A daily battle

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cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/16/2012 6:32 PM (GMT -6)   
Hi All,

During my last PM visit, I was told to increase my BT med use -- I wanted to change to a stronger time release, buy my PM thought I was still using a very modest amount of BT meds.

Well, I followed his advice and now rarely is there a day where I don't use something. Also about 1/3 of the days, I'll take two.

My pain is being managed, but as I posted a few weeks ago, I've been getting headaches. I'm also more lethargic and just not getting much work done.

Where I was typically writing 10 pages per day, now days go by before I get anything done. I find it hard to concentrate and am just too cloudy. These symptoms don't necessarily arise only after I've taken my BT dose. Rather, they are just persistent.

I've tried various supplements, an extra cup of coffee, more exercise. But something is going on. I don't know if it is due to some sort of brain fatigue from the added meds, something related to my cervical scoliosis, or is unrelated.

It sounds wimpy to go to the doctor about the symptoms, but they are just not what I am used to. For most of my career, I've been a publishing powerhouse, but now am barely able to stay focused long enough to write a sentence.

So far this week I have:
1) written a 3 page proposal for a book series I've been asked to develop
2) corresponded with possible contributors to that series
3) made calls, emails to local hotels to set up a conference for the Fall
4) ran two research meetings, a total of about 4hrs
5) evaluated some work from more junior members

The above list illustrates my problem. It looks like I'm doing a reasonable amount of work and so nothing could really be that wrong. But I'm constantly fighting through this fog and am far less lucid. In the past, the above would have been a standard single day of work for me. But it took huge effort to get through these tasks over five days... and I haven't touched my book since last week.

I would like to cut back on my BT meds, or actually, take a few weeks off everything to clean out my system and see if my mental powers return.

Day after day, I think I'm going to start. But at some point or another, I just can't handle the pain and give in.

On Valentine's day, I dealt with the pain until I wrapped my wife's gifts. That put me in such agony, I had to take something else I would be in bed for the rest of the day. Then yesterday, I had a meeting and had to take something so I could tolerate sitting. Today, I was again going to start my break, made it through until 4pm, but was in so much pain, again took something. The pain has now abated, but a headache is starting and I would like to just lie down and veg out.

Instead, I'm at my computer, hoping to muster the focus to work on my book until my wife gets home. But as I just don't feel up to the effort, I'm venting here instead.

I don't know if the symptoms have to do with my meds and would like to take a few weeks off to find out. But that will be a costly two weeks for I'll have to stay in bed through most of it and will get even less done. I'd be thrilled if my concentration improves and can thus identify the cause, but I dread the idea of having to take weeks off, be in even more pain, and just discover that it is not the pain meds but something else behind these symptoms.

Ideas?
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Lindaloo
Veteran Member


Date Joined Sep 2006
Total Posts : 1713
   Posted 2/16/2012 7:11 PM (GMT -6)   
Cognito,

I read your list of things you accomplished and I agree, you could probably accomplish that in one day instead of five, if you are a hard worker like I was when I was an home health administrator. The pain is definitely hindering you.

As for the meds, I take oxycodone 15mgs every four hours and lyrica 400 mgs twice a day along with various other meds, some of which are giving me a very foggy brain, but I am retired now, so it doesn't impact my business day like your day. I had to retire when I realized that the pain, and thus, the pain meds were impacting me as you described.

I want to share with you that my oxycodone does give me headaches at times and so I take a couple of motrin and that seems to help knock the headache down. You could try that. It's innocuous and just may help with the headaches!

You talk about breakthrough meds and I really don't know your med regime, or your history for that matter, but maybe, you need a stronger medication as a daily medication for the pain to begin with. This would, therefore, eliminate the need for a break through med. Just a thought. I may be out in left field here. I don't know.

I do see a bit of history below your name and you have an SI joint problem and a narrowed foramen, the headaches, and the tachycardia. You and I share similar medical histories. Add fibromyalgia and clinical depression and you have me!

Anyway, I don't know if I helped you or not, but I'll tell you this, I will include you in my prayers and I do wish success with your career and all your endeavors. God bless you!

Linda
Believe in yourself. Be kind to fellow humans and animals. Take time to smell the flowers and the coffee.

And by all means, when you are down, ask me for help. I will be there.



Linda

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/16/2012 7:51 PM (GMT -6)   
I think you answered in your other thread...but how much water do you drink each day? I drink close to 13 glasses throughout the day/evening...(I don't have any kidney issues that this could effect)...This makes a huge difference for me....I can tell right away if I'm behind as I get tired or a headache.

Also....what is your BT medicine? If it has Acetaminophen....there are studies now that taking this long term can cause rebound headaches....

This, along with nausea is the reason I switched from Percocet to OxyIR....just plain Oxycodone....

I know it's a simple thing...but if most of your day is spent in front of a computer....the screen and lighting can cause headaches....so this is something to play around with..

Another question...when is the last time you had an eye check up? If there are any changes...as well as working with a computer each day....can cause eye strain which leads to headaches...

Just trying to think of some natural things to help...

It could also be a sleep issue.

For me...my fatigue levels changed dramatically when I started using Ambien after my last surgery....Just one pill at night right before bed. I suffered from extreme fatigue where I could sleep for hours but never feel rested...this in turn would cause headaches in the afternoon/evening. It turns out that I was never getting to deep sleep...stage 4 sleep...I know that this medicine can work for some...but not for others...and it has side effects....but the pros outweigh the cons for me absolutely.

Just some thoughts...

Sorry you are having a tough time:(

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3702
   Posted 2/16/2012 7:59 PM (GMT -6)   
Cogito
Have you ever been diagnosed with depression, and given any medication for it? Allot of people that suffer with chronic pain also suffer from depression. Allot of the things you mentioned in your post sound like it could be caused from depression. Anyway it is just a thought that you might want to consider cheching out, possibly going to a counselor may help you. So  many of the things you described is so common among so many of us that suffer from chronic pain. Counseling and taking an antidepressant might be just the thing you need to help you get back to your more productive self. At least it might be another avenue for you to try anyway. I wish you well and hope things work out for you!
 
White Beardd
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Post Edited (White Beard) : 2/16/2012 6:03:14 PM (GMT-7)


cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/17/2012 11:25 AM (GMT -6)   
Hi,

Thanks for the input.

I do drink quite a bit of water -- 2-4 liters per day.

An eye check-up did cross my mind. I've not had these problems before, however. I can see fine with my current prescription, except when I'm tired -- and also age-related focus issues (presbyopia) is just starting to set in. So, it is just about time for bi-focals.


As for depression, I agree that my symptoms could have a psychological origin, but I don't feel particularly depressed. I've been depressed in the past, very depressed, but despite the pain, my mood has been quite good for at least 5 yrs. Anxiety is a different story -- but I've suffered with anxiety for quite a while and have never had these issues.

I've finally decided to see my GP and was able to get an appointment today. I'll report back afterwards.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/17/2012 1:41 PM (GMT -6)   
Well,

I just got back from my GP. I saw him about these symptoms in August, when they were also quite bad.
Then, he followed the conjecture that they were related to my scoliosis. This time, he wants to see if they are merely a result of either labryinthitis or a sinus infection (though I have no congestion and no discharge).

So, he prescribed a steroidal nasal spray (which cost an astounding $125), Singulair, and Mobic. It would be great if it were that simple. I guess I'll see over the next few days.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/17/2012 3:47 PM (GMT -6)   
Thanks for the update....

That is kind of strange as you don't have the majority of the symptoms of a sinus infection...Fever, discharge, facial pain...etc....

The Mobic is for treatment of osteo and rheumatoid arthritis....and of course Singular is for allergies...

As well as it's odd to prescribe 3 different medicines....as if it works...it may be one of them...not all that is doing the trick...They usually try one and then replace or build on it if needed....

But....I'm not a Dr.! LOL....Just commenting...

Obviously whatever helps...this would be great!..Keep us posted....
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/18/2012 11:24 PM (GMT -6)   
Hi All,

So far, no real change. I've been using the meds my GP prescribed and I just don't think his labrythitis/sinusitis diagnoses are correct. I have no fever, no congestion, no discharge, no colored mucus, no pain when sinuses are pressed, etc..

I'm back to thinking it is related to the scoliosis as the symptoms seem to track with my pain and, particularly, with muscle tension.

It would have been nice if the mobic helped with my back pain, but no difference.

Earlier this evening, I was in a lot of pain, had extremely spasmed upper back & neck muscles, headache, head pressure & vertigo. I then took a long hot shower and that loosened up the back and relieved the other symptoms. I felt well enough to get down to some work, but now, about 90 minutes later, all the symptoms are coming back. Maybe I need to find a muscle relaxant that I can tolerate. Skelaxin, flexeril, zanaflex all had horrible side effects. Baclofen helps, but it makes me feel a bit crummy and is too short acting. Valium is o.k. at night, but I'll fall asleep. I have a really old bottle of Soma. I think I'm going to give it a try.

Has anyone found a muscle relaxant that doesn't make them feel drunk or sleepy?
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Heather Lynn
Regular Member


Date Joined May 2011
Total Posts : 283
   Posted 2/18/2012 11:45 PM (GMT -6)   
Cogito,

Have any of your doctors considered a fibromyalgia diagnosis? Fibro is common in people with other chronic pain conditions, especially back pain. The theory is your nervous system is under constant siege from the pain, and this eventually causes central sensitization of the nervous system to pain signals. My fibromyalgia was triggered by chronic upper back and neck pain.

Fatigue is a really prominent symptom in fibromyalgia, as is "brain fog". Headaches are also very common in people with fibromyalgia, and in my experience are also prone to "medication overuse headache", which seems to be part of what you are experiencing with your BT hydrocodone/APAP.

The real symptom that made me think fibromyalgia though is your sensitivity to medications. You mention not tolerating three muscle relaxants, and in the past you've mentioned not tolerating other medications well either. Being very sensitive to medication side effects is common in people with fibromyalgia and requires a very different approach to medication dosing.

Fibromyalgia can be hard to get diagnosed, and since it's seen as a "woman's disease", even more so for men. But I would look into it and bring it up with your doctor if you think it fits. If you do have fibro, I would suggest the book "Healing Fibromyalgia" by David Edelberg. I think a lot of his treatment options make a lot of sense, although I disagree with his "change everything at once" approach.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/20/2012 5:14 PM (GMT -6)   
Hi Heather,

My Father has been diagnoses with Fibro, so I suppose I am at risk for it. But so far, the pain is very specific and linked to my scoliosis -- left side of my back from shoulder blade up, left side of neck. Also right hip & SI pain from car accident.

I tried a Soma two nights ago to help with muscle tension. The good news is that it didn't make me feel horrible, like the others I listed. It did totally knock me out, however. I couldn't even walk I was so drugged. I fell right asleep. Unfortunately, I woke up 2hrs later after regurgitating some food (ug!). I thought I was going to throw up and rushed out of bed to the toilet.

I usually have a meal around 11pm (that night was a curried tuna sandwich with some salt and pepper pistachios). Typically, I'm up to 1am-2am reading. But with the Soma, I fell asleep immediately. Perhaps the regurgitation was then due to lying down right after a spicy meal (usually doesn't bother me) plus the relaxation of my cardiac sphincter.

Due to the bad night, and wanting a break from BT meds, I spent all yesterday in bed. I'm also taking it easy today. I'll give my GP's hypothesis a few more days, then when I return from a visit with family early next week, I'll probably have to see him again to deal with the headaches, dizziness, etc..
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/20/2012 6:11 PM (GMT -6)   
Sorry to hear that the meds are not helping very well...

May I ask why you eat a meal so late? I'm sure you know that this is not a good thing to do at all..Not only for weight gain...but just as what happened to you....Eating and then lying down can have the food and acid go back up in your esophagus as well as possible choke on the food...

I eat my dinner at 6pm and in bed by 10pm...As well as I go for a walk with my dog at 8pm...this way...it not only helps digest and metabolize my dinner...but the light exercise (just walking) helps me wind down and be tired enough in a few hours to get to bed...

Another reason it's not good to eat late...is that you tend to eat more throughout the day....

I'm 43 and have been able to maintain my weight my whole life by grazing all day...My biggest meal of the day is at lunch...but I get up at 5am each morning...and eat a nice light and healthy breakfast...snack at 9am....lunch by 12pm...another healthy snack at 3pm...and then light dinner at 6pm...

Having a sleep, wake, and food schedule has also helped keep my energy level much more consistent as well as feeling less fatigue...

So...it may be something to look into changing...or at the very least...make sure you do not eat anything spicy or anything less than 4 hours from going to sleep...

Ok..sorry for the ramble...just want to help...and it threw me as I've never seen anyone eat dinner so late!! LOL..

As far as muscle relaxers go...I had good luck with Robaxin...it worked well and didn't cause any fatigue....I actually really like Skelaxin....it's too bad that you didn't have luck with that one...That one also didn't make me sleepy one bit...

I am now on Flexeril as it is so darn cheap and I don't have insurance...So I take one in the afternoon which helps with pain as it gets worse throughout the day...

As I mentioned before...it really was strange for your Dr. to put you on 3 new medicines all of a sudden without trying one at a time to see what works and doesn't work...and your symptoms didn't match up with a sinus infection...but hey....what do we know..right???LOL

I'm sorry it's been a bad few days..hope that you can get some better answers soon....
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/20/2012 6:36 PM (GMT -6)   
Hi Snowbunny,

Pretty much my whole life, at least from teen years on, I would have a late meal. I have no appetite in the morning and only have a very light breakfast (a few granola bars, some toast with cream cheese, etc.), then I eat a modest lunch, and through the evening have most of my calories.

I've never had a weight issue (I'm 6' tall and weight about 165lbs) and my meal pattern has never been an issue for me. The only other times I've had nighttime regurgitation are after taking too many NSAIDS.... and maybe after too much booze here and there in my youth.

Thanks for the suggestion about Robaxin. I'll research it and see if I can bring it up with my doctor.

I'm also going back into PT, which in the past helped with the symptoms.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/20/2012 6:46 PM (GMT -6)   
Then it really seems to work for you...that is great! I've never met anyone like that...so you have widened my circle!! LOL (Well..I guess I should say it's much more common over in Europe...I remember traveling around and everyone is out and about eating dinner at 10 or later.....

Hopefully the PT will help this flare...It's really tough when we are plugging along and seemingly managing our pain and then wham....we have this awful stretch...

And I agree with you when it's something new...I almost feel bad about approaching my Dr. with yet another symptom or pain issue...I think..."really? more?...can't I get a break here?".....:(

Keep us posted on how the PT and the next Dr. appt. goes...
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3702
   Posted 2/20/2012 7:16 PM (GMT -6)   
Snowbunny21 I admire your ability at going to bed at 10 and getting up at 5 AM. I used to do that at one time, and I admit I liked seeing the sun rise in the morning. But the last few years, since my divorce, I am like cogito, I usually always go to bed after one or two AM. and often don't get up till 8 or nine in the morning. Pumpkin ( my dog a king charles cavalier spaniel) has also adopted my schedule, and is even more of a sleey head than me when it come to gettng up in the mornings!

cogito you mentioned that baclofen worked for you but did not last long enough. Usually Baclofen is started off in low dosage and is slowly increased, and it is also usually given every eight hours, so you maintain a constitent level of the medication in your system. At least for me, I have found it to be the best of all the antispasmodics I have used. But it took awhile to get the dosage right, I am on the max recommended dosage of 30 mg every eight hours and it does for the most part control my muscle spasms and charley horses. Another positive thing they have found about Baclofen, is that allot of people that use baclofen have also found it also helps reduce ones pain too, and people using it have had to use less BT pain meds. Robaxin is also a very good muscle relaxant, but often for allot of people it requires you to be on it for awhile before it becomes really effective!

I think that going back to PT is excellent, I do hope that it helps you, Good Luck!

White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/20/2012 7:56 PM (GMT -6)   
WB...I had to train myself to do this as I found that it really helps my pain and fatigue level...along with trying to never nap during the day...This way...along with my nightly walk a few hours before bed...my body is more 'ready' to sleep. And it is more natural with the rhythm of night and morning sunrise...and during the winter months...I use the light box I own while I have my cup of coffee..

I shut off the tv, computer, and all the lights and "listen" to a book until I fall asleep...Yes..I do use Ambien because of the pain that makes me toss and turn....but combined with all of this...it has really made it where I wake up instantly at 5am...no alarm....and I am not tired during the day...

I started doing this when I switched over to eating all Organic..(not vegan or vegetarian...just all natural and Organic)...Not only is my digestion better...but my fatigue levels and overall well being has made a huge difference....I was truly amazed at how much this matters...Now that most all grocery stores have their own Organic brands...It doesn't cost me any more than it did before...I do lean towards more vegetarian but still eat lean meats and fish...

I just learned that sleeping better and eating healthy are two absolutely crucial things that I can change naturally to help with my pain and energy levels...

I'm divorced at well...my ex just laughs at me now as this was his schedule for most of our marriage and I was a night owl...LOL...

Anyway...sorry to hijack Cognito...just wanted to share that it took some effort to change but I would never go back as it's made such a big difference in my life.
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3702
   Posted 2/20/2012 8:44 PM (GMT -6)   
Well Snowbunny I will admit I am a bit envious of you, I am pretty good about being self disciplined and that sort of thing but my sleeping schedule and eating are just two things I have reeally had a hard time with since the divorce. Fixing meals for just my self I find difficult, I love to cook and make cookies and candy, but I find it is just to hard to fix a normal meal for just me and then eat on regular schedule. Sleeping is also a whole nother thing. I seem to have a second wind about ten at night and find my self wide awake and doing things either. on the internet or around the house such as cleaning. Maybe I will start another thead about eating and sleeping with chronic pain. As I to do not want to hijack cognito's thread.
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/21/2012 5:18 PM (GMT -6)   
No worries about the "hijack".

I'm fortunate to have a metabolism such that eating has never been an issue for me -- except when I was a vegetarian and struggled to keep my weight UP (I dropped as low as about 135lbs for a while). Sleeping, too, usually isn't an issue. Once I lay down for a few hours, my pain subsides (about 90% of the time) to a point where I can sleep.

I'm now waiting for PT to call me.... I phoned them yesterday but they hadn't gotten the GP's referral yet and wouldn't set up an appt.. So I phoned my GP's office who said that they had sent it and will send it again. If I don't hear from them today, I'll call again tomorrow (or just email the PT I always see there, who I've gotten to know well after seeing him for 7 years).
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/21/2012 6:02 PM (GMT -6)   
Thanks for letting us wander a bit:)

I really hope you hear from the PT asap so you can get started with that!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/21/2012 6:07 PM (GMT -6)   
Just got the call. My favorite PT is booked up for the week (but I emailed him directly just in case he can squeeze me in). I'll see someone else this week then back to him next week.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/21/2012 6:33 PM (GMT -6)   
Ohhh..well..that is good news/bad news...lol..

Glad you can get started at least....My mom is going through PT right now and it certainly helps to have someone who really knows you and all our "issues"....

Keep us posted..
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006
 
 

tmjpain
Veteran Member


Date Joined Oct 2008
Total Posts : 2024
   Posted 2/21/2012 7:22 PM (GMT -6)   
Sorry you are going thru such a rough time Cogito. Sure hope things improve for you very soon.

Suzane

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/21/2012 9:24 PM (GMT -6)   
Thanks.

I little bit of good news is that my PT emailed me back to let me know that he traded patients with the other therapist so he can see me this week.

He's really the only truly great medical provider I've ever known.... both his skill level and his personal commitment. I've been seeing him for 7 years and we've grown close enough that my wife and I attended his wedding a few years ago and have gone out for dinner with him and his new wife.

I took some oxycodone this evening (the real stuff, not the donut -- joke), dipping into the scant supply my PM gives me above my usual hydrocodone for BT pain. It really manages pain so much better than hydrocodone and I reserve it for days that are really bad.

I'm actually feeling well enough right now that I'm going to get a bit of writing done.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray

Heather Lynn
Regular Member


Date Joined May 2011
Total Posts : 283
   Posted 2/23/2012 2:25 PM (GMT -6)   
The fact that oxycodone works so well for you makes me wonder why your PM won't just bite the bullet and switch your ER med to Oxycontin 10 mg twice a day. It's a tiny dose and it could make a huge difference, since you have some problems with the BT meds. It's annoying that he seems to feel you only require strong ER meds if you're burning through the BT meds.

Unrelated...I read recently (in the Healing Fibro book) that some people have better results with Ultram when they divide their dose to twice a day rather than once a day. There's no 150 mg ER tab, but maybe you could try splitting it 200/100? That'd also allow you to use the generic, although the price difference isn't that great if you are self-pay.

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 2/23/2012 3:36 PM (GMT -6)   
I did talk with my PM a few times about moving from Ultram to something stronger.

Last year, we gave Kadian a try. He indicated that he doesn't like to use Oxycontin since most patients find that 2x isn't enough and really need it 3x daily. This causes various issues regarding prescribing rules (I'm not sure what he meant, but I suppose it has to do with records related to DEA/state law...or just his being cautious). So, he only goes to it once other options have failed.

In my case the Kadian completely knocked me out and so I went back to Ultram.

During our last visit, I brought up trying Opana ER, but he thought I still was using so little BT med, we should stick with the Ultram. He told me to not wait until the pain gets really bad before taking a BT med and I can realistically double the quantity I use. So, I'm now taking about 20mg of hydrocodone through the day, basically every day.

One benefit of relying upon BT meds for most of my pain control is that I can adjust the quantities as needed, another is cost. The down side, though, is that I probably net more pain since I'll only turn to it once the pain ramps up enough, rather than the time-release helping to keep the pain down throughout the day.

I wish that he would just let me increase my ultram to 400mg (maybe then 200mg in the morning and 200mg around dinner). But he won't go over 300mg. Alternately, I look forward to when hydrocodone is finally available as a time-release. As 20mg (above the ultram) is enough to manage my pain 80% of the time, I would prefer it over oxycodone (again, to slow tolerance).

During my next visit (late March), I might again pitch the idea of staying with the Ultram and adding to it the lowest dose or Opana ER. We'll see how I fare with pain any my head symptoms after another round of PT.

BTW, I saw my PT this morning and he said that the left neck muscles were extremely tight. He worked on them for 45 minutes or so and told me to just give him a call tomorrow if I want and he'll fit me in.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs), RT hip and SI joint damage from car accident. Also, pectus excavatum, supraventricular tacycardia and mitral valve prolapse syndrome.
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .25-.5mg ativan as needed for sleep, Verapamil 240mg SR (for tachycardia). [/gray
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