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Problems with pain medication not lasting
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browndog posted:
I am new to the forum. I am 39 years old. I was in a wreck 10 years ago and broke C1-C7. I also have degenerative disk disease in my lower back. Several surgeries were performed to reconstruct my neck.

I am currently going to pain management and am prescribed;
75 micrograms of Fentanyl.
15 Milligrams of Oxycodone 4 times daily.
Botox injections in neck every 3 months for torticollis.
Muscle relaxers, meds for sleep, and meds for anxiety and depression.

My question is, does anyone else have issues with the pain medecine wearing off prematurely? The meds that I am prescribed do not give me relief for the time prescribed. Fentanyl patches only last 36 hours, when they are supposed to last 48 hours. Pain pills last 4 hours when they are supposed to last 6. Injections only provide 6 weeks of relief when they are supposed to help for 3 months.

I am interested in discussing an intracatheter drug pump with my doctors as an alternative to all of the prescribed medication. I am hopeful that this will give me more consistent and steady pain relief.

If anyone has experienced these same situations, or has moved from pain meds to a drug pump, your input would be greatly appreciated.
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tuloud54 responded:
Ouch! Sounds sore too me. Pls click to read my history.A lot of people have said the same thing.Kinda like mpg/your mileage may vary. The problem is running out a gas is an inconvenience but you do not suffer physically for it. When you have severe,chronic pain, you can tell exactly when meds quit working full strength. It has nothing to do with losing what little buzz you may get it just flat out hurts. Talk to your dr and be real honest.Maybe it's time to rotate meds. I wish you didn't hurt. Most here truly feel your pain. After 4 years of sporadic pain relief,I opted for a pain pump in Nov 2012.Since then,my relief is consistant. About a four on the pain scale versus 5 or 6. I take no other meds and hope to never again. If I have cut my life span in half then that is ok with me. Pain sucks but at least now it is no longer sucking the life out of me! Oly true pain patients know what I mean. Stay hopefully that every day doesn't need to be a hope my meds get the mileage promised.No way to live but good way to die basically. Take care and know you're in a good place with some pretty decent people here.
 
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browndog replied to tuloud54's response:
Thank you for your advise! I am wondering how you went about bringing the topic of the pain pump up to your doctor? I have done exstensive research on the Medtronic drug pump and it looks like the way to go. Also, am I supposed to tell my doctor about options or isn't it his job to keep me informed of various treatments? It's all so frustrating and maddening! I have suffered with cronic pain for 13 years and I will be 40 in sept. I have no quality of life other than moving from bed to couch and from couch to bed. I feel like I'm in the body of an 80 year old. But even my 90 year old great grandmother still drives, gardens, and keeps her house up. I'm so depressed. Thank you so much for your reply and I wish you good luck and good health!
 
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cweinbl responded:
YES!!! I've been monitoring people using Fentanyl Transdermal for many years. I've yet to hear from one person who said that she or he experienced pain relief from a Fentanyl patch past 48 hours. I know... the pharmaceutical company and physicians think that the patch works for a full three days (72 hours). Virtually everyone in my anecdotal group testified that the Fentanyl patch worked well for ONLY 48 HOURS and THEN STOPPED working.

If you feel that this is the case for you, inform your prescribing physician and request that your next Fentanyl Rx allows you to change the patches every two days, rather than three days. I think you'll find it a huge step in the right direction. Some people change the patch daily! Whoever testified that the Duragesic (Fentanyl Transdermal) patch works for a full three days should be shot. It does not come close.

The intrathecal infusion pump (what you called the "pain pump") is a last resort option - like the spinal cord stimulator. It should only be used when everything else has failed. Remember, surgery is required to implant and to remove the pump, which has only a 40% to 60% success rate. Morbidity is involved in almost all surgical procedures, including those to implant a "pain pump."
cweinbl
csw2@bex.net
 
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sybilangel responded:
I feel you! in the past i was also on the patch, however i had to use the brand which was Duragesic which i had to get because i was allergic to the glue on the fentanyl patches but like you they also only lasted 2 days and not 3. I was also on morphine pills also and was still in extreme pain and that was back in 2010 so i decided to just stop my pain management because i did not feel my pain management doctor was listening to me regarding my pain issues and i also lost something thru death and went into a deep depression and basically gave up, however i did not want to put my loved ones thru the pain i was dealing with. For a while my doctor tried to help me with my pain issues but unfortunately they can only do so much and i suffer with extreme pain everyday and they have referred me to a doctor that does the pain pump.I have multiple pain conditions i deal with everyday as i have had osteoarthritis that is now Rheumatoid and possibly Lupus and fibromyalgia and a lot of nerve type diseases but am limited to what i can take because at the age of 21 i had an operation that i now have Cirrhosis and am unable to take a lot of meds they are trying to give me. My heart really goes out to everyone out there that are dealing with chronic pain issues. Because myself personally i just want to be able to function as i will be 56 next month and feel like my life is over. So God Bless and i pray for all of you that are going thru all the pain issues because your regular Doctors can't do much for you and i find with some of these so called pain Management Doctors sometimes they treat you like your just there for drugs and personally myself i don't do illicit drugs and i don't drink either. Even with my health issues i look a lot younger then what i'am and that is a shame because i have the records to back it up. Good luck to you!!!!! Linda
 
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tuloud54 replied to browndog's response:
Pls read my discussions and history. My family dr had me on fentanyl 50mcg every 3 days and 4 5mg Percocet for a couple of years.This gave me solid relief.Dr referred me to pain mgmt. and they immediately took me off percocets.I really would do whatever they said because these are the supposed professionals. Right away I realized the patch was not lasting as long as promised.The Percocet were covering up for the short life of the patch. Nightmare with this pain dr telling me I would never be pain free. If I had been able to get consistant relief with whatever meds,I would not have needed the pump. Being in pain and withdrawals every month will weat your A$$ down. Need a caring dr that believes your pain is real. It is almost impossible with the dea being involved to get any dr to provide some comfort. No regrets but it should not be this hard. This was a last resort for me and I am grateful. Would do it again but really don't feel like I had a choice. My life is worth saving and that is what I've done. Ask dr all your options.Good luck. Painfully less,Tom
 
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cweinbl replied to tuloud54's response:
So sorry to hear about the doctor change and increase in pain. One reason that I use my family doctor for all medications, including pain drugs, is because of trust. I trust my doctor, who is also my lifelong close friend. In return, he trusts me.

I have no doubt that if I were to suddenly change to a pain management physician, she or he would be doing the same to me as has happened to you (taking me off the drugs that have worked well for decades).

The (Intrathecal Infusion) pump is NOT for physicians who wish to dump their chronic pain patients, for fear of going on an FDA list. The pump requires surgery to implant and to remove. All surgery entails morbidity.

What if you were to perish from MRSA infection as a result of having an implant only because your doctor didn't want to be seen as prescribing too many opioids? You can bet that this has already occurred repeatedly. The spinal cord stimulator and intrathecal infusion pump are for last resort options, AFTER it has been determined that the patient cannot benefit from or tolerate conventional oral, IM, IV or Transdermal pain medications.

In conjunction with conventional pain management techniques like biofeedback, injections and acupuncture, many of us with chronic severe pain have learned to manage our lives for decades with today's powerful opioids (Fentanyl Transdermal, Kadian, Oxycontin, Oxycodone, Hydrocodone, etc.). These powerful drugs enable us to remain a productive husband, wife, mother, father and employee.

But today we see doctors subservient to insurance companies and the FDA. As a result, chronic pain patients are often booted out of doctor's care, shuffled off to community pain management programs (where their effective pain medications are removed) and are made to feel like a drug addict rather than a chronic pain patient.

We live in an age when ironically the palliative end-of-life scenario makes the unconscious cancer patient comfortable, while the pain-filled conscious patient must suffer without the pain drugs that will allow them to remain a viable and productive member of society and her or his family. All of this is in the name of the doctor who fears the DEA, or the patient who slips between the lines of physicians who prefer not to prescribe narcotics.

Guess what, physicians? The Hippocratic Oath that you swore by upon medical school graduation does not have a sell-by date. You must obey that oath as long as you practice medicine. In this oath, you promised to do everything within your power to heal the sick, including the horrible discomfort of chronic pain patients. No, you are not allowed to shuffle these patients along to injection mills or pain management programs, where the trusting human being that you just dumped has become a stranger inside of a system that trusts no one. You may not discard a chronic pain patient just because they require drugs you would rather not prescribe, simply because you fear having too many Schedule II prescriptions on record. You owe your allegiance to your patients, not the FDA.

Doctors - wake up! How would you feel if you were in constant severe pain for months or decades, only to find that your doctor would rather not prescribe a narcotic - just for the sake of keeping the doctor's record clean with the DEA? What do you suppose happens to your patients after you dump them from your practice into an inhumane pain management program? When you next wash your hands, consider the human beings you have washed from your care (from your sworn oath), just so that you and your partners may avoid government scrutiny over Schedule II prescriptions. How would you feel if it happened to you or to a loved one?
cweinbl
csw2@bex.net
 
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tuloud54 replied to cweinbl's response:
Well said my Friend.Imagine you're the dr for a minute and can have all your privileges taken away by the dea even when writing needed scripts. Need to get dea out of drs offices but how? I'm from the gov't and I'm here to help!lol. Wish the drs would read your letter and at least somehow get this to the ama. This is just wrong but only pain sufferers and their loved ones know this. Any ideas how to fight this? Saw the Oxycontin Express on current tv and thought of contacting Maria van Zant to maybe present the flip side/our side. People have gotten high since walking upright,probable even wallowing in the muck. This is a totally different beast. I truly hope no one ever has intractable pain.There is nothing like it. I wish I could help but don't know where to start. Stay safe. Tom


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