Chronic pain management


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So who has chronic pain? How do you manage it - whether medically, psychologically, holistically, via kittens, etc.? Has anyone ever found a solution that actually works, at all, even just a little? Or failing that, how do you keep your sadistic nerves from driving you into abject despair?

This is my story. Telling it not in an effort to get any specific medical advice or anything (though if you know what you're talking about, I'm all ears). Honestly not even sure why I'm sharing at all. Chalk it up to catharsis I suppose. Also: this is a gaming site as opposed to one related to medicine, pain, therapy, etc. I am aware/don't care. Will try to limit medical jargon.

Poor Me :'( :

Have dealt with two forms of chronic pain for many years. First is in the lower back; specifically a sacroiliac joint which frequently flares up and causes sharp, shooting, excruciating pain. Second is in the sternum. Although it's technically classed as costochondritis (aka, inflammation of the cartridge in the rib cage), it's also related to a deformity called pectus carinatum (a weird protrusion/bump in the sternum). Wake up most days with breathtaking sternum pain that can take hours to dissipate. If it dissipates at all.

Tried so many anti-inflammatories that I've lost track. Literally not a single one has had any effect, ever. Corticosteroid injections? Lidocaine injections? Neither does a damn thing. Actually that's a lie: pain and inflammation increased quite a bit after either, often for days. Numbing agent my sweet arse.

Can't take opioids because they cause major illness (aka opioid-induced nausea and vomiting). NSAIDs might as well be sugar pills and Valium has no appreciable analgesic effect. Carisoprodol (Soma) helps somewhat and am thinking of asking for Flexeril to see if that might do anything. Haven't tried tricyclic antidepressants yet. Occasionally use herbal supplements (if you catch my meaning), but the side effects make me useless more than is preferable.


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GV:

I had a co-worker (who has since retired) who had the misfortune of only being able to use the 'newest' wonder-painkiller on the market, and invariably it'd get recalled within six months to a year because someone developed one of the many disclaimer'd health issues surrounding it.

Personally?

I used to take 800mg ibuprofen every day before I'd start work, and then another 4-600mg halfway through my shift.

I was at the point I was having a *migraine* every other day and *everything* hurt.

Co-worker put me up to a challenge of going 'clean' for a month.

That was in July, 2012.

The first two weeks were gawdawful. Then I actually started to be able to 'feel' out what as a real *pain* and what was *imagined pain*.

A week after that 'clean' period, I got a migraine (a change-up from every couple of days). Took aspirin for it. Did nothing. Best cure was cool quiet room with cold ice pack and everything shut off.

Aside from the dentist and a trip for an exam recently, I haven't had any sort of painkiller/anesthesia since August, 2012.

Sure, it means I have to move slow for some things when I feel actual pain, but overall it's been the best thing for me, at least?

Grand Lodge

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Sorry to hear it GV. Wish I could offer some insight, but my issues are pretty minor. Joint pain around the knees, and some intermittent aches around the back and chest. I take ibuprofen when it seems really bad, but otherwise don't do anything. But then, I've never had to deal with it for hours on end.


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Meditation seems to help me some, as does - surprisingly - tai chi. Tai chi hurts like the devil while I do it, but I can move and walk more freely after and with much less pain.

I agree with Wei Ji: get off everything you can. I went from 2.4 g ibuprofen daily to a target of 0. Now if I am having a terrible day, I can take 400 mg and feel relief.

When I had to take opoids after recent surgery, they gave me this along with them: Ondansetron 4mg Tablets. It's an anti-nausea drug to help tolerate the opoids. Otherwise the pills and patches have me retching all day long.

Oh, and watching things you find funny or playing video games is supposed to help a lot. You focus on those things and not on pain. I think laughter also releases some arcane substance that makes you better; hilariphins or something.

One extreme therapy recommended for people with lots of inflammation (which can cause lots of pain as well as asthma, anaphylaxis, etc.) is to eat clean and near starvation: 600 calories per day made up of organic fruits, veggies, and meat. No packaged foods, no breads, etc. It's brutal, but if it helps...

Best of luck. Chronic pain is no joke. My dentist said she had a sinus infection that pressed on one tooth root and now understands why people come to her nearly crying and beg "just take it out, I don't care anymore."

Hang in there.


I have chronic pain in my back, both legs, and the occasional migraine. I take Norco (hydrocodone) twice a day to help manage it. I supplement them with Tylenol at least twice a day when it's really bad. The chronic pain along with some pretty bad psychiatric issues combine to make me disabled and unable to work, which I sometimes miss pretty badly. It gets kinda dull sitting around the house all day.


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I strongly recommend seeing a Doctor of Osteopathy (DO) rather than an MD. MD's first instinct is to disbelieve you are in pain, and then to prescribe opioids. A DO has an additional specialized set of tools called Osteopathic Manipulative Medicine (OMM).

Changed my life. Even relieves migraine headaches.


I agree with Treppa. Tai Chi helps a lot. Fortunately, it doesn't hurt when I do it.

I have repetitive strain injury in both arms, triggered by stiff shoulder musculature. The excercise helps to warm up and relaxe the muscles. I occasionally have to take ibuprofen or use a diclofenac-based salve, though.


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BigDTBone wrote:

I strongly recommend seeing a Doctor of Osteopathy (DO) rather than an MD. MD's first instinct is to disbelieve you are in pain, and then to prescribe opioids. A DO has an additional specialized set of tools called Osteopathic Manipulative Medicine (OMM).

Changed my life. Even relieves migraine headaches.

Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.


Fabius Maximus wrote:
Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.

Are you sure you aren't confusing Doctor of Osteopathy with chiropractor?

Osteopaths are physicians who are licensed by the state and allowed to practice in hospitals just like people with an MD. There are even DOs who are full professors on the faculty of major Tier 1 university medical schools. For example

University of Michigan Medical School


CrystalSeas wrote:
Fabius Maximus wrote:
Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.

Are you sure you aren't confusing Doctor of Osteopathy with chiropractor?

Osteopaths are physicians who are licensed by the state and allowed to practice in hospitals just like people with an MD. There are even DOs who are full professors on the faculty of major Tier 1 university medical schools. For example

University of Michigan Medical School

Pretty much this. DO's are legit doctors. Allopathic doctors tend to spread the same misconception that Fabius has.

Fabius, don't take my word for it. Insurance companies pay DO's for OMM services. If they were bogus do you think that would be true?


BigDTBone wrote:
If they were bogus do you think that would be true?

Fabius, if they were bogus, do you think they'd have a faculty bio page at the University of Michigan Medical School?

I suspect you're confused by the terminology. Osteopathy is not chiropathy.


Folks, this back and forth about medical practitioners isn't really answering the OPs question.


Continuing the derail -- "osteopathy" means something different in the US than it does in Europe. From Wikipedia:

Quote:

In the United States, osteopathic physicians are trained and are certified to practice medicine. They represent a branch of medicine called Osteopathic Medicine. Osteopaths trained elsewhere are trained only in manual osteopathic treatment, generally to relieve muscular and skeletal conditions, and are referred to as osteopathic practitioners.[5][6][7] They are not allowed to call themselves Osteopaths in the United States to avoid confusion with certified physicians. In the United Kingdom, France, Germany, Australia and New Zealand osteopaths are registered and regulated by law as therapists but may not practice medicine (although Germany, like Canada, allows US-trained osteopathic physicians to practice).

Thus Britain's National Health Service advises that, while there is "good" evidence for osteopathy as a treatment for low back pain and "limited evidence to suggest it may be effective for some types of neck, shoulder or lower limb pain and recovery after hip or knee operations", there is no, or insufficient, evidence that osteopathy is effective as a treatment for health conditions "unrelated" to the bones and muscles, "such as headaches, migraines, painful periods, digestive disorders, depression and excessive crying in babies (colic)"; an explicit reference to the claims of osteopathic manipulative medicine.[8] Osteopaths are not certified for medical practice in Britain, while European osteopaths are not allowed to practice in the USA lest they be mistaken for physicians who are still commonly called osteopaths there. Hence studies prepared in different countries must be applied with care in reference to one another.

Osteopathic medicine as practiced in the States -- e.g, Osteopathic Manipulative Treatment -- has been shown in peer-reviewed studies to be effective in medium-term pain reduction of certain types (including, for example, migraines). So it might be worth looking into.


Hey guys, thanks for all your feedback. I appreciate it. Also a disclaimer: I am currently on those herbal supplements I mentioned, so yeah. A bit out of it. Mind is a-swimming', though not too much. Still, probably gonna be a semi-rambling post. Will split it up for brevity's sake. Anyway!

-----------------------

Wei Ji the Learner wrote:

I was at the point I was having a *migraine* every other day and *everything* hurt.

A week after that 'clean' period, I got a migraine (a change-up from every couple of days). Took aspirin for it. Did nothing. Best cure was cool quiet room with cold ice pack and everything shut off.

I didn't mention it in my post, but I too get frequent migraines. Mine are like clockwork: when major pressure fronts move it, that's my hell time. I take Fiorinal (combination aspirin, caffeine, and barbiturate) and it works quite well. I've tried non-medicinal approaches like the ones you noted, but other than massaging my temples, there are very few notable benefits.

TriOmegaZero wrote:
Sorry to hear it GV. Wish I could offer some insight, but my issues are pretty minor. Joint pain around the knees, and some intermittent aches around the back and chest. I take ibuprofen when it seems really bad, but otherwise don't do anything. But then, I've never had to deal with it for hours on end.

Hey man I appreciate the kindness, but it is what it is. Everyone has their own crap to deal with. For me I have to often resort to narcotics, but I am genuinely glad you and so many others don't have to put up with this nonsense. And I'm not even complaining. Or not complaining much anyway. It's my life and I deal. I'm not a martyr or a victim, just a dude who drew this particular short straw. And chronic pain aside, I am actually a pretty happy fella.

Treppa wrote:

Meditation seems to help me some, as does - surprisingly - tai chi. Tai chi hurts like the devil while I do it, but I can move and walk more freely after and with much less pain.

When I had to take opoids after recent surgery, they gave me this along with them: Ondansetron 4mg Tablets. It's an anti-nausea drug to help tolerate the opoids. Otherwise the pills and patches have me retching all day long.

Oh, and watching things you find funny or playing video games is supposed to help a lot. You focus on those things and not on pain. I think laughter also releases some arcane substance that makes you better; hilariphins or something.

One extreme therapy recommended for people with lots of inflammation (which can cause lots of pain as well as asthma, anaphylaxis, etc.) is to eat clean and near starvation: 600 calories per day made up of organic fruits, veggies, and meat. No packaged foods, no breads, etc. It's brutal, but if it helps...

I try meditation to an extent, but nothing formalized. For me, I try to visualize my pain being physically removed from my body. The results are... mixed. What does work for me is listening to the music I love. And it just so happens that surprise! Music has legitimate analgesic properties. I also took anti-nausea meds for a while, but it got to the point where I just threw my arms up and said screw it. I was tired of gulping pills, and gulping other pills to keep those first pills from making me miserable.

Here's a crazy thing though: for all my chronic pain, I play recreational ice hockey twice a week, year-round. And one might imagine that would exacerbate my symptoms, but from my anecdotal experience, it is either neutral or even positive. I have been in the locker room pre-game just dying, and yet after the game concludes, somehow feel significantly better. And it's not just the adrenaline, because the benefits can last for days.

I also totally agree with you that laughter is, indeed, a potent medicine. I may be a grim dude, but I can also indulge in life's absurd pleasures. I have a solid 1,000+ saved pictures, and I reckon 90% of them are cats doing dumb stuff that make me laugh. It's important to me.

It's interesting that you mention starvation. I've never heard of it before (and will do some research now that you've brought it to my attention), but I am an incredibly fickle eater. Within the past year I have drastically reduced processed foods, and in the span of about 3 months, went from weighing 140 lbs to 120 lbs. I can see it being brutal for many people, but for me I don't particularly like eating. That's a weird sentiment I know, but I can easily for most of my day without eating. Perhaps I should keep a journal concerning chronic pain and caloric intake. Thanks for the lead.


DungeonmasterCal wrote:
I have chronic pain in my back, both legs, and the occasional migraine. I take Norco (hydrocodone) twice a day to help manage it. I supplement them with Tylenol at least twice a day when it's really bad. The chronic pain along with some pretty bad psychiatric issues combine to make me disabled and unable to work, which I sometimes miss pretty badly. It gets kinda dull sitting around the house all day.

I've seen you posts before DMCal, and I really appreciate your candor. For me it sucks to admit this kind of "weakness," but I think it helps people when we share. Alas, as I said, taking pretty much any opioids, even in tiny doses, is a guaranteed 2-3 days of severe nausea, stomach cramps, and my favorite: vomiting. That wasn't always the case though. For a solid two or three years I took therapeutic doses of hydrocodone/Vicodin, and it worked well enough. Then the damnable tolerance reared its ugly head, and I found myself taking 3, 4, 5 Vicodins at a time just to feel human. I know now I was approaching addiction. That is also when I started developing the aforementioned nausea. In a way I'm almost glad that happened, because part of me thinks I would have ended up a junky if my tolerance kept creeping up with nothing to stop me. And like you, I have my fair share of psychiatric issues as well. OCD, depression, and an obscure personality disorder.

BigDTBone wrote:

I strongly recommend seeing a Doctor of Osteopathy (DO) rather than an MD. MD's first instinct is to disbelieve you are in pain, and then to prescribe opioids. A DO has an additional specialized set of tools called Osteopathic Manipulative Medicine (OMM).

Changed my life. Even relieves migraine headaches.

Thank you for the insight. I will say this: I have been seeing my general practitioner since I was a wee lad. And my parents and aunts saw my doctor's father - also a doctor, obviously - when they were kiddos. We are blessed to have a trusting, meaningful relationship with this man. And I am blessed that, when I see him, he doesn't dismiss my complaints. Even so, I will look into your advice about a doctor of osteopathy. Because no matter how solid my relationship is with my general practitioner, the man is a generalist and not a specialist. A very smart and well-versed generalist, but that can only count for so much.


Chronic pain is not a joke, this is true. To an extent, painkillers can help. However, they often bring serious side effects like gastric ulcers, liver toxicity, nausea and constipation. Many find that the pills aren't worth it. Opioids have a serious risk of addiction, which you see by how the required dose creeps up. So, just be careful, make sure you read up on the drugs you use, and be certain not to end up with serious interactions (alcohol and paracetamol).

Beyond painkillers, be aware that if your pain is the problem, how you feel is your capacity for withstanding it. Otherwise put: If you feel out of sorts, you will be worse impacted by pain you could deal better with if you felt more in balance. The most serious issue here is depression. If you have symptoms of it, GET HELP FOR IT. The drugs used to treat depression are generally effective and with reasonable side effects. Your pain will remain the same, but it will be far less of a problem.

Other things to do work in the same vein. Do what makes you feel good. So long as the pain is not dangerous to you, do your exercise even if it hurts. Listen to music. Make time for important things. Tai chi and similar activities often help. Likewise meditation and such. Some like TENS.


Regarding going to alternative practitioners, it is important to realize that there are limits to what classic medicine an do. Once you hit that limit, why not go and see if someone else can help you? Just make sure you keep informed and don't get taken advantage of.


Orfamay Quest wrote:
[Osteopathy]

Okay, my bad. Thanks for the clarification.


Sissyl wrote:
Regarding going to alternative practitioners, it is important to realize that there are limits to what classic medicine an do. Once you hit that limit, why not go and see if someone else can help you? Just make sure you keep informed and don't get taken advantage of.

I'm very open-minded culturally, but that doesn't necessarily translate to being ready to try... what have you. That said, I have given it serious thought. I also have a surgical option on the table that has a decent chance of success, but by the same token, am not ready for that yet either.

The old dilemma, wherein choosing to do nothing is a choice itself, and carries with it unique consequences. Ah well.


Sissyl wrote:

Chronic pain is not a joke, this is true. To an extent, painkillers can help. However, they often bring serious side effects like gastric ulcers, liver toxicity, nausea and constipation. Many find that the pills aren't worth it. Opioids have a serious risk of addiction, which you see by how the required dose creeps up. So, just be careful, make sure you read up on the drugs you use, and be certain not to end up with serious interactions (alcohol and paracetamol).

I haven't touched an opioid in at least a year. Not even cough syrup with codeine. Mostly because how much it messes up my GI tract, but also because I'm terrified of potential addiction. I've lost two people whom I dearly loved in the past 2 years due to opioid abuse, and a close friend, while mercifully still alive, was pronounced clinical dead 4 separate times over the course of several years because of the same. Never again for me. Never.

Sissyl wrote:


Beyond painkillers, be aware that if your pain is the problem, how you feel is your capacity for withstanding it. Otherwise put: If you feel out of sorts, you will be worse impacted by pain you could deal better with if you felt more in balance. The most serious issue here is depression. If you have symptoms of it, GET HELP FOR IT. The drugs used to treat depression are generally effective and with reasonable side effects. Your pain will remain the same, but it will be far less of a problem.

Depression has been my constant companion for a very long time. That said, I have developed a grim, bitter stoicism about my pain. I'm on anti-depressants and anti-anxieties, but more to the point, when I'm at my worst pain-wise, I get angry. Sad, depressed, hopeless at times? Yes. But these days, just furious. When I wake up and can barely breathe without crying out, it makes me want to punch something over and over again because f%+@ the thing I'm punching. I may be a nihilist, a pessimist, a coward, a fatalist, but one thing I refuse to be is a pathetic victim.

Sissyl wrote:


Other things to do work in the same vein. Do what makes you feel good. So long as the pain is not dangerous to you, do your exercise even if it hurts. Listen to music. Make time for important things. Tai chi and similar activities often help. Likewise meditation and such. Some like TENS.

I try. Immerse myself in internal realms where external stimuli can piss right off. Play hockey for 2 hours straight because the adrenaline is the best analgesic there is. Listen to music always. And ultimately, for all my griping, I know I am blessed in so many ways compared to so many people who have it so much worse than me in so many ways.

Anyway, thanks for the thoughts. One day - perhaps one day soon - there might be a real and lasting solution to chronic pain, and not just medicinal heroin or disassociation anesthetics. Though I sure would like to give those dissociative anesthetics a try...


All I can do is wish you the best GV. I hope that things improve in your life but I am glad that you are still fighting and still with us.


Fabius Maximus wrote:
BigDTBone wrote:

I strongly recommend seeing a Doctor of Osteopathy (DO) rather than an MD. MD's first instinct is to disbelieve you are in pain, and then to prescribe opioids. A DO has an additional specialized set of tools called Osteopathic Manipulative Medicine (OMM).

Changed my life. Even relieves migraine headaches.

Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.

and yet, all have their adherents. Insulting what works for someone's chronic pain is unwise at best. It would be better to add possible solutions to a list and cross off what doesn't work for oneself instead of demanding all dismiss what doesn't work for you.


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I've got some of this badness.

The worst part is the complete inability to explain it to people. I'm not a hypochondriac, I'm really pretty pragmatic about pain and getting older. I try to deal with it.

But sometimes you're just in a bad spot, and it affects your attitude and capabilities. If you let on that's what's going on, your loved ones are usually all about "go to the doctor" and so on.

Then you go to the doctor, and they do tests that maybe you can afford if you're lucky but are always an inconvenience. They might put you on drugs that don't help, or make things worse.

I'm not saying all doctors suck, or that treatments don't work. I'm say a tragic number of people have to just live with it, either because they can't afford to deal with it or nobody can isolate the problem.

After years of this, you just kind of shrug and decide to live your life. Basically, at this point I'm just waiting for them to invent cyborg bodies so I can replace this crappy one.


Freehold DM wrote:
Fabius Maximus wrote:
BigDTBone wrote:

I strongly recommend seeing a Doctor of Osteopathy (DO) rather than an MD. MD's first instinct is to disbelieve you are in pain, and then to prescribe opioids. A DO has an additional specialized set of tools called Osteopathic Manipulative Medicine (OMM).

Changed my life. Even relieves migraine headaches.

Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.
and yet, all have their adherents. Insulting what works for someone's chronic pain is unwise at best. It would be better to add possible solutions to a list and cross off what doesn't work for oneself instead of demanding all dismiss what doesn't work for you.

I already admitted I made a mistake. Let it rest.


I have a chronic back issue caused by ripping both Quad muscles within minutes of each other playing soccer. I find properly stretching helps alleviate a lot of the back pain.

But that is me. Generally, I think living an active life doing things you enjoy will alleviate much pain, or at least make the pain bearable to some extent. I also believe having a balanced diet with good food (non-processed, few additives) in general makes one feel better and therefore mitigates pain. Finally, a positive state of mind helps me a lot.


Pink Dragon wrote:

I have a chronic back issue caused by ripping both Quad muscles within minutes of each other playing soccer. I find properly stretching helps alleviate a lot of the back pain.

But that is me. Generally, I think living an active life doing things you enjoy will alleviate much pain, or at least make the pain bearable to some extent. I also believe having a balanced diet with good food (non-processed, few additives) in general makes one feel better and therefore mitigates pain. Finally, a positive state of mind helps me a lot.

The active life doing the things I enjoy is what causes most of my pain.


thejeff wrote:
The active life doing the things I enjoy is what causes most of my pain.

Everyone is different. That's what makes pain management so hard.

I find that activity helps manage pain. However, for me over-exertion also causes pain. Finding the balance is key for me.


A couple strategies that I use:

I monitor pain levels as I'm falling asleep. If I don't fall asleep quickly, it is often because the pain is not acute, but *IS* sufficient to keep me from sleeping well.

If I don't fall asleep, I make a cup of hot chocolate and take a pain pill. My pain is still controlled by OTC meds, so I rotate between aspirin, ibuprofen, and acetaminophen, using a different one each night.

The hot chocolate is a way of harnessing my neuro-system in aid of pain management. It turns out that pain receptors can be trained in a pavolovian-style, so that eventually the drink itself elicits the anti-inflammatory response even if you don't take the tablet.

This also helps me keep down the amount of drugs: the fourth night I drink the hot chocolate without any pills.

Quashing the pain signals so that I get a good night's sleep is also a pain management strategy: Nights where I don't sleep well I have more pain the next day.


oxcodone based Painkillers.

There's a reason they're so widely prescribed: they work. Take with milk and something fatty that tastes good (i'll do a big glass of milk and a block of cheese) seems to make them work better and help with the naseau. I really wish the doctor took me more seriously when i tell her "No. really. That dose isn't nearly enough for a 500 pound irish sasquatch...ask my anesthesiologists what my tolerance is. Any of them. They'll remember me"

Since my major problem is my back, walking also helps, but its really tricky getting the right amount of walking to help without getting so much that it hurts (see the first paragraph for what to do when you misjudge it)

A very large part of my coping is just denial and not thinking about it. get so involved in doing something that the world kind of tunes out. ( I am allowed to whittle. I am allowed to whittle on painkillers. I am allowed to whittle with a kabar. I am no longer allowed to combine options 2 and 3....)


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It could also be that your liver breaks them down faster than it should. If you react badly to other drugs, you could check your liver enzymes.


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Found the link to the research on the placebo effect
How To Train Your Immune System


BigNorseWolf wrote:
A very large part of my coping is just denial and not thinking about it

QFT


BigNorseWolf wrote:

oxcodone based Painkillers.

I occasionally get kidney stones. Usually fairly minor. Rarely, the kind that teach you entirely new realms of human suffering. The next time I get the latter? I will find a way to cope without opioids.

My tolerance for them was terrifyingly high over a year ago. If I wasn't addicted, I was damn close. Then one day I popped some and boom: vomited all day. Intense nausea that lasted several more. I had developed a little-researched reaction called opioid-induced nausea and vomiting. I figured it was a one-off thing. Waited a week or two, took a single 325/5 hydrochodone - not enough to even scratch my tolerance level. Just a test. Spent several days in nauseated hell. And I'm grateful. I live in a part of the country where opioid abuse is at epidemic levels. If I didn't end up with OINV, every indicator points to my following suit.

I'm glad it works for you. I'm glad when anyone finds anything that works for them. I'll find something. Or I won't.

Sharoth wrote:
All I can do is wish you the best GV. I hope that things improve in your life but I am glad that you are still fighting and still with us.

Thanks. I hang on out of spite. Which is particularly messed up when you consider that I work in the field of psychology (PhD or PsyD one of these days...), and know precisely how important a positive internal state is. That one's thoughts and emotions have a direct, measurable affect on one's physiology, pain response, etc. But for me, I'll take bile any day. Anything else would be inauthentic.


Generic Villain wrote:


My tolerance for them was terrifyingly high over a year ago. If I wasn't addicted, I was damn close.

Those aren't the same thing. (though one can lead to the other)

Quote:
Then one day I popped some and boom: vomited all day.

Were you only taking them when you were in absolute agony? Your body may have concluded that they were causing the pain since they always arrived with it.

I don't know if a doctor would go along with this, but you need to find something BEFORE you're in agony again. Experimental medicine has its place but its not while you're screaming. That might include trying to take the hydrocodone on a day you don't need it to convince your body its not whats making you sick.

Does this work: "ARRRRRGH!
No? well does this work.. "BLERGH"
"Does this work..." oh mental side effects when you may already feel like ending it anyway...

Quote:
I'm glad it works for you. I'm glad when anyone finds anything that works for them. I'll find something. Or I won't.

I don't know if there's anything else strong enough for kidney stone pain.


BigNorseWolf wrote:
Generic Villain wrote:


My tolerance for them was terrifyingly high over a year ago. If I wasn't addicted, I was damn close.

Those aren't the same thing. (though one can lead to the other)

Oh I know. I have my BS in psychology and am working on my masters. Not trying to brag or anything - I'm a moron about so many things, but psych is one of the few exceptions. Tolerance is an entirely physiological effect. Addiction is, depending on the definition, a matter of liking/wanting something, and eventually wanting it despite no longer liking it. Always related to dopamine. I liked Vicodin. A lot. And I knew even as it was happening that the degree to which I was craving it had passed the threshold of being purely therapeutic.

As an interesting aside: I have obsessive-compulsive disorder in a big way. OCD is about maintaining control, and becoming an addict is very much about the loss of control. It was fascinating to experience my OCD function as a barrier against addiction for as long as it did (roughly 3 years). It was a resolve borne not from any personal conviction, but rather pure pathology. That same desperate, white-knuckle death grip I am compelled to maintain in so many areas of my life, now suddenly working in my favor. It's rare, but there are times I appreciate my OCD.

BigNorseWolf wrote:


Were you only taking them when you were in absolute agony? Your body may have concluded that they were causing the pain since they always arrived with it.

I don't know if a doctor would go along with this, but you need to find something BEFORE you're in agony again. Experimental medicine has its place but its not while you're screaming. That might include trying to take the hydrocodone on a day you don't need it to convince your body its not whats making you sick.

To your first question: initially yes. Then, as time passed slowly but surely no. If you want me to get real specific, I think the catalyzing event was when I took Tramadol (Ultram). Tramadol worked for my back pain, and though not an opioid, it functions similarly. Anyway, I was using the Tramadol at a proper dosage. However, a possible side effect of the stuff is awful, days-long stomach cramps, nausea, and inflamation. Obviously I stopped taking Tramadol. However, when I went back to Vicodin, surprise! My body reacted almost identically. I suspect that the response has less to do with the opioid, than the learned/conditioned response from the Tramadol.

As in, I took the Vicodin and my body spazzed out because it thought, holy crap he's taking more of that awful stuff. Time to cause dramatic, awful stomach issues.

And again, the true cause is ultimately irrelevant. I won't go back to opioids. What I'm taking now is a muscle relaxant called Soma (Carisprodal) that works sufficiently well. It is by no means an ideal situation, but it takes the edge off.

BigNorseWolf wrote:


I don't know if there's anything else strong enough for kidney stone pain.

Whiskey and... herbal supplements. To be honest, if I get a bad one again, I'll likely see if I can pursue a surgical treatment, or optimally shock wave lithotripsy.


Tramadol is a synthetic opioid. It is also a drug that requires activation through being metabolized in the body to have its analgetic properties. When iit does, it affects the mu-receptor and several others.


Sissyl wrote:
Tramadol is a synthetic opioid. It is also a drug that requires activation through being metabolized in the body to have its analgetic properties. When iit does, it affects the mu-receptor and several others.

Yeah, I did a lot of research on it when it started murdering every square inch of my GI tract. Again I suspect that my body developed a defensive/conditioned response to opioids, synthetic or otherwise. The chemical equivalent of conditioned taste aversion as it were.

Sovereign Court

BigDTBone wrote:
CrystalSeas wrote:
Fabius Maximus wrote:
Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.

Are you sure you aren't confusing Doctor of Osteopathy with chiropractor?

Osteopaths are physicians who are licensed by the state and allowed to practice in hospitals just like people with an MD. There are even DOs who are full professors on the faculty of major Tier 1 university medical schools. For example

University of Michigan Medical School

Pretty much this. DO's are legit doctors. Allopathic doctors tend to spread the same misconception that Fabius has.

Fabius, don't take my word for it. Insurance companies pay DO's for OMM services. If they were bogus do you think that would be true?

I know this tangent has passed - but of note - many (potentially most) DOs were originally students who couldn't get into school to get their MDs. (DO schools are a bit easier to get into [considerably lower MCAT and GPA score averages for their students] and their schools do less research etc. Not that that matters much for primary care physicians - which I think DO medical schools focus on more.)


Charon's Little Helper wrote:
BigDTBone wrote:
CrystalSeas wrote:
Fabius Maximus wrote:
Osteopathy is about as scientifically proven to work as homoeopathy, i.e. not at all. The effect may be all in your head. It's great that it helps you personally, but I would be hesitant to throw money at what probably is quackery.

Are you sure you aren't confusing Doctor of Osteopathy with chiropractor?

Osteopaths are physicians who are licensed by the state and allowed to practice in hospitals just like people with an MD. There are even DOs who are full professors on the faculty of major Tier 1 university medical schools. For example

University of Michigan Medical School

Pretty much this. DO's are legit doctors. Allopathic doctors tend to spread the same misconception that Fabius has.

Fabius, don't take my word for it. Insurance companies pay DO's for OMM services. If they were bogus do you think that would be true?

I know this tangent has passed - but of note - many (potentially most) DOs were originally students who couldn't get into school to get their MDs. (DO schools are a bit easier to get into [considerably lower MCAT and GPA score averages for their students] and their schools do less research etc. Not that that matters much for primary care physicians - which I think DO medical schools focus on more.)

As someone who happens to know, (I work on a health science center campus which houses a college of osteopathic medicine) this statement is 99% false/misleading. Many (most) students choose to go to a DO school for the same reasons anyone goes to any school; it is geographically convenient to do so. And many candidates seek out osteopathy because of its focus on treatment of the person, rather than the disease, focus on community based medicine, and the uniqueness of OMM. But, that said, the program is rigorous, and the students are first tier. The regulatory / accreditation bodies for all schools of medicine in this country specifically limit the number of student slots available in total across the US. This makes every seat at every school highly competitive.


Sissyl wrote:
Tramadol is a synthetic opioid. It is also a drug that requires activation through being metabolized in the body to have its analgetic properties. When iit does, it affects the mu-receptor and several others.

Tramadol is about as effective as baby aspirin for my chronic pain.


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My experience with a variety of pain, as well as that of family members and friends, is that the solution to pain is often individual. My mother had fibromyalgia with horrible pain across her head, neck and shoulders. What kept that surpressed for her was originally massage. Later, it got worse after she had a stroke, we found that accupuncture actually helped (and we doubt it was a placebo effect as she had very poor understanding of what was happening at that point). Another friend was hobbled with major joint pain that was resolved after he was determined to be gluten intolerant -- he cut out gluten and had an amazing recovery. Personally I had a long fight with sciatica and finally resolved it through attention to body position (a kneeling chair, new mattress, and an assortment of body pillows to sleep without stress on my back) together with massage and stretching in the hot tub.

While none of these examples may be your solution, I just want to encourage you to continue trying different things especially, attention to body position as well as things like massage and Tai Chi to improve flexibility.


Wei Ji the Learner wrote:


Best cure was cool quiet room with cold ice pack and everything shut off.

While an ice pack won't solve every pain problem, it is worth trying each time. I have been surprised with how it can help with both healing and pain and it is inexpensive.


DungeonmasterCal wrote:


Tramadol is about as effective as baby aspirin for my chronic pain.

I was legit expecting the same (non) result, but for whatever reason Tramadol actually worked wonders for me. Until it murdered my colon.

Greymist wrote:


While none of these examples may be your solution, I just want to encourage you to continue trying different things especially, attention to body position as well as things like massage and Tai Chi to improve flexibility.

I appreciate your thoughts, and they are not falling on deaf ears. For example, I have found a few non-medicinal approaches. Listening to my favorite music, as mentioned above, has a quantifiable affect on pain. If I'm sitting at my computer my favorite tunes are playing. Always. And counter-intuitively, playing contact hockey often provides significant relief that can last for days.

Chronic pain is a legitimately awful experience. In a sick way though, part of me not only accepts it, but perhaps even exults in it. It's very hard to explain in words, or for that matter even thoughts, but there it is. Daily and excruciating pain is a feeling. An experience to be endured and despised, but also a reminder that I'm a living human.

Don't get me wrong - if I could snap my fingers and be rid of this relentless hardship, I would do it. No hesitation. But that isn't an option, and so instead I can only endure; tolerate; exist. That is my lot and where the spite, the venom, and the bitterness come from.

And for all my self pitying, I won't let my suffering define me. I'll survive until I don't.


Going back and reading the above post, it sounded a bit darker than I had intended. Probably something a Zon-Kuthon worshiper would say. To elaborate: pain is a purely physical stimuli, but one's emotional/mental response to pain? That is within our control. The typical reaction to chronic pain is stress, which releases cortisone. Normally cortisone reduces inflammation, but cortisone from prolonged stress actually does the exact opposite. So I make a conscious effort to get pissed off, angry, grimly determined, bitter. But not hopeless, stressed, or depressed... or at least, I try not to. Willpower is a finite resource.

Regardless, going to doctor today to discuss options.

Sovereign Court

Not sure if it's been mentioned, but drinking lots of water throughout the day helps to flush the system and to keep all the parts moving better.

Cranberry juice (unsweetened - I know, hard to find) as well as pomegranate (eating the actual seeds; you can buy them already peeled in most grocery stores) will help reduce inflammation/pain.

Eat/drink a lot of vegetable soup throughout the day (make your own at home: boil water, and add veggies, broth, not too much salt, and throw whatever herbs in in you can get your hands on). Soups and stews really help make people healthier. Throw lots of beans in your soup (if you don't find the dried ones convenient, buy canned red/lima/navy beans); we recently bought a pressure cooker and dried beans can be fully cooked in 20min... otherwise you can throw your dried beans into the soup directly but most of the time will require overnight soaking before you start cooking them (don't cook them overnight from dry: dried beans will sink to the bottom and absorb all the heat and burn)


Nociceptive signals are purely physical, yes. That is what happens when your reflex reaction to heat removes your hand from the stove. The experience of pain is when those have been filtered through our consciousness. There is a lot that happens along the way. One of the things this makes possible is the concept of feeling pain even without nociceptive signals. And, most likely, this is a large part of chronic pain.

Note: Not saying anyone is making things up, just that the brain is fully capable of making you experience anything.

What it underscores is the vital importance of keeping yourself as mentally healthy as possible. The impact of your pain will be far less if you are feeling okay otherwise.


Generic Villain wrote:
Willpower is a finite resource.

That turns out not to be true.

A closer look at the research upended that theory (upended a whole field of psychology for that matter).

Carter, Kofler, Forster, McCullough, 2015


CrystalSeas wrote:
Generic Villain wrote:
Willpower is a finite resource.

That turns out not to be true.

A closer look at the research upended that theory (upended a whole field of psychology for that matter).

Carter, Kofler, Forster, McCullough, 2015

Oh I agree entirely that self control/discipline is not limited. However, if your approach to self-control is gritting your teeth and sweating profusely while desperately wanting to do something, eventually you'll give in. The important thing about self-control is learning new modes of thinking. Not to say "I can't have a cigarette" but rather "I don't want a cigarette" can have a profound impact.

In my case, it's more a matter of: I can only endure pain for so long before it wears on me mentally. This isn't about laziness, addiction, or other classical forms of self-control. It's emotional attrition.

(Btw, saved that PDF and will look at it more closely. I love that sort of stuff).


Sissyl wrote:

Note: Not saying anyone is making things up, just that the brain is fully capable of making you experience anything.

Yup. People typically talk about the placebo effect in a positive light, but what many don't consider is that it can go both ways.


Called the nocebo effect. To be technical, it's when you think doing X will hurt, and X hurts despite not having a mechanism for causing hurt.

Still, the brain IS you. All you are. And even expecting pain can cause it. When someone has been in pain long enough, the way to that pain is easy to fall into.

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