Teenagers on morphine....

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BadFootBill
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Date Joined Feb 2012
Total Posts : 9
   Posted 2/18/2012 7:22 AM (GMT -6)   
I'm 17 and will be 18 on the 22nd of February, I've been suffering for 11 months with a now chronic foot problem thought to be related to a crack in the cartilage surrounding the base of the talus as there is a great deal of bruising on the talus itself which should have in theory healed by now! There was no one injury that triggered the severe pain I'm in it instead came on slowly.
I'm currently taking Tramadol, Codeine, paracetamol, Naproxen and Amytriptyline to try and control the pain. Ive tried various quantities in various combinations but am still getting no moderate pain relief. I have also tried a TENS machine and various creams, herbs, salts, acupuncture to try and relieve the symptoms with no luck.
My GP said that he does not feel comfortable therefore will not prescribe me with morphine, (morphine sulphate, oramorph or such like) due to my age but may be able to refer me to someone who will.
Should I be taking morphine for the severe pain I'm in despite my age? I'd like to hear some people's opinions about this. Also I'm from the UK if that makes any difference!

cogito
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Date Joined Oct 2010
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   Posted 2/18/2012 1:46 PM (GMT -6)   
Hi Bill,

I'm not going to say whether or not you should take morphine, but rather address the broader issue of chronic pain for someone of your age.

I'm in my mid-40's and my pain issues started in my mid-30's. For about six months, I said no to any opioids, hoping that the pain would go away. It didn't. I then only accepted the weakest options (darvocet, tramadol). Another six months in, I finally turned to hydrocodone.

Along the way, I had various treatments (PT, injections, and eventually some surgeries). I also tried NSAIDS, TENS, etc..

So, nearly a year in (like you) I came to realize I needed something to help me -- so I didn't have to spend most of my time in bed, so I could go out for a meal, so I could focus on work, etc..

The meds have allowed me to do all that, but it is now a daily battle between how much pain to tolerate vs. how many meds to use, fully aware that the more I use, the more tolerant I become, the more dependent, and the sooner I'll have to ask my PM for a refill (which always scares me). So, moving on to opioids may help relieve the pain, but generated a bundle of new issues.

At just 18, those issues will be even greater for you: more years ahead, and more potential suspicion from doctors. I don't know whether there are surgical options or other treatments, but if you can find a way to be without pain through them, they would be far superior to a life of opioid use.

Only once all else has been tried and failed, especially at your age with possibly 60 years of opioid use ahead, should you accept that fate. Just consider how in the world will you be able to keep the meds effective for so long?

Hope this offers a helpful perspective.
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

NiNi53
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Date Joined Mar 2011
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   Posted 2/18/2012 3:07 PM (GMT -6)   
I believe your doctors concern with having you on morphine, (I take ms contin extended release) is that starting you on that strong a pain med while you are 17, and if it turns out to be a chronic pain problem, by giving you morphine, althought by far not the strongest med available, it may be they would rather try other meds to see if they work before starting you on something like morphine at your age.
 
I dont know if that is your doctors thinking, but you can ask.
 
Kathy
degenerative disc disease, fibromyalgia, osteoarthritis, neuropathy, lumbar laminectomy july 1998 no help, rechargeable neurostimulator unit low right back w/lead wires to left side and right leg unit not working just sitting there.i am 57 years young in may will turn 58. i have 2 grown daughters, 25 and 29. i have 2 grandchildren, 9 year old grandaughter and 5 yr. old grandson

CRPSpatient
Forum Moderator


Date Joined Mar 2011
Total Posts : 1276
   Posted 2/18/2012 5:19 PM (GMT -6)   
Hi Bill, and welcome. Cogito and Kathy have answered you well. I'm in a similar position to yourself, though I'm now a bit older at 27. My doctors had no choice but to start using stronger opioids when I was 22, because we'd tried everything else and my pain was getting so severe I couldn't function. I can only tolerate a couple of different meds which makes the problem greater still, as it means even at my age now, my options are becoming limited.

One thing that concerns me - is that you've said your pain is "thought to be related to...". I take it you've had full investigation? As far as the bone bruise goes - a bruise on the bone as you might know is when some of the fibres that make up the bone break, but not enough to cause the bone to fracture. I'm not sure if I'm thinking down the right track here, but when you have true fracture that won't heal, you can use something called a 'bone growth stimulator' which is a special type of ultrasound. I wonder if it's worth asking about. Come to that - have you tried regular ultrasound therapy and does that help?

Do you walk on it? If you do, it's probably also worth talking to a podiatrist if you haven't already and seeing if they can do anything with your footwear - see if it's possible to make changes, support your ankle - anything that might help your pain.

Laura
Moderator - Chronic Pain Forum

Full body CRPS with spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bursitis, CTS, osteoporosis, multiple compression fx, disc bulges.

Oxycodone ER/IR, Topamax, Mobic, Somac, Cipramil, Midodrine, Vit D & C, SCS, baclofen/bupivacaine pump

Heather Lynn
Regular Member


Date Joined May 2011
Total Posts : 283
   Posted 2/18/2012 10:32 PM (GMT -6)   
Hi Bill,

I agree with Laura's advice that you need to make sure this has been thoroughly investigated and that everything possible is being done to heal your injury. A podiatrist is a good possibility. Have you seen an orthopedic specialist? I would assume you have, but since you only mention your GP I'm not sure.

As far as codeine, have you been on a higher dose? Many doctors prescribe Tylenol #3 (30 mg of codeine per tablet), but my doctor prescribed Tylenol #4 and it has made a big difference in my pain relief. Tylenol #3 barely touched the pain and Tylenol #4 gives me enough relief to do most of my daily activities.

Finally, I'm sure you have already gone this route, but have you tried icing it very religiously? Ice can be a very effective adjunct to the pain medications. I have hip problems that don't respond especially well to pain medicine, but DO respond to being iced for 20-30 minutes, 2 to 3 times a day. For me the difference is dramatic, but I didn't give it a fair chance the first time my doctor suggested it because I didn't believe something as simple as ICE could possibly help, and a single ice treatment did nothing for my pain level.

I was young when my chronic pain started, and I got very good advice to wait as long as possible to move on to stronger painkillers. That isn't to say you should never move on to them, just that as you move to stronger medications, you reduce the options available to you in the future. So make sure you've explored all your options, and then it is reasonable to move on to stronger pain medication.
Fibromyalgia, low back pain/SI joint dysfunction, anxiety, obstructive sleep apnea, endometriosis, asthma

BadFootBill
New Member


Date Joined Feb 2012
Total Posts : 9
   Posted 2/19/2012 11:32 AM (GMT -6)   
Hi everyone thanks for your replies,
I've seen orthopaedic surgeons and podiatrists (my aunt is one which is very handy!) and already have orthopods to help with my foot alignment. I also walk with a cane, which is why everyone calls me House! The fact I want to be a doctor and am always taking pills also adds to it haha. Tylenol #3 over here is called solpadol over here, 30mg codeine and 500mg paracetamol (acetaminophen). I was previously taking 2 of them, four times a day, equivalent to tylenol #4. Although this reduced pain my physical state was very bad and the pain was till present!
I've seen a lot of specialists and am now waiting for an operation, unfortunately i'll be waiting for a few months before I actually get it! Hopefully this will sort out the pain problem and make everything a little more bearable. So does anyone think the strong pain killers would be suitable for that period of time?
about using ice, Heather, the area has no swelling or external bruising. Do you still think it's worth trying?

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16285
   Posted 2/19/2012 3:07 PM (GMT -6)   
Hi BadfootBill, its really hard to say whether or not a stronger pain medication will help you or not. Everyone metabolizes medications differently. What may help me in a pain medication may not help you one bit, its all pretty much trial and error till you find what works the best. I would also imagine with you being so young, drs really do not want to put you on a strong narcotic. That is something we run into here in the states, drs are not willing to give much for pain medication to young patients. In fact, in some parts of our country its getting harder and harder for adults to get pain medication. With the war on drugs and all the hype going on here in the US it is getting harder and harder for CP patients to get medication prescribed.l Plus the DEA is involved and they have new rules in place for drs that rx narcotics, some drs are just scared and want no part of a visit from the DEA in their offices.

I do hope your dr can do something to help ease your pain. Take care....Susie
Moderator-Chronic Pain Forum

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/19/2012 4:01 PM (GMT -6)   
Hi there,

Sorry to hear of your pain issues...

I agree that it's really going to be a collaboration between you and your Dr.s on where to go from here.

Usually a Dr. will go in steps...Since you are on Tylenol #3....the next step is possibly Tramdol...(the generic name for Ultram)...or perhaps something like Vicodin or Norco.

It's done in stages whether you are younger or older. As well as looking to find a way to "fix" the issue if that is possible. If not...than adding in other modalities to help you live with chronic pain is the way to go.

There is never just one pill that is the answer or meant to take away all the pain.

That is great that you have a Dr. in the family. I'm surprised they haven't been able to pull a few strings to get you into an appt. sooner than a few months from now...lol...

Anyway...the main thing right now is making sure that they show you the proper way to walk with a cane as many people do so in the wrong way which can cause other issues in the hip and back.

I do wish you luck and keep us posted on any appts...
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
 
 

Heather Lynn
Regular Member


Date Joined May 2011
Total Posts : 283
   Posted 2/19/2012 11:27 PM (GMT -6)   
Bill - I'd go ahead and try the ice. If it works, you should notice an improvement in 2 to 3 days, so there's not much harm in trying it.

If you're thinking about the meds just until surgery, and not long term, that might not be a bad idea. Maybe you should see the pain doctor and talk it through with him? You can ask all the questions you have and decide for yourself if it's worth it.
Fibromyalgia, low back pain/SI joint dysfunction, anxiety, obstructive sleep apnea, endometriosis, asthma

SmurfyShadow
Veteran Member


Date Joined Dec 2008
Total Posts : 2386
   Posted 2/19/2012 11:32 PM (GMT -6)   
Ask your doctor for a full body MRI, I had a friend who had pain like you described and he found out he had compressed spinal cord. Its operatable. Also take a copy of your MRI to a chiropractor to see if they notice anything wrong
"The Walking Medical Mystery"

Too many Allergies / Too many RXs & DXs

A Rare Gem for Doctors and Guinee Pig
~Medical Caregiver and Doctors Worse Nightmare~

Jim1969
Veteran Member


Date Joined Jul 2009
Total Posts : 2042
   Posted 2/21/2012 2:11 AM (GMT -6)   
What your next step is really is something that needs to be discussed with your doctors and your parents (if you are living at home) even though you will be 18 tomorrow.

Something to consider is "reasonable expectations" when it comes to pain control/management. Unless the underlying cause of the pain is corrected it may not be possible or advisable to eliminate the pain through medication or any other kind of therapy. The best that may be realistically hoped for is to reduce the pain to tolerable levels.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.
Moderator Depression Forum.

BadFootBill
New Member


Date Joined Feb 2012
Total Posts : 9
   Posted 2/22/2012 10:27 AM (GMT -6)   
I've finally got my appointment for the pain clinic but its not for another month :(
I haven't had what I would consider a 'good day' for about 3 weeks now :/ I had to stop taking the high strength tramadol and codeine together as I went to sleep on monday and it felt as if I was floating and I was having some respiratory troubles, although only minor I thought I should stop! I've had a few of the pharmacists I work with say that not only would I get more pain relief by taking morphine but I should also have less side effects.
My consult to book my op has also been booked, devastatingly for the first of June!
I'm icing it now and hoping that doing this religiously will give me a little more relief.
Thanks again for all your replies and advice

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/22/2012 11:44 AM (GMT -6)   
I'm still a bit confused why you are set and keep mentioning only the Morphine...This would not be the normal next step in medications from taking Tramadol or Codeine...

The next in line is Vicodin and then Percocet....

Has the Dr. mentioned moving you towards Morphine? The Pharmacists are only going to give you side effect information...not be able to tell you what you should be taking for your pain...This will be solely up to your Dr. And every pain medication has side effects...Morphine included....Most of the time....the main side effects will start to fade after a month of use...


How many of the Tramadol and Codeine were you taking together to cause such a strong reaction which almost sounds like too much medication...

It's good that you have the operation date....Hopefully you can work with the new pain clinic and they can find a good mixture of medication and all the other modalities like PT, ice, massage, etc....

As mentioned...pain medicine is only one small part of the puzzle...

Thanks for keeping us updated..
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
 
 

BadFootBill
New Member


Date Joined Feb 2012
Total Posts : 9
   Posted 2/22/2012 12:13 PM (GMT -6)   
I'm from the UK so vicodin is not available and the next step up form the level of tramadol I'm on is morphine, I know that morphine too comes with side effects however I'm willing to accept them if it actually relieves my pain!
I was aware that I was taking a lot of tramadol and codeine (and paracetamol) but I was still under the maximum 24 hour dose for both.
If only pain was easy to understand!

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/22/2012 1:00 PM (GMT -6)   
Ahh...thanks for explaining more about living in the UK and different prescribing procedures...

I am on Morphine in the long acting version and have gotten here after over 11 years of pain management, so that is why I was saying that it's usually not prescribed in the beginning stages...

I certainly hope that you can manage to lessen the pain some with using ice and finding a good dosage of your medication until you get to the pain clinic...
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
 
 

BadFootBill
New Member


Date Joined Feb 2012
Total Posts : 9
   Posted 2/22/2012 5:12 PM (GMT -6)   
Thanks snowbunny, as I say I'm hoping this is only a temporary thing and will be over within the next few months. As much as it's daunting being on something as strong as morphine I think it may be worth a try at least to see if it will enable me to finish my a-levels and start training as a doctor!
If not anything, this is all good experience for me in terms of a medical career!

Snowbunny21
Veteran Member


Date Joined Jan 2010
Total Posts : 3557
   Posted 2/22/2012 5:20 PM (GMT -6)   
I certainly hope this is a temporary situation for you...

And really, Morphine in pill form is completely different and about 10 times less strong than what you get in a hospital in IV form...

So...I don't want to scare you or anyone about this medicine as I was just curious if they had tried other medicines leading up to this...

As you've explained...you have different options in the UK...

Is your Dr. starting you on the MSIR (Morphine Sulfate Immediate Release) which are the short acting ones or the MSContin...(Morphine Sulfate Continuous), the long acting ones? Or do you know yet.....

It certainly has worked well for me...Just know that constipation can be a real issue so be prepared and stay ahead of it with drinking lots of water, and upping your fiber intake....along with any natural supplements you may need....

As well as there can be some fatigue and/or nausea the first week or two...

That's the downside to meds...as they all have side effects but most will go away and can be managed...

That's exciting that you are going to school to be a Dr.! This temporary experience will add to your empathy with patients who have pain...
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
 
 
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