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    increased pain from pain meds
    mel0222 posted:
    I recently broke down and asked for a narcotic to manage my back pain. I have tried an epidural, which was successful for the first two times but not at all the third. I have 3 bulging discs (L3-L5), stenosis, spondylosis, degeneration from L1 to my tail bone, scoliosis, and other. Neurosurgeon says I need a tri-fusion. Strangely enough, it seems like after taking Norco 5/325, my pain has increased. One thing I do know is that a side effect of pain meds is constipation which aggravates my back pain. Also, I seem to be retaining fluids again which is not good for my CHF nor the pressure felt in my back and knee.( I also have a dysfunctional left knee replacement which had been re-done 3 times already.) I am taking stool softeners and a diuretic. Any thoughts or suggestions?
    trs1960 responded:
    All analgesics cause constipation. They also suppress your respiratory system. Actually, pain itself causes constipation. The analgesics just make it worse. There are over the counter stool softener s that can help you out. The last thing you need added to your back pain is severe constipation. 5/325 Norco is a mild analgesic. It's 5 mg of hydrocodone and 325 of acetaminophen. If you took it and laid down I bet it would help push the pain back further in your mind. If you took it and did anything physical it likely allowed you to do a little more and in about three hours the pain came back with vengeance.

    This is the circle or roller coaster of pain meds. Along with desensitizing the meds can sometimes allow to make yourself worse.

    Not knowing what your activity was before and after the usage I'm just guessing and trying to explain what to look out for. As always work with your doctor when using opiads to assure they can work right.

    Best of luck

    trs1960 replied to trs1960's response:
    Let me add. I don't mean to be accusatory. I am actually pointing out flaws I have found the hard way. I have found that pain and sleep deprivation...and constipation are torture 101 and unfortunately there often is no simple answer. It's like telling someone who is suffering depression to not worry and be happy. Sure it's is true in an oversimplified impossible way.

    Sorry if I sounded a bit presumptuous. I was in the lobby of the Drs office and when I read what I wrote it sounded different then it did in my head.

    Best of luck and while nobody wants to talk about this, take stool softener s if you are starting or increasing analgesics. I almost went to ER once because I felt like I was giving birth to a watermelon and I'm a 50 year old man so that's not a good thing!

    mel0222 replied to trs1960's response:
    Hey Tim, thanks for your reply. No, I was not offended but thank you for being sensitive to the challenges of online discussions, especially when speaking of chronic pain. Without the benefits of vocal inflection, eye contact, and body language, one can easily misconstrue what was said. I have raised a few boys though and understand that guys just give the fact.

    I do understand that that taking opiates of any kind or strength causes constipation. I have been on and off pain medication for about 10 years due to a nasal staph infection, bilateral total knee replacements, a double patella reconstruction, and an additional total knee replacement on my left knee, which incidentally, needs to be "serviced" again due to mechanical complications. Now my back pain has been added to the list. Opiates have always caused constipation so I was expecting that one. I have to use a mild stimulant as well as stool softeners to "keep things moving along". I also am limited in my water intake because of my congestive heart failure (CHF) so that doesn't help matters at all. I weaned off of all pain medication while in the hospital for my CHF and heart attack. I managed to stay off of them for 3 months but the pain, not sleeping, and inability to barely move wore me down enough to begin again with the pharmaceutical regiment. Unfortunately, as you are aware, my body does quickly adjust and the prescribed milligrams become ineffective. The 5/325 mg prescription is very low; seeing as I had been through the process of increasing strength and was at the top of the chart in last October before my CHF.

    I was, and still am, trying to manage my pain without narcotics but my pain level just continues to increase faster than I can get into a pain management doctor and my neurosurgeon. I am on medi-cal and am praying that they will pay for alternative procedures since all pain meds increase my heart rate and tax my heart unnecessarily. I also don't like the water retention and seemingly increased pain from the narcotics. I just wondered if I was imagining the connection between increased pain and beginning the Rx pain med again or if other people had experienced the same thing.

    Incidentally, I too have experienced "birth pains" while defecating. I have had three children and that pain is comparative to labor pains. Thanks again for the reply.


    georgia888 replied to mel0222's response:
    Hello Mel,
    Atlhough I, too, suffer from pretty severe pain, I have chosen a non-narcotic plan. I take only aspirin. I do take many supplements which have been known to ease pain including vitamin D, calcium, magnesium & 5-HTP. I also inlude many herbs & spices in my healthy diet including ginger, cayenne, & turmeric; all known to ease pain & inflammation.

    I've always heard that constipation is a side effect of many pain killers & wondered if a very high fiber diet might help counter act this. In addition to lots of fruits & vegetables, ground flax seed is a wonderful form of fiber. Would eating such a high fiber diet help with drug-related constipation?

    trs1960 replied to mel0222's response:
    Mel, you know way more about this than I do. I never thought about CHF and spine pain. I thought spine pain was bad enough! Although if I don't change something about my life(work) I may find out. My BP was 200/110 and was similarly high two months ago when checked. One bad effect of letting your pain levels go too high is the stress on your body such As BP.

    Sounds like your damned if you do and damned if you don't :-0

    bj1208 replied to trs1960's response:
    Hey Mel & TIm -

    Yes I can relate to pain meds increasing the pain - over the last couple of years I would intentionally go off my pain meds for about a week or two then start up on them again and i can tell you that yes certain pain meds do increase pains. - they even say can cause back pains - sometimes I have to wonder if they mean it to relate to constipation!!

    So much for those of us trying to get pain under control when our pain meds can be increasing our pains - vicious cycle~~
    ~~ Click on my name or picture and read my story ~~

    Take care ~~ God Bless ~~

    ~~ Joy ~~
    mel0222 replied to bj1208's response:
    Hi Joy, I'm intrigued that I am not the only one that has experienced this phenomenon of increased pain from pain meds. While being in a coma from my congestive heart failure, I was weaned off of all my prescriptions and had dropped 30 pounds of water and had pretty much completely emptied my intestinal track (poor nurses). Previous to my CHF, I had a pain doctor tell me that my "Rx cocktail" was causing me more pain than helping it. I had just started that process when my heart failed.

    For the first few weeks of recovery, my pain was not bad at all. I don't understand why but it slowly returned to its previous level. I had resigned myself to the level of pain I was experiencing (with a whole lot of prayer and dependance upon God) when I tried an inversion table upon my doctor's recommendation. I tipped 15% for 3 minutes and when I turned upright, my pain level went from a 5 to a 10!!! I was told that I tore some connective tissues but it should have healed up by now. Since I wasn't sleeping and my blood pressure and heart had significantly increased, due to extreme pain, I finally broke down and asked for help.

    So, now I'm in this nasty cycle of managing my pain as well as digestive system, and now my heart. I do think that constipation and water retention is what contributes to increased pain. Consequently, I take I diuretic and mild stimulant and stool softeners. So very frustrating; I wanted to try and stay away from any med I could but my pain was just too much to handle.

    I have an appointment with my neurosurgeon this week to try and get a spinal stimulator, or implanted TENS unit, or RF ablation, or anything I haven't tried that is non-narcotic. My biggest challenge there is that I am on Medi-Cal and they are very picky about what they will cover. It seems like the county would rather medicate than treat pain.

    Well, thanks for replying. I pray you have a restful Sunday.
    mel0222 replied to trs1960's response:
    Oh wow Tim, I would be concerned if I were you! My blood pressure was similar to yours before my CHF and heart attack. My NP kept telling me it was because I was in so much pain...NOT! Yes, pain does increase your bp and hr but I would ask for an EKG or a referral to a cardiologist if I were you. Adding bp meds may save your life. I am such an advocate now for watching your heart for those of us on a pain med regiment for chronic pain. Don't just write it off as a result of pain. You are right when you say that you're damned if you do and damned if you don't but my doc and I are now monitoring my vitals and weight to know how to adjust my bp meds accordingly. Seriously, I wouldn't wait too long or buy a bp cuff and monitor it yourself at home; it's well worth the investment. Take care, Mel
    mel0222 replied to georgia888's response:
    Hi Georgia, thank you so much for the suggestions. I have tried aspirin, Tylenol, and Ibuprofen as well, however, unsuccessfully. I also take vitamin D3, calcium, and magnesium but have not added 5-HTP. I know that the three spices you mention reduce inflammation but really dislike all three. I know, I know, "buck up" and quit being such a baby, right?

    I eat mostly fresh fruits and vegetables because of my sodium limit pertaining to my congestive heart failure so I'm on board with that one. I eat very few, if any, unhealthy complex carbs which can also cause water retention and inflammation. I try to eat lettuce/greens but cannot use any salad dressings because they are very high in sodium so I can easily discourage myself. I have not tried the flax seed. I'm going to have to try both that and the 5-HTP, after checking with my doc.

    Thanks so much. Mel
    georgia888 replied to mel0222's response:
    Hi Mel,
    I make my own very basic salad dressing with Extra Virgin Olive Oil & Apple Cider Vinegar. I find that many of the spices/herbs can be easily disguised in this mix. If not, alone they are very tasty. Both the olive oil & vinegar are very healthy foods & don't contain the many additives found in most bottled dressings. Vinegar has many beneficial properties & of course, most of us by now are aware of the medicinal benefits of olive oil.

    Good luck,
    trs1960 replied to georgia888's response:
    Everyone is different and we all travel a long journey. Sometimes we can stay opiad free an sometimes not. Like Joy I too try and take narcotic holidays to cleanse my body and reset my opiad sensitivity

    I want to add that taking continuous high doses of aspirin and NSAIDs can be more harmful than opium.

    I read a book by a doctor Adams in which he felt strongly that the social stigma of opiads is killing people by falsely teaching them that OTC means safe and morphine means dangerous and addictive. The percent of addiction to morphine by chronic pain sufferers is single digit...low single digit. While aspirin and NSAIDs help reduce inflammation, they slowly destroy your kidneys, liver and stomach. That's why Norco was created for longer term pain control (still considered short acting) it is basically Vicodin, but much less acetaminophen per mg of hydrocodone to lesson the dangerous side effects of the acetaminophen.

    I'm not telling you to drop the aspirin and grab the morphine, just be aware that OTC drugs carry many risks that you need to be careful with.

    Aspirin derived from the white willow bark has been around as long as opium. Both have been used as analgesics for 3,000 years.

    Best of luck

    mel0222 replied to trs1960's response:
    Good morning Georgia and Tim, I gleaned a lot of great information from both of you.

    Georgia, thank you so very much for the salad dressing suggestion. I've been trying to find a solution to salad dressings because all of them are very high in sodium. I bought rice vinegar to mix with olive oil but haven't tried to mix it yet. Rice vinegar is a little sweeter than the apple cider vinegar. Do you know by any chance if the rice vinegar has the same healing properties as the apple cider vinegar? I just spoke with a trainer at the gym I go to and he mentioned that turmeric is in a capsule form. However, your suggestion of adding them to salad dressing is a fantastic solution as well.

    Tim, the information about OTC NSAID's is also great information. Actually, my mom was recently hospitalized because of them. She was taking Aleve for shoulder pain but was doubling the amount taken to make it prescription strength. She was admitted to the hospital for symptoms indicating a heart blockage somewhere. It turned out that she was extremely anemic. She had a bleeding ulcer and ended up needing 2 units of blood. I also know that acetaminophen is very bad for your liver.

    Those of us who have to live with chronic pain that is beyond help with natural products or OTC drugs are forced to choose between the lesser of more than one evil. Recently, because of my pain level increasing, because of my dysfunctional knees and back, the whole section between my knees and my lower back throbs and burns beyond what I can stand at times. It makes me feel like giving surgery a try. I figure it can't get much worse than what it is. But then I read of other people who have done the very same thing and have regretted it. This just sucks! I'm obviously having a hard time staying positive at this point. Mel
    trs1960 replied to mel0222's response:
    Ons last thing. everyone metabalizes each drug differently. Some drugs may not do anything for you, however they may knock me on my butt. NOt every drug reacts the sane to everyone

    I've leved with time on the couh with a PHD. The reading of mamy books condiered experts on the matter and some great doctors wprking on a conservatiyve approach to an anelgesic program. I educate my mind on how each medicine works.

    Amd after all that I may be ending my work career, I just don'w if I can continue,

    mel0222 replied to trs1960's response:
    Hey Tim, again, thanks for the information. I've never stopped to realize that each of us with our different metabolisms would process and react individually to pain medication.

    I think I hear discouragement in your reply. I am so sorry for your pain, as I am for so many people. It's kinda' crazy to me that I have no one around me who can understand my level of pain and frustration over how it limits and disables me. I feel judged on days that I just can't do my daily chores even. This social website is helpful in that I realize that there are so many people in so much more pain than I am. Also, I feel understood and affirmed.

    I've been in the process of getting my BA in Education but have been interrupted so many times because walking across campus is just too painful as well as even sitting at a computer for the time it takes to learn on-line. The combination of my knee and back just kicks my butt. I continue to read books as I can and hope to finish soon. I am learning so much about pain and alternative treatments and how to deal with it as well.

    I just saw my neurosurgeon yesterday to request a spinal stimulator or implanted TENS or RF ablation or anything else along that line of procedures. Unfortunately, I am on Medi-Cal for another two years before I qualify for Medi-Care. At this point, the only procedure Medi-Cal will pay for is a cortisone injection or surgery. My neurosurgeon stated yesterday that he had never performed the surgery I need to the extent that is needed. I think my next step is a second opinion. Again, I'll see if Medi-Cal will cover that.

    Hang in there Tim; one day, or sometimes one minute, at a time. Take care. Mel

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