and welcome to our little home on the web!
You have a lot going on. You said that your symptoms are returning in the wrists. It may be that you have some ulnar nerve compression going on if you spend any time leaning on your elbows. The ulnar nerve sits in a little groove ( where your "funny bone" is- it really isn't the bone, but the ulnar nerve). Sometimes if you do a lot of leaning on your elbows, you can compress the nerve and it causes very similar symptoms to carpal tunnel. You also have cervical problems so it may be the numbness is a by product/symptom of the nerve compression going on there. Check out a dermatome of the upper body and you will find that each nerve in the spine effects a different area of the body. If you look at the diagrams , it will show you where each nerve effects what part of the body. http://www.backpain-guide.com/Chapter_Fig_folders/Ch06_Path_Folder/Ch06_Images/06-4%20Radiculopathy.jpg
As far as pain meds go, I tend to shy away from making recommendations about what pain meds someone should try for a couple of reasons, I am not a doctor and I feel that the best person to discuss your pain medication options with is your doctor. He knows your medical history, allergies, reactions, etc and we don't.....if you have other medical conditions, some meds may not be good for you to try, and lastly, because every pain medication out there reacts differently for each one of us. Some have gotten terrific relief with oxycodone and others, it hasn't done a thing. You are in a unique situation because of the gastric bypass, and the malabsorption issues that come with that type of surgery, so we really shouldn't make any recommendations because of that factor alone.
I can tell you about the different meds though- fentanyl is a patch worn on the body for typically three days. It does provide consistent pain relief because there is no pill taking involved with it. It is NOT for someone who has not been on opiate pain medications for some time though, and there are dangers involved with it's use. You must avoid hot showers or baths with the patch on. Too much heat means that the medication which is delivered through your skin (transdermally) can be too fast if your body heat rises too much, which can lead to an overdose. If you have an allergy to adhesives, it is probably not the medication for you since it uses an adhesive to stick to your skin. Most of the manufacturers have now gone to a newly designed patch in which the adhesive actually holds the fentanyl, instead of the alcohol/gel base it used to have.
Methadone is a long acting pain medication- in fact, it was first used as a pain medication before any relationship to treating drug addiction came along. It is usually dosed between 1 and 3 times a day. Many people get extraordinary pain relief from it, but there are side effects that some find unpleasant to deal with. It does make you drowsy. It has a long half life, which means that it stays at a higher level in your body for a longer period of time than the other opiate pain meds out there. If it is not titrated very carefully, one can overdose on it. You can not take an extra because you are having more pain that day. Doing that can kill you.
Morphine based medications are good pain relievers as well- they come under several brand names- some are long acting, some short acting which means dosing every 4-6 hours, whatever schedule your doctor provides. Morphine causes sleepiness and nausea in some people but those may go away after being on them for some time.
Anyway, I hope this helps you at least go into your appointment with some ideas about the different types of pain meds out there and the options that you have to choose from, after discussing them with your doctor.
I'm sorry that you are having such pain, you are young to be going through this, but then again, we all are .....
Nice to have you join us,
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.
Avascular necrosis of left wrist- maybe hips too
Post Edited (mrsm123) : 12/28/2009 9:58:30 AM (GMT-7)