question needing immeadeate responses about pain management and crohns

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joshxlong
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/11/2008 7:54 PM (GMT -7)   
I was diagnosed this past week with crohns while hospitalized. out of the last 2 weeks I was hospitalized twice for my mystery ailment that turns out to be crohns. My question is this... I've been having stomach pain constantly for years that I did my best to ignore because I used to be an alchy and I blamed those days. Now I find out its something I can hopefully treat and help heal, but my question is will I be looked at as abusing my disease if I request to continue the 5mg OxyIRs (every 6) and the ultram (50mg every 8) for my daily pain? Is that overdoing it? I've literally missed one day a month at best of work because of my stomach ailments for years now, more commonly its one every 3 weeks. My bowel movements are constantly irregular, my gas cramping and specific site pains are constantly there even while i'm not in what i consider to be a flareup. anybody have any advice on how i should handle this? Should i let them know that the meds have reduced my pain drastically and I'd like to continue them, or were they just given to me to get me through the flareup? I think the flareup ended before i was released, because before that only dilauded IV helped... but for my daily pains these two meds hit the nail on the head. I dont wanna look a gift horse in the mouth or be labled an addict, but i really do need pain management and so far ultram and oxyIR helps alot. should i request to be given it regularly?

MAG102886
Veteran Member


Date Joined Jul 2008
Total Posts : 674
   Posted 10/11/2008 8:31 PM (GMT -7)   

Hi, and welcome. =)

Im sure you could request the pain meds, but I guess it would be up to your doctor if they want to give them to you.  Ive only had pain meds a few times in my 5yrs that Ive been dx'd with this disease, mainly because my GI does not like to prescribe them, he says if Im in pain then something is wrong and we need to find the solution not hide it...easy for him to say.  How bad is your pain? You said you feel a lot better now that youve been treated?  What kinda meds are you on? 


Dianogsed with Crohns at 16, 21 yrs old now.
Surgeries:2 Bowel Resections, Gallbladder Removed.
Current Meds: Humira (bi-weekly), 50mg Pred, Levbid, Nexium, B12 injections.
 

ivy6
Elite Member


Date Joined Sep 2005
Total Posts : 10404
   Posted 10/11/2008 8:34 PM (GMT -7)   
Hi Josh.

I'm just replying so you know that people are reading your post and thinking about it.

I really don't know what to say. I don't think it's unreasonable to ask to continue on that medication regime if you know it controls your pain and it works for you, but (and it's a big but) I don't think you should be surprised if the answer is "no". I'm not familiar with the brand names you mentioned (I'm in Australia; the names are often different) but I do know that gastro doctors can be unwilling to let us use pain meds indefinitely. Sometimes they say the meds "mask symptoms", and sometimes they say the meds can affect our bowel habits, and sometimes they have their own, peculiarly individual reasons: any way, the answer is often "no".

I say this so you can be prepared for a negative answer, and so that you don't necessarily take it personally or think that it's a reflection on your former addiction. Many of us have a hard time getting adequate pain management.

Best wishes, and welcome,

Ivy.
Co-Moderator Crohn's Forum.


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 10/11/2008 10:03 PM (GMT -7)   
I stayed on pain medication until I didn't need it anymore taking the "as needed" label as seriously as I could. As long as you don't take too many for a very prolonged period then it should be fine. I'm sure your doctor would not let you stay on them too long anyway(or so my faith in my GI leads me to believe..).
There are other things you can take to reduce the pain in that they reduce the symptoms eg antispasmodics like bentyl.
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 10/11/2008 10:04 PM (GMT -7)   
And I just wanted to add that it's obvious you are aware that you can become addicted but have every intention of preventing that so you should be able to trust yourself in knowing when you no longer need pain medication.
I won't lie in saying that there have been times when I wasn't in terrible pain but just mildly uncomfortable or stressed and wanted to take my leftover ulctracet, but it's easy to say no every time once you've said no once.
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


Bible
Regular Member


Date Joined Jul 2007
Total Posts : 188
   Posted 10/12/2008 5:32 AM (GMT -7)   
I have had Crohns for 20 years along with resection, kidney stones, lithotrypsy,stints in the ureter so the stones would pass, pred, imuran, arthritis, cyst on pelvis (by the way is very painful), etc. I requested lortab bout three years ago b/c I had just gotten out of hospital with a flare. I had never asked for pain meds andc never taken them in the 17 years before that., Let me tell you what happened- ,I had to get my med records this doctor was stopping practice to take care of his father in India. Well, I being courious looked over my records and b/c I asked for pain med one time- It was put in my med. records that I may be narcotic dependent- I was so upset- So be very careful- This was in Atlanta.

MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 10/12/2008 5:51 AM (GMT -7)   
I really think that pain meds are not an unreasonable request, but I think the as needed needs to be strictly adhered to. If you can function most days out of the month without them.
However I also want you to know once you find a med combo for crohns that works for you and has reached a theraputic level, you will most likely not need pain meds.
I think the most important thing is to let your doctor know you are in pain and find a solution together. It may be that you do a large amount of pred or something like that.
Forum Co-moderator - Crohn's Disease
We will find a way, or make one.-Hannibal (crossing the Alps in the 15th Century on war elephants) 
Make sure your suffering has meaning...
All suggestions/options/opinions are caveated with please consult with your local health care provider...


joshxlong
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/12/2008 10:45 AM (GMT -7)   
thanks for the quick results guys, i much appreciate everyone's input. i've been thinking and first of all i've realized i'm on two different pain meds (tramadol/oxycodone)... so i'm definitely going to cut that back to one. i haven't had much luck with the ultram, but i've been told it is non-narcotic, is that statement accurate? and as far as the oxyIR goes, i'll see what the doctor recommends. i've gotta adjust to this whole thing very quickly, as all day today i've been feeling like my GI tract is under severe distress which not only angers me but confuses me because i thoroughly believed i was past the flare up i've been recouping from the past 2 weeks. i can't afford to miss work as the last biweekly check will include 3 days pay total, but i can't work in pain and constant urgency of having a rest room available either. regardless, hopefully the pentasa has been helping the healing process, i'm working on the smoking because i understand it raises my blood pressure making it harder for the healing process to be effective due to restricting blood flow. i knew in my mind that something major was wrong for at least a year but i just kept brushing it under the rug and shrugging it off. now that i'm aware of the disease i almost wish i weren't but at least i know what it is that is wrong and what i can do to control it. thanks again though to the informative responses... i really do hope not to need these full time but on a temporary basis they've been a huge help in dealing with the stomach pains without taking a hot bath or going to the hospital. i'll work it out with my doctor, and regardless of the outcome i'll just try to take it from here. i should mention, the entire time i've been out i've taken both pain meds every time i'm due and haven't skipped out or held off longer than a few hours without taking them... but i believe some of that is because the healing process hasn't progressed to long term relief yet. only thing i'd still like to know is whether or not the ultram (tramadol 50mg) is a narcotic or if it runs no risk of addiction. thanks again guys.

Zanne
Veteran Member


Date Joined Apr 2005
Total Posts : 3763
   Posted 10/12/2008 6:16 PM (GMT -7)   
One thing that no one else has mentioned is that you might want to start out with asking for a referral to a pain management clinic. That is what a lot of us do. The GI's want to treat the disease and not mask the symptoms, but the meds take time to work, sometimes months, and that is really not fair to those of us who have to live day to day in pain. And some of us have pain that is just there despite treatment, and needs to be dealt with, and we want to make sure that we don't become addicted and that be are treated with medication that is appropriate and at the right level so that we can function but not be loopy. Pain clinics are really set up to meet all of these needs. And with your history of addiction they really would be a good option for you.
Suzanne

CD 19 years offically, 29 unofficially. 3 resections '93, '95 '97
Symptoms constantly but all tests show only minor ulcerations. Currently having multiple episodes of gastritis with no known cause.


Prednisone, 6MP,Prevacid, B12 shots, Bentyl, Xifaxan.....


General Colon Bowel
Regular Member


Date Joined Nov 2003
Total Posts : 282
   Posted 10/12/2008 8:57 PM (GMT -7)   
You should avoid comparing the "self medicating" of your past with "treating yourself with medicine" in the present. If you can handle it, break the pills in half and only take the minimum to get by.

However, in the end......the medicine is there to help you feel better....if that means knocking your *** out for a couple hours, then do it. You have a disease, bro. Pain meds help us all through the worst times.

General Colon Bowel

eva124
Regular Member


Date Joined Sep 2007
Total Posts : 246
   Posted 10/13/2008 1:06 AM (GMT -7)   
i think if u need pain medicines constantly then i think ur just covering up the main problem,im sure if i was drugged to my eye balls on pain med then i wldnt of needed surgery,the most pain meds i took was panadol.
dx 17 aug 2007
21 yrs old
13 dec 2007 resection/temp illeostomy 14 feb 2008 temp illeostomy reversed 
150mg azamun
3000mg pentasa


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 10/13/2008 7:01 AM (GMT -7)   
First off welcome to Healingwell. As for the pain meds, I would use them only when needed. I do think two different pain meds is a little bit of overkill. I think you are right in just asking for one. Another thing that has not been discussed is, have you changed your diet. Diet is extremely important in helping to ease some of the symptoms too. Some folks have success with the SCD or Makers Diet. I personally live on a low residue diet all the time now, and it works great for me. One suggestion might be to keep a food diary and keep track of how different foods affect you. Most GI's won't give pain meds, I get mine from my family doc. And I currently don't use the pain meds so much for the Crohns pain, but more for the joint pains associated with the Crohns. Good luck!
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


joshxlong
New Member


Date Joined Oct 2008
Total Posts : 7
   Posted 10/13/2008 7:02 AM (GMT -7)   
i also dont think at the time i posted this message i was aware of the difference in pain levels between what i normally deal with and what i was experiencing. if it is so bad i would require pain meds all the time, why wouldn't they just do the surgery? i feel kinda dumb after thinking about this a little harder, and i realize certainly pain medication is a necessity at times but as some of you have mentioned, once i start the healing process i shouldn't experience the same pain except during a flareup (the most recent of which i found out yesterday is not over) and the pain i've experienced 24/7 to this date is probably just because i wasn't being medicated to heal my small intestine or regulate my bowels. i'd attempt to destroy this topic now if it weren't for the fact that someone else in my shoes may be able to reference it in the future. i feel like because i was experiencing relief for the first time in at least 18 months, i should continue the pain meds. it's probably a combination of everything i'm on working toward getting my stomach back to par (pentasa, immodium, levsin, another stomach med i forget because i'm out of it, and diet).

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 10/13/2008 8:04 AM (GMT -7)   
As far as work goes, I think you should start planning on how you will manage there if you are still flaring. Crohns is a disability under the ADA and your employer should make reasonable accomodations, such as not expecting you to work where there is no or limited bathroom access. As embarassing as this disease is, it is often in our best interest to be open about it and set up our work the way we need to in order to work comfortably.

For example, I used to work corrections and would miss work when I couldn't get off the toilet. Then I told my supervisor and partners about my disease. We worked it out so I was never alone and then if I had to go to the bathroom I could just go. I may have hit the restroom 10 times per shift but at least I was there, working the rest of the time, and most importantly, getting paid and getting my benefits. I had a commute and had to figure out all the bathrooms along the way, but overall it was worth it to be able to keep supporting myself.
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.

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