Mark, before you address the issue of how to get pain meds, I think you need to come to terms with the use of them. Once we have used narcotics for a long time, our bodies become DEPENDENT on them and stopping treatment will result in physical withdrawl.
DEPENDANCE is not the same as ADDITION.
Your girlfriend built up a TOLERANCE to the Vicodin she had been taking for several years. This meant that she needed to be prescribed a stronger narcotic in order for her to obtain the same level of relief.
TOLERANCE is not the same as ADDICTION.
After several years, she NEEDED that increase. In fact, most people with Chronic Pain are better off with an extended release medicatoin like Oxy which allows us a minimum of 12 hours relief without having to pop pills and wait for them to kick in. Often, these meds cut out the constant ups and downs we get from the shorter acting meds and this alone can help reduce overall pain by keeping the pain level from shooting up as it does when the 4 hour med wears off.
By the time I got Dx, my Primary was already giving my script
s of Vicodin to help with the pain, so I never really asked my GI for pain meds. As you can see from other replies here, GIs don't like the use of narcotics and many use the excuse of their constipating effects as the reason. Although there are some Crohnies who suffer primarily with constipation, most of us do actually benefit from these constipating effects. I certainly do!
When my joints got bad, I discussed the issue of pain relief with the Rheumy who had just Dx me with Spondylitis. He gave me some samples of Ultracet and said he wouldn't give me anything stronger. I already knew I couldn't tolerate Ultram because I had a paradoxical effect from it. Where most people would become sleepy, I got the inability to sleep.
I got to the point where I was tired of the Vicodin wearing off and suddenly finding myself in excrutiating pain so I called the Pain Mgmt Center at my local hospital. They have been wonderful and I honestly believe that anyone who suffers from chronic pain be treated by a paim Mgmt Doc. You wouldn't have your Primary treating your Crohn's would you? No, so why have GI treat pain?
The issue of Pain Mgmt is vry important for several reasons. First, these Docs are specially trained to know which meds will help the most with different types of problems. Second, they understand the differences in the words I used above: DEPENDANCE, TOLERANCE and ADDICTION. They know how to appropriately treat the first two and avoid the last. Thirdly, once you become accustomed to some level of pain relief from narcotics, you need to carefully address any new pain issue which might arise.
For example, I have been taking 40 mgs of Oxycontin twice a day for about
3 years. I also have a script
for Noroc to use when I have breakthrough pain. In several weeks, I am going to have some extensive dental work done. I wouldn't even consider asking the Dentist how to treat that pain because I am already taking more narcotics than he would ever prescribe for a patient. So what am I going to do about
my post-op pain? I discusses it with my Pain Doc and was told to take an additional Norco and was prescribed Dilaudid in case I need it. Now I know that I have a way to treat the pain when the time comes.
I hope that you can work something out with your Primary Doc so that either he will prescribe for you or will refer you to a good Pain Doc. Everyone DESERVES treamtent for pain. Don't give up until you get it!
Keah a.k.a. Wormy
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