Pain Management

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Pain Management

Post  7777Trinity on Fri 11 Oct 2013, 6:34 am

We went to Lexington, KY this week to see the Pain Management doctor I was seeing in 2007 when we lived there. We went over all of my options and have a new temporary treatment plan.

First, because we noticed whenever I have had a surgery and have been on pain meds, I would not have a migraine. So he put me on Percocet three times a day and I will see him in 2 months to see how this is working. I still have the Relpax if I get a head banger.

Second, there is a doctor in Franklin, TN with a newer implanted stimulus procedure that we may check out.

Third, there is the doctor in Boston, MA doing nerve decompression surgery for migraine treatment.

I think long term, I want to try the 3rd choice and in the meantime stay on the Percocet. Too soon to know if this will work, but I have hope!

Trinity
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Re: Pain Management

Post  tortoisegirl on Fri 11 Oct 2013, 9:51 pm

I hope this is helpful. If you decide to stay on the daily opiate pain meds, you are probably better off on a long acting medication, plus one that doesn't contain Tylenol or other analgesics. I imagine this doctor want to see how you do first though. Is it feasible to see them every month for a new script, or will you need a local pain doc?

I'm surprised you got two months worth, especially to start. They are getting pretty strict with pain meds now. I had to sign a contract (including random drug screens and to agree to not get pain meds from other doctors), plus I have to have an appointment every 4 weeks to get my scripts. If I was more stable they might let me pick up my scripts from the office in between appointments every 2 or 3 months though.

The daily pain meds have been the only thing to significantly help me. I have developed a high tolerance though, which is an issue going forward. Everyone is different, but methadone is the most helpful med for me. So glad this doctor was willing to let you try it. So many doctors are anti-opiates for all headache patients.

What doctor in Boston? Nerve decompression surgery scares me since they physically mess with the nerves and there is a chance of some permanent damage, but there have been some limited promising results. Same with some of the doctors doing nerve stim procedures. Best wishes.

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Pain Management

Post  KimbaK on Tue 15 Oct 2013, 9:53 am

Hey Trin,

I'm glad they are looking at different options. I know that my treatment plan seems to be fairly effective. It includes 15mgs of Morphine Extended Relief every 8 hours. I have Oxycodone for breakthrough pain with Relpax as my first line of defense. I think I am doing better than when I was just taking the Norco PRN. I wasn't too thrilled to try the morphine. I was worried about being stoned all the time and becoming addicted. That hasn't happened, thank you God!!! I don't feel any kind of pull to take morphine.

I'm still not pain free, but most days I am more functional. I don't feel stoned or exhausted all the time either. That's been a plus. And my purse does not rattle like a portable pharmacy. Sometimes, I've even forgotten my middle of the day dose of morphine. It may catch up with me later in the evening though.

I still plan to see the neuro in Houston next month. I've read a lot of favorable things about her as a physician.

K

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Re: Pain Management

Post  Platypus on Wed 16 Oct 2013, 12:07 am

hey trinity,

sounds good that you have some new treatment and new options. i agree w/ tortoisegirl -- i would ask the pain specialist if you can switch from percoset to oxycontin. both are oxycodone but oxycontin doesn't have the tylenol, and tylenol gets implicated in more and more body damaging ways all the time. the FDA has started pulling meds that contain too much tylenol.

i've been on lisinopril for a few weeks which you had some initial success with. do you remember why you went off? i had 6 HA free days but then they came back Crying or Very sad 

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Re: Pain Management

Post  7777Trinity on Wed 16 Oct 2013, 12:20 pm

Platy
I went off the Lisinopril because it worked initially but then didn't last.
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Re: Pain Management

Post  7777Trinity on Sat 26 Oct 2013, 7:33 am

Update:

The Percoset was a horrible drug for me. I was mean, cranky, irritable. My skin itched like crazy and I scratched till I bled. I was constipated to the point I thought there was concrete in my bowels. Not to mention I felt so drugged...ugh.

If I could have worked through any of that it might have been a good plan, I was taking it 3 times a day and had no migraines the entire time, 9 straight days in a row. I called Pain Management to see if we could switch the med to something else and he said no. So I am off that med.

Went to PCP and asked for Elavil, I had read this might help as a prevention. I started it on Wednesday. He said it has been shown to increase our pain threshold and he never prescribes it as an antidepressant med, but uses it for fibromyalgia, migraine and other things.

I did not look up the side effects because I don't want to sabotage myself. So we'll see if this works, he said it will take about 2 months to get in my system, so I am hanging in and trying this.


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Re: Pain Management

Post  milo on Sat 26 Oct 2013, 8:34 am

Percocet worked for me as a rescue. If I took it regularly it would give me a headache that I call my percent headache. For this reason I only used it to rescue. I certainly couldn't go on it three times a day. I'd be such a b with an itch! It's one of the meds that makes me really irritable.
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Re: Pain Management

Post  sconesail on Mon 11 Nov 2013, 9:54 am

Trinity,

So sorry to hear that the Percocet didn't work. I am sort of surprised that he wouldn't switch you to another medication- there are many that don't have oxycodone. I know this must be extremely disappointing for you and it also leaves you with nothing to treat the pain.

I know you mentioned you had taken pain meds after surgery- do you remember what medicine helped the most. (I know I have been given Lortab, Tylenol 3, and vicodin.) Lortab and Tylenol 3 worked best for me. I was also on long acting Morphine for a while and took immediate release Morphine for break through pain.

Is there anyway that you can make another appointment with your pain dr and see about switching to something else? I know that sometimes seeing a patient- especially with the new laws-makes it a little harder for them to ignore the problem.

How is the Elavil working? Nortriptylene was one of the first preventatives I tried. However, it actually made me depressed and I had very little energy.

I have an implanted occipital nerve stimulator and that has helped me.

Anyway, I really hope that things get better for you soon.

Pain free days,
sconesail

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Re: Pain Management

Post  7777Trinity on Tue 12 Nov 2013, 8:17 am

Hey Scone
The Pain Management doctor would not switch me to Tylox, which I can tolerate. The Elavil is not bothering me at all. I feel fine but so far don't notice any change. My PCP said it takes about 2 months for it to kick in so we'll see.

Thanks for checking on me, I really appreciate it.

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Re: Pain Management

Post  Platypus on Tue 12 Nov 2013, 8:03 pm

Tylox is the same as Percoset: Oxycodone + Tylenol. You might ask your doctor(s) for Fiorinal w/ Codeine which many migraineurs swear by. It contains a 4 ingredient cocktail which is very effective: aspirin, butalbital, caffeine and codeine. Explain that you need this as a rescue medication for breakthrough pain, i.e. when the Elavil is not enough.
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