was done, etc.
Oh well, google to the rescue: Caution urged on antibiotic cure to back pain - The Globe and Mail
I want to thank you for the informaion. It's much appreciated. Although I have a fear of antibiotics when not neccesary. That whole superbug thing. I wish it was that simple for me. There's just too much disease in my spine. I'm having an epidural steroid injection tomorrow. I’m not looking forward to this at all. They stick that needle right into my spine. Yipes!
Note: My appologies if my typing is sloppy. My eyes are messed up. I have cataract in my left eye and its getting worse by the week. Plus I've had a few beers and I'm tired.
Yipes, indeed! It felt like a kidney punch. I was out of commision for the rest of the day. It seems to have helped a bit with my hip pain but has left the sciatica totall untouched.
After a poor choice of a primary care physician I found a really great one yesterday. I'm now on opioid therapy and no longer suffering intolerably. It's wonderful.
I also picked up the book [b]Prescription Drug Addiction[b] by Rob Colvin who states on page 106 that in a according to a National Institute on Drug Abuse, in study of 12,000 patients who were given opioids for acute pain, oly 4 became addicted. That's quite a difference compared to what all the people I've spoken to about this have come to believe. A friend of a friend told me that patients who take opioids for pain don't get addicted to it. I now see how right he is.
The following is like my life story for the past 10 years.From http://opioids.com/chronicpain/
I've been slandered by doctors like this many times. These jerks are free to slander my name at will. It's not fair!Some physicians apparently have difficulty with that. Many of my patients with chronic pain have been refused treatment by previous caregivers who apparently believed that their pain was not real. Even after undergoing painful procedures and surgeries that failed to bring relief, some of these patients were labeled as drug-seekers when they continued to ask for help. They had to contend not only with the pain but also with feelings of frustration, isolation, and abandonment by those on whom they had most relied.
...
The fear of drug abuse and drug addiction is the major reason that physicians are reluctant to prescribe opioid medications for patients in severe pain. The inappropriate use of a medication for a nonmedicinal problem is drug abuse. Using a pain medication to get high or euphoric is clearly inappropriate, as is using drugs to escape family or other problems that should be dealt with by other means. If a patient's physical pain has prevented him or her from living life fully, using a medication that allows a return to normal activities cannot be called drug abuse.
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