|| PAIN MANAGEMENT || I'M BROKE || I'M BROKE BUT PLANNING TO TRAVEL ANYWAY ||

[twoapennything]

BTW, I really appreciate you guys hanging in there with me as I bitch and moan about my health. My goal for 2009 is to regain my health fully and to implement strategies for pain management that are helpful and not all-consuming.

I had this long entry typed up whinging about why I'm on pain management, but I deleted it because, really, who wants to read that shit? LOL! Basically, I am on clinical pain management for arthritis in my knees (I'm trying to stave off full knee replacements as long as I can, and quite honestly I don't know why my knees are so crappy. I had my first knee surgery when I was 15 and my second when I was 16, for a condition called Plica Syndrome. I think there might be some nefarious genetic thing going on . . .) Anyhow, I don't like the way I feel when I'm taking narcotics every day; I can't take NSAIDs because of the GI bleed I had last year from ibuprophen, and really it's too bad because ibuprophen works really well for me. I was supposed to see my doctor Thursday, but I cancelled because of the blizzard and I ran out of pain meds last Tuesday. God almighty, let me tell you what: opioid withdrawal - and I'm having a very minor bout of it, just to be clear - is horrible. Just UGH. No wonder heroin addicts keep going back to the drug! I did some research online and found a forum post that had some really great suggestions for dealing with minor opioid withdrawal more holistically that mainly involves a structured daily schedule, NSAIDs (obviously, I skip this step), exercise, outdoor activity, vitamins and treating individual symptoms of the withdrawal with various medications (i.e. a Unisom for insomnia; Clonidine for anxiety/creepy crawlies; Immodium for stomach upset *hemhem*).

I don't like feeling like I am going to be that person who is eventually an invalid, and whose life revolves around pain medication and doctor appointments. I have lost 125 pounds in the past 18 months and I didn't do that in order to become a reclusive sickly woman. I still want to peel off another 40 pounds and I can't do that if I'm not exercising, and I can't exercise if I'm not feeling tip-top (well, okay, we all have our days where we're not feeling tip-top, but you know what I mean - in general, we need to feel okay most of the time). So, it's important to me that I change my pain management regime - I've been on 22.5 mgs of oxycodone (Percocet) for 11 months now, and I'm just not happy with that. As you all know, my health has been awful this past year and I can't help but believe that being on narcotics full-time contributes to how I feel emotionally and mentally, and when one is feeling generally sedated, maybe depressed, maybe dull-minded, then everything is affected negatively.

So, yeah, I'm here, in my fifth day of opioid withdrawal, determined to make some changes in my life that bring more of a balance to my personal health and weight loss goals. Mainly I feel okay - the anxiety is the symptom that I'm finding most uncomfortable, and I've experienced it only one day (yesterday) so far. Coincidentally, Ariel takes Clonidine, so I filched one (Mother of the Year moment, yes) and it did help alleviate those symptoms.

I'll call on Monday to make a new appointment with my pain doctor, but I plan to discuss my treatment regime with him in depth. I'm not sure if this is the pain management clinic for me ultimately, to be honest. Long story short, although I was originally referred to the pain management clinic for my arthritis, I have two other conditions that require pain medications, and when you sign onto pain management, you sign a pretty thorough contract about how you will handle your pain medication needs. Essentially, you agree that you will under no circumstances fill any narcotic prescriptions from any other doctors, hospitals, urgent care centers, etc. I understand this is to reduce incidents of "doctor shopping" and try and prevent severe addiction (to give you a comparison, a hardcore pain pill addict can easily take upwards of 20-50 pain pills per day, or more; you can imagine the level of withdrawal that comes with that kind of narcotic consumption). Anyhow, when addressing one of my pain issues that the oxycodone doesn't work for, they immediately wanted to put me on the Fentanyl patch, which, NO. Fentanyl is a whole 'nother level of narcotics* and . . . JUST, NO.

I think it's time for me to do some research into alternative pain management clinics, ones that provide a more well-rounded approach. Narcotics are sometimes necessary and understandable, but there are other tools, such as TENS units, acupuncture, massage, non-narcotic nerve blocks, etc.

*Fentanyl is an odorless, rapid-acting opioid (or synthetic opiate, narcotic analgesia), which depresses central nervous system and respiratory function. It is the most powerful opioid known, with a potency approximately 80 times that of morphine and 100 times that of heroin. (Wiki)

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I have $7.34 in cash until I'm paid on the 31st. LOLOLOLOL!!!! Because, really, how lame is that? One of my New Year's Resolutions this year was to not use credit cards anymore and to pay cash for everything (I have a few exceptions to this rule, such as buying plane tickets, etc). We have a set budget and we're sticking to it. IT'S REALLY HARD! *FLAIL*

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Here are, hopefully, my upcoming travel plans. April: possibly Las Vegas to visit cryptaknight and to see The Cure (Liz, I'm still waiting on the funds that would facilitate this). May/June: Birmingham to visit longtimegone! June: New Mexico and Arizona, roadtrip to Orme for the annual reunion. It's not my reunion year (I'm class of '87) but a lot of my friends from high school are going, and I would really love to see them, and also to show Shawn and the kids where I went to high school and what that experience was all about. Then, we plan to visit the Grand Canyon, which Shawn really wants to see. I hope to visit my cousin and aunt in Phoenix while we're there, too. And, of course, to visit my New Mexico friends on the way there/back. August: Roadtrip to Hudson Bay, Saskatchewan, for a week on Shawn's father and step-mother's farm. Total R&R, and I have not yet gone up with them to the farm. Shawn's dad and stepmom are awesome, and it'll be good to see them again, and hopefully Shawn's brothers and sister, too.

Comments

[aome.livejournal.com]

I'm going to be getting some nerve blocks for pain next month. If they make them for knees, definitely worth pursuing. I also have heard good things about accupuncture/pressure. I'm all about avoiding oral meds whenever possible, so I definitely hope you can find something that works for your knees.

Btw, I wish we lived closer. Then you could pick me up and realize just exactly what you're NOT carrying around 24/7 anymore. :D Congrats to you!

[twoapennything.livejournal.com]

Would you remind me where your pain is again? I'm blanking. I did do the Syn Visc injections in November and those actually did help quite a bit. I can have them done every six months. I know that nerve blocks are used a lot with back pain and sciatic pain.

My kids together weigh about 130 pounds and it amazes me to look at the sheer volume that amount of weight represents! Thanks for the well wishes :D

[aome.livejournal.com]

Are you on my medical filter? If so, I did a post on the source of the pain on Thurs (2 days ago), and you can read all the TMI (no, seriously) over there. If you're not on the filter, and don't want to be on it as a general principle, I can email you about it. Just let me know. :)

Btw, I LOVED that "Dr Feel vs Dr Phil" bit on SS. :D

[twoapennything.livejournal.com]

I'm not sure! I will go check to see if I can see the post and will let you know.

Dr. Phil amuses me ;P

[twoapennything.livejournal.com]

Hey, Plu, I'm not on your medical filter -- would you add me? I obviously missed the call for that filter. If you wouldn't mind adding both my journals, I'd appreciate it. I'm sorry you're struggling with pain, too. MEH!

[aome.livejournal.com]

I've added both journals. The post in question is here. It's definitely TMI but not overly graphic. (You'll see when you get there.) Most of my medical-filter posts are about my battle with Crohn's, but this one ... isn't. :P Anyway, if at any point you want back off again, just let me know. :)

*hugs* Hope you can find relief soon - you've definitely suffered enough of late!

[prunesnprisms.livejournal.com]

I'm cheering for you over here. I have a lot of sympathy for what you're trying to do for yourself and I want to see you succeed.

[twoapennything.livejournal.com]

Thank you ♥ I want so much to succeed, too, and I feel like I need to take my self care to a more holistic and well-rounded level. Otherwise, I feel like I'm just living day-to-day dealing with one symptom or another. I'm too young to live like that - not that I ever want that to be my norm.

[xturtle.livejournal.com]

Having just finally been diagnosed with plica problems in the knee that I've been having problems with for 20-odd years, I feel your pain (well, that pain, at least). Hoping for surgery this spring to finally get rid of the unbearable pinch-pop between my patella and femur.

I work in a University department that focuses on integrative medicine, and have seen both Mindfulness Based Stress Reduction and acupuncture work for chronic pain conditions. Haven't used them myself (I do meditate and find relief, but can't do acupuncture due to highly generalized needle phobia) but seen crazy awesome results. You should be able to find a clinic that will integrate "alternative" and "conventional" therapies to minimize narcotic use. You also might want to look into warm pool exercise, which can be both good therapy and good, limited-impact exercise.

[twoapennything.livejournal.com]

Oh, I'm sorry to hear that you have Plica! I will say, though, that the surgeries I had did alleviate the pain and 99.999% of the popping and grinding. Okay, so I had my knees done in 1985 and 1986 respectively, so we're talking almost 25 years ago . . . but make sure and talk to your surgeon about not exacerbating joint deterioration through the actual surgical procedure itself. My last two orthopedists thought that the Plica procedure might have contributed to the early deterioration of my knees. I do not have arthritis anywhere else in my body.

I'm so into the integrative approach and it makes so much sense to me. It bothers me to approach EVERYTHING from a pharmaceutical standpoint. Sure, there is a time and a place for regular medications. But that can't be the only solution offered. I myself am not fearful of needles, so acupuncture is an option I'm willing to explore. I have an irrational aversion to the smell of swimming pools, so water therapy can be a challenge. The problem I've had is finding a clinic that isn't completely polarized, either anti-narcotics or anti-integrative.

[primaflora.livejournal.com]

I *love* our TENS units, very easy to use.

What's your blood pressure like BTW? Clonidine drops blood pressure so is seriously contraindicated if you are below normal. I like clonidine, was so sad when ::ahem:: someone in this household stopped needing it.

[twoapennything.livejournal.com]

Blood pressure runs slightly high, actually, which is why I felt okay filching the clonidine. Because I only have $7.34 until pay day, I can't pick up one of my usual BP meds, so I'm considering the clonidine to be therapeutic ;p My blood pressure is the only residual issue I have still since losing weight. All my other co-morbidities have resolved completely. I tend to run around 140/90, which isn't horrible, but it always was very normal 110/70 until a few years ago.

I'm having Shawn look for the electrodes for our TENS right now!

[quidditchgrrl.livejournal.com]

*wince* It's a good thing you are actually aware of the effects of narcotic pain relievers and motivated to get off of the wagon, esp. with your inability to take NSAIDs. (Are you able to take kids' doses of the liquid stuff? I can tolerate a 60-lb kids' dose if I sip it slowly. Not that it'll kill all the pain, but it takes a bit of the edge off.)

You might be interested in holistic/vitamin therapies for pain/depression. I've been looking into Vitamin D and Omega-3 supplements as emerging treatments for mood disorders and depression. Also, they're turning out to be important to maintaining skeletal integrity with post-WLS shrinkage. FYI and all, YMMV.

Feeling you on the $$ issue - only I'm trying to make mine last until April 7th *ded* I feel like I'm in college again(only with more pantry options than generic mac n cheese, ramen, and stale iced tea bags)!

[twoapennything.livejournal.com]

Yeah, but, man, even being highly aware of the effects of narcotics, I have to say that the cumulative negative symptoms rolled over me pretty subtly. This is a wake up call. Just because a doctor gives you certain medications doesn't mean it's in your best interest to just take the meds carte blanche.

Thanks for the heads up re: post-WLS skeletal integrity. I definitely am into holistic treatments and supplements. For me, diet is also a major factor. I tend to carb out big time, which makes me feel like crap.

Hey, thanks for reminding me - I have stale tea bags in my cabinet! But seriously . . . ugh.

[pumagrrl.livejournal.com]

I hope you can get rid of the pain eventually.Pain sucks. *sending good vibes*
And go you for sticking to your budget and not using credit cards!

[twoapennything.livejournal.com]

Thank you :) I made it through the day without losing my mind! At least it shouldn't last too much longer. I'm actually trying to sleep through it as much as possible.

I think the credit industry tries to fool people into thinking that they HAVE to use credit cards in order to have a good credit score. I'm beginning to think it's a big conspiracy, to be honest. Like it's a bad thing to, you know, just pay cash? WHATEVERZ!!!!

[pumagrrl.livejournal.com]

I've actually had the same though. They're tricking you into using credit card so that they can make lots of many from the interest you pay. Despite the financial crisis, they're pushing credit cards and loans like never before. I'm completely disgusted with them. Thy even call you and run after you in malls.

[piperki.livejournal.com]

Can you at least take some Tylenol? It doesn't cause the bleeds, right?

Wow, that doesn't sound like fun, dude! Good luck.

[twoapennything.livejournal.com]

Yes, I can definitely take Tylenol and I find it works really well for me for, like, tension headaches. Unfortunately it's not a good med for me for joint/arthritis pain, alas. The oxycodone that I'm prescribed is actually a combo of 500 mgs aceteminophen and oxycodone. It does not cause the bleeds normally, no.

I'm positive that I'm going to be okay. It's just a matter of working through this and finding the right path and the right care providers. I'm an eternal optimist :D

[cathouse-mary.livejournal.com]

Amendment 20 does mandate medical marijuana for pain control. Mom has had to go off the opioids and we're in the process of getting her approved. There are loads of doctors and dispensaries in Colorado, and alternatives to smoking the stuff, too.

[twoapennything.livejournal.com]

Hmm, interesting. I had not thought about medical Marijuana, to be honest. I have absolutely no moral issue with marijuana -- I feel like in a country where alcohol and tobacco are legal, substances that kill more people than probably all other drugs combined, it's patently absurd that weed is illegal. I'm actually familiar with the medical marijuana process, too, as I've had four probationers who have used it for various conditions, including Tourette's Syndrome and AIDS.

I just have to tell this story briefly - my probationer who used marijuana to treat his Tourette's was especially interesting. I met him before he got his MM license and his tics were constant and extremely disruptive. I have to give the kid credit - he totally waited until he was legal to use marijuana before, well, using it. He was patient. Anyhow, the first time I saw him after he began using marijuana, his tics had completely disappeared. I'm talking a kid who was on SSI for Tourette's. It was very eye-opening, seriously.

As for myself, again, I don't have a moral issue with weed. I haven't smoked it since, God, probably 1991? I did not like pot - at all. It made me extremely paranoid and nauseated. Aside from smoking it and eating pot brownies, are there other/better delivery methods? Because of my job, I'm not sure this would be an option for me realistically . . . but is it really worse than narcotics? Technically, probably not.

[cathouse-mary.livejournal.com]

http://www.naturalalternativesforhealth.com/index.html

This is the most informative site and most helpful organizations that I've found. You can see that there are lots of alternatives to lighting up on the right hand side of the page. Mom likes the idea of marijuana pastilles, for when the pain is bad but it's not acceptable to fire up. She also like the idea of magic brownies, or spaghetti sauce or what have you.

The paranoia might be a function of the massive delivery of THC. I'm frequenting MMJ boards to find strains that will not knock my little old lady mother on her ass. After all, she has not smoked since the seventies! I've had cannabis ruderalis indic pointed out to me as a very mild strain, or one of the hybridized sativa/indica mixes like Bubblegum and Bubbleberry.

Man, and you though rose-breeders were obsessive...

[shewalksonroses.livejournal.com]

<333 Much love to you, sweetie. I'm proud of you, both for taking a proactive approach to the pain management issues AND for the cash/credit/budget stuff! :D