Thank you Frances for you in depth post.
Just to clarify a few things...
1) This isn't post-op pain. The last surgery I had was a c-section nearly 20 months ago. No other procedures since. A colonoscopy a year ago, managed with no pain meds.
2)I have been on Loratabs since July. When I was admitted in July for severe pain (Literally was being dosed with Dilaudid, 2mg, every 90 minutes for 14 straight hours.) I was admitted and you could watch my blood pressure dramatically rise when the pain would become painful. In the ambulance on the way to the hospital (I tried to get into the car myself, but no such luck - DH had to call 911). I spent 8 days admitted on complete bowel rest with dilaudid for pain via PICC line.
3) Since my discharge in July, I have been struggling on and off medications for Crohn's.. Remicade, steroids, Aisle 12/ABT-874, Humira, and now Tsyabri. That is a LOT of biologics in my body, but I'm at a point of no return. If the Tsyabri, a biologic for certain auto-immune disorders is the only drug I have left. If that doesn't work, they WILL do a total colectomy.
4) Since the discharge as well, I have been on Loratabs and/or Norcos. Gradually increasing from 7.5mg/500 to 10mg/500. I have tried to wean off the pain pills more then once, and then I was hit with a Crohn's drug that was once again failing. I did fairly well (maybe 2 pain pills total per day) while still on steroids. But, unfortunately, the steroids shot my blood pressures up and the GI immediately took me off of them. Anyway, I basically was getting NO relief on the Loratabs (10mg/500) and that is what sent me to the hospital. I was 2-3 hours into the drug and felt as if it never took affect. I'm sure the reason (based on my understanding of fentanyl now) they gave me fentanyl was because I have been on Loratabs long-term at this point. But, to be 100% truthful..the fentanyl did not relieve the pain 100%, yet a week before, the dilaudid did.
I'm not asking to get IV drugs..I'm just not getting the relief from Dilaudid orally. I hate all these medications. I am calling my surgeon tomorrow... I have been up all night contemplating on whether or not he will put me in. Part of me wants to..part of me is scared to death of it. I'm very aware of the dependence and difficulties brought on by pain medication, but I'm truly stuck between a rock and a hard place. My ER doc this time actually has a sister-in-law & niece with this disease...and worked at Barnes Jewish where my new GI is (well, since summer). He seemed very knowledgeable about the problems with Crohn's for an ER doc.
I'm so lost and confused with all of these. Now, I get to wait on insurance AGAIN. It took them 3 weeks to approve Humira... I cannot go on like this for 3 more weeks.. I have got to get a drug in me and fast... which is why I worry about an admission... I firmly believe they might keep me there for 1-2 weeks until they can get this drug started...
Right now I'm exhausted, but would love some more input. I'm at a loss of what to do. OH, and wanted to note..Dilaudid via IV in the hospital is the only time I was knocked out flat from the drug (I literally fell asleep on it), but obviously, I was on a blood pressure and oximeter, so they knew I was fine. Again, reasonings why I still don't agree that they haven't admitted me. I have cried twice in the ER that I was not sure going home was the *right* thing to do... So, I'm going to rest, try and call the surgeon and see what he says....for now, the dilaudid pill form does NOT knock me out.. it doesn't even make me loopy what-so-ever. All it does is take a "bit" of the edge off so I can sleep... I have been using other non-medicinal forms of therapy as well. And, my surgeon has talked to me about getting a pain specialist to wean OFF the medications once I'm under control...
I think there are too mean cooks (docs) in the kitchen right now!
Kaycie - Age: 26
Crohn's - Dx Nov 05
Failed Remicade, Failed Clinical Trial ABT-874/Aisle 12, Failed Humira. Onto Tsyabri. If I fail that, total colectomy.
IVF #1 (In-Vitro Fertilization) - Failed
IVF #2 - IVIg, Heparin, Baby Aspirin - TWIN GIRLS!!!
Reagan Dawn - 8/2/07 - Lived 1 hour 27 minutes due to Cloaca, NOT affiliated with my Crohn's
Addison Maria - 8/2/07 - 20 months old