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Regular Member

Date Joined May 2009
Total Posts : 99
   Posted 5/16/2010 6:02 AM (GMT -6)   
As most of you know- its a long road right? Well I was silly enough to think that I had maybe hit a rest stop. After trying Neurontin and Lyrica with mild success (they had the usual suspects of side effects and work for a couple of months but lost effectiveness just as I thought that I might have found my holy grail). I tried Savella. That was a disaster. I was sick for days- and I don't mean nauseous, I mean something is really wrong having a reaction should stop taking and call your doctor sick. I had similar experiences with Cymbalta and Paxil (I took Paxil years ago for migraines- which it turns out was the beginning of my Fibro). I have taken Zoloft for 4 years with success and it too lost its effectiveness. And then I tried Effexor, Lexapro and...
AS most of you I have had numerous doctors of all different types. Right now I am seeing a pain mgt doc. We have just increase my Topamax to the largest allowable dose of 400mgs/day Tramadol 300mgs/4hours, 1500mgs/Robaxin- 3 times/day. And even though it worked really well four months ago when I first started it, its not working now. And this is exactly how it went on the others. But each time I go in to see the Doctor he keeps asking me how the Savella was or he says "So the Savella really didn't work huh?" and the last time he asked me what other anti-depressants I had tried, well his pen went into overdrive trying to keep up! I am all for exhausting my options- but I have given it the old college try don't you think? I went into it on Vicodin asking for better pain treatment, and yes, I was hoping for something in the Narcotic group that would work for sure quickly and get me back into my life since I had already lost over a year of it trying to get the dx and treatment up to that point. When he said that he didn't think that was a good idea I went with what he said because he was the doctor and lets try it. But now I believe I have literally tried it all. Up to this point I have been able to side step his suggestions of the anti-depressants because there was still wiggle room to up my current meds. But now I am at a cross roads. It was hard for me to get off the Zoloft once it stop working (actually it was worse that hard). And since the Zoloft didn't actually help the pain the good it may do is not worth the bad it will do.
So I need some advice on how to nicely, but firmly, explain to him that anti-depressants are not an option for my future treatment as they have not been successful in my past treatment; and I need to know how to ask for pain medicine without asking for pain medicine. I don't need to be humiliated and degraded on top of miserable. I am no longer interested in pain prevention- that ship has sailed. Now I want pain control. And I need him to realize that at this point, the pain levels are intruding in my life to the point that it is being interrupted. And that can't happen. I am all alone, and because of that I have to support myself. I have to work. I have to pay my bills. I have to pay my mortgage. I have to keep my job. And I have a great job in a small area so getting another job like this if I lose this job would literally be impossible (literally-I would have to take a job that pays literally half). I guess now that I am reading it- my life looks pretty sad. So he better get me some good pain medicine so I can go out and embellish it a little huh? smhair
Well thanks for letting me unload- I don't post often but it seems to be pretty lengthy when I do. As I said- I am all alone, but when I am on here I don't feel so much so. Thank you.

Dx'd with Fibromyalgia, High Blood Pressure, TMJ & Migraines
Atenelol (50 mgs/day)  Vicodin (1000mg as needed).  Oh and a LOVELY retainer for the TMJ! 

Veteran Member

Date Joined Apr 2009
Total Posts : 856
   Posted 5/16/2010 6:21 AM (GMT -6)   
Hi. I haven't tried antidepressants, but my doctor did want me to if my other new medicine didn't work. I'm lucky to have a doctor that understands my worry about trying new medications. I wouldn't have asked for more pain control had it not been for everyone on this forum.

I have to say that you have tried so much! You have been more than compliant! I would be upfront with him. Others will be along with more advice, but that's what worked for me. I said that I needed something stronger. I was so scared to talk to my doctor though, but my pain is at least under better control now that it was. I was at the point where I couldn't deal with anything. It was terrible. Now, when it comes on strong, I have the ability to get the pain down. That is such a blessing and helps me so much. I can do more too, even though I still can't do a lot.

So, I guess my advice would be to be completely honest with your doctor. Maybe others will have better advice though.


Veteran Member

Date Joined Sep 2009
Total Posts : 663
   Posted 5/16/2010 3:34 PM (GMT -6)   
I was completely up front with my doc and just straight up asked for some pain relief. I did try all the conventional meds for migraines and fibro and had bad reactions to most and no relief from others. I am one of those that only gets relief from narcotics. I didn't feel like beating around the bush or dropping hints to get what I needed. I felt like that method is like running a scam on the doc. I just asked her, can we please try pain meds and something long acting and without tylenol (I have done enough damage to my liver over the years dut to headaches). She put me on oxycontin 20mg to start, I slowly built my way up to what I currently take which is 160 mgs a day (60mg am, 40mg afternoon and 60mg pm) I finally have a life! My doc recently gave me a blood test to check to make sure my oxy levels were ok, which they were. I was worried as to why she did the test but it turned out they just need to stay on top of how we all metabolize (sp?) pain meds so as not to have any problems. I sure hope you can get some relief and only you can decide the best way to approach your doc. Take care!
Gentle Hugs,
Fibromyalgia, Chronic daily headaches, Migraine disorder (with and without aura), GERD, High blood pressure, Depression and Anxiety
Oxycontin, Flexeril as needed, Lopressor, Lexapro, Omeprazole, Clonazepam as needed, Promethazine as needed for nausea from migraines

Veteran Member

Date Joined Nov 2007
Total Posts : 6795
   Posted 5/16/2010 7:17 PM (GMT -6)   
Hi, Trish,
Oh, I guess I want to say "I hear you". I am alone, too, although most everything has already been lost for me - job, financial security (not wealth, just basics), social life, etc, etc, etc. It sounds to me like you need another PM doctor if this doctor is not willing to help you with something that WORKS. Is this a PM specialist or your PCP? I realize we always look like we're "drug seeking" but if you bring in a list (and I would do just that) of everything you've tried, and your body's response, coupled with the need for you to try to maintain your life as much as possible, and a doctor isn't willing to give you something stronger, then I would ask why. Have you ever just asked why? I don't mean in an accusatory way, but with all you've tried you do seem to be at the end of the line without adding narcotics.

Anyway, I hope you can find a doctor - your current one or another - who will truly help manage your pain. But I know it's easier said than done.


Mrs. Dani
Veteran Member

Date Joined Jun 2009
Total Posts : 2787
   Posted 5/16/2010 8:13 PM (GMT -6)   
   Dear Trish,
     Is your pain from Firbo or do you have back problems too? I am not very knowladgeable about fibro, but Chutz is and has extensive knowladge about it. Hopefully she will stop by.
    Now on to a doctor not hearing you...Talk to them straight forward about you needs. if they dont hear you.... nothing will change until you change the doctor. How long have you been seeing him/her? I am very forward with my doctors about what is and isnt working. What areas I need help in, areas that are progressing. They confirm with X rays (or what ever else tests they need) and we try something new/diffferent approach. I have a progressive spinal deformity (among other things. that being the MOST painful), and the "goal" in my case is restore quality of life while allowing me as much mobility and independence as possible. If you and your doctor(s) have been together for a long time now and they arnt providing you with the quality of service you need, you might need to try someone else. shakehead   Though it is a hard, long, frustraiting process to switch to new medicial professionals.
     I do hope you are able to come to a compramise with your physician. Last thing you need is to be in extensive pain over the summer AND trying to find a new physician. You are in our hearts here.



Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood



Veteran Member

Date Joined Aug 2006
Total Posts : 9607
   Posted 5/16/2010 9:27 PM (GMT -6)   
Don't know if this would help, but this past month at the local fibro meeting they had a pain management doctor speak and they
are doing trigger point cooling injections for fibro, might be something for you to consider...anyways
good luck in what you choose to do, I hope you can work better with your doctor..might be time to switch doctors..
just my 2 cents, only trying to help...
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...


Regular Member

Date Joined May 2009
Total Posts : 99
   Posted 5/18/2010 12:02 AM (GMT -6)   
Hey everyone!
Thanks so much for the great advice and hugs!! I think its just time to stop being afraid and polite. But fibro has made me so afraid for so long I am not exactly sure how to pull the fight out of me. Which is so hilarious- because I work for a big box retailer in the warehouse division as an area manager on a team of about 60 people. With about 7 of us being women and I can tell you that I have had to be a pit bull more times than not- but not with my doctor. Sometimes I have to remind myself to "Insert Big Box Name- Up" before I do something that needs to be done.
I guess I just need someone to tell me that its okay to ask for narcotics because so many doctors have told me that its not. Because so many have made me feel dirty and ashamed. And now I am. And even now I am crying and I know that I can't when I ask him because it makes me look desperate- but I am. But not for the reasons he thinks and I am frustrated and scared. And why can't this just be easy? And now I feel spoiled and like I am having a temper tantrum and why can't I? And now I feel guilty and I'm so sorry. And I really wish that I had someone to stand up for me, but I don't. So I will. But does anyone have like a mantra that they say before they go into a visit that might give them courage? Cause I think I could use some of that right now. I can't seem to find those darn ruby slippers! Thanks guys for listening while I have my little break down!

<FONT] Trish

[color=#808080>Dx'd]Fibromyalgia 2008

<FONT color=#808080>] Medications- Who can keep up?

It is What it is

Retired Mom
Veteran Member

Date Joined Feb 2010
Total Posts : 1753
   Posted 5/19/2010 5:56 PM (GMT -6)   
Hi Sad,

I just read (and re-read) your post. Please correct me if I am wrong....I think you said you are already seeing a PM specialist and that you have tried many anti-depressants and only a few "real" pain medications. I used to have migraines (and thankfully don't suffer much from them now)....mine were hormonal...

I do have fibro, though, and understand what that can do to you. Depression is the little buzz word they like to use to link with the fibro. I do not consider myself depressed and I can not take anti-depression meds. They are serotonin based, as are many of the migraine meds.

With regard to your Dr apt and requests, perhaps "asking" what the next step is and "allowing" them to make the medication suggestion would be best. This way the ball is in their court and you don't come of as a seeker.

Now for the other suggestion (which may get me some negative comments), please consider adding tylonol to the Ultram if you can take it. It seems to be the combination of the two that helps with fibro more than the Ultram alone. It's just a suggestion, but it may help some until you can get better meds.

Best to you!
Retired Mom

Veteran Member

Date Joined Sep 2008
Total Posts : 1670
   Posted 5/19/2010 7:06 PM (GMT -6)   
Hi SSt, look I've only just recently started having migraines and I was on opiaes and the neuro team took me off them because they can fuel migraines. We can't win can we!

They put me on an antidepressant called dothiapin which is seemingly good for migraines and Tramadol both a slow release and one for BT. I also take tylenol with it just two a day as it is suppose to help plus I've been seeing someone for my neck. I'm told migraines are often triggered by your neck being slightly out of allignment.

Anyway Just thought I'd tell you about the opiates as it may not be the answer you think it'll be. I was on them for several months before the migraines got out of control. It was a slow build up in my system. I've since come back off the dothiapin, too strong for me, made me too sleepy.

Hope some of this helps, golitho

Regular Member

Date Joined Feb 2009
Total Posts : 487
   Posted 5/19/2010 8:26 PM (GMT -6)   
One thing I try to keep in mind with doctors is that they work for us.  Without us as patients, they would not be able to put food on their tables.  I know doctors like to act like we should be grateful to have them as our doctor, but I feel the opposite - they are priviledged to have us as patients! 
I know many of us have had bad experiences with being treated like drug addicts, but a good pain management doctor can tell the difference between someone who is truly in pain and someone who is drug seeking - unfortunately they do deal with this issue all of the time.  I think if you pour your heart out to this doctor, the way you have us, he/she will be able to tell that you are desperate for pain relief, not desperate for a fix.  If not, it is a sure sign that you need to find yourself a "real" pain management doctor.
Hang in there,
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