What's a good way to talk to my doc abut pain meds?

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Regular Member

Date Joined Jan 2010
Total Posts : 64
   Posted 5/27/2010 6:59 AM (GMT -7)   
Hi, I see my rheumy tomorrow for a checkup- my pain is getting bad again. I am wondering what is a good way to be diplomatic about bringing up stronger pain meds. I am taking Plaquenil and Lyrica (for RA and fibro respectively), and we have tried several prescription NSAIDs. They either work for a couple days and then stop, or give me terrible intestinal issues and don't work, etc. I don't ever bother with OTC NSAIDs because they don't work either. I tried Tramadol and that worked for a couple weeks (and it was an amaxing couple of pain-free weeks!) and then stopped working. I am allergic to Sulfa, so I can't take anything that has sulfa in it. I have high blood pressure which I take medication for, so I have to be careful about that too.
  My question is, do I have to go through the list of every single NSAID to hopefully find one that works? Is it just depending on your individual doc and what their stance is on giving out different levels of pain meds? I don't want to seems like I am drug-seeking, but I took Percocet last year when I broke my arm, and it helped with all my pain-I had no fibro pains while I was healing from that! I don't know if I would even have to use it every day, just if I was having a flare I guess. I am just tired of living with this pain, it's a low-level pain, but then more pain will come along and kick my butt. And I have nothing to help me get through  that except taking a hot shower, but I can't stay in the shower all day.
  Does anyone have any tips on how to talk to your doc about this? Any advice is appreciated!
Diagnoses: Depression/Anxiety, PTSD, Hypothyroidsim, High Blood Pressure, Fibromyalgia, Raynaud's, Rheumatoid Arthritis, Osteoarthritis, Sjogren's
Meds: Celexa (once a day), Buspar (2x a day), Levoxyl (once a day), Metoprolol (once a day), Lyrica (3x a day), Plaquenil (2 times day), Clonazepam to help me sleep for the moment until I find something else.
Allergic to: Sulfa, Ceftin, Augmentin, and Synthroid (probably the filler).

Veteran Member

Date Joined Dec 2007
Total Posts : 2113
   Posted 5/30/2010 7:54 PM (GMT -7)   
Well first I think there are two issues. NSAIDS deal with inflamation which other pain medications will not do. So you almost certainly need to stay on an NSAID.
Second issue is the pain. Tell your doctor that even when you are taking a daily NSAID you are having pain that significantly disrupts (sleep, work, daily activities-which ever). Then ask him/her to give you something to deal with that.

I actually asked my GP-I had her crackin up because I don't tolerate medication well so I was like, what can you give me that isn't codiene, that really will wear off overnight, that might help-and what is the lowest possible dose....

I was given Tramadol. You really just need to be upfront with your doc-and be willing to stay on the NSAIDS rather then go off of that to go on pain meds.
Good luck and I hope you feel better soon.

Veteran Member

Date Joined Mar 2010
Total Posts : 2474
   Posted 6/2/2010 1:38 PM (GMT -7)   
Does your doctor ask you what your level of pain is on a scale of 1-10? Does he ask you if you have trouble sleeping? This is how my doctor determines if I need something stronger. If you have high pain levels and trouble sleeping - if he doesn't bring it up- i would myself. All the best to you!

Veteran Member

Date Joined Sep 2008
Total Posts : 1670
   Posted 6/2/2010 6:06 PM (GMT -7)   
Some doctors just don't want to deal with pain. But just be honest, say you're not coping. Like Sjkly I'm on tramadol slow release and I have break through tramadol too if I need it.You might have needed a stronger dose, I can take up to 400mg per day. I tried fentanyl pain patches for a few months too but then I started to get migraines so we swapped to the tramadol and so far so good. You may need something stronger to help your overall symptoms.

But not being a doctor I can't give advice there. Just be honest, ssay you're in pain, its impacting on your life , you need help, etc. Go armed with a list of what you can and can't do because of the pain, diary style, sometimes brings it home to the doctors. Sometimes they don't seem to hear you. Goodluck with your next visit. golitho
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