How many drugs do you take?
How many drugs do you take? In early November of last year I decided I need to make an appointment with a local pain management doctor. Luckily a good family friend (www.drdaveysuh.com) is a doctor and thus has many different contacts and has helped me over the years find the appropriate care. He recommend I make a call to the office of Dr. Edward Shin.
Once the appt. was made I had to fill out all the normal paperwork. The generals, allergies, previous surgeries, previous medicines, etc. I always laugh at the small amount of space given for previous surgeries. I usually just put the major ones as I really can't even remember them all. Dr. Shin was very thorough at first examination of the paperwork. He asked me to list as many surgeries I could think of and when they were. After that was finished he explain who he was, what he did and the process of pain management. Basically I rattled off my aches and pains and he gave me a few options. I then told him my history of visiting my primary physician and how he would only write me scripts for Hydrocodone and that I usually had to take much more then prescribed to escape the pain I was in. He informed me that most doctors were not able to prescribe anything more then that because of all sorts of different laws. Basically most doctors are afraid to prescribe anything stronger because of the paperwork required and attention they would get. My primary physician is a kick ass guy so I don't blame him.
After the first visit Dr. Shin prescribed me Fentanyl (25MCG/HR patch) and Hydrocodone (10MG/500MG). At first this combination worked really well. Other then the smaller more manageable headaches the Hydrocodone gave me, I felt little to no pain the majority of my days and the biggest improvement was my new found ability to sleep through the night. However, I wanted to sleep a lot, like all day. The urge was nearly irresistible. I could easily sleep most of the day if I didn't make myself get up and stay active. At first this was really nice because my ability to get a good night rest has diminished over the years as a result of the various surgeries. My neck and shoulders constantly hurt and I rarely have a moment where I don't have a headache. I've always been a side sleeper and since I begun using the wheelchair I haven't really been able too. The size of my shoulders makes it pretty hard to sleep on my side now. Ultimately I simply got tired of all the pain and wanted to feel what it was like not to hurt. I've always known pain, it's been a part of me for as long as I can remember but I had enough. So boy ... this new combination really helped. Unfortunately the day my prescription ran out and I had a few days before my next visit to Dr. Shin I became grossly ill. I felt terrible! I was anxious, I couldn't sleep, I couldn't sit still, I wanted to puke but I wasn't eating, I wanted to drink but then I would puke. I felt like a drug addict who needed his dope. I never wanted to feel that way again so when I went for my follow-up with Dr. Shin I told him all of this and he explained to me why I felt that way and how I was going through withdrawals but that was uncommon because of the small amount of time I had been using the meds. None the less, never again.
So Dr. Shin explained yet again my options. He said their was only four meds in this category, Fentanyl, Oxycodone, Methadone and Morphine. He recommend I try a low dose of Morphine (30MG) combined with Oxycodone (10-325MG). After my initial intro with this new meds (take one the first day, wait a day, take second, etc) I immediately tested if I would go through withdrawals if I stopped taking them. I didn't so that was nice. However I still slept too much. This side effect simply doesn't work for me. I have a full-time job and usually just as much contract work to do on the weekends. I simply can't afford to sleep. Not to mention how crappy you feel about yourself when you sleep this much. It's easy to become very depressed when you're not accomplishing anything. I normally run best on six hours of sleep, maybe a little more. If I get a full eight it's hard for me to get up. So 12 or 14 hours was killer! So what am I doing now? I'm back dealing with the pain the best way I know how. I do my best to stay as busy as possible. As long as I'm distracted I'm not so bad. Of course my pain never goes away but at least I'm not passed out on the couch while everyone else is living.
One last thing that freaked me out a little. Dr. Shin never once measured my breathing or explained the side effects of any of these meds (before I took them). They all effect your respiratory system in some way right? I also told him that I felt like I was getting a bigger dose right after I got out of a hot shower and he said that didn't matter. However, Fentanyl is affected by body temperature. Odd doc. He simply wrote the next script and said see ya' next time. I took my best friend Paul with me one visit so someone would believe me. This raises interesting concerns because of the severity of these meds. I imagine it's just as easy as someone with "fake pain" to stroll in and get whatever they want as long as they say the right words. What's the answer? I don't know but damn it seemed to easy.
So if you are taking strong pain meds and not getting anything done. Stop. Figure out a schedule that works for you and stick to it. If that means you have get up at 5AM, work and then take a nap at 11AM then do it. Make sure you stay active any way possible. Also be honest with yourself and your loved ones. Tell them how you feel and what helps and what doesn't. Clean your house, room, car, whatever. Get to the gym, wheel around the block, pick up sticks in the front yard. It doesn't matter what you do as long as you're doing something I swear you will feel better. I've always believed that a strong positive attitude is much more potent and effective then any med a doctor has prescribed me. I just wanted to try the dark side. Am I saying I will never take another pain med again? Of course not. There are days it's necessary to make it through but on those days, good ol' Hydrocodone or hell even Advil will be suffice.
I'm anxious to hear other gimps story in regards to pain meds. Let me know your story, send me an e-mail.